NCLEX RN ABG Advanced Practice Questions (30 Q&A with Detailed Rationales & Explanations)

NCLEX ABG ADVANCED PRACTICE QUESTIONS quiz
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1 Question 1



A client has ABG: pH 7.52, PaCO₂ 48 mmHg, HCO₃ 35 mEq/L. What is
the interpretation?

☐ A. Respiratory alkalosis


☑ B. Metabolic alkalosis with compensation


☐ C. Respiratory acidosis


☐ D. Metabolic acidosis



RATIONALE
The pH is high (alkalosis), and HCO₃ is elevated, indicating a metabolic cause. The CO₂ is also
high, showing the lungs are retaining CO₂ to compensate. Since pH is still abnormal, this is partial
compensation.
KEY TERMS EXPLAINED
Metabolic alkalosis = high pH due to high bicarbonate
Compensation = body trying to correct imbalance
PaCO₂ = controlled by lungs

,2 Question 2



Which ABG change occurs first in respiratory disorders?

☐ A. Change in HCO₃


☑ B. Change in CO₂


☐ C. Change in sodium


☐ D. Change in potassium



RATIONALE
Respiratory disorders directly affect CO₂ levels first because CO₂ is controlled by the lungs.
KEY TERMS EXPLAINED
PaCO₂ = respiratory component
HCO₃ = metabolic component

, 3 Question 3



A client with kidney failure is likely to develop which ABG imbalance?

☐ A. Respiratory alkalosis


☑ B. Metabolic acidosis


☐ C. Metabolic alkalosis


☐ D. Respiratory acidosis



RATIONALE
Kidneys cannot remove acid effectively, leading to buildup of acids and metabolic acidosis.
KEY TERMS EXPLAINED
Renal failure = kidney dysfunction
Acid buildup = increased hydrogen ions
Metabolic acidosis = low pH due to kidney failure