Registered Dietitian Nutritionist Practice Test

RDN exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives

Exam Code: RDN
Exam Name: CDR Registered Dietitian Nutritionist
Exam Format: Computer-based- multiple-choice questions
Number of Questions: 125–145 (scored questions- plus 25 unscored pilot questions)
Total exam Time: 2.5 hours (150 minutes)
Passing Score: Scaled score of 25 (on a scale of 1–50)
Passing Rate: ~70% (varies slightly each year)

DOMAIN I – PRINCIPLES OF DIETETICS
TOPIC A – Food- Nutrition and Supporting Sciences
- Food science
- Physical and chemical properties of food
- Water
- Vegetables and fruits
- Sugars
- Flours- grains- and cereals
- Milk and dairy products
- Eggs
- Meats- fish- poultry- meat alternatives
- Fats and oils
- Beverages
- Functional foods
- Sensory evaluation of food
- Food safety- processing- preservation- and packaging
- Food biotechnology and genetic engineering

- Scientific basis for preparation and storage
- Function of ingredients
- Techniques of food preparation
- Leavening agents- batters- and doughs
- Effects of techniques and methods on
- Sensory properties
- Nutrient retention
- Roles of food additives

- Composition of food
- Labeling and packaging claims
- Macro and micronutrients sources
- Phytochemicals
- Nutrient databases
- Nutrient analysis
- Principles of normal nutrition
- Function of nutrients and non-nutritive substances
- Macro and micronutrients
- Water
- Fiber- prebiotics and probiotics
- Non-nutritive sweeteners and sugar alcohols
- Herbals- botanicals- and supplements
- Nutrient and energy needs throughout the life span
- Developmental stages and feeding patterns throughout the life span

- Principles of human anatomy- physiology- microbiology- and biochemistry
- Gastrointestinal
- Renal
- Pulmonary
- Cardiovascular
- Neurological
- Musculoskeletal
- Reproductive
- Social determinants of health (e.g.- income- culture- social status- education- physical environment- social network- genetics- gender- race- and sexual orientation)
- Nutrition requirements for health promotion and disease prevention

- Education- Communication and Technology
- Components of the educational plan
- Targeted setting/clientele
- Cultural competencies and diversity
- In-service education (e.g.- students and health and rehabilitative service providers)
- Patient/client counseling
- Group/individual education
- Goals and objectives (e.g.- collaborate with partners and stakeholders)
- Needs assessment (e.g.- external constraints- competing programs- illness- and learning needs)
- Individual
- Group
- Content (e.g.- community resources- learning activities/methodology- references- handouts- and instructional materials)
- Evaluation criteria
- Budget development
- Program promotion

- Education Theories
- Educational readiness
- Human behavior and change management theory
- Implementation
- Communication
- Interpersonal
- Group process (e.g.- interprofessional)
- Teach classes (e.g.- culinary demonstrations and grocery tours)
- Interviewing (e.g.- techniques of questioning: open-ended- closed-ended- leading)
- Counseling (e.g.- techniques: motivation interviewing- behavioral- other)
- Methods of communication
- Verbal/non-verbal
- Written (e.g.- reports- grant proposals- other)
- Media (e.g.- print- electronic- and social media)

- Evaluation of educational outcomes
- Measurement of learning
- Formative
- Summative
- Evaluation of effectiveness of educational plan
- Documentation
- Client information
- Records
- Confidentiality
- Healthcare and nutrition informatics systems/technologies
- Telehealth and remote health monitoring systems
- Electronic health records (e.g.- meaningful use- privacy and protection for Protected Health Information (PHI)- use for outcomes and use for National Consumer Panel (NCP))
- Food and nutrient analysis software and databases
- Public policy advocacy and legislation

- Research Applications
- Types of research
- Research process (e.g.- secure funding- hypothesis testing- study design- Institutional Review Board (IRB)- statistical analysis- results- and discussion)
- Data collection- analysis- interpretation- and outcomes to make decisions
- Application of statistical analysis (e.g.- analysis- interpretation- and integration of evidence-based research findings)
- Presentation of research data and outcomes
- Report research findings (e.g.- write manuscripts- translation of results for diverse uses)
- Use of grading systems (e.g.- Evidence Analysis Library) and the application of evidence analysis as the basis for practice decisions.


