Let us help you review the concepts behind arterial blood gas interpretation for the NCLEX with these acid-base balance practice questions.
Arterial Blood Gas Interpretation Practice Quiz
In this section are the practice problems and questions for arterial blood gas interpretation. This nursing test bank set includes 40 questions divided into two parts. Includes topics are arterial blood gas interpretation, acid-base balance and imbalances, respiratory acidosis and alkalosis, and metabolic acidosis and alkalosis.
Quizzes included in this ABG nursing test bank are:
- Arterial Blood Gas Interpretation Practice | Quiz #1: 20 Questions
- Arterial Blood Gas Interpretation Practice | Quiz #2: 20 Questions
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Arterial Blood Gas Interpretation Practice | Quiz #1: 20 Questions
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Question 1 of 20
George Kent is a 54-year-old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He has difficulty communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2 60 mm Hg. How would you interpret this?CorrectIncorrect
Question 2 of 20
Carl, an elementary student, was rushed to the hospital due to vomiting and a decreased level of consciousness. The patient displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. He appears to be dehydrated—his eyes are sunken and mucous membranes are dry—and he has a two-week history of polydipsia, polyuria, and weight loss. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 23 mm Hg, and HCO3 12 mmol/L; other results are Na+ 126 mmol/L, K+ 5 mmol/L, and Cl- 95 mmol/L. What is your assessment?CorrectIncorrect
Question 3 of 20
A cigarette vendor was brought to the emergency department of a hospital after she fell into the ground and hurt her left leg. She is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen her pain. Suddenly, she started complaining that she is still in pain and now experiencing muscle cramps, tingling, and paraesthesia. Measurement of arterial blood gas reveals pH 7.6, PaO2 120 mm Hg, PaCO2 31 mm Hg, and HCO3 25 mmol/L. What does this mean?CorrectIncorrect
Question 4 of 20
Ricky’s grandmother has been suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What acid-base disorder is shown?CorrectIncorrect
Question 5 of 20
Mrs. Johansson, who had undergone surgery in the post-anesthesia care unit (PACU), is difficult to arouse two hours following surgery. Nurse Florence in the PACU has been administering Morphine Sulfate intravenously to the client for complaints of post-surgical pain. The client’s respiratory rate is 7 per minute and demonstrates shallow breathing. The patient does not respond to any stimuli. The nurse assesses the ABCs (remember Airway, Breathing, Circulation!) and obtains ABGs STAT! Measurement of arterial blood gas shows pH 7.10, PaCO2 70 mm Hg, and HCO3 24 mEq/L. What does this mean?CorrectIncorrect
Question 6 of 20
Baby Angela was rushed to the Emergency Room following her mother’s complaint that the infant has been irritable, difficult to breastfeed, and has had diarrhea for the past 3 days. The infant’s respiratory rate is elevated and the fontanels are sunken. The Emergency Room physician orders ABGs after assessing the ABCs. The results from the ABG results show pH 7.39, PaCO2 27 mmHg, and HCO3 19 mEq/L. What does this mean?CorrectIncorrect
Question 7 of 20
Mr. Wales, who underwent post-abdominal surgery, has a nasogastric tube. The nurse on duty notes that the nasogastric tube (NGT) is draining a large amount (900 cc in 2 hours) of coffee ground secretions. The client is not oriented to person, place, or time. The nurse contacts the attending physician and STAT ABGs are ordered. The results from the ABGs show pH 7.57, PaCO2 37 mmHg and HCO3 30 mEq/L. What is your assessment?CorrectIncorrect
Question 8 of 20
Client Z is admitted to the hospital and is to undergo brain surgery. The client is very anxious and scared of the upcoming surgery. He begins to hyperventilate and becomes very dizzy. The client loses consciousness and the STAT ABGs reveal pH 7.61, PaCO2 22 mmHg, and HCO3 25 mEq/L. What is the ABG interpretation based on the findings?CorrectIncorrect
Question 9 of 20
Three-year-old Adrian is admitted to the hospital with a diagnosis of asthma and respiratory distress syndrome. The mother of the child reports to the nurse on duty that she has witnessed slight tremors and behavioral changes in her child over the past four days. The attending physician orders routine ABGs following an assessment of the ABCs. The ABG results are pH 7.35, PaCO2 72 mmHg, and HCO3 38 mEq/L. What acid-base disorder is shown?CorrectIncorrect
