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Arterial Blood Gas Interpretation for NCLEX Quiz (40 Questions)

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By Gil Wayne BSN, R.N.

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.

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Quizzes included in this ABG nursing test bank are:

Arterial Blood Gas Reviewer

For your reviewer on the concepts behind arterial blood gas (ABGs) and interpretation, please visit:

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43 thoughts on “Arterial Blood Gas Interpretation for NCLEX Quiz (40 Questions)”

  1. 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.

    20. Question
    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.

    • Hi Thompson,

      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

    • 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.

  2. 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

  3. Thompson,
    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).

  4. 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.

  5. 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.

  6. 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.

  7. 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.

    • 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

  8. 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.

  9. 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.

  10. 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.

  11. 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

    • Hi Acquah, Glad to hear it was helpful! If there’s anything else you’re looking to understand better or need more info on, just let me know. Here to help!

  12. The answer should be fully compensated respiratory acidosis since the PCO2 is elevated and is being compensated by the kidney due to increase of HCO3

  13. Please help me with this question I’m quite confused.
    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 7.64, PaCO2 25, HCO3- 19


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