NAPLEX Critical Care Questions with Correct Answers (Grade A+)
Question 1: What are the advantages to using crystalloids over colloids and starches?
Answer: cheaper, fewer ADE
Question 2: How do colloids work?
Answer: large molecules that increase oncotic pressure; no clear benefit over crystalloids
Question 3: When is dextrose-containing fluid used?
Answer: crystalloid, free-water, used when water is needed intracellularly
Question 4: When are LR or NS used?
Answer: for volume resuscitation
Question 5: When is albumin used?
Answer: colloid; significant edema ex. cirrhosis
Question 6: Why are starches not used?
Answer: BBW for mortality, AKI, coagulopathy
Question 7: When is hyponatremia symptomatic?
Answer: Na <120
Question 8: hypotonic hypervolemic hyponatremia
Answer: fluid overload - treat with diuretics
Question 9: hypotonic euvolemia hyponatremia
Answer: SIADH - treat with diuretics, demeclocycline, conivaptan, tolvaptan
Question 10: hypotonic hypovolemia hyponatremia
Answer: due to diuretics, salt wasting, vomiting, diarrhea - treat with hypertonic saline if severe symptoms
or Na <120
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, Question 11: How fast can you correct hyponatremia?
Answer: no faster than 12 mEq/L/24h - risk for osmotic demyelination syndrome/central pontine myelinosis
Question 12: conivaptan
Answer: Vaprisol
Question 13: Vaprisol
Answer: conivaptan
Question 14: tolvaptan
Answer: Samsca
Question 15: Samsca
Answer: tolvaptan
Question 16: conivaptan, tolvaptan MOA
Answer: arginine vasopressin receptor antagonists
Question 17: conivaptan indications
Answer: SIADH
Question 18: tolvaptan indications
Answer: SIADH
Question 19: tolvaptan BBW
Answer: initiate and reinitiate inpatient and closely monitor Na; risk for osmotic demyelination syndrome
Question 20: tolvaptan ADE
Answer: hepatotoxicity (max 30d), thirst, nausea, dry mouth, polyuria
Question 21: Tolvaptan may only be used for a max of ___ due to risk for ___
Answer: 30 days; hepatotoxicity
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Question 1: What are the advantages to using crystalloids over colloids and starches?
Answer: cheaper, fewer ADE
Question 2: How do colloids work?
Answer: large molecules that increase oncotic pressure; no clear benefit over crystalloids
Question 3: When is dextrose-containing fluid used?
Answer: crystalloid, free-water, used when water is needed intracellularly
Question 4: When are LR or NS used?
Answer: for volume resuscitation
Question 5: When is albumin used?
Answer: colloid; significant edema ex. cirrhosis
Question 6: Why are starches not used?
Answer: BBW for mortality, AKI, coagulopathy
Question 7: When is hyponatremia symptomatic?
Answer: Na <120
Question 8: hypotonic hypervolemic hyponatremia
Answer: fluid overload - treat with diuretics
Question 9: hypotonic euvolemia hyponatremia
Answer: SIADH - treat with diuretics, demeclocycline, conivaptan, tolvaptan
Question 10: hypotonic hypovolemia hyponatremia
Answer: due to diuretics, salt wasting, vomiting, diarrhea - treat with hypertonic saline if severe symptoms
or Na <120
Page 1
, Question 11: How fast can you correct hyponatremia?
Answer: no faster than 12 mEq/L/24h - risk for osmotic demyelination syndrome/central pontine myelinosis
Question 12: conivaptan
Answer: Vaprisol
Question 13: Vaprisol
Answer: conivaptan
Question 14: tolvaptan
Answer: Samsca
Question 15: Samsca
Answer: tolvaptan
Question 16: conivaptan, tolvaptan MOA
Answer: arginine vasopressin receptor antagonists
Question 17: conivaptan indications
Answer: SIADH
Question 18: tolvaptan indications
Answer: SIADH
Question 19: tolvaptan BBW
Answer: initiate and reinitiate inpatient and closely monitor Na; risk for osmotic demyelination syndrome
Question 20: tolvaptan ADE
Answer: hepatotoxicity (max 30d), thirst, nausea, dry mouth, polyuria
Question 21: Tolvaptan may only be used for a max of ___ due to risk for ___
Answer: 30 days; hepatotoxicity
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