RDN Scope of Practice 2 — Questions and Answers
Question 1: An RDN working in a hospital notices a patient's diet order appears medically contraindicated. What is the appropriate first action?
- Change the diet order directly in the chart
- Consult with the prescribing physician before making changes (Correct answer)
- Ignore the order if the patient is stable
- Contact the patient's family for permission to change the order
Correct answer: Consult with the prescribing physician before making changes
RDNs must collaborate with the prescribing physician before altering medical diet orders to ensure safe, coordinated care.
Question 2: Which of the following best describes medical nutrition therapy (MNT) as it falls within the RDN scope of practice?
- General healthy eating advice provided to the public
- Nutrition assessment and individualized intervention for diagnosed conditions (Correct answer)
- Selling dietary supplements to patients
- Prescribing medications to complement dietary changes
Correct answer: Nutrition assessment and individualized intervention for diagnosed conditions
MNT involves specialized nutrition assessment, diagnosis, and intervention for individuals with specific medical conditions, which is central to the RDN scope.
Question 3: An RDN is asked to provide nutrition counseling via telehealth to a client in another state. What must the RDN verify first?
- That the client owns a webcam
- Whether their licensure covers practice in the client's state (Correct answer)
- That the client has seen a physician in the past year
- Whether the client's insurance covers telehealth services
Correct answer: Whether their licensure covers practice in the client's state
Licensure is state-specific, so RDNs must confirm they are authorized to practice in the state where the client is located.
Question 4: Which scenario represents an RDN operating outside their scope of practice?
- Developing a gluten-free meal plan for a celiac patient
- Diagnosing irritable bowel syndrome based on dietary history (Correct answer)
- Recommending increased fiber intake for a constipated client
- Educating a diabetes patient on carbohydrate counting
Correct answer: Diagnosing irritable bowel syndrome based on dietary history
Diagnosing medical conditions is the scope of licensed physicians, not RDNs, even if diet history suggests a GI disorder.
Question 5: A patient refuses to follow the RDN's nutrition care plan. How should the RDN proceed?
- Discharge the patient from nutrition services immediately
- Document the refusal and explore barriers to adherence (Correct answer)
- Report the patient to the attending physician as non-compliant
- Modify the plan without discussing it with the patient
Correct answer: Document the refusal and explore barriers to adherence
Documenting the refusal and exploring barriers respects patient autonomy while maintaining professional accountability.
Question 6: Under the Nutrition Care Process, which step immediately follows nutrition assessment?
- Nutrition intervention
- Nutrition monitoring and evaluation
- Nutrition diagnosis (Correct answer)
- Nutrition education
Correct answer: Nutrition diagnosis
The Nutrition Care Process order is assessment → diagnosis → intervention → monitoring/evaluation.
Question 7: An employer asks an RDN to sign off on a nutrition protocol that the RDN believes is unsafe. What should the RDN do?
- Sign it to maintain employment
- Refuse and document concerns based on professional ethics (Correct answer)
- Ask a non-dietitian colleague to sign instead
- Implement the protocol and monitor for adverse outcomes
Correct answer: Refuse and document concerns based on professional ethics
RDNs are ethically and professionally obligated to refuse endorsing unsafe practices regardless of employer pressure.
RDN Scope of Practice 2
An RDN working in a hospital notices a patient's diet order appears medically contraindicated.
What is the appropriate first action?