Principles of Dietetics
21%of exam
Nutrition Care
45%of exam
Management Programs
21%of exam
Foodservice Systems
13%of exam
Quick Facts
- Exam
- CDR RD/RDN
- Vendor
- Pearson VUE
- Questions
- 125-145 MCQ
- Scored
- 100-120 scored
- Pretest
- 25 unscored
- Time
- 3 hours
- Pass
- Scaled 25/50
- Fee
- $250
- Auth
- One year
Research Errors
Type I sees; Type II misses
Type I: false positiveType II: false negative
Lab Picker
- Iron stores→Ferritin
- Iron transport→Transferrin
- Warfarin control→INR
- Long glucose→A1c
- Kidney function→eGFR
- Acute protein trend→Prealbumin
Exam Facts
- Outline
- 2022-2026 specs
- Minimum
- 125 questions
- Maximum
- 145 questions
- Pass score
- 25 scaled
- Review
- No backtracking
- Ordering
- Domains intermixed
- Score areas
- Advisory only
Nutrition Science
- AMDR carb
- 45-65%
- AMDR fat
- 20-35%
- AMDR protein
- 10-35%
- Thiamin
- Pyruvate cofactor
- Ferritin
- Iron storage
- Transferrin
- Iron transport
- CCK
- Bile, enzymes
- Intrinsic factor
- B12 absorption
Research + Education
- Mean
- Arithmetic average
- Median
- Middle value
- Mode
- Most frequent
- SD
- Data spread
- Type I
- False positive
- Type II
- False negative
- Preparation
- Change within month
- Action
- Changed under six months
Ethics + Practice
- Nonmaleficence
- Do no harm
- Autonomy
- Respect choice
- Beneficence
- Promote benefit
- Justice
- Fair treatment
- Scope
- Practice limits
- COI
- Disclose interests
- HIPAA
- Protect PHI
ADIME
Assess, Diagnose, Intervene, Monitor, Evaluate
A: dataD: PESI: planME: outcomes
Assessment vs Diagnosis
Assessment
- Collect data
- Anthros/labs/intake
- Reassess often
Diagnosis
- Name problem
- PES statement
- RDN-treatable
Data vs problem
MNT Picker
- Gut works→EN(Prefer enteral)
- Gut unusable→PN(IV nutrition)
- Celiac disease→Gluten-free(Wheat/barley/rye)
- Warfarin use→Vitamin K consistency
- Refeeding risk→Slow calories(Monitor phosphorus)
- Pancreatitis severe→Early EN(24-48 hours)
- Ascites→Sodium restriction
- Dialysis→Higher protein
NCP
- Assessment
- Collect data
- Diagnosis
- Name problem
- PES
- Problem, cause, proof
- Intervention
- Treat etiology
- Monitoring
- Track indicators
- Evaluation
- Judge progress
- Intake domain
- Consumption problems
- Clinical domain
- Medical conditions
PES
Problem related-to Etiology evidenced-by Signs
Problem: labelEtiology: causeSigns: proof
Nutrition vs Medical Diagnosis
Nutrition
- Intake/clinical/behavior
- RDN resolves
- PES format
Medical
- Disease label
- Provider diagnoses
- ICD condition
Nutrition problem vs disease
Assessment + Labs
- BMI
- Weight/height screen
- SGA
- History, physical
- NFPE
- Muscle, fat exam
- Albumin
- Inflammation marker
- Prealbumin
- Shorter half-life
- A1c
- Long-term glucose
- eGFR
- Kidney function
- INR
- Warfarin effect
EN vs PN
EN
- Functional gut
- Tube formula
- Maintains mucosa
PN
- Gut unusable
- IV formula
- Higher infection risk
Gut first
MNT
- Diabetes
- Carb consistency
- CKD 3-5
- Protein restrict
- Dialysis
- Protein increase
- Celiac
- Avoid gluten
- GERD
- Trigger control
- Pancreatitis
- Early EN
- Ascites
- Sodium restrict
- Warfarin
- Consistent vitamin K
Albumin vs Prealbumin
Albumin
- Long half-life
- Inflammation affected
- Poor nutrition marker
Prealbumin
- Shorter half-life
- Trends faster
- Still inflammation affected
Inflammation clouds both
Nutrition Support
- EN
- Gut works
- PN
- Gut unusable
- NG
- Short-term stomach
- PEG
- Long-term stomach
- J-tube
- Post-pyloric feeding