DOMAIN II – NUTRITION CARE FOR INDIVIDUALS AND GROUPS
TOPIC A – Screening and Assessment
- Nutrition screening
- Purpose
- Selection and use of risk factors and evidence-based tools
- Parameters and limitations
- Methodology
- Participation in interdisciplinary nutrition screening teams
- Cultural competence
- Prioritize nutrition risk
- Nutrition assessment of individuals
- Dietary intake assessment- analysis- and documentation
- Medical and family history
- Obtain and assess physical findings
- Anthropometric data
- Nutrition-focused physical exam
- Intake and output
- Medication management
- Prescriptions- over-the-counter medications- and supplements
- Medication/food/supplement interactions
- Obtain and assess biochemical data- diagnostic tests- and procedures
- Assessment of energy and nutrient requirements
- Physical activity habits and restrictions
- Comparative standards (e.g.- energy requirements and growth)
- Economic/social
- Psychosocial and behavioral factors
- Socioeconomic factors
- Functional factors
- Educational readiness assessment
- Motivational level and readiness to change
- Educational level
- Situational (e.g.- environmental- economic- and cultural
- General wellness assessment
- Nutrition assessment of populations and community needs assessment
- Obtain and assess community and group nutrition status indicators
- Demographic data
- Incidence and prevalence of nutrition-related status indicator
- Prevalence of food insecurity
- Review and utilize nutrition screening and surveillance systems (e.g.- national- state- and local reference data- NHANES- BRFSS and YRBSS)
- Availability of community resources
- Food and nutrition assistance programs
- Consumer education resources
- Health services
- Studies on food systems- local marketplace- food economics
- Public health programs

- Relationship between nutrition diagnoses and medical diagnoses
- Pathophysiology
- Identifying medical diagnoses affecting nutrition care
- Determining nutrition risk factors for current medical diagnoses
- Determining nutrition factors for groups
- Data sources and tools for nutrition diagnosis
- Organizing assessment data
- Using standardized language
- Diagnosing nutrition problems for individuals and groups
- Making inferences
- Prioritizing
- Differential diagnosing
- Etiologies (e.g.- cause/contributing risk factors)
- Identifying underlying causes and contribution risk factors of nutrition diagnoses
- Making cause and effect linkages
- Signs and symptoms (e.g.- defining characteristics)
- Linking signs and symptoms to etiologies
- Using subjective (symptoms) and/or objective (signs) data

