What is the primary cause of refeeding syndrome in TPN patients?

High fat content in the diet

Rapid reintroduction of carbohydrates

Excess protein intake

Vitamin deficiency

Answer and Explanation

The Correct Answer is B

Rationale:
A. High fat content does not directly cause refeeding syndrome; fat is less likely to trigger the electrolyte shifts seen in this condition.

B. Rapid reintroduction of carbohydrates in malnourished patients stimulates insulin release, which drives phosphate, potassium, and magnesium into cells, leading to potentially life-threatening electrolyte imbalances—the hallmark of refeeding syndrome.

C. Excess protein intake can strain kidney function but is not the primary cause of refeeding syndrome.

D. Vitamin deficiencies, such as thiamine, can worsen complications, but the immediate trigger is the rapid carbohydrate load.

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Correct Answer is B

Explanation

Rationale:
A. Replacing lost blood components requires blood products, not isotonic crystalloids.
B. Isotonic crystalloid fluids (e.g., 0.9% sodium chloride, lactated Ringer’s) are administered to restore extracellular fluid volume in clients with fluid volume deficit.
C. While isotonic solutions contain electrolytes, their primary purpose is volume replacement, not rapid electrolyte correction.
D. Correcting metabolic acidosis may require specific interventions; isotonic fluids alone do not address acid-base imbalances.

A. Dietary sources of fiber should be eliminated to prevent excessive gas formation. B. Use of this type of laxative to prevent constipation does not cause adverse effects. C. Fiber-containing laxatives may reduce the absorption of fat-soluble vitamins. D. Large amounts of fluid should be taken to prevent impaction or bowel obstruction.

Correct Answer is D

Explanation

Rationale:
A. Dietary sources of fiber should not be eliminated; in fact, fiber from food complements the effect of psyllium and supports normal bowel function.

B. Fiber-containing laxatives can have adverse effects, such as bloating, gas, or, rarely, intestinal obstruction if not taken with adequate fluid.

C. Psyllium does not significantly reduce absorption of fat-soluble vitamins; this concern is more relevant to certain other medications, like cholestyramine.

D. Psyllium absorbs water in the intestines, forming a bulky stool. To prevent fecal impaction or bowel obstruction, it is essential to take large amounts of fluid when using this type of laxative.

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What is the primary cause of refeeding syndrome in TPN patients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the primary reason for administering isotonic crystalloid IV fluids to a client with fluid volume deficit?

Correct Answer is B

Explanation

A patient who has chronic constipation asks the nurse about the use of psyllium (Metamucil). Which information will the nurse include in the response?

Correct Answer is D

Explanation

A nurse is planning care for a client who is to start receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?

What is the primary cause of refeeding syndrome in TPN patients?

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