Question 10 of 20
Anne, who is drinking beer at a party, falls and hits her head on the ground. Her friend Liza dials “911” because Anne is unconscious, depressed ventilation (shallow and slow respirations), rapid heart rate, and is profusely bleeding from both ears. Which primary acid-base imbalance is Anne at risk for if medical attention is not provided?CorrectIncorrect
Question 11 of 20
Dave, a 6-year-old boy, was rushed to the hospital following her mother’s complaint that her son has been vomiting, nauseated and has overall weakness. After a series of tests, the nurse notes the laboratory results: potassium: 2.9 mEq. Which primary acid-base imbalance is this boy at risk for if medical intervention is not carried out?CorrectIncorrect
Question 12 of 20
An old beggar was admitted to the emergency department due to shortness of breath, fever, and a productive cough. Upon examination, crackles and wheezes are noted in the lower lobes; he appears to be tachycardic and has a bounding pulse. Measurement of arterial blood gas shows pH 7.2, PaCO2 66 mm Hg, HCO3 27 mmol/L, and PaO2 65 mm Hg. As a knowledgeable nurse, you know that the normal value for pH is:CorrectIncorrect
Question 13 of 20
Liza’s mother is seen in the emergency department at a community hospital. She admits that her mother is taking many tablets of aspirin (salicylates) over the last 24-hour period because of a severe headache. Also, the mother complains of an inability to urinate. The nurse on duty took her vital signs and noted the following: Temp = 97.8 °F; apical pulse = 95; respiration = 32 and deep. Which primary acid-base imbalance is the client at risk for if medical attention is not provided?CorrectIncorrect
Question 14 of 20
A patient who is hospitalized due to vomiting and a decreased level of consciousness displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. The doctor diagnosed him of having dehydration. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 22 mm Hg, and HCO3 14 mmol/L; other results are Na+ 120 mmol/L, K+ 2.5 mmol/L, and Cl- 95 mmol/L. As a knowledgeable nurse, you know that the normal value for PaCO2 is:CorrectIncorrect
Question 15 of 20
A company driver is found at the scene of an automobile accident in a state of emotional distress. He tells the paramedics that he feels dizzy, tingling in his fingertips, and does not remember what happened to his car. Respiratory rate is rapid at 34/minute. Which primary acid-base disturbance is the young man at risk for if medical attention is not provided?CorrectIncorrect
Question 16 of 20
An elderly client was admitted to hospital in a coma. Analysis of the arterial blood gave the following values: PCO2 16 mm Hg, HCO3- 5 mmol/L and pH 7.1. As a well-rounded nurse, you know that the normal value for HCO3 is:CorrectIncorrect
Question 17 of 20
In a patient undergoing surgery, it was vital to aspirate the contents of the upper gastrointestinal tract. After the operation, the following values were acquired from an arterial blood sample: pH 7.55, PCO2 52 mm Hg and HCO3- 40 mmol/l. What is the underlying disorder?CorrectIncorrect
Question 18 of 20
A mountaineer attempts an assault on a high mountain in the Andes and reaches an altitude of 5000 meters (16,400 ft) above sea level. What will happen to his arterial PCO2 and pH?CorrectIncorrect
Question 19 of 20
A young woman is found comatose, having taken an unknown number of sleeping pills an unknown time before. An arterial blood sample yields the following values: pH 6.90, HCO3- 13 meq/liter, and PaCO2 68 mmHg. This patient’s acid-base status is most accurately described as:CorrectIncorrect
Question 20 of 20
A mother is admitted to the emergency department following complaints of fever and chills. The nurse on duty took her vital signs and noted the following: Temp = 100 °F; apical pulse = 95; respiration = 20 and deep. Measurement of arterial blood gas shows pH 7.37, PaO2 90 mm Hg, PaCO2 40 mm Hg, and HCO3 24 mmol/L. What is your assessment?CorrectIncorrect
Arterial Blood Gas Reviewer
For your reviewer on the concepts behind arterial blood gas (ABGs) and interpretation, please visit:
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37 thoughts on “Arterial Blood Gas Interpretation for NCLEX Quiz (40 Questions)”
Thank you for work done so far. god bless you.