- Nutrition care for health promotion and disease prevention
- Identification of desired outcomes/actions
- Evidence-based practice for nutrition intervention
- Evaluation of nutrition information
- Food fads
- Health fraud
- Health and wellness promotion and risk reduction programs
- Implementing care plans
- Nutrition recommendations to promote wellness
- Communication and documentation
- Medical Nutrition Therapy
- Identify desired outcomes and actions
- Relationship of pathophysiology to treatment of nutrition-related disorders
- Critical care and hypermetabolic states
- Disordered eating and eating disorders
- Food allergies and intolerance
- Immune system disorders- infections- and fevers
- Malnutrition (e.g.- protein- calorie- vitamin and mineral)
- Metabolic
- Endocrine
- Inborn errors of metabolism
- Oncologic and hematologic conditions
- Organ system dysfunction
- Gastrointestinal
- Renal
- Pulmonary
- Cardiovascular
- Nervous system
- Musculoskeletal
- Reproductive
- Orthopedic
- Wounds
- Obesity
- Mental/Behavioral health and addiction
- Gastrointestinal and bariatric surgery
- Determine energy/nutrient needs specific to condition
- Determine specific feeding methods
- Oral
- Composition/texture of foods and liquids
- Chewing difficulty
- Swallowing difficulty (International Dysphagia Diet Standardization Initiative)
- Diet patterns/schedules
- Diet modification for diagnostic test
- Modified diet products and food supplements
- Adaptive equipment
- Breastfeeding
- Enteral and Parenteral nutrition
- Formulas and calculations
- Routes- techniques- equipment
- Complications
- Integrative and functional care- herbal therapy
- Implementing care plans
- Nutrition therapy for specific nutrition-related problems
- Basis for quality practice (e.g.- evidence-based guidelines- standardized processes – National Consumer Panel (NCP)- regulatory and patient safety issues)
- Counseling and training (e.g.- nutrition plans- medical devices and formula preparation
- Communication and documentation
- Patient rounds
- Care conference
- Coordination of care/interprofessional coordination
- Discharge planning
- Recommend appropriate physical- social- behavioral or psychological services
- Referral to community resources (e.g.- WIC and home-delivered meals)
- Implementation and promotion of national dietary guidance
- MyPlate and other diet instructional tools
- Dietary Guidelines for Americans and Healthy People
- State and community resources and nutrition-related programs
- Block grants to states
- Federal and state funded food and nutrition programs
- Community-based interventions
- Development of programs and services
- Identification and attainment of funding
- Resource allocation and budget development
- Provision of food and nutrition services to groups

- Monitoring progress and updating previous care
- Monitoring and determining tolerance to interventions (e.g.- medications- tube feeding- parenteral nutrition- medical nutrition and dietary supplements)
- Measuring outcome indicators using evidence-based guides for practice
- Selecting indicators
- Using reference standards
- Explaining variance
- Evaluating effectiveness and outcomes of nutrition interventions for individuals and populations
- Direct nutrition intervention outcomes
- Clinical and health status outcomes
- Patient-centered outcomes
- Resource utilization outcomes
- Relationship with outcome measurement systems and quality improvement
- Determining continuation and transition of care
- Continuing and updating care
- Discontinuing care

DOMAIN III – MANAGEMENT OF FOOD AND NUTRITION PROGRAMS AND SERVICES (21%)
TOPIC A – Functions of Management
- Functions
- Planning
- Short and long range
- Strategic and operational
- Policies and procedures
- Emergency preparedness
- Organizing
- Schedules and FTE allocations
- Department or unit structure
- Processes- procedures- and improving productivity
- Resources
- Directing
- Coordination
- Delegation
- Communication
- Motivation strategies
- Leadership theories
- Management theories
- Controlling
- Establishing standards
- Monitoring established plans
- Developing corrective actions
- Staffing
- Forecasting personnel needs
- Alignment of personnel
- Management characteristics
- Skills
- Technical
- Human
- Conceptual
- Roles
- Informational
- Conflict resolution
- Problem-solving
- Decision-making
- Other (e.g.- change management)
- Traits
- Management styles
- Leadership styles
- Interpersonal styles
- Managing a diverse workforce
- Emotional intelligence

TOPIC B – Human Resource Management
- Employment laws and regulations
- Compliance (e.g.- Equal Employment Opportunity Commission (EEOC)- Americans with Disabilities Act (ADA)- Occupational Safety and Health Act (OSHA) or other)
- Credentialing and licensure
- Unions and contracts
- Employment standards
- Job analysis
- Job specifications
- Job descriptions
- Employment processes
- Recruitment and selection- interviewing skills
- Orientation and training
- Performance improvement- development- and evaluation
- Discipline
- Grievance
- Compensation
- Retention and turnover
- Personnel records
- Cultural humility/competence (e.g.- diversity and inclusion- equitable workplaces- scheduling implications- training- etc.)

