Fall - Sample Rd Examination

1. What areas of the body are assessed for muscle mass wasting during the NFPE?

Temporalis muscle, feet and mouth

Temporalis muscle, quadriceps and interosseous muscles

Scalp, mouth and gums

Temporalis muscle, feet and gums

B- temporalis, quads and interosseous muscles

Explanation

B- temporalis, quads and interosseous muscles

2. What electrolytes are monitored in refeeding syndrome

Sodium, chloride and calcium

Potassium, phosphorous and magnesium

Bicarb, potassium and calcium

Sodium, zinc and manganese

B is the correct answer--again a straight forward "known fact" question

Explanation

B is the correct answer--again a straight forward "known fact" question

3. What key areas are assessed for fat loss during a nutrition focused physical examination?

Feet, scalp and triceps

Orbital area, triceps and ribs

Deltoids, gastricnemius and trapezius

Nail beds, eyes and lips

B orbital area, triceps and ribs

Explanation

B orbital area, triceps and ribs

4. Which B vitamin is likely deficient in a patient with known chronic alcoholism

Calciferol

Retinol

Thiamin

Pyridoxine

thiamin

Explanation

thiamin

5. A patient had a pre-surgery serum albumin level of 3.7mg/dl and a post-surgery level of 3.1mg/dl. The dietitian should recognize that:

Lab error occurred

The patient has protein losing enteropathy

A decrease albumin level is normal after surgery

Patient has severe visceral protein storage depletion

the answer is C -it is normal to observe shifts in albumin levels post op

Explanation

the answer is C -it is normal to observe shifts in albumin levels post op

6. Which is the best advice for an individual with chronic lung disease like COPD or Cystic Fibrosis to increase intake

Drink lots of liquids to thin the mucous production

Consume six small meals that are energy and nutrient dense

Use margarine instead of butter

Nocturnal TPN

B-Six small meals

Explanation

B-Six small meals

7. An adult client has a BMI of 24. According the CDC, this BMI is classified as:

Obese

Normal weight

Obese Class III

Overwieght

B-normal weight

Explanation

B-normal weight

8. An adolescent diagnosed with anorexia nervosa, who is exhibiting growth retardation and skin lesions may also have a deficiency in:

Manganese

Selenium

Cobalt

Zinc

Zinc-is the correct answer

Explanation

Zinc-is the correct answer

9. A client is 65 inches and weighs 189 pounds, what is the BMI?

14

32

44

52

B--know these types of calculations!

Explanation

B--know these types of calculations!

10. The ASPEN/AND malnutrition criteria use handgrip strength calipers. If the dietitian did not have the calipers, what other information is available to you to help you assess functional status?

Nothing you have to use the calipers

Lange skinfold calipers

A firm handshake or ability to feed themselves

Skip that part of the assessment since it isn't useful

C-firm handshake works!

Explanation

C-firm handshake works!

11. Which of the following food choices is the most appropriate for a vegan

Rice milk

Almond milk

Whole milk

Fortified soy milk

D-fortified soy milk

Explanation

D-fortified soy milk

12. A patient who recently experienced a cerebral vascular accident has dysphagia. The first recommendation by the RD should be:

Initiate a tube feeding

Initiate small frequent feedings

Recommend a swallow study

Provide nectar thick liquids

Swallow study is the correct answer. This must be done before any of the other recommendations would be appropriate

Explanation

Swallow study is the correct answer. This must be done before any of the other recommendations would be appropriate

13. Spoon shaped nails or Koilonychia is associated with a deficiency of which of the following nutrients

Iron

Copper

Magnesium

Phosphorous

iron!

Explanation

iron!

14. To assess the adequacy of a patient's tube feeding in meeting calorie needs, the dietitian should request

Albumin test

Transferrin test

Indirect calorimetry

Nitrogen balance study

C Indirect calorimetery is the Gold standard!

Explanation

C Indirect calorimetery is the Gold standard!

15. An individual status Roux- en-Y surgery weight loss, is craving ice and reports chewing larger quantities every day. What condition is most likely responsible for this behavior? What condition is likely responsible for this behavior?

