American Association of Critical-Care Nurses (AACN) Certification Practice Test

In refeeding syndrome, which symptom is associated with electrolyte imbalances?

1. Seizures

2. Hypertension

3. Bradycardia

4. Nausea

The correct answer is: Seizures

In refeeding syndrome, seizures are associated with severe electrolyte imbalances, primarily due to the rapid reintroduction of carbohydrates in individuals who have been malnourished or in a state of starvation. When carbohydrates are introduced, insulin secretion increases, leading to shifts of electrolytes, particularly phosphorous, potassium, and magnesium into the cells. This can result in a significant drop in the serum levels of these electrolytes, causing symptoms such as seizures, which are manifestations of neurological disturbances stemming from these imbalances. The other options, while they may occur in various clinical scenarios, are less directly linked to the specific electrolyte shifts seen in refeeding syndrome. Hypertension may result from fluid overload or other factors but is not a hallmark symptom of electrolyte disturbances in this context. Bradycardia could be associated with high potassium levels, but it is not as directly indicative of the profound imbalances seen in refeeding syndrome as seizures. Nausea is a common symptom in many clinical situations and is not specific to the electrolyte changes occurring in refeeding syndrome. Thus, seizures stand out as a significant clinical sign strongly tied to the electrolyte imbalances characteristic of this condition.