TOPIC C – Financial Management
- Budgeting processes and fiscal periods
- Budget procedures
- Types
- Operational
- Capital
- Methods
- Incremental
- Performance
- Zero-based
- Flexible
- Fixed
- Components
- Types of expenses
- Revenue streams
- Profitability
- Resource allocation
- Financial monitoring
- Accounting principles
- Cash control and auditing
- Financial statements
- Financial analysis

TOPIC D – Marketing and Public Relations
- Marketing analysis
- Process
- Identification of target market
- Determination of needs/wants
- Marketing mix
- Customer satisfaction
- Documentation and evaluation
- Pricing
- Strategies
- Breakeven
- Revenue-generating
- Loss leader
- Rationale
- Public relations
- Media relations
- Social networking
- Campaign development
- Customer service
- Marketing mix principles
- Product
- Place
- Price
- Promotion

TOPIC E – Quality Management and Regulatory Compliance
- Regulatory guidelines (e.g.- federal- state- local and accreditation agencies)
- Food and nutrition policy (e.g.- older adults act legislation- farm bill)
- Federal feeding programs (e.g.- Supplemental Nutrition Assistance Program (SNAP)- National School Breakfast Program and National School Lunch Program- Child and Adult Care Food Program (CACFP))
- Coding and billing- insurance requirements
- Accreditation agencies (e.g.- The Joint Commission- Centers for Medicare & Medicaid Services (CMS)- DNV GL Healthcare)
- Process- implementation- evaluation
- Cost/benefit analysis
- Productivity analysis
- Program and product analysis
- Tools (e.g.- Kaizen- Total Quality Management- Lean Six Sigma)
- Scope of practice and standards of professional performance (SOP- SOPP)
- Code of ethics

DOMAIN IV – FOODSERVICE SYSTEMS (13%)
TOPIC A – Menu Development
- Menu
- Patient/resident
- Multi facility
- Single site
- Commercial
- Non-commercial
- Menu development
- Master menu
- Guidelines and parameters
- Sensory characteristics
- Nutritional adequacy
- Cost
- Regulations
- Modifications
- Diet/disease states/life span
- Preferences/substitutions
- Nutritional adequacy
- Food allergies and sensitivities
- Cultural/religious
- Vegetarian/vegan
- Demographics
- Satisfaction Indicators
- Customer/patient evaluation
- Sales data
- Employee satisfaction
- Operational influences
- Facility/equipment
- Labor
- Budget
- Organizational philosophy (e.g.- mission- vision- culture- values)
- External influences
- Trends
- Seasonality
- Emergency/disaster management
- Product availability

TOPIC B – Procurement- Production- Distribution- and Service
- Procurement- receiving- and inventory management
- Procurement principles- concepts- and methods
- Bid process and contract implementation
- Specification development
- Group purchasing/prime vendor
- Ethics
- Foodservice management software
- Procurement decisions
- Product selection/yield (e.g.- fresh- frozen- prepackaged)
- Quality standards
- Product packaging
- Cost analysis
- Receiving and storage
- Equipment and methods
- Records
- Security
- Safety and sanitation
- Inventory management
- Control procedures (e.g.- par levels- rotation and minimum/maximum)
- Issuing procedures
- Inventory technology
- Principles of quantity food preparation and processing
- Cooking methods
- Equipment
- Preservation and packaging methods
- Modified food preparation
- Food production control procedures
- Standardized recipes
- Ingredient control
- Portion control and yield analysis
- Forecasting production
- Production scheduling
- Food waste management
- Inventory management
- Safety and sanitation
- Production systems
- Conventional
- Commissary
- Ready-prepared (e.g.- cook-chill- cook-freeze)
- Assembly/serve
- Display cooking
- Distribution and service
- Type of service systems (e.g.- centralized- decentralized and room service)
- Equipment
- Packaging

