Registered Psychiatric Nurses of Canada Examination (RPNCE) Practice test

What is a significant risk for a malnourished child, such as one diagnosed with severe malnutrition?

1. Refeeding syndrome

2. Bulimia

3. Developmental delay

4. Stunted growth

The correct answer is: Refeeding syndrome

Refeeding syndrome is a significant risk for a malnourished child diagnosed with severe malnutrition because it occurs when feeding is restarted in individuals who have been in a state of starvation or significant malnutrition. During prolonged periods without adequate nutrition, the body downregulates metabolic processes to conserve energy and nutrients. This can lead to an imbalance in electrolytes and other critical nutrients. When feeding is reintroduced, especially with carbohydrates, it can trigger a surge in insulin, leading to rapid shifts of electrolytes such as phosphate, potassium, and magnesium into the cells, causing dangerously low levels in the blood. This condition can have severe consequences, including heart failure, respiratory failure, and even death if not properly managed. Therefore, careful management and gradual refeeding strategies are essential in the treatment of malnourished children to prevent the onset of refeeding syndrome. Other conditions, while relevant in malnourished children, do not present the immediate and severe physiological threats that refeeding syndrome does in this context.