- Refeeding
- Low phosphorus
- Dumping
- Hyperosmolar intolerance
- Cycling PN
- Liver support
Management Cycle
Plan, organize, direct, control
Plan: goalsOrganize: resourcesDirect: peopleControl: standards
Mission vs Vision
Mission
- Current purpose
- Why exists
- Guides decisions
Vision
- Future aim
- Where going
- Aspirational direction
Now vs future
Formula Picker
- Labor yearly→FTE(2080 hours)
- Inventory speed→Turnover
- Food cost percent→Food cost/sales
- Usable food→EP yield
- Break-even volume→Fixed/contribution
- Productivity→Output/labor
Management
- Planning
- Set direction
- Organizing
- Arrange resources
- Directing
- Lead people
- Controlling
- Compare standards
- Mission
- Purpose now
- Vision
- Future state
- Policy
- Broad rule
- Procedure
- Step method
Finance + Quality
- Budget
- Financial plan
- Fixed cost
- Volume independent
- Variable cost
- Volume dependent
- Prime cost
- Food plus labor
- FTE
- 2080 hours/year
- Turnover
- COGS/avg inventory
- PDSA
- Quality cycle
- Benchmark
- Comparison standard
HR + Marketing
- Job analysis
- Work requirements
- Job description
- Duties, qualifications
- Orientation
- Initial onboarding
- Training
- Skill building
- Delegation
- Assign authority
- 4 Ps
- Product, price, place, promotion
- Target market
- Defined audience
Safety Temps
Cold 41 | Hot 135 | Reheat 165
Cold: <=41 FHot: >=135 FReheat: 165 F
AP vs EP
AP
- Purchase weight
- Includes waste
- Lower unit cost
EP
- Usable weight
- After trimming
- Higher unit cost
Bought vs usable
Safety Picker
- Prevent hazards→HACCP
- Control hazard→CCP
- Hot holding→135 F
- Cold holding→41 F
- Reheat leftovers→165 F
- Surface sanitizer→Test strips
Foodservice Systems
- Conventional
- Prepare onsite
- Commissary
- Central production
- Ready-prepared
- Cook, chill/store
- Assembly-serve
- Minimal preparation
- Standard recipe
- Consistent yield
- Production sheet
- Forecast quantities
- Menu
- Operations blueprint
Conventional vs Commissary
Conventional
- Onsite production
- Same-day service
- More local labor
Commissary
- Central kitchen
- Satellite service
- Transport required
Onsite vs central
Procurement + Production
- AP
- As purchased
- EP
- Edible portion
- Yield
- Usable percentage
- FIFO
- Oldest first
- Par stock
- Minimum inventory
- Reorder point
- Buy trigger
- Bid buying
- Competitive pricing
- Forecasting
- Predict demand
Sanitation + Safety
- HACCP
- Preventive controls
- CCP
- Critical control point
- TCS
- Time/temp control
- Danger zone
- 41-135 F
- Reheat
- 165 F, 15 sec
- Cool step 1
- 135 to 70
- Cool step 2
- 70 to 41
- Chlorine
- 50-100 ppm
Common Traps
Score areas
Subscores guide only ≠ Total score passes
Question review
Answer then advance ≠ No return later
NCP sequence
Assessment before diagnosis ≠ Intervention targets etiology
Labs
Albumin is inflammation ≠ Ferritin stores iron
Nutrition support
Use gut if possible ≠ PN when gut fails
Refeeding
Hypophosphatemia hallmark ≠ Start low, monitor
Foodservice cost
EP exceeds AP ≠ Waste raises cost
Cooling rule
135 to 70 first ≠ 70 to 41 next
Last Minute
- 1.Weights: 21 / 45 / 21 / 13
- 2.Minimum 125; maximum 145 questions
- 3.Pass = scaled 25
- 4.No skipping or backtracking
- 5.NCP = ADIME
- 6.PES = problem, cause, proof
- 7.Use EN when gut works
- 8.Refeeding = low phosphorus
- 9.Warfarin = consistent vitamin K
- 10.AP bought; EP usable
- 11.Cold 41; hot 135; reheat 165
- 12.Type I = false positive
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