TOPIC C – Sanitation and Safety
- Sanitation
- Sanitation practices and infection control
- Personal hygiene
- Food and equipment
- Waste disposal
- Food handling techniques
- Food laws and regulations (e.g.- Food Code- government and other agencies)
- Food safety
- Principles
- Contamination and spoilage
- Microbiological control
- Signs and symptoms of food borne illness
- Allergens/cross contact
- Food safety management
- Standard operating procedures
- Time and temperature control
- Documentation and recordkeeping
- Recalls
- Operational emergencies
- Bioterrorism
- Employee behaviors and training
- Inspections and audits
- Hazard Analysis Critical Control Point (HACCP)
- Safety
- Employee
- Universal precautions
- Equipment use and maintenance
- Personal work habits
- Protective equipment
- Practices
- Environmental conditions
- Regulations
- Fire safety
- Accident prevention
- Occupational health and safety guidelines
- Documentation and recordkeeping
- Reporting (e.g.- work restrictions- injuries- accidents- Workers’ Compensation- spills- falls- exposures)

TOPIC D – Equipment and Facility Planning
- Facility layout
- Equipment and layout planning
- Menu
- Flow of food
- Service systems
- Safety and sanitation
- Privacy and accessibility
- Codes and standards
- Budget (e.g.- equipment- staff- operational inputs)
- Staffing (e.g.- skill and number)
- Planning team
- Composition
- Roles and responsibilities
- Project management schedule
- Equipment
- Specifications
- Selection
- Installation schedule
- Staff training
- Sustainability
- Food and water
- Non-food
- Supplies
- Equipment
- Waste management
- Storage
- Reduce- reuse- recycle
- Disposal
- Emergency preparedness and contingency planning
- Inventory (e.g.- food- water- and supplies)
- Technology
- Operational inputs (e.g.- utilities)
- Staffing
- Safety plan

