NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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What situation is hypertonic NaCl (3%) recommended for?

Hypotonic isovolemic hyponatremia
Hypotonic hypovolemic hyponatremia
Hypotonic hypervolemic hyponatremia
Isotonic hyponatremia

The correct answer is: Hypotonic hypovolemic hyponatremia

Hypertonic NaCl (3%) is recommended for hypotonic hypovolemic hyponatremia. In this condition, there is a low level of sodium in the blood along with decreased volume of body fluid. The administration of hypertonic saline helps to increase the sodium concentration in the blood, thereby correcting the hyponatremia while also expanding the volume of body fluid. This makes choice B the correct answer. In contrast: - Hypotonic isovolemic hyponatremia (choice A) refers to low sodium levels in the blood without changes in the volume of body fluid. Hypertonic saline is not recommended in this scenario as it may lead to fluid overload. - Hypotonic hypervolemic hyponatremia (choice C) involves low sodium levels along with increased volume of body fluid, and hypertonic saline is not the treatment of choice in this situation. - Isotonic hyponatremia (choice D) does not require the administration of hypertonic saline as the sodium concentration in the blood is normal, but it could be a sign of underlying conditions such as hyperlipidemia or hyperproteinemia.