CDR Registered Dietitian (RD) Exam Flashcards

Q: How is the CDR Registered Dietitian (RD) exam scored?

The RD exam is computer-adaptive and reported on a scaled score from 1 to 50. A scaled score of 25 is the passing standard. The adaptive engine selects questions based on your responses, so the exam ends when it can reliably determine a pass or fail, typically between 125 and 145 questions including unscored pretest items.

Q: What are the four content domains on the RD exam and their weights?

The CDR RD test specifications cover four domains: Principles of Dietetics (21%), Nutrition Care for Individuals and Groups (45%), Management of Food and Nutrition Programs and Services (21%), and Foodservice Systems (13%). Nutrition Care is the largest domain, so medical nutrition therapy, assessment, and counseling deserve the most study time.

Q: How long is the RD exam and how many questions does it have?

Candidates have 2.5 hours of testing time within a 3-hour appointment. The exam delivers between 125 and 145 multiple-choice questions, a range that varies because the test is computer-adaptive and includes unscored pretest items that do not count toward your score.

Q: What is the difference between RD and RDN credentials?

RD (Registered Dietitian) and RDN (Registered Dietitian Nutritionist) are interchangeable credentials issued by CDR. The RDN designation was introduced in 2013 to emphasize the nutrition expertise of the profession. Both require the same exam, education, and supervised practice; practitioners may use either set of initials.

Q: What are the eligibility requirements to sit for the RD exam?

Candidates must hold a graduate degree from a USDE-recognized accredited institution, complete ACEND-accredited didactic coursework, and finish an ACEND-accredited supervised practice pathway. CDR exam authorization is required before scheduling with Pearson VUE, and authorization expires after one year or after an exam attempt.

Q: Where is the RD exam administered and what does it cost?

The RD exam is delivered at Pearson VUE testing centers as a computer-based exam; remote proctoring is not offered. The exam fee is $250. Candidates who do not pass must reauthorize and submit a new fee, and CDR policy generally applies a 45-day wait before retesting.

Question 1

Nutrition Care Process (NCP)

Accepted Answer

The standardized four-step framework dietitians use: Assessment, Diagnosis, Intervention, and Monitoring/Evaluation (ADIME). It structures critical thinking and documentation so care is consistent and outcome-driven.

Question 2

PES statement

Accepted Answer

A nutrition diagnosis written as Problem related to Etiology as evidenced by Signs/symptoms. It links the diagnosis to its cause and the measurable data supporting it, guiding the intervention.

Question 3

Harris-Benedict vs. Mifflin-St Jeor equations

Accepted Answer

Both estimate resting/basal energy expenditure. Mifflin-St Jeor is now preferred for accuracy in healthy and overweight adults; Harris-Benedict is older and tends to overestimate needs.

Question 4

Respiratory quotient (RQ)

Accepted Answer

Ratio of CO2 produced to O2 consumed. Pure carbohydrate oxidation gives RQ near 1.0, fat near 0.7, and mixed substrate around 0.85. An RQ above 1.0 suggests overfeeding and lipogenesis.

Question 5

Subjective Global Assessment (SGA)

Accepted Answer

A bedside nutrition assessment tool rating patients as A (well-nourished), B (moderately/suspected malnourished), or C (severely malnourished) using history and physical exam rather than lab values alone.

Question 6

Why is serum albumin a poor marker of acute malnutrition?

Accepted Answer

Albumin has a long half-life (about 18-20 days) and falls mainly with inflammation, infection, and fluid shifts. It reflects illness severity more than nutritional status, so it is no longer a primary malnutrition criterion.

Question 7

Kwashiorkor vs. marasmus

Accepted Answer

Marasmus is severe energy/calorie deficiency causing wasting of muscle and fat without edema. Kwashiorkor features edema and fatty liver, classically linked to protein deficiency amid relatively maintained calories.

Question 8

Refeeding syndrome

Accepted Answer

Dangerous fluid and electrolyte shifts when feeding restarts in malnourished patients. Insulin drives phosphate, potassium, and magnesium into cells, causing hypophosphatemia, arrhythmias, and heart failure. Advance calories slowly and supplement thiamin.

Question 9

Carbohydrate counting for diabetes

Accepted Answer

One carbohydrate choice equals about 15 grams of carbohydrate. Patients match insulin to grams consumed; consistent carb intake stabilizes blood glucose better than focusing on sugar alone.

Question 10

HbA1c target for most adults with diabetes

Accepted Answer

A general goal is below 7%, reflecting average glucose over roughly the prior 2-3 months. Targets are individualized; tighter or looser goals apply based on age, comorbidities, and hypoglycemia risk.

Question 11

Glycemic index vs. glycemic load

Accepted Answer

Glycemic index ranks how fast a carbohydrate raises blood glucose. Glycemic load multiplies that index by the actual grams of carbohydrate in a serving, giving a more practical measure of glucose impact.

