Which of the following is a key sign of refeeding syndrome?

• A. Mild dehydration
• B. Rapid declines in phosphorus, potassium, and magnesium
• C. Elevated blood sugar only
• D. Increased calcium levels

Answer: (B)

Refeeding syndrome revolves around dangerous electrolyte shifts that occur when nutrition is restarted after prolonged starvation, driven by insulin sending electrolytes into cells. The most telling sign is a rapid drop in phosphorus, potassium, and magnesium. Phosphorus is essential for ATP and cellular energy; when it falls quickly, weakness, respiratory failure, and heart problems can result. Low potassium increases the risk of arrhythmias and muscle weakness, while low magnesium can trigger cardiac dysrhythmias and neuromuscular irritability. Together, these electrolyte declines explain the serious complications of refeeding and serve as the key clue.

Other options aren’t as specific to this syndrome: mild dehydration isn’t a defining feature, elevated blood sugar can occur but doesn’t by itself indicate refeeding syndrome, and increased calcium is not characteristic.