I’ll like you to review this question No:20 under ABGs NCLEX Quiz 2. The correct answer you gave contradicts with the rationale -” For these ABG values, pH is NORMAL but slightly acidic and lines up with PACO2 which is METABOLIC. Therefore, this group of ABG values is considered METABOLIC ALKALOSIS.” Thank you.. pls see below.
Match the acid-base status of the following blood samples to the disorders in the given choices. (PaCO2 values are in mm Hg and bicarbonate values in mmol/l).
pH 7.39, PaCO2 59, HCO3- 35
A. Respiratory Acidosis, Uncompensated
B. Metabolic Alkalosis, Uncompensated
C. Respiratory Acidosis, Fully Compensated
D. Metabolic Alkalosis, Partially Compensated
Correct Answer: C. Respiratory Acidosis, Fully Compensated
Based on the given ABG values, pH is 7.39. For pH, the normal range is 7.35 to 7.45. So it is NORMAL.
PaCO2 is 59. The normal range for PaCO2 is from 35 to 45. If PaCO2 is above 45, it is acidosis. Based on the given ABG values, PaCO2 is above 45, so it is considered ACIDOSIS.
HCO3- is 35. The normal range for HCO3 is from 22 to 26. If HCO3 is above 26, it is alkalosis. Based on the given ABG values, HCO3 is above 26, so it is considered ALKALOSIS.
For these ABG values, pH is NORMAL but slightly acidic and lines up with PACO2 which is METABOLIC. Therefore, this group of ABG values is considered METABOLIC ALKALOSIS.
Lastly, it is FULLY COMPENSATED because pH is normal. It is considered fully compensated if pH is normal.
Agreed, the symptoms also line up with patient being alkalosis as well: irritability and diarrhea. Assuming SaO2 levels are normal, increased respirations would point to alkalosis as well.
I beg to disagree with your analysis.
The answer is correct Respiratory Acidosis with Fully compensated. The pH is within normal limits, the PCO2 is high meaning respiratory aspect is getting acidotic and because the respiratory is getting acidotic the kidney which the HCO3 is compensating well by increasing.
The answer is Respiratory acidosis; fully compensated.
I respectfully disagree with your analysis of the question as well. Since the pH is within normal limits, it is fully compensated, you are correct. The absolute normal for pH is 7.4, so since 7.39 is below the absolute it is still considered acidic. From there, The PaCO2 is elevated above normal range of 35-45, along with HCO3- elevated from the normal range of 22-26. HCO3- is elevated due to renal compensation. We know with respiratory disorders of ABGs, respiratory values go in opposite directions of one another and metabolic values go in the same directions (ROME method). Therefore, this situation is respiratory acidosis.
This is fully compesated Respiratory acidosis because PCO2 is corrected by respiratory system and not metabolism as it does the Kidney to HCO3
No, the answer should be Respiratory Acidosis. PaCO2 is respiratory fully compensated.