Malnutrition

Iron deficiency

Oral fixation

Dehydration

Iron!

Explanation

Iron!

16. A patient with dry, scaly skin and Bitot's spots has the classical signs of a deficiency in

Vitamin D

Vitamin A

Vitamin K

Vitamin C

Vitamin A

Explanation

Vitamin A

17. A client can not speak English. The client's first language is Spanish. The dietitian needs to provide nutrition education on a low sodium diet. What is the best choice to provide the needed education?

Talk to a family member who knows the client and speaks both languages

Use a hospital based interpreter

Inform the physician that you are unable to speak the language and refer patient to a specialist

Ask a colleague who speaks some Spanish to help with the education

the correct answer is use the interpreter --no matter what happens in real life!

Explanation

the correct answer is use the interpreter --no matter what happens in real life!

18. A nurse reports that a tube feeding is causing a patient to have diarrhea. The patient has been on the same tube feed for six months prior to admission to the hospital. The first step the dietitian should take is:

Initiate PN

Change the tube feeding formula

Evaluate the medication list for new medications

Check for c difficile contamination.

C is correct -especially since the enteral nutrition worked for 6 months then the diarrhea occurred

Explanation

C is correct -especially since the enteral nutrition worked for 6 months then the diarrhea occurred

19. What are contraindications with the soy oil based fat emulsions used in the US for TPN?

Out of date compared with Europe's fat emulsions

Always out of stock

Increase triglyceride levels

If the patient is allergic to eggs or soy then this type of fat can't be used in the TPN

D-allergies to soy and eggs-

Explanation

D-allergies to soy and eggs-

20. High doses of this herbal supplement will interfere with warfarin treatment

Kava kava

L-citrulline

Ginkgo Biloba

Beet juice

C- Ginkgo Biloba

Explanation

C- Ginkgo Biloba

21. Which of the following amino acids may be beneficial post burn injury

Leucine

Maltose

Arginine

Taurine

Arginine!

Explanation

Arginine!

22. Which medication requires enteral nutrition to be held during its administration?

Ibuprofen

Dilantin

Tylenol suspension

Neutraphos

Dilantin!

Explanation

Dilantin!

23. What is an example of a soluble fiber?

Resistant starch

Inulin

Lactose

Palm kernel oil

inulin

Explanation

inulin

24. A dietitian can best evaluate a client's knowledge and ability to apply dietary modification by asking the client to:

Name five foods to avoid

Explain the new diet restrictions

Select an appropriate meal from the hospital menu

List all foods to avoid from memory

C--select foods from the menu

Explanation

C--select foods from the menu

25. Which of the following vitamins is responsible for capillary integrity and wound healing such that a deficiency may result in reddish-purple spots around hair follicles

B12

Niacin

Riboflavin

Vitamin C

Vitamin C!

Explanation

Vitamin C!

26. What is the correct nutrition diagnosis for a client who frequently eats in restaurants and has the following laboratory findings: BP 135/86 mmHg, fasting glucose 130mg/dl, total cholesterol 256 mg/dl, LDL cholesterol 192 mg/dl and HDL cholesterol 34 mg/dl?

Limited access to food

Excessive oral food/beverage intake

Impaired ability to prepare food/meals

Altered nutrition-related laboratory values

D altered nutrition related lab values

Explanation

D altered nutrition related lab values

27. What is the formula for Respiratory Quotient?

0.8/0.7

PCO2/P02

VCO2/V02

HCO3/CO2

VCO2/VO2

Explanation

VCO2/VO2

28. One month ago, a patient began receiving parenteral nutrition that delivers 2300 kcal per day. Since then, the patient has experienced unintentional weight gain. Which of the following formulas is the best choice?

