RD EXAM: Nutrition Care Questions And
Answers.
A registered dietitian nutritionist is working with a client to reduce blood cholesterol
levels. The client is knowledgeable about a hyperlipidemia diet and is able to devise
healthy meal plans, but he has moderate readiness in independently following the
nutrition care plan. To be most effective in meeting the client's needs, what would be the
RDN's approach?
A. Continue to provide dietary instructions to the client and closely monitor compliance.
B. Help the client gain confidence through listening, advising, and coaching.
C. Listen to the client. Encourage and support the skills the client has developed.
D. Turn over responsibility for nutrition care to the client. -
\The correct answer is C.
The patient is knowledgeable with moderate readiness, so the RDN needs to find out
what the client knows by listening to, encouraging, and supporting the client to help him
be fully ready to execute the diet to reduce blood cholesterol.
What daily energy intake should result in a weight loss of 2 pounds per month if one had
been consuming 2,000 kcal per day?
1,500 kcal
1,650 kcal
1,750 kcal
1,850 kcal -
\The correct answer is C.
3,500 kcal/pound = 7,000 kcal deficiency needed for 2 pound weight loss over 4 weeks;
7,000/28 (4 weeks x 7 days/week) = 250 kcal. 2000-250 = 1750 kcal.
Which of the following is the BEST example of an "open-ended" question?
A. Why would you want to follow that meal plan?
B. Do you use skim milk or whole milk?
C. What are some of the challenges you've faced in your weight loss journey?
D. Do you feel positive or negative about your weight loss goal? -
\The correct answer is C.
Open-ended questions typically start with "What" or "How" and invite the client to tell a
story. Open-ended questions should never begin with "why," as it risks putting the client
on the defensive.
,Imagine a client says, "I don't know if I can eat bananas or watermelon on this diabetic
meal plan. I wonder if I need to be using exchanges." Which of the following is the best
example of a reflective statement/question to ask this client?
"You're uncertain about how to choose foods?"
"You're interested in your health?"
"Do you want a diabetic meal plan?"
"I'm happy that you've come in today." -
\The correct answer is A.
Reflective statements take what is said and reword it to better inform understanding of
the speaker's intent. They usually include some "feeling" words. It also helps to clarify
the problem.
A 56-year-old male client presents to the ambulatory clinic for a team visit. Physical
exam reveals: Height: 5'9"; weight: 223 pounds; body mass index (BMI) 33; blood
pressure: 168/96; heart rate 74. Pertinent laboratory results : hemoglobin A1c: 7.0%,
thyroid-stimulating hormone (TSH): 2.0 mU/L, Medications: Metformin (Glucophage
1000 mg daily), Hydrochlorothiazide 25 mg, Lisinopril 20 mg. Review of symptoms:
positive for daytime sleepiness, wife complains of loud snoring. Mood: affect appears to
be good. Despite excellent adherence to DASH (Dietary Approaches to Stop
Hypertension) meal plan, blood pressure continues to be elevated. What is the best
explanation for his elevation in blood pressure and daytime somnolence?
A. A drug/drug interaction of hydrochlorothiazide and Metformin
B. Untreated thyroid disease
C. Undiagnosed obstructive sleep apnea
D. Untreated depression -
\The correct answer is C.
There is no drug/drug interaction with these two medications, TSH is normal, and mood
has been assessed as positive so depression can be ruled out. All symptoms point to
the likely possibility of obstructive sleep apnea
Consider the following clinical scenario: Age: 52-year-old male; weight 163 lb; Height:
5'11" BMI: 22.7; Current medications: Metformin 1 g; Saxagliptin 5 mg; Glucotrol XL 10
mg. Laboratory work: Hemoglobin A1c: 13.9%; fasting blood glucose: 356 mg/dl; +
glutamic acid decarboxylase (GAD) auto antibodies test). The referring physician note
states: "Patient needs diet instruction." Which of the following is the best action for the
RDN to take?
Educate the patient about low carbohydrate foods to minimize glucose elevations.
Contact the referring physician to consider insulin therapy.
Emphasize meal spacing and carbohydrate consistency.
, Negotiate a weight loss of 5% to 7% body weight loss. -
\The correct answer is B.
The GAD shows that the patient has type 1 diabetes and will need insulin therapy for
glucose control. Options A, C, and D would be appropriate actions for individuals with
type 2 diabetes mellitus who have insulin resistance. Dietary or nutrition approaches will
not fix the glucose problem for this patient
What component of serum cholesterol do plant stanols/sterols lower?
Total cholesterol
High-density lipoprotein (HDL)
Triglycerides
Low-density lipoprotein (LDL) -
\The correct answer is D.
Plant stanols are often used in place of statin therapy for lowering LDL, especially for
those patients who are unable to tolerate statins.
Based on this client statement, determine which stage of change he or she is in: "I know
what you are going to tell me, and I know a lot about nutrition. I know what I need to do
to lose weight, but I just can't do it."
Precontemplation
Contemplation
Preparation
Action -
\The correct answer is B.
The classic indicator for a patient in the contemplation stage of change is a "yes, but"
statement. The majority of RDNs' clients are in the contemplation stage when they
come to their first appointment.
Which of the following components comprise the core of motivational interviewing?
Collaboration, empathy, autonomy, and patient-centered care
Partnership, acceptance, compassion, and evocation
Rolling with resistance, unconditional positive regard, empowerment, and empathy
Partnership, autonomy, setting smart goals, and evocation -
\The correct answer is B.
In the 3rd edition of the groundbreaking Motivational Interviewing, the authors added
compassion to the core of motivational interviewing and elaborate on the concept of
what acceptance really is.
