A 22-year-old man with type 1 diabetes presents with polyuria, polydipsia, abdominal pain, and confusion. Labs show glucose 550 mg/dL, pH 7.18, bicarbonate 8 mEq/L, and moderate ketones in urine. He is hypotensive. What is the most appropriate initial intravenous fluid?

✓ Correct Answer: Option B

This patient has severe DKA with hypovolemia (hypotension). Initial fluid resuscitation should be with 0.9% normal saline (isotonic) to rapidly restore intravascular volume. Hypotonic saline (0.45%) is used later, and D5 is only added when glucose levels fall to prevent hypoglycemia.