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

Which characteristic is most common in refeeding syndrome?

1. Hyperkalemia

2. Hypophosphatemia

3. Vitamin A deficiency

4. Severe dehydration

The correct answer is: Hypophosphatemia

Hypophosphatemia is indeed the most common characteristic of refeeding syndrome. This condition often occurs when feeding is restarted in individuals who have been malnourished or in a state of starvation. When carbohydrates are reintroduced, insulin secretion increases, driving phosphate from the serum into the cells to be utilized in the production of ATP, which can lead to a significant decrease in serum phosphate levels. This phosphorus shift can result in a range of symptoms, including muscle weakness, respiratory failure, and cardiac dysrhythmias. Monitoring and managing phosphate levels is crucial during the refeeding period to prevent complications associated with refeeding syndrome. In contrast, while hyperkalemia can occur in other contexts, it is not a defining characteristic of refeeding syndrome. Vitamin A deficiency is unrelated to the immediate metabolic changes seen during refeeding. Severe dehydration may be present in some patients but is also not a hallmark of this syndrome. Therefore, hypophosphatemia stands out as the primary concern when addressing refeeding syndrome in clinical practice.