Step by step:

1. pH = low = acidosis
2. HCO3 = low = acidosis
3. CO2 = high = acidosis

So, what I've learned is that, in essence, metabolic acidosis always takes priority in these scenarios. It's evident that the person is not compensating, but you want to calculate anyway by using Winter = 1.5 (HCO3) + 8 .
If you calculate you will see that the expected is 30.5.

1. If CO2 is higher than expected = concomitant respiratory acidosis
2. If CO2 is lower than expected = concomitant respiratory alkalosis

Here it is higher than expected (65) so concomitant respiratory acidosis.

I guess if you wanted to start with the respiratory acidosis you would've taken into consideration that bicarbonate should've gone up to compensate. It didn't so it's uncompensated. Not sure if there's a formula to calculate the other stuff

For the simple minded, if pH and CO2 are moving in opposite directions its respiratory. Here, pH is low and CO2 is high, so Respiratory Acidosis. Then looked at Bicarb, noticed it was below normal. If normal would have chosen uncompensated but since it decreased I assumed metabolic acidosis. Overall, weird Q bc tachypnea would mean hyperventilation which is respect alkalosis. But signs of weak response muscles or respiratory distress which would be responsible acidosis. Also, LOW pH with plasma Bicarb between ~8-33 means Mixed Acidosis (FA 2019 pg 580) so could also just pick the one with both Acidosis.

A little math here.. pH is low --> acidosis pCO2 is high --> respiratory Normal compensation should be roughly a 1 (acute) to 4(chronic) increase in bicarb per every 10 increase in pCO2.. Its lower here, so clearly not compensated and indicated additional drop in bicard --> add on metab acidosis

Pco2 Is high, acidosis; Respiratory acidosis.

If Compensated well, ΔHCO3-= E(Erythrocytiv compensation)ΔPCO2/10, (1~2)(65-40)/10=2.5~5 >> ΔHCO3=15-24=-9, not compensated, even less HCO3-; Combined metabolic acidosis.

for, Kidney compensation. use 3~4 instead of 1~2 in erythrocyctic compensation. and with this, the Gap between well compensated and the case even farther.