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Arterial Blood Gas (ABG) Interpretation is one of the most important and frequently tested topics on the NCLEX-RN Exam.
NCLEX questions commonly assess a nurse's ability to identify:
Understanding ABGs helps nurses recognize life-threatening conditions and respond quickly to changes in a patient's respiratory and metabolic status.
An Arterial Blood Gas (ABG) test measures:
ABGs provide valuable information about how well the lungs and kidneys are maintaining normal body pH.
| Component | Normal Range |
|---|---|
| pH | 7.35 – 7.45 |
| PaCO₂ | 35 – 45 mmHg |
| HCO₃⁻ | 22 – 26 mEq/L |
| PaO₂ | 80 – 100 mmHg |
| SaO₂ | 95% – 100% |
ROME
This helps identify whether the disorder is respiratory or metabolic.
| pH Value | Interpretation |
|---|---|
| Below 7.35 | Acidosis |
| Above 7.45 | Alkalosis |
| 7.35–7.45 | Normal |
| PaCO₂ Value | Interpretation |
|---|---|
| Above 45 | Respiratory Acidosis |
| Below 35 | Respiratory Alkalosis |
| HCO₃⁻ Value | Interpretation |
|---|---|
| Below 22 | Metabolic Acidosis |
| Above 26 | Metabolic Alkalosis |
Compensation occurs when the lungs or kidneys attempt to restore normal pH.
| Type | Description |
|---|---|
| Uncompensated | pH abnormal |
| Partially Compensated | pH abnormal but compensating |
| Fully Compensated | pH normal but compensation present |
| Value | Finding |
|---|---|
| pH | Low |
| PaCO₂ | High |
| HCO₃⁻ | Normal or High |
| Value | Finding |
|---|---|
| pH | High |
| PaCO₂ | Low |
| HCO₃⁻ | Normal or Low |
| Value | Finding |
|---|---|
| pH | Low |
| HCO₃⁻ | Low |
| PaCO₂ | Normal or Low |
| Value | Finding |
|---|---|
| pH | High |
| HCO₃⁻ | High |
| PaCO₂ | Normal or High |
CO₂ = Acid
| High CO₂ | Acidosis |
|---|---|
| Low CO₂ | Alkalosis |
HCO₃⁻ = Base
| Low HCO₃⁻ | Acidosis |
|---|---|
| High HCO₃⁻ | Alkalosis |
Focus on:
ABG interpretation is a critical NCLEX skill that frequently appears in clinical judgment and prioritization questions. Nurses should be able to quickly recognize acid-base imbalances, identify their causes, and implement appropriate nursing interventions.
Mastering ABG interpretation will improve both NCLEX performance and real-world clinical decision-making.
4 Frequently Asked Questions About the NCLEX Nursing License & Exam
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