Certified Medical-Surgical Registered Nurse Practice Test

What could be an early sign of malnutrition in a postoperative lung cancer patient following a lobectomy?

1. A retinal-binding protein level of 2.0 mg/dL

2. Dry, flaky, discolored skin and brittle nails

3. A body mass index (BMI) of 20

4. An albumin level of 3.0 g/dL

The correct answer is: A retinal-binding protein level of 2.0 mg/dL

Possible explanations - A low retinal-binding protein level can be an early sign of malnutrition because it is a marker of overall protein status in the body. In a postoperative lung cancer patient following a lobectomy, the body may not be able to absorb and utilize protein properly, leading to a decrease in retinal-binding protein levels. - Option B, dry, flaky, discolored skin and brittle nails, may also be a sign of malnutrition, but it is not an early sign. These symptoms may occur after a prolonged period of malnutrition. - Option C, a body mass index (BMI) of 20, is within the normal range but may not accurately reflect malnutrition in elderly or postoperative patients. Muscle loss and fluid shifts can affect BMI readings, making it a less reliable indicator. - Option D, an albumin level of 3.0 g/dL, is a commonly used marker of malnutrition. However, it is not an early sign and may only decrease in the later stages of malnutrition. A retinal-binding protein level is a more sensitive marker and can detect malnutrition earlier.