This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Miscellaneous, Subject name: Surgery
An obese 50-year-old woman undergoes a laparoscopic cholecystectomy. In the recovery room she is found to be hypotensive and tachycardic. Her arterial blood gases reveal a pH of 7.29, partial pressure of oxygen of 60 kPa, and partial pressure of CO2 of 54 kPa. The most likely cause of this woman's problem is 
Select and explain. 
A. Acute pulmonary embolism, B. CO2 absorption from induced pneumoperitoneum, C. Alveolar hypoventilation, D. Pulmonary edema
C: Alveolar hypoventilation
Answer: C: Alveolar hypoventilation 
Explanation: Because of the ease with which carbon dioxide diffuses across the alveolar membranes, the PaCO2 is a highly reliable indicator of alveolar ventilation. In this postoperative patient with respiratory acidosis and hypoxemia, the hypercarbia is diagnostic of alveolar hypoventilation. Acute hypoxemia can occur with pulmonary embolism, pulmonary edema, and significant atelectasis, but in all those situations the CO2 partial pressures should be normal or reduced as the patient hyperventilates to improve oxygenation. The absorption of gas from the peritoneal cavity may affect transiently the PaCO2 , but should have no effect on oxygenation.