1800ml of 25% dextrose and 5% amino acids plus 250ml of 20% lipids

1800ml of 20% dextrose and 5% amino acids plus 250ml of 20% lipids

1680ml of 25% dextrose and 5% amino acids plus 500ml of 20% lipids

1560ml of 20% dextrose and 5% amino acids plus 500ml of 20% lipids

go with the formula -lower caloric intake by 500 calories a day-then calculate the calorie content of the choices. B is correct

Explanation

go with the formula -lower caloric intake by 500 calories a day-then calculate the calorie content of the choices. B is correct

29. What is the RQ for a mixed fuel utilization?

0.7

0.83

1.00

1.04

0.83

Explanation

0.83

30. A morbidly obese, ventilator dependent ICU patient has end stage renal disease, diabetes, and sacral decubiti. The number one concern in the enteral feeding recommendations is:

Increased Protein

Adequate Calories

Increased Electrolytes

Lower carbohydrates

The correct answer is B. Calories is correct -since the patient has endstage renal disease -adequate protein is best, not increased protein -but the body needs the correct amount of calories to recovery from illness.

Explanation

The correct answer is B. Calories is correct -since the patient has endstage renal disease -adequate protein is best, not increased protein -but the body needs the correct amount of calories to recovery from illness.

31. Which enteral product is the best choice for a patient diagnosed with pancreatitis

Jevity or a fiber containing formula

Peptamen or an elemental formula

NPO

TPN

elemental !

Explanation

elemental !

32. A patient who receives bolus tube feedings experience abdominal distention shortly after feeding, most likely related to>

Feeding volume

Formula osmolarity

Formula osmolality

High fat content in feeding product

A- the volume!

Explanation

A- the volume!

33. A patient with diabetic gastroparesis diet should avoid foods that are

High in simple sugars

Low in protein

Low in fiber

High in fat

fat is the correct answer--fat slows gastric emptying further compounding the issue

Explanation

fat is the correct answer--fat slows gastric emptying further compounding the issue

34. During a counseling session about lowering sodium, the client states " I have begun reading labels to identify the sodium content of foods" The client is in which of the following stages of change?

Pre-contemplation

Contemplation

Preparation

Action

Correct answer is C-preparation.

Explanation

Correct answer is C-preparation.

35. A patient with chronic kidney disease on hemodialysis has the following laboratory test results: BUN =50 mg/dl albumin=2.8g/dl and calcium 8mg/dl. What recommendations should the dietitian make to improve these lab values

Decrease fluid intake

Increase protein intake

Use a calcium supplement

Increase the amount of phosphate binders

Patient needs more protein to boost albumin levels

Explanation

Patient needs more protein to boost albumin levels

36. To calculate the estimated calorie needs of a patient who is significantly underweight, the dietitian should use:

A. Actual body weight

B. Adjusted body weight

C. Desired body weight

D. Usual body weight

A-actual body weight

Explanation

A-actual body weight

37. A 53 year old obese male with a FBG=115 mg/dl has been diagnosed with pre-diabetes. The dietitian should focus first on which of the following nutrition interventions?

Increase protein intake

Increase fiber intake.

Weight loss.

Decrease carbohydrate intake.

Weight loss is the correct answer and the best choice

Explanation

Weight loss is the correct answer and the best choice

38. What is the highest acceptable range for the dextrose infusion rate in adults on PN

4-6mg/kg/min

10-12mg/kg/min

2-3mg/kg/min

8-10mg/kg/min

A is the correct answer. This is a straight forward "known fact" type question

Explanation

A is the correct answer. This is a straight forward "known fact" type question

39. A dietitian who is counseling the mother of a child with eating difficulties has evaluated needs and decided on the best alternatives for feeding. The dietitian should next:

Evaluate the mother's level of comprehension

Instruct the mother in various feeding approaches

Obtain a list of the child's food preferences and typical eating patterns

Review with the mother the ways to implement the recommended feeding practices

The correct answer is D. For this question, follow the nutrition care process-you have completed assessment, diagnosis and now you are in the intervention component. Avoid answers with the words like "instruct". As dietitians it is all about involvement with the patient or family. Review implies that we included the mother in the process.

Explanation

The correct answer is D. For this question, follow the nutrition care process-you have completed assessment, diagnosis and now you are in the intervention component. Avoid answers with the words like "instruct". As dietitians it is all about involvement with the patient or family. Review implies that we included the mother in the process.