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Question: 1606
A 68-year-old female with chronic kidney disease (Stage 4) on hemodialysis is monitored for nutrition
intervention outcomes. Her prealbumin increases from 12 mg/dL to 18 mg/dL but CRP levels remain
elevated. How should this be interpreted regarding nutrition intervention effectiveness?
A. Ineffective intervention due to unchanged CRP
B. Improved protein status despite persistent inflammation
C. Prealbumin is not useful in renal patients
D. Nutrition intervention caused increased inflammation
Answer: B
Explanation: Prealbumin increases reflect improved protein status, but its interpretation must consider
CRP as a marker of inflammation; persistent elevation of CRP indicates ongoing inflammation. The
increased prealbumin despite inflammation suggests intervention is improving nutrition status. CRP
elevation alone does not negate improved protein status. Prealbumin can be used cautiously and along
with inflammation markers in renal patients. There is no indication that nutrition intervention caused
inflammation.
Question: 1607
A commercial restaurant is analyzing sales data for a new vegan dish. The dish has a 20% contribution
margin and costs $5.00 per serving. What is the selling price?
A. $6.25
B. $6.00
C. $5.50
D. $6.50
Answer: A
Explanation: Contribution margin = (Selling price - Cost) � Selling price. For 20% margin: (P - $5.00) �
P = 0.20. Solving, 0.80P = $5.00, so P = $5.00 � 0.80 = $6.25.
Question: 1608
An RDN is designing a diet for a renal failure patient needing low potassium intake. Which fruit listed
below should be limited based on high potassium content?
A. Apple
B. Grapes
C. Blueberry
D. Banana
Answer: D
Explanation: Bananas have high potassium content (~358 mg/100g), making them less suitable for low-
potassium renal diets. Apples, blueberries, and grapes have substantially lower potassium.
Question: 1609
An RDN is counseling a patient with type 1 diabetes who experiences frequent hypoglycemia (blood
glucose <70 mg/dL). Using Solution-Focused Brief Therapy, which question should the RDN ask to
promote goal-setting?
A. �What challenges do you face in managing your blood glucose?�
B. �What has worked well for you in preventing hypoglycemia?�
C. �Why do you think you keep having low blood sugar?�
D. �Would you like a list of high-glycemic snacks?�
Answer: B
Explanation: Solution-Focused Brief Therapy focuses on strengths and past successes. Asking �What has
worked well for you in preventing hypoglycemia?� encourages the patient to identify effective strategies.
The other options focus on problems or solutions not tailored to the patient�s experience.
Question: 1610
A dietitian advocates for a policy to regulate sugar content in beverages. Opponents argue it restricts
consumer choice. Which evidence best supports the dietitian's stance?
A. General sugar consumption trends
B. Consumer surveys on beverage preferences
C. A case study of a single school's success
D. A study linking reduced sugar intake to lower obesity rates
Answer: D
Explanation: A study linking reduced sugar intake to lower obesity rates provides strong evidence for
health benefits, countering choice restrictions. Consumer surveys are subjective. A single case study lacks
broad impact. Consumption trends do not address health outcomes directly.
Question: 1611
In documenting patient progress, which is the most critical to include for legal and clinical evaluation?
A. Only subjective reports from patients
B. Objective data, interventions, patient responses, and follow-up plans
C. Billing codes without clinical notes
D. Informal notes recorded weeks after interaction
Answer: B
Explanation: Comprehensive documentation includes objective data, interventions, responses, and plans;
others are insufficient or risky legally.
Question: 1612
An RDN reviewing job descriptions notes that the statement "must be able to lift 50 pounds" is listed
under job specifications. Which complaint could arise based on this requirement?
A. Potential non-compliance with ADA reasonable accommodation
B. Violation of OSHA safety standards
C. Conflict with EEOC gender discrimination rules
D. Misclassification of exempt/non-exempt employee status
Answer: A
Explanation: Physical requirements like lifting could conflict with ADA if they exclude qualified
employees with disabilities without considering reasonable accommodations. OSHA deals with safety
but not discriminatory job specs. EEOC addresses discrimination unrelated to physical demands
explicitly. Employee classification is unrelated.
Question: 1613
A dietitian is tasked with reducing food waste in a hospital kitchen. A yield analysis shows that a
standardized recipe for roasted chicken has a 30% trim loss, with 100 kg of raw chicken yielding 70 kg of
cooked product. What is the most effective strategy to reduce waste?
A. Incorporate trim into stock production
B. Increase portion sizes to utilize trim
C. Adjust the recipe to use chicken parts with less trim loss
