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

Which vitamin deficiency may result from refeeding syndrome?

1. Vitamin C deficiency

2. Vitamin B12 deficiency

3. Vitamin D deficiency

4. Thiamine deficiency

The correct answer is: Thiamine deficiency

Refeeding syndrome is a serious condition that can occur when nutrition is reintroduced to individuals who have been malnourished or have experienced significant weight loss. This metabolic disturbance is characterized by shifts in electrolytes and fluid balance, which can lead to serious complications. One of the key nutrients affected during refeeding syndrome is thiamine (Vitamin B1). When carbohydrates are reintroduced into the diet after a period of starvation or malnutrition, the body's insulin secretion increases, facilitating a higher demand for thiamine to metabolize the glucose. If thiamine is not adequately supplied, this can lead to a deficiency, resulting in Wernicke's encephalopathy or Korsakoff syndrome, which are serious neurological conditions. The risk is particularly high among patients with alcohol use disorders, chronic illness, or those who have undergone prolonged fasting. In contrast, deficiencies of the other vitamins listed are less directly linked to the process of refeeding. Vitamin C, for example, is essential for wound healing and immune function but does not have the same immediate metabolic interactions during refeeding. Vitamin B12 and Vitamin D are also critical nutrients, but their deficiencies are not specifically precipitated by the sudden reintroduction of carbohydrates that characterizes refeeding syndrome.