Question 12

Medical nutrition therapy for chronic kidney disease (pre-dialysis)

Accepted Answer

Restrict protein (often around 0.6-0.8 g/kg), sodium, potassium, and phosphorus to slow progression and reduce uremia. Energy needs stay adequate to prevent catabolism of body protein.

Question 13

How do protein needs change once a CKD patient starts dialysis?

Accepted Answer

Protein requirements increase (roughly 1.2 g/kg or more) because hemodialysis removes amino acids and increases catabolism. Fluid, potassium, and phosphorus are still restricted between treatments.

Question 14

DASH diet

Accepted Answer

Dietary Approaches to Stop Hypertension emphasizes fruits, vegetables, whole grains, low-fat dairy, and limited sodium (often under 2,300 mg, ideally 1,500 mg). It lowers blood pressure and supports heart health.

Question 15

Nutrition therapy for celiac disease

Accepted Answer

Strict lifelong avoidance of gluten (wheat, barley, rye). Even small cross-contamination triggers intestinal damage. Monitor for iron, folate, calcium, and vitamin D deficiencies from prior malabsorption.

Question 16

Low-FODMAP diet

Accepted Answer

A staged elimination of fermentable oligo-, di-, monosaccharides and polyols used for irritable bowel syndrome. Trigger foods are removed, then systematically reintroduced to identify individual tolerances.

Question 17

Dumping syndrome management

Accepted Answer

Common after gastric surgery. Eat small, frequent meals; separate fluids from solids; limit simple sugars; and increase soluble fiber and protein to slow gastric emptying and prevent rapid glucose swings.

Question 18

Enteral nutrition

Accepted Answer

Feeding through the functioning GI tract via a tube (NG, NJ, PEG, or jejunostomy). Preferred over parenteral when the gut works because it preserves gut integrity and lowers infection risk.

Question 19

When is parenteral nutrition (PN) indicated over enteral?

Accepted Answer

When the GI tract is nonfunctional, inaccessible, or must rest, such as bowel obstruction, short bowel syndrome, severe ileus, or intractable vomiting. Nutrients are delivered intravenously, bypassing digestion.

Question 20

Central vs. peripheral parenteral nutrition

Accepted Answer

Central PN (TPN) uses a large central vein and tolerates high dextrose concentrations and osmolarity for long-term needs. Peripheral PN uses a smaller vein, limits concentration, and suits short-term, lower-need cases.

Question 21

Nitrogen balance

Accepted Answer

Nitrogen intake minus nitrogen losses. Positive balance means anabolism (growth, healing); negative balance means catabolism (stress, starvation). Estimate intake as protein grams divided by 6.25.

Question 22

Why is thiamin given before glucose to malnourished or alcohol-dependent patients?

Accepted Answer

Glucose metabolism consumes thiamin. Giving carbohydrate first to a thiamin-deficient patient can precipitate Wernicke encephalopathy, an acute neurologic emergency. Thiamin must be replaced first.

Question 23

Fat-soluble vitamins

Accepted Answer

Vitamins A, D, E, and K. They are stored in fat and the liver, require dietary fat and bile for absorption, and can reach toxic levels because the body does not readily excrete excess.

Question 24

Vitamin B12 deficiency and pernicious anemia

Accepted Answer

B12 absorption requires intrinsic factor from gastric parietal cells. Autoimmune loss of intrinsic factor causes pernicious anemia, presenting as macrocytic anemia plus neurologic symptoms like paresthesias.

Question 25

Folate vs. B12 in macrocytic anemia

Accepted Answer

Both cause megaloblastic anemia. Folate supplementation can correct the anemia but masks B12 deficiency while neurologic damage progresses. Always rule out B12 deficiency before giving folate alone.

Question 26

Iron absorption enhancers and inhibitors

Accepted Answer

Vitamin C and acidic environments enhance non-heme iron absorption. Phytates, tannins (tea/coffee), calcium, and high fiber inhibit it. Heme iron from animal sources is absorbed more efficiently than non-heme iron.

Question 27

Calcium and vitamin D relationship

Accepted Answer

Vitamin D is required to absorb dietary calcium from the intestine. Without adequate vitamin D, calcium absorption drops sharply, increasing risk of rickets in children and osteomalacia or osteoporosis in adults.

Question 28

Normal fasting blood glucose range

Accepted Answer

About 70-99 mg/dL is normal. Impaired fasting glucose is 100-125 mg/dL (prediabetes), and 126 mg/dL or higher on repeat testing indicates diabetes.

Question 29

Why monitor potassium closely during refeeding and renal disease?

Accepted Answer

Normal serum potassium is about 3.5-5.0 mEq/L. Both hyperkalemia and hypokalemia disrupt cardiac rhythm. Refeeding drives potassium intracellularly, while failing kidneys retain it, so diet and labs must be tracked.

Question 30

Estimated Average Requirement (EAR) vs. Recommended Dietary Allowance (RDA)

Accepted Answer

EAR meets the needs of 50% of a population and is used to assess group adequacy. RDA, set about two standard deviations above EAR, meets the needs of 97-98% of individuals and guides individual intake goals.

