CDR RD Exam Questions

Page 2 of 50

21.

Three independent farmers agree to specifications for their seed ordering and make the purchase together. What type of purchasing does this illustrate?

  • Group buying

  • Cooperative purchasing

  • Centralized purchasing

  • Group purchasing organization

Correct answer: Group buying

Group buying is purchasing done by independent entities, as a group. The farmers are independent of each other and purchase together, so this illustrates group buying.

Cooperative purchasing is a group of buyers, within the same organization, coming together to make purchases. Since the farmers are independent, this is not cooperative purchasing.

Centralized purchasing is the control by one department of all purchasing in an organization, which allows for centralized management, cost-effectiveness, and time-savings. The farmers are not part of the same organization, so this is not an example of centralized purchasing.

A group purchasing organization (GPO) is an entity created to leverage the purchasing power of a group of businesses to obtain discounts from vendors. This is a common practice in the grocery, healthcare, electronics, industrial manufacturing, and agricultural industries. This is not a type of purchasing, but rather an organizational type.

22.

Camila is the owner and manager of a nutrition and fitness company, Nutritious Fitness. This week she is hosting a company-wide training session to provide information, ideas, and the latest research in sports nutrition to her employees. According to Mintzberg's theory, which managerial role category best describes Camila during the training?

  • Informational

  • Interpersonal

  • Decisional

  • Negotiator

Correct answer: Informational

Management expert and professor Henry Mintzberg argued there are ten primary roles that can be used to categorize a manager's different functions. The 10 roles are divided into 3 categories:

  1. Interpersonal: The managerial roles in this category include figurehead, leader, and liaison. The responsibilities of these roles include performing duties of a symbolic, legal, or social nature. This also includes evaluating subordinates and interacting with peers inside and outside the organization.
  2. Informational: The three informational roles of monitor, disseminator, and spokesperson characterize the manager as the central focus for receiving and sending of non-routine information. Given this scenario, where Camila is hosting a company-wide training session to provide information and the latest research in sports nutrition, she fits into the "informational" role category. Within this category, she specifically embodies the "disseminator" role, as she distributes valuable information to her employees.
  3. Decisional: The managerial roles in this category include entrepreneur, disturbance handler, resource allocator, and negotiator.  In these roles, the manager is involved in shaping the direction of the organization, resolving conflicts, allocating resources effectively, and ensuring that the organization can navigate its external environment through effective negotiation. 

Negotiator is a role under decisional, where you may be needed to take part in and direct important negotiations within your team, department, or organization.

23.

Which dietary recommendation is appropriate for an individual with Crohn’s disease?

  • Consume a high-calorie and high-protein diet

  • Take vitamin E and omega-3 supplements

  • Consume a high-fat diet when steatorrhea is present

  • Take anti-constipation medication regularly

Correct answer: Consume a high-calorie and high-protein diet

Crohn’s disease is a chronic inflammatory bowel disease that affects the lining of the digestive tract, typically the distal ileum and colon. Appropriate dietary recommendations for a person with Crohn’s disease include consuming a high-calorie and high-protein diet, taking vitamin D and vitamin B-12 supplementation, and eating a low-fat diet when steatorrhea is present. Since diarrhea and steatorrhea are more common side effects, anti-diarrhea medication is more likely to be recommended.

24.

Which of the following food programs provides grants for nutrition services?

  • ENP

  • SNAP

  • Medicare

  • NSLP

Correct answer: ENP

Grants are non-repayable funds or products given by one party (typically a government department, corporation, foundation, or trust) to a recipient (typically a nonprofit entity, educational institution, business, or individual). An example of a food program that provides grants is the Elderly Nutrition Program (ENP), which provides grants for nutrition support services.

Entitlement programs require payment and services to all eligible people that qualify as established by the law. Examples of these programs include SNAP, Medicare, NSLP, SFSP, and SBP.

25.

"Fruit-For-All" is a community nutrition program focused on increasing the accessibility of fresh fruits in low-income areas. Fruit-For-All is in the beginning stages of program development, and their community nutrition RD has conducted a needs assessment.

What is the next step the RD should take in program development?

  • Develop program goals and objectives

  • Develop a program plan

  • Identify funding sources

  • Seek support from stakeholders

Correct answer: Develop program goals and objectives

The steps of program development and planning are as follows:

  1. Conduct a needs assessment
  2. Develop program goals and objectives
  3. Develop a program plan
  4. Identify funding sources
  5. Seek support from stakeholders

26.

Which of the following was not involved in the creation of the Food Code?

  • Congress

  • Food and Drug Administration

  • Centers for Disease Control and Prevention

  • U.S. Department of Agriculture

Correct answer: Congress

The Food Code is not an act of Congress or a law. It is a reference document for city, state, county, and tribal agencies to use in the development of food safety regulations.

The Food Code was created by the Food and Drug Administration, the Centers for Disease Control and Prevention, and the U.S. Department of Agriculture.

27.

Which lipoprotein transports dietary cholesterol to cells?

