Registered Dietitian Nutritionist Registered Dietitian Problem 3

Question 1

A patient on total parenteral nutrition (TPN) develops hyperglycemia. The RD should recommend:

Accepted Answer

Reducing dextrose concentration and adding insulin to the TPN bag if needed

Answer

Managing TPN-related hyperglycemia involves reducing dextrose load and adding insulin to the formulation to maintain blood glucose between 140–180 mg/dL.

Question 2

A breastfeeding mother asks how to increase her milk supply. Which dietary recommendation has the strongest evidence?

Accepted Answer

Ensure adequate caloric intake and hydration

Answer

Adequate caloric intake (approximately 500 extra kcal/day) and hydration are the most evidence-based dietary strategies to support milk production.

Question 3

Which carbohydrate counting approach is recommended for a type 1 diabetic patient using an insulin-to-carb ratio?

Accepted Answer

Count total carbohydrates including fiber in grams per meal

Answer

Total carbohydrate grams per meal are counted and matched to an individualized insulin-to-carb ratio to calculate mealtime insulin doses.

Question 4

A 78-year-old patient is at high fall risk with a BMI of 17.5. The RD's FIRST priority should be:

Accepted Answer

Conducting a comprehensive nutrition assessment to identify root causes of underweight

Answer

A comprehensive nutrition assessment must precede intervention to identify causes such as dysphagia, depression, or poverty-related food insecurity.

Question 5

The respiratory quotient (RQ) of a patient receiving a high-carbohydrate TPN formula is 1.2. This indicates:

Accepted Answer

Overfeeding with lipogenesis from excess carbohydrates

Answer

An RQ above 1.0 indicates de novo lipogenesis due to carbohydrate overfeeding, increasing CO2 production and respiratory burden.

Registered Dietitian Nutritionist Practice Test

Registered Dietitian Nutritionist Practice Test

Registered Dietitian Nutritionist Registered Dietitian Problem 3