Registered Dietitian Nutritionist Registered Dietetic Technician Basic 3 — Questions and Answers
Question 1: Which type of dietary fiber is most effective at lowering LDL cholesterol by binding bile acids in the gut?
- Insoluble fiber (cellulose)
- Soluble fiber (beta-glucan, pectin) (Correct answer)
- Resistant starch
- Lignin
Correct answer: Soluble fiber (beta-glucan, pectin)
Soluble fibers like beta-glucan and pectin form a gel that binds bile acids, increasing their fecal excretion and lowering LDL cholesterol.
Question 2: A DTR is planning a menu for a patient with stage 3 chronic kidney disease (CKD) who is not on dialysis. Which nutrient requires the most careful restriction?
- Sodium only
- Phosphorus and potassium (Correct answer)
- Iron and zinc
- Vitamin C
Correct answer: Phosphorus and potassium
In CKD stages 3-4, phosphorus and potassium accumulate due to reduced renal excretion, requiring dietary restriction to prevent hyperphosphatemia and hyperkalemia.
Question 3: What is the Acceptable Macronutrient Distribution Range (AMDR) for carbohydrates in adults?
- 20-35% of total energy
- 45-65% of total energy (Correct answer)
- 55-75% of total energy
- 10-25% of total energy
Correct answer: 45-65% of total energy
The AMDR for carbohydrates in adults is 45-65% of total energy intake, as established by the Dietary Reference Intakes.
Question 4: Which condition is characterized by a deficiency of iron, folate, or vitamin B12 and produces abnormally large red blood cells?
- Iron-deficiency anemia
- Sickle cell anemia
- Megaloblastic anemia (Correct answer)
- Hemolytic anemia
Correct answer: Megaloblastic anemia
Megaloblastic anemia results from impaired DNA synthesis due to folate or B12 deficiency, producing large, immature red blood cells (megaloblasts).
Question 5: A DTR counseling a vegetarian client who avoids all animal products should emphasize combining which two plant foods to ensure complete protein intake?
- Fruits and vegetables
- Legumes and grains (Correct answer)
- Nuts and seeds alone
- Refined grains and sugar
Correct answer: Legumes and grains
Legumes are rich in lysine but low in methionine, while grains are the opposite; combining them provides all essential amino acids.
Question 6: During the nutrition care process, which step immediately follows nutrition assessment?
- Nutrition intervention
- Nutrition monitoring and evaluation
- Nutrition diagnosis (Correct answer)
- Implementation
Correct answer: Nutrition diagnosis
The Nutrition Care Process follows four steps: assessment, diagnosis, intervention, and monitoring/evaluation (ADIME).
Question 7: A DTR notices a patient's parenteral nutrition bag is cloudy and has visible particulates. What is the appropriate first action?
- Administer it immediately to avoid delays in nutrition support
- Discard the bag and notify the pharmacist and nurse (Correct answer)
- Filter the solution through a 0.22-micron filter before use
- Return it to room temperature and reassess in 30 minutes
Correct answer: Discard the bag and notify the pharmacist and nurse
A cloudy or particulate-containing PN solution indicates instability or contamination and must be discarded; the pharmacist and clinical team must be notified.
Registered Dietitian Nutritionist Registered Dietetic Technician Basic 3
Which type of dietary fiber is most effective at lowering LDL cholesterol by binding bile acids in the gut?