pH 7.2 (acidaemia) with a high PCO2 (68) = respiratory acidosis. The kidneys compensate by retaining HCO3, but renal compensation is slow. Here HCO3 is only 27 (barely above the normal 22–26) and the pH is markedly low, so compensation has not had time to develop. This is acute respiratory acidosis in a young cyanosed patient.

• Chronic respiratory acidosis would show a clearly raised HCO3 and a pH closer to normal.
• The alkalosis options are wrong because the pH is low.