  • LDL

  • VLDL

  • HDL

  • IDL

Correct answer: LDL

LDL transports cholesterol from the diet to all cells and is known as the number one transporter of cholesterol. 

VLDL transports endogenous triglycerides from the liver to adipose cells. HDL transports cholesterol from the liver to be excreted in reverse cholesterol transport and is known as the "good" cholesterol. IDL is the precursor to LDL that enables fats and cholesterol to move within the water-based solution of the bloodstream.

28.

Would you recommend the Feingold diet to a patient with hyperkinesis? Why or why not?

  • No, because the efficacy of the diet is not proven.

  • Yes, because sugar causes hyperactivity.

  • Yes, because artificial colors decrease attention span.

  • No, because consistent carbohydrate intake is important to control blood sugar.

Correct answer: No, because the efficacy of the diet is not proven.

Attention-deficit/hyperactivity disorder is a chronic condition of attention difficulty, hyperactivity, and impulsiveness. The Feingold diet is an elimination diet initially devised following research in the 1970s that appeared to link food additives with hyperactivity; it was thought that eliminating these additives and other various foods would alleviate the condition. However, the efficacy was not proven because positive results may be due to the placebo effect. Recent research (Lange et al, 2017) suggests it may be beneficial for those children who have sensitivities, but not for those who do not.

Sugar does not directly cause hyperactivity, and artificial colors do not directly decrease attention span. Consistent carbohydrate intake is important to control blood sugar for patients with diabetes.

29.

The director of the hospital has assigned you the responsibility of the creation of a complex work task. According to the PDCA model, what is the first step you should take?

  • Analyze the processes

  • Train and develop employees and management on how to use TQM

  • Establish methods to implement improvement

  • Take action to standardize the process

Correct answer: Analyze the processes

The PDCA (Plan Do Check Act) model is a plan for improvement. The first step is Plan, which includes the following parts:

  • Analyze the processes
  • Be open-minded and flexible
  • Brainstorm
  • Be selective
  • Be persistent
  • Listen to employees' problems regarding their jobs
  • Learn from others, particularly from the best
  • Establish the objectives and processes necessary to deliver results in accordance with the expected output

Train and develop employees and management on how to use TQM is part of Do.

Establish methods to implement improvement is part of Check.

Take action to standardize the process is part of Act.

30.

Which of the following people is most likely to not have nutrition information targeted to them?

  • 30-year-old healthy female

  • 40-year-old obese male

  • 15-year-old diabetic female

  • 70-year-old healthy male

Correct answer: 30-year-old healthy female

Healthy adults from 25 to 65 are the least likely to have nutrition education information targeted to them. Most nutrition education is aimed at individuals with chronic diseases, children, older adults, or individuals at risk of chronic disease.

31.

You are following up with a patient receiving enteral nutrition as their sole source of nutrition. The nursing staff notes that the patient has been passing hard, separate clumps of stool.

Which of the following would be an appropriate way to address this?

  • Change to a fiber-containing formula

  • Decrease the rate of the enteral feeding

  • Change to an elemental formula

  • Decrease the fluid flushes between feedings

Correct answer: Change to a fiber-containing formula

According to the Bristol Stool Chart, separate hard lumps of stool are an indication of severe constipation. Therefore, you need to address constipation in this patient. Using a fiber-containing formula and making sure fluids are adequate would be an appropriate way to address constipation. 

Therefore, decreasing fluid flushes between feedings would not be appropriate. Diarrhea in patients receiving enteral nutrition could be addressed by decreasing the rate of enteral feeding or, in some cases, using an elemental formula.

32.

Marcy is a 47-year-old female with metabolic syndrome, and over the past two years she has worked with a registered dietitian. She reports significant weight loss, a healthy eating style, and a better quality of life.

What is a potential direct nutrition outcome of medical nutrition therapy?

  • Increased high-density lipoprotein cholesterol by 2.4 mg/dL

  • Increased systolic blood pressure by 4.9 mm Hg

  • Increased triglycerides by 21 mg/dL to 35 mg/dL

  • Increased functionality of daily activities

Correct answer: Increased high-density lipoprotein cholesterol by 2.4 mg/dL

A direct nutrition outcome helps to evaluate the efficacy of a nutrition intervention. In adults with metabolic syndrome, research regarding the impact of medical nutrition therapy reported significant outcome improvements (NCM):

  • Decreased fasting blood glucose by 2.5 mg/dL to 9 mg/dL (0.1 mmol/L to 0.5 mmol/L)
  • Decreased hemoglobin A1c by 0.12% to 0.23%
  • Decreased triglycerides by 21 mg/dL to 35 mg/dL (0.2 mmol/L to 0.4 mmol/L)
  • Increased high-density lipoprotein cholesterol by 2.4 mg/dL (0.06 mmol/L)
  • Decreased body weight by 2.5 kg to 4.1 kg
  • Decreased waist circumference by 1.9 cm to 4.8 cm
  • Decreased systolic blood pressure by 4.9 mm Hg

33.

