ATI TEAS (Test of Essential Academic Skills) Version 7ScienceMedium

A nurse is reviewing a patient's arterial blood gas (ABG) results. The pH is 7.28, PaCO2 is 55 mmHg, and HCO3- is 24 mEq/L. Based on these values, which acid-base imbalance is the patient experiencing?

  1. ARespiratory alkalosis
  2. BMetabolic acidosis
  3. CMetabolic alkalosis
  4. DRespiratory acidosis
Show answer & explanation

Correct answer: D. Respiratory acidosis

A pH of 7.28 indicates acidosis (normal 7.35-7.45). A PaCO2 of 55 mmHg indicates hypercapnia (normal 35-45 mmHg), which is a respiratory cause of acidosis. An HCO3- of 24 mEq/L is within the normal range (22-26 mEq/L), indicating the primary problem is not metabolic. Therefore, the patient is experiencing respiratory acidosis.

Why the other options are wrong

  • A. Respiratory alkalosis would involve a high pH and a low PaCO2, opposite of these findings.
  • B. Metabolic acidosis would involve a low pH and a low HCO3-, which is not seen here.
  • C. Metabolic alkalosis would involve a high pH and a high HCO3-, which is not seen here.

Acid-Base Imbalance

A condition in which the body's pH balance is disrupted, often due to respiratory or metabolic issues affecting carbon dioxide (acid) or bicarbonate (base) levels.

  • Normal pH: 7.35-7.45.
  • Normal PaCO2: 35-45 mmHg (respiratory component).
  • Normal HCO3-: 22-26 mEq/L (metabolic component).

Memory trick: ROME: Respiratory Opposite, Metabolic Equal.

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