Very good explanation — simple and understanding
You are correct Thompson, that there is compensation. This is because the bicarb has increased, providing a normal ph. A client with a PaCO2 of 59 is still having respiratory issues despite the body compensating. In response to Aliyah, Increased respirations are an attempt to get rid of more CO2.
i love this material i never understand before
A 73year man has been admitted to the unit with a diagnosis of chronic obstructive pulmonary disease .he states that he has difficulty breathing when walking short distance .he also states that his heart feels like it is racing at the same time .he states that he is tired all the time and while talking to you he is continually wringing his hands and looking out the windows.1.Identify the 4 health problem of the patient.2.formulate the nursing diagnosis
The PaCo2 is high and the pH is normal but slightly acidic because it is on the lower end. Using the ROME method, this would make it respiratory acidosis, fully compensated. I recommend using the ROME method (respiratory opposite metabolic equal).
B. Metabolic Acidosis, Partially Compensated
pH (ACID 0 10 ALK)
CO2 (ACID 100 0 ALK.)
HCO3 (ACID 0 50 ALK)
Thanks for this topic of ABGs here on NCLEX
I have understood this topic than I did ever in my academic career
Thanks for the lesson I can answer the question correctly
In the Arterial Blood Gas Interpretation Practice Quiz (Part 1: 20 Items), I think the correct answer to Q3. should have been : Respiratory Alkalosis, Partially Compensated. Please revisit and let me know. Thanks for the resources.
The answer is quite in order. Pls disregard comment. Thanks
This ABG’s study with the practice quiz was great and help me understand the difference in acidosis and alkalosis, respiratory versus metabolic and also compensated as well as uncompensated to fully compensated. Thanks for the resources.
The blood Ph is more towards Acidic. the PaCo2 is elevated, which is always an indicator for respiratory acidosis.
the HCO3 is also elevated, but an elevated HCO3 is is also always an indicator for Metabolic Alkalosis.
Since the Ph of the blood is is towards acidity, and the PaCO2 is elevated, the patient is in respiratory acidosis, the HCO3 is also elevated because homeostasis have set in an the body needs to form more alkaines to compensate for the increased acidity. since the Ph of the blood, though towards acidity but still within normal, that means the RESPIRATORY ACIDOSIS IS FULLY COMPENSATED.
This is such a helpful one> thank you so much for sharing this.
Very helpful and informative
This helpful thank you so much for sharing.
The answer is Respiratory Acidosis, Fully compensated. This is because the ph is within normal range and based on the principle of ROME which is Respiratory Opposite Metabolic Equal, the PCO2 of 59 is Acidotic. Therefore, the PCO2 is Opposite to the ph (7.39) meaning that the result is Respiratory Acidosis, Fully compensated.
Really helpful. Thanks
Thanks for the lecture and this quiz. Now I understand ABG better and it will be quite helpful in my practice!
This was very helpful. I truly understand ABG and compensation now. Love that the questions were NCLEA style questions
For #9 shouldn’t the answer be Metabolic Alkalosis, Fully Compensated?
why metabolic? it’s Asmathic baby! with Pco2 is 72, so it’s resp acidosis, the body inorder to compensate raises the bicarbonate to 38, so it’s fully compensated
Everything was well explained and understood,thank you
Hello Thompson and other colleges,
I disagree as well. Please read the case history before reading the ABG chart. The PH was leaning towards acidic hence being compensated. It’s not metabolic alkalosis.
Known about blood gases in 1974 as a Navy Corpsman and now an RN, this tic tac toe made it as simple as ever, and it is free. Awesome lesson! A+!
While reading, I thought that the Allen test, which is needed to show blood flow to the hand, would be intact if the radial artery was damaged while drawing arterial blood, thus dependent on the ulnar artery. Seen myriads of ABGs but do not recall an Allen test ever being done. This lesson was EXCELLENT, systematic, step by step.
Shouldn’t number 1 have been uncompensated respiratory acidosis? Partially compensated is when all 3 variables are abnormal, and the HCO3 was normal in this case.
The answer for this question should be Respiratory Acidosis, partially compensated. HCO3 is in normal range.
Wonderful practice questions.
Great practice questions. I had 19 right answers and the one I did not get still don’t make sense to me. Because I though the highest is the altitude, the less oxygen is present in the air and it is most likely for the person’s PaCO2 to goes up. But it was the opposite