A nurse is reviewing the arterial blood gas (ABG) results of a client. The client's ABGs are: pH: 7.6, PaCO_2: 40 mm Hg, HCO_3: 32 mEq/L. Which of the following acid-base conditions should the nurse identify the client is experiencing?

Choice A rationale The client's pH of 7.6 is alkaline (normal range 7.35-7.45), indicating an alkalosis. The PaCO_2 of 40 mm Hg is within the normal range (normal range 35-45 mm Hg), ruling out a primary respiratory cause. The HCO_3 of 32 mEq/L is elevated (normal range 22-26 mEq/L). An elevated pH with an elevated HCO_3 and a normal PaCO_2 indicates uncompensated metabolic alkalosis. Choice B rationale Respiratory alkalosis is characterized by a high pH (alkaline) and a low PaCO_2 (primary respiratory derangement), due to hyperventilation. The client's PaCO_2 is 40 mm Hg, which is within the normal range, thus ruling out a primary respiratory alkalosis. Choice C rationale Respiratory acidosis is characterized by a low pH (acidic) and a high PaCO_2 (primary respiratory derangement), due to hypoventilation. The client's pH is 7.6 (alkaline) and PaCO_2 is 40 mm Hg (normal), directly contradicting the criteria for respiratory acidosis. Choice D rationale Metabolic acidosis is characterized by a low pH (acidic) and a low HCO_3 (primary metabolic derangement). The client's pH is 7.6 (alkaline) and the HCO_3 is 32 mEq/L (high), which is the opposite of the findings expected in metabolic acidosis.