Medical-Surgical Nursing: Renal, Fluid-Electrolyte &
Acid-Base - 330 NCLEX Questions
Course: Nursing Fundamentals | Medical-Surgical | NCLEX-RN Prep
Total Questions: 330 with Answers & Rationales
Edition: 2026 High-Yield | Seller: Original Author
INSTRUCTIONS: Each question includes 4 options, correct answer, and detailed
rationale for learning. Suitable for NCLEX-RN, ATI, HESI.
1. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
2. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
3. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
4. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
,5. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
6. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
7. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
8. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
9. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
10. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
, C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
11. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
12. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
13. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
14. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
15. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
, Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
16. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
17. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
18. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
19. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
20. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
21. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
Acid-Base - 330 NCLEX Questions
Course: Nursing Fundamentals | Medical-Surgical | NCLEX-RN Prep
Total Questions: 330 with Answers & Rationales
Edition: 2026 High-Yield | Seller: Original Author
INSTRUCTIONS: Each question includes 4 options, correct answer, and detailed
rationale for learning. Suitable for NCLEX-RN, ATI, HESI.
1. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
2. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
3. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
4. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
,5. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
6. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
7. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
8. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
9. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
10. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
, C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
11. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
12. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
13. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
14. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
15. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
, Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
16. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
17. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
18. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
19. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
A. Tall peaked T waves
B. Prolonged QT
C. ST elevation
D. Wide QRS bradycardia is late
Correct Answer: A
Rationale: Hyperkalemia: tall peaked T waves early, then prolonged PR, wide QRS, sine wave. Critical.
20. Which fluid is best for hypovolemia with metabolic alkalosis?
A. 0.9% NS
B. 0.45% NS
C. LR
D. D5W
Correct Answer: A
Rationale: NS is acidifying (chloride) and helps correct alkalosis while expanding volume.
21. Client with acute kidney injury has hyperkalemia. Which ECG change is expected?