D. Switch to pre-trimmed chicken
Answer: A
Explanation: Incorporating trim into stock production utilizes the 30% trim loss (30 kg) to create a value-
added product, reducing waste. Adjusting the recipe may compromise quality. Increasing portion sizes
does not address trim loss and may increase plate waste. Pre-trimmed chicken is costlier and may not be
feasible.
Question: 1614
A patient consumes a supplement containing 500 mg of vitamin C daily. Which lab test would best
reflect his vitamin C status?
A. Plasma ascorbic acid concentration
B. Serum ferritin level
C. Serum retinol concentration
D. Urinary sodium measurement
Answer: A
Explanation: Plasma ascorbic acid directly indicates vitamin C status. Serum ferritin relates to iron stores,
serum retinol to vitamin A, and urinary sodium to salt balance.
Question: 1615
A 30-year-old female with anorexia nervosa is admitted with a BMI of 16 kg/m� and a serum potassium
of 3.2 mEq/L. Her estimated needs are 2,000 kcal and 80 g protein daily. Which initial feeding approach
is most appropriate to prevent refeeding syndrome?
A. Begin with 2,000 kcal via oral diet immediately
B. Provide parenteral nutrition at 1,500 kcal/day
C. Initiate enteral feeding at 1,000 kcal/day, increasing gradually
D. Restrict to 500 kcal/day for 1 week
Answer: C
Explanation: Anorexia nervosa with low BMI and hypokalemia increases refeeding syndrome risk.
Initiating enteral feeding at 1,000 kcal/day, increasing gradually, minimizes electrolyte shifts while
addressing malnutrition. Starting at 2,000 kcal orally risks refeeding syndrome. Parenteral nutrition is
unnecessary if enteral is feasible. Restricting to 500 kcal/day is inadequate and delays recovery.
Question: 1616
A dietitian is assessing a 50-year-old male with newly diagnosed pancreatic cancer. He reports nausea,
vomiting, and a 10% weight loss in 3 months. His lab results show a serum albumin of 2.5 g/dL and a
prealbumin of 10 mg/dL (normal: 15�35 mg/dL). What is the primary etiology of his malnutrition?
A. Decreased nutrient absorption due to pancreatic insufficiency
B. Increased metabolic demand due to cancer cachexia
C. Inadequate oral intake due to nausea and vomiting
D. Medication side effects reducing appetite
Answer: B
Explanation: Increased metabolic demand due to cancer cachexia is the primary etiology. Pancreatic
cancer often leads to cachexia, characterized by increased metabolic rate and muscle wasting,
contributing to significant weight loss and low serum albumin and prealbumin. Inadequate oral intake and
decreased nutrient absorption are contributing factors, but cachexia is the dominant etiology. Medication
side effects are not mentioned in the scenario.
Question: 1617
An RDN is conducting a nutrition assessment on a 10-year-old child. The child's height-for-age is at the
5th percentile, weight-for-age at the 15th percentile, and BMI-for-age at the 25th percentile. Which of
the following is the MOST appropriate interpretation?
A. The child is at risk for overweight
B. The child has normal growth parameters
C. The child is wasted but not stunted
D. The child is stunted but likely not wasted
Answer: D
Explanation: Height-for-age at the 5th percentile suggests stunting (chronic malnutrition or growth
delay), weight-for-age at 15th percentile is low but above cutoff for underweight, and BMI-for-age at
25th percentile is within normal limits, indicating adequate weight relative to height. This pattern
suggests stunting without wasting (acute malnutrition).
Question: 1618
A dietitian is evaluating a hospital�s foodservice financial ratios. Current assets are $200,000, current
liabilities are $100,000. What is the current ratio?
A. 1:1
B. 2:1
C. 3:1
D. 4:1
Answer: B
Explanation: Current ratio = Current Assets � Current Liabilities = $200,000 � $100,000 = 2:1. The
option �2:1� is correct. Other options miscalculate the ratio.
Question: 1619
An RDN is reviewing a HACCP plan and identifies a critical control point (CCP) at hot holding of
cooked soup. What is the MOST appropriate critical limit for this CCP based on FDA standards?
A. Soup must be held at or above 135�F (57�C)
B. Soup must be held at or above 140�F (60�C)
C. Soup must be held at or above 150�F (66�C)
D. Soup must be held at or above 165�F (74�C)
Answer: A
Explanation: The FDA Food Code specifies hot holding of TCS foods at or above 135�F (57�C).
Holding above 140�F or 150�F is acceptable but not required; 165�F is required only for reheating, not
hot holding. Lower temperatures increase risk of microbial growth.
Question: 1620
A dietitian is developing content for a heart-healthy eating curriculum. Which content element BEST
supports evidence-based practice?
A. Providing only standardized government pamphlets without adaptation
B. Including community recipes modified to reduce saturated fat and sodium
C. Excluding culturally relevant foods to avoid complexity
D. Promoting unverified supplements for cardiovascular health
Answer: B