Question 31

Tolerable Upper Intake Level (UL)

Accepted Answer

The highest daily nutrient intake unlikely to cause adverse health effects in almost all people. Intake above the UL raises the risk of toxicity, which is most relevant for supplements and fortified foods.

Question 32

Acceptable Macronutrient Distribution Range (AMDR)

Accepted Answer

Recommended percentage of total calories from each macronutrient: carbohydrate 45-65%, fat 20-35%, and protein 10-35%. Staying within these ranges supports adequate intake while reducing chronic disease risk.

Question 33

Danger zone for food temperatures

Accepted Answer

40°F to 140°F (4°C to 60°C). Bacteria multiply rapidly in this range. The FDA Food Code limits total time in the danger zone to 4 hours of cumulative exposure.

Question 34

Safe minimum internal cooking temperature for poultry

Accepted Answer

165°F (74°C) for poultry, stuffing, and reheated leftovers, held for the required time. Ground meats reach 155-160°F, whole cuts of beef/pork 145°F with rest, and fish 145°F.

Question 35

HACCP

Accepted Answer

Hazard Analysis and Critical Control Points, a preventive food safety system. It identifies biological, chemical, and physical hazards and sets critical control points (like cooking and cooling temps) with monitored limits.

Question 36

Two-stage cooling rule (FDA Food Code)

Accepted Answer

Cool hot food from 135°F to 70°F within 2 hours, then from 70°F to 41°F within an additional 4 hours, for a 6-hour total. This limits the time pathogens can grow during cooling.

Question 37

FIFO inventory method

Accepted Answer

First In, First Out: use older stock before newer stock by storing newest deliveries behind existing inventory. It reduces spoilage and waste and ensures food is used before expiration.

Question 38

How do you convert a recipe using a conversion factor?

Accepted Answer

Conversion factor = desired yield divided by original yield. Multiply each ingredient amount by this factor. For example, scaling 25 servings to 100 uses a factor of 4.

Question 39

Edible portion (EP) vs. as-purchased (AP) weight

Accepted Answer

AP is the weight bought including trim and waste; EP is the usable weight after preparation. Yield percentage = EP divided by AP. Purchasing uses AP, while recipes and portioning use EP.

Question 40

Food cost percentage

Accepted Answer

Food cost divided by menu selling price, expressed as a percent. If a dish costs $3 to produce and sells for $12, the food cost percentage is 25%. Lower percentages mean higher gross margin.

Question 41

Cook-chill production system

Accepted Answer

Food is fully cooked, rapidly chilled, stored cold, then reheated near service. It separates production from service, improving labor scheduling and food safety when cooling and reheating rules are followed.

Question 42

Conventional vs. commissary foodservice systems

Accepted Answer

Conventional prepares and serves food in the same facility. A commissary centralizes production at one site and distributes to multiple satellite locations, gaining economies of scale but requiring transport controls.

Question 43

Cross-contamination

Accepted Answer

Transfer of harmful microbes from one food, surface, or person to ready-to-eat food. Prevent it by separating raw and cooked foods, using color-coded boards, and proper handwashing and sanitizing.

Question 44

SMART goals in nutrition counseling

Accepted Answer

Specific, Measurable, Achievable, Relevant, and Time-bound. Framing patient goals this way (for example, walk 30 minutes 5 days a week for 4 weeks) improves accountability and behavior change.

Question 45

Motivational interviewing

Accepted Answer

A client-centered counseling style that strengthens a person's own motivation for change by exploring ambivalence. It uses open questions, affirmations, reflective listening, and summaries rather than direct persuasion.

Question 46

Stages of change (Transtheoretical Model)

Accepted Answer

Precontemplation, Contemplation, Preparation, Action, Maintenance, and sometimes Relapse. Matching interventions to a client's stage makes counseling more effective than pushing action before readiness.

Question 47

Continuous Quality Improvement (CQI) in dietetics management

Accepted Answer

An ongoing, data-driven process to improve services and outcomes, often using the Plan-Do-Study-Act (PDSA) cycle. It emphasizes incremental, measurable change rather than one-time fixes.

Question 48

Difference between a budget variance and a fixed cost

Accepted Answer

A fixed cost (like rent or salaried staff) stays constant regardless of volume. A budget variance is the difference between projected and actual figures, signaling whether operations met financial plans.

Question 49

Academy of Nutrition and Dietetics Code of Ethics

Accepted Answer

Sets professional standards built on principles of autonomy, beneficence, nonmaleficence, justice, and integrity. RDs must practice within their competence, avoid conflicts of interest, and protect client confidentiality.

Question 50

Scope of practice vs. standards of practice for RDs

Accepted Answer

Scope of practice defines what services an RD is legally and professionally authorized to perform. Standards of practice describe the expected level of competent care and performance within that scope.

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