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Exam NCLEX-RN topic 3 question 36 discussion

Actual exam question from Test Prep's NCLEX-RN
Question #: 36
Topic #: 3
[All NCLEX-RN Questions]

A 66-year-old female client has smoked 2 packs of cigarettes per day for 20 years. Her arterial blood gases on room air are as follows: pH 7.35; PO2 70 mm Hg;
PCO2 55 mm Hg; HCO3 32 mEq/L. These blood gases reflect:

  • A. Compensated metabolic acidosis
  • B. Compensated respiratory acidosis
  • C. Compensated respiratory alkalosis
  • D. Uncompensated respiratory acidosis
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Suggested Answer: B 🗳️
(A) In compensated metabolic acidosis, the pH level is normal, the PCO2level is decreased, and the HCO3level is decreased. The clients primary alteration is an inability to remove excess acid via the kidneys. The lungs compensate by hyperventilating and decreasing PCO2. (B) In compensated respiratory acidosis, the pH level is normal, the PCO2level is elevated, and the HCO3level is elevated. The clients primary alteration is an inability to remove CO2from the lungs, so over time, the kidneys increase reabsorption of HCO3to buffer the CO2. (C) In compensated respiratory alkalosis, the pH level is normal, the PCO2level is decreased, and the HCO3level is decreased. The clients primary alteration is hyperventilation, which decreases PCO2. The client compensates by increasing the excretion of
HCO3from the body. (D) In uncompensated respiratory acidosis, the pH level is decreased, the PCO2level is increased, and the HCO3level is normal. The clients primary alteration is an inability to remove CO2from the lungs. The kidneys have not compensated by increasing HCO3reabsorption.

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