Explanation: Modifying community recipes to align with nutritional guidelines while respecting culture
makes evidence more accessible.
Question: 1621
A population-level survey utilizing NHANES data shows an increased prevalence of vitamin D
deficiency in elderly adults living in northern latitudes. Which factor is least likely contributing to this
observation?
A. Increased outdoor physical activity
B. Decreased dietary vitamin D intake
C. Reduced skin synthesis due to low UV exposure
D. Impaired renal conversion to active vitamin D
Answer: A
Explanation: Increased outdoor physical activity would increase UV exposure and vitamin D synthesis, so
it is least likely contributing to deficiency. Reduced skin synthesis, decreased dietary intake, and
impaired renal conversion are all common contributing factors in elderly populations.
Question: 1622
A community-based intervention targets childhood obesity in a rural area. The RDN plans a multi-level
strategy incorporating school, family, and community environments. Which intervention BEST reflects
evidence-based practice?
A. Focusing solely on after-school physical activity programs
B. Distributing brochures on healthy eating to schools without further engagement
C. Implementing school curriculum changes combined with parent education sessions and local grocery
store partnerships to increase healthy food access
D. Providing free dietitian counseling only to children already obese
Answer: C
Explanation: Multi-level interventions that combine school-based education, family involvement, and
improving food access at the community level are most effective.
Question: 1623
A multi-facility healthcare system is revising its menu to comply with CMS regulations for long-term
care. The dietitian must ensure a dinner entree provides 700 kcal, 25% protein, and =1,500 mg sodium
for a patient with hypertension. Which option is compliant?
A. Baked chicken with rice (720 kcal, 20% protein, 1,600 mg sodium)
B. Pork chop with potatoes (750 kcal, 22% protein, 1,700 mg sodium)
C. Pasta with marinara (680 kcal, 15% protein, 1,200 mg sodium)
D. Grilled fish with quinoa (700 kcal, 25% protein, 1,400 mg sodium)
Answer: D
Explanation: Grilled fish with quinoa meets the calorie (700 kcal), protein (25%), and sodium (1,400 mg)
requirements. Baked chicken and pork chop exceed sodium limits. Pasta with marinara is low in protein.
Question: 1624
A patient with severe burns covering 40% total body surface area (TBSA) is being fed enterally. The
resting energy expenditure (REE) was calculated at 1800 kcal/day using indirect calorimetry. Which is
the best estimate of total energy expenditure (TEE) to guide nutrition?
A. REE � 1.5 to 2.0 due to hypermetabolic state
B. REE � 0.9 due to metabolic slowdown
C. REE � 1.0, feeding at resting needs only
D. REE � 3.0 due to extreme catabolism
Answer: A
Explanation: Burns cause a hypermetabolic response; TEE is typically 1.5 to 2 times REE. Underfeeding
worsens outcomes, while multiplying by 3 is excessive risking overfeeding.
Question: 1625
A 48-year-old female from a rural area with limited healthcare access presents with hypertension (BP
150/95 mmHg) and a BMI of 28 kg/m�. Which intervention addresses social determinants and
cardiovascular health?
A. DASH diet with community-based nutrition workshops
B. High-sodium, low-potassium diet to stabilize blood pressure
C. Restrict all fats to reduce cardiovascular risk
D. Use of weight-loss supplements without dietary changes
Answer: A
Explanation: The DASH diet with community-based nutrition workshops addresses hypertension and
social determinants (limited healthcare access) by promoting sustainable dietary changes. A high-sodium,
low-potassium diet would worsen hypertension. Restricting all fats is unnecessary and may limit healthy
fats. Weight-loss supplements do not address dietary patterns or social barriers.
Question: 1626
A 28-year-old female with gestational diabetes mellitus (GDM) has a fasting blood glucose of 110 mg/dL
(normal: <95 mg/dL) and a 2-hour postprandial glucose of 160 mg/dL (normal: <120 mg/dL). She
consumes a high-carbohydrate diet (60% of total calories). What is the most likely nutrition risk factor
contributing to her uncontrolled GDM?
A. Inadequate protein intake affecting glycemic control
B. Inadequate fiber intake reducing glucose absorption
C. Excessive carbohydrate intake relative to insulin sensitivity
D. Insufficient caloric intake leading to gluconeogenesis
Answer: C
Explanation: Excessive carbohydrate intake relative to insulin sensitivity is the primary nutrition risk
factor. GDM is characterized by insulin resistance, and a high-carbohydrate diet (60% of calories) can
exacerbate hyperglycemia, as evidenced by elevated fasting and postprandial glucose levels. Inadequate
fiber intake may contribute but is less critical without specific dietary data. Inadequate protein intake and
insufficient caloric intake are not supported by the scenario, as the focus is on carbohydrate excess.
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