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

Refeeding syndrome can be monitored through which common electrolyte abnormality?

1. Hypocalcemia

2. Hypernatremia

3. Hyperkalemia

4. Hypophosphatemia

The correct answer is: Hypophosphatemia

Refeeding syndrome is a potentially serious condition that can occur when nutrition is restarted in individuals who are malnourished or have been in a state of starvation. One of the hallmark features of refeeding syndrome is the disturbance of electrolyte levels, particularly hypophosphatemia. During the process of refeeding, there is a rapid shift of electrolytes into the cells, which leads to a decrease in serum phosphate levels. Phosphate is crucial for energy metabolism and is an essential component of ATP, as well as being involved in other important biochemical processes. The presentation of hypophosphatemia can manifest as weakness, respiratory failure, and neurological disturbances, making it a critical condition to monitor. In addition to phosphate, refeeding syndrome can also lead to other electrolyte imbalances, including hypokalemia and hypomagnesemia, but hypophosphatemia is the primary abnormality that signifies the onset of this syndrome. Understanding the role of phosphorus in energy metabolism highlights why monitoring for hypophosphatemia is essential when refeeding patients.