In motivational interviewing, which type of question is considered more restrictive and gives the dietitian less control over the conversation?

  • Closed

  • Open-ended

  • Neutral

  • Primary

Correct answer: Closed

Closed questions are more restrictive, limit the answers of the client , and give the dietitian less control.

Open-ended questions are the best types of questions to ask in motivational interviewing. They are broad and give the client more freedom to respond. Neutral questions are questions that do not reveal bias from the dietitian's side. Primary questions introduce new topics.

34.

Which of the following is an example of an endocrine gland?

  • Adrenal

  • Sweat

  • Gastric

  • Salivary

Correct answer: Adrenal

Endocrine glands release substances directly into the bloodstream or tissues. Examples of these glands include the thyroid, pituitary, and adrenal glands.

Exocrine glands release substances through ducts to the outside of the body. Examples of these glands include the sweat, gastric, and salivary glands.

35.

What type of budget includes estimates of cost for capital expenditures?

  • Master

  • Operating

  • Cash

  • Fixed

Correct answer: Master

Master budget: Includes at least the operating and capital budgets. In practice, this is a collection of several small budgets that together make up the operation's overall budget.

Operating budget: Includes at least revenues and expenses.

Cash budget: Helps determine if funds will be available when needed by the operation.

Capital budget: Includes estimates of cost for capital expenditures.

Fixed budgets are a method of establishing line item amounts, but they are not a distinct type of budget.

36.

A university posts a public announcement of goods and services they need, suppliers respond to these announcements by submitting bids, and then a final selection of the supplier is made. What type of purchasing method is this?

  • Competitive bid buying

  • Informal purchasing

  • Just-in-time purchasing

  • Open market purchasing

Correct answer: Competitive bid buying

Formal, competitive bid buying involves opening the procurement process to bids and tenders to obtain the best value.

Informal, open market purchasing is the purchase of goods usually in smaller quantities without contracts or negotiations. Just-in-time purchasing is the purchasing of products only as they are needed for production and consumption, in order to increase efficiency, decrease waste, and reduce inventory costs.

37.

Before providing nutrition advice to a client, what step should the dietitian take to make the client more receptive?

  • Ask the client's permission

  • Assess the client's current nutrition knowledge

  • Ask at least two patient identifiers

  • Give the client instructional materials

Correct answer: Ask the client's permission

Asking permission is a powerful strategy and places the client in an autonomous position, making them more receptive to incoming information. On the other hand, if the provider gives advice to the client without asking permission, or acts in a more authoritative way, the client may be less receptive, less engaged in learning, and may feel targeted or judged.

Although assessing the client's knowledge can be helpful before providing advice, the first step would be to ask permission. Asking at least two patient identifiers is a standard set by The Joint Commission to properly identify a patient and decrease wrong-patient clinical errors. For example, a dietitian can ask a patient their name and birth date before starting an assessment. Providing instructional materials can be a good takeaway for clients, but it should not be the first thing you do.

38.

Which of the following has the broadest definition for diagnosis?

  • Irritable bowel syndrome

  • Celiac disease

  • Crohn's disease

  • Lactose intolerance

Correct answer: Irritable bowel syndrome

IBS (irritable bowel syndrome) has been defined as "abdominal discomfort associated with altered bowel habits". There is no test for IBS, and it has become the diagnosis by elimination, meaning that IBS is often diagnosed when other conditions, such as Celiac disease, Crohn's disease, and lactose intolerance have been ruled out.

39.

Which of the following is not an example of being culturally competent?

  • Recognizing that all members of a cultural group share similar beliefs

  • Understanding and respecting the cultural meanings given to food

  • Understanding the environmental stressors experienced by your audience

  • Being aware of your own personal biases

Correct answer: Recognizing that all members of a cultural group share similar beliefs

Being culturally competent includes:

  • Being aware of your own personal biases
  • Being respectful of cultural differences
  • Obtaining relevant information about the culture you will be working with
  • Understanding and respecting the cultural meanings given to food
  • Understanding the environmental stressors experienced by your audience

It is important not to assume that all members of a cultural group share the same beliefs, as there may be differences within the group.

40.

If you worked overtime and did not get paid, which labor law would help your claim?

  • The Fair Labor Standards Act

  • The National Labor Relations Act

  • The Equal Pay Act

  • The Civil Rights Act

Correct answer: The Fair Labor Standards Act

The Fair Labor Standards Act (FLSA) is the primary federal labor law in the United States that governs issues related to minimum wage, overtime pay, child labor, and record-keeping. Under the FLSA, employees who work overtime (typically over 40 hours per week) are entitled to overtime pay, which is generally set at 1.5 times their regular hourly rate. If an employee works overtime and is not paid accordingly, they can file a claim under the FLSA.

The National Labor Relations Act, also known as the Wagner Act, guarantees employees the right to organize and join labor unions. The Equal Pay Act is a federal law that addresses pay equity and prohibits wage discrimination based on gender. The Civil Rights Act is a federal law that prohibits discrimination on the basis of race, color, religion, sex, or national origin.