40. A food borne illness often associated with deli meats that has an onset time of 3 to 7 days, causing nausea, vomiting, headache, chills, backache and meningitis, with a high fatality in the immune compromised is:

Clostridium perfringens

Shigella

Staphlococcus aureous

Listeria moncytogenes

Listeria!!!

Explanation

Listeria!!!

41. A female patient with newly diagnosed diabetes is 65 inches tall and weighs 212 pounds. Exam and lab values reveal the following : BP level of 145/95 mmHg, fasting BG level of 150 mg/dl with a 2 hours post prandial glucose of < 200mg/dl and a cholesterol of 250 mg/dl. What is the dietitian's first most appropriate intervention?

Counsel the client on the DASH diet

Advise the client to reduce their caloric intake

Educate the client on carb counting

Calculate a meal plan with very low carbohydrates

C is the correct answer. carb counting the key to this question is "newly diagnosed "

Explanation

C is the correct answer. carb counting the key to this question is "newly diagnosed "

42. What diet is typically recommended for a patient who has undergone a gastrectomy

Carbohydrate, protein and fat at each meal and no dairy products

Low-fiber foods and adequate fluids with meals

High-fiber food and restriction of fluids with meals

Carbohydrate, protein and fat at each meal, and restriction of fluids with meals.

D is the answer balanced diet and no fluid with the meals. The other restrictions are not needed.

Explanation

D is the answer balanced diet and no fluid with the meals. The other restrictions are not needed.

43. Which enteral feeding product would you recommend for a patient who is sedated and ventilated due to complications of the flu and pneumonia

Peptamen or elemental

Jevity or fiber containing

Impact- a specialty product

Ensure-oral supplement

B-Jevity will work fine

Explanation

B-Jevity will work fine

44. Skinfold thickness would be most appropriate for which of the following population groups?

An 18 month old toddler with failure to thrive

A 36 year old elite athlete

A 54 year old male with significant weight loss

An 82 year old female with type 1 diabetes

the athlete is the best answer--body composition is useful in identifying areas for performance improvement

Explanation

the athlete is the best answer--body composition is useful in identifying areas for performance improvement

45. A patient has dysphagia. Which food meets the nectar consistency requirement in a diet

Pudding

Yogurt

Strained cream soup

Cherry jello

C-soup is the best choice

Explanation

C-soup is the best choice

46. Which of the following types of enteral nutrition is recommended for patients who will need enteral nutrition for more than 4 weeks after undergoing an esophagectomy?

Nasogastric

Gastrostomy

Jejunostomy

Nasojejunal

Jejunostomy--key is the type of surgery "esophagectomy"

Explanation

Jejunostomy--key is the type of surgery "esophagectomy"

47. A 42 year old female who is 70 inches tall - needs how many grams of protein a day?

70

100

50

60

Answer is 60 gms of protein a day

Explanation

Answer is 60 gms of protein a day

48. Which of the following does not occur in diabetic ketoacidosis

Incomplete breakdown of fatty acids

Dehydration.

Decreased blood levels of counterregulatory hormones such as epinephrine.

Loss of bicarbonate buffer in the blood.

straight forward pathophysiology knowledge. counterregulatory hormones increase

Explanation

straight forward pathophysiology knowledge. counterregulatory hormones increase

49. A dietitian should consider the absorption of which nutrient associated with peritoneal dialysis.

Potassium

Carbohydrates

Protein

Fat soluble vitamins

Dextrose is used in the dialysis solution for osmosis in order to pull the electrolytes and protein out of the peritoneal fluid.

Explanation

Dextrose is used in the dialysis solution for osmosis in order to pull the electrolytes and protein out of the peritoneal fluid.

50. Which food is acceptable on a pureed nectar thick liquid diet?

Vegetable soup

Ice cream

Compleat enteral product

Canned peaches cut up into bite size pieces

C-Compleat enteral product-know the enteral products!

Explanation

C-Compleat enteral product-know the enteral products!