True or false: Hypertonic crystalloids are the go-to fluid for dehydrated patients with intracellular fluid (ICF) contracture.

• A. True
• B. False
• C. Both true and false
• D. Cannot be determined

Answer: (B)

The key idea is how osmolality affects where water moves in the body. Hypertonic solutions have a higher osmolality than plasma, so they pull water out of cells into the extracellular space. That means they shrink cells rather than rehydrate them. If a patient has intracellular fluid (ICF) contraction, you want to increase water inside the cells, not pull it out. Therefore, hypertonic crystalloids are not the go-to choice for this situation. In practice, restoring circulating volume with isotonic crystalloids is typically the initial step, and hypotonic or carefully chosen fluids may be used later to address intracellular hydration if needed. Hypertonic fluids are reserved for specific indications (such as certain neurologic conditions) and require close monitoring.