Registered Dietitian Nutritionist Risk Assessment & Management 3 — Questions and Answers
Question 1: Which biochemical marker best reflects short-term changes in nutritional status over a 2–3 day period?
- Albumin
- Prealbumin (transthyretin) (Correct answer)
- Transferrin
- C-reactive protein
Correct answer: Prealbumin (transthyretin)
Prealbumin has a half-life of 2–3 days, making it the most sensitive biochemical marker for detecting rapid changes in nutritional status, though it is also affected by inflammation.
Question 2: A patient with heart failure is prescribed a 2,000 mg/day sodium restriction. Which food choice poses the greatest risk of exceeding this limit in a single meal?
- Fresh grilled salmon with steamed broccoli
- Canned tomato soup with crackers and deli turkey (Correct answer)
- Homemade vegetable stir-fry with olive oil
- Banana and low-fat Greek yogurt
Correct answer: Canned tomato soup with crackers and deli turkey
Canned soups, processed crackers, and deli meats are among the highest sources of hidden sodium, and this combination can easily exceed 1,500 mg in a single meal.
Question 3: When assessing aspiration risk in a patient with dysphagia, which IDDSI framework level represents minced and moist foods?
- Level 3
- Level 5
- Level 4
- Level 6 (Correct answer)
Correct answer: Level 6
IDDSI Level 6 represents minced and moist foods that require minimal chewing, are easily mashed with the tongue, and have particles no larger than 4mm.
Question 4: A 55-year-old patient has a 10-year cardiovascular risk of 18% calculated by the Pooled Cohort Equations. How should this result guide dietary counseling?
- Risk is too low to warrant dietary intervention
- Risk is borderline; recommend moderate dietary changes only
- Risk is high; aggressively target LDL through diet and lifestyle (Correct answer)
- Risk calculation is not applicable for dietary recommendations
Correct answer: Risk is high; aggressively target LDL through diet and lifestyle
A 10-year cardiovascular risk ≥7.5% is classified as intermediate-to-high, warranting aggressive therapeutic lifestyle changes including a heart-healthy diet targeting LDL reduction.
Question 5: Which practice poses the highest foodborne illness risk for immunocompromised oncology patients?
- Eating pasteurized cheese
- Consuming raw sprouts or unpasteurized juices (Correct answer)
- Drinking filtered tap water
- Eating well-cooked frozen vegetables
Correct answer: Consuming raw sprouts or unpasteurized juices
Raw sprouts harbor Salmonella and E. coli that survive rinsing, while unpasteurized juices carry Listeria and E. coli O157:H7, both extremely dangerous for immunocompromised patients.
Question 6: A registered dietitian notes that a hospitalized patient's serum sodium is 128 mEq/L. Which dietary strategy is appropriate while the medical team addresses the underlying cause?
- Encourage high sodium foods immediately
- Implement a fluid restriction as directed by the care team (Correct answer)
- Increase protein intake to correct sodium levels
- No dietary modifications are needed for hyponatremia
Correct answer: Implement a fluid restriction as directed by the care team
In dilutional hyponatremia, fluid restriction (often 500–1,000 mL/day) is the cornerstone management strategy to allow sodium concentration to normalize.
Question 7: Which tool is specifically designed to assess malnutrition risk in community-dwelling older adults?
- MUST (Malnutrition Universal Screening Tool)
- MNA (Mini Nutritional Assessment) (Correct answer)
- NRS-2002 (Nutritional Risk Screening)
- SGA (Subjective Global Assessment)
Correct answer: MNA (Mini Nutritional Assessment)
The Mini Nutritional Assessment (MNA) was specifically developed and validated for use in geriatric populations including community-dwelling, outpatient, and long-term care settings.
Registered Dietitian Nutritionist Risk Assessment & Management 3
Which biochemical marker best reflects short-term changes in nutritional status over a 2–3 day period?