Answers.
A registered dietitian nutritionist is working with a client to reduce blood cholesterol
levels. The client is knowledgeable about a hyperlipidemia diet and is able to devise
healthy meal plans, but he has moderate readiness in independently following the
nutrition care plan. To be most effective in meeting the client's needs, what would be the
RDN's approach?
A. Continue to provide dietary instructions to the client and closely monitor compliance.
B. Help the client gain confidence through listening, advising, and coaching.
C. Listen to the client. Encourage and support the skills the client has developed.
D. Turn over responsibility for nutrition care to the client. -
\The correct answer is C.
The patient is knowledgeable with moderate readiness, so the RDN needs to find out
what the client knows by listening to, encouraging, and supporting the client to help him
be fully ready to execute the diet to reduce blood cholesterol.
What daily energy intake should result in a weight loss of 2 pounds per month if one had
been consuming 2,000 kcal per day?
1,500 kcal
1,650 kcal
1,750 kcal
1,850 kcal -
\The correct answer is C.
3,500 kcal/pound = 7,000 kcal deficiency needed for 2 pound weight loss over 4 weeks;
7,000/28 (4 weeks x 7 days/week) = 250 kcal. 2000-250 = 1750 kcal.
Which of the following is the BEST example of an "open-ended" question?
A. Why would you want to follow that meal plan?
B. Do you use skim milk or whole milk?
C. What are some of the challenges you've faced in your weight loss journey?
D. Do you feel positive or negative about your weight loss goal? -
\The correct answer is C.
Open-ended questions typically start with "What" or "How" and invite the client to tell a
story. Open-ended questions should never begin with "why," as it risks putting the client
on the defensive.
,Imagine a client says, "I don't know if I can eat bananas or watermelon on this diabetic
meal plan. I wonder if I need to be using exchanges." Which of the following is the best
example of a reflective statement/question to ask this client?
"You're uncertain about how to choose foods?"
"You're interested in your health?"
"Do you want a diabetic meal plan?"
"I'm happy that you've come in today." -
\The correct answer is A.
Reflective statements take what is said and reword it to better inform understanding of
the speaker's intent. They usually include some "feeling" words. It also helps to clarify
the problem.
A 56-year-old male client presents to the ambulatory clinic for a team visit. Physical
exam reveals: Height: 5'9"; weight: 223 pounds; body mass index (BMI) 33; blood
pressure: 168/96; heart rate 74. Pertinent laboratory results : hemoglobin A1c: 7.0%,
thyroid-stimulating hormone (TSH): 2.0 mU/L, Medications: Metformin (Glucophage
1000 mg daily), Hydrochlorothiazide 25 mg, Lisinopril 20 mg. Review of symptoms:
positive for daytime sleepiness, wife complains of loud snoring. Mood: affect appears to
be good. Despite excellent adherence to DASH (Dietary Approaches to Stop
Hypertension) meal plan, blood pressure continues to be elevated. What is the best
explanation for his elevation in blood pressure and daytime somnolence?
A. A drug/drug interaction of hydrochlorothiazide and Metformin
B. Untreated thyroid disease
C. Undiagnosed obstructive sleep apnea
D. Untreated depression -
\The correct answer is C.
There is no drug/drug interaction with these two medications, TSH is normal, and mood
has been assessed as positive so depression can be ruled out. All symptoms point to
the likely possibility of obstructive sleep apnea
Consider the following clinical scenario: Age: 52-year-old male; weight 163 lb; Height:
5'11" BMI: 22.7; Current medications: Metformin 1 g; Saxagliptin 5 mg; Glucotrol XL 10
mg. Laboratory work: Hemoglobin A1c: 13.9%; fasting blood glucose: 356 mg/dl; +
glutamic acid decarboxylase (GAD) auto antibodies test). The referring physician note
states: "Patient needs diet instruction." Which of the following is the best action for the
RDN to take?
Educate the patient about low carbohydrate foods to minimize glucose elevations.
Contact the referring physician to consider insulin therapy.
Emphasize meal spacing and carbohydrate consistency.
, Negotiate a weight loss of 5% to 7% body weight loss. -
\The correct answer is B.
The GAD shows that the patient has type 1 diabetes and will need insulin therapy for
glucose control. Options A, C, and D would be appropriate actions for individuals with
type 2 diabetes mellitus who have insulin resistance. Dietary or nutrition approaches will
not fix the glucose problem for this patient
What component of serum cholesterol do plant stanols/sterols lower?
Total cholesterol
High-density lipoprotein (HDL)
Triglycerides
Low-density lipoprotein (LDL) -
\The correct answer is D.
Plant stanols are often used in place of statin therapy for lowering LDL, especially for
those patients who are unable to tolerate statins.
Based on this client statement, determine which stage of change he or she is in: "I know
what you are going to tell me, and I know a lot about nutrition. I know what I need to do
to lose weight, but I just can't do it."
Precontemplation
Contemplation
Preparation
Action -
\The correct answer is B.
The classic indicator for a patient in the contemplation stage of change is a "yes, but"
statement. The majority of RDNs' clients are in the contemplation stage when they
come to their first appointment.
Which of the following components comprise the core of motivational interviewing?
Collaboration, empathy, autonomy, and patient-centered care
Partnership, acceptance, compassion, and evocation
Rolling with resistance, unconditional positive regard, empowerment, and empathy
Partnership, autonomy, setting smart goals, and evocation -
\The correct answer is B.
In the 3rd edition of the groundbreaking Motivational Interviewing, the authors added
compassion to the core of motivational interviewing and elaborate on the concept of
what acceptance really is.
