RD Exam Practice Test

RD Exam Medical Nutrition Therapy Practice Questions

Medical Nutrition Therapy makes up 5 of every 50 questions on a Tigertest RD Exam practice test. Here are 10 of the 20 questions on it, each with the answer and the reason.

Updated 2026-11-10 by the Tigertest team. Based on the CDR Registration Examination for Dietitians test specifications. Original questions; 50 per test, weighted like the real exam. Not affiliated with the Commission on Dietetic Registration.

1. 1. A metabolically stable adult with stage 4 chronic kidney disease, not on dialysis and without diabetes, is seen. What protein intake do current KDOQI guidelines suggest?

   • A.0.2 to 0.3 g/kg a day
   • B.0.55 to 0.6 g/kg a day
   • C.1.0 to 1.2 g/kg a day
   • D.1.5 to 2.0 g/kg a day

   Answer: B. The 2020 KDOQI nutrition guideline suggests 0.55 to 0.6 g/kg a day (or 0.28 to 0.43 g/kg with keto acid analogues) for stable CKD stages 3 to 5 without dialysis. Dialysis raises needs to about 1.0 to 1.2 g/kg.

2. 2. A patient on maintenance hemodialysis has a serum phosphorus of 7.2 mg/dL. When should the phosphate binder be taken?

   • A.One hour before dialysis
   • B.On an empty stomach
   • C.At bedtime only
   • D.With meals and snacks

   Answer: D. Binders work by binding phosphorus from food in the gut, so they are taken with meals and snacks that contain phosphorus. Taken between meals they have nothing to bind.

3. 3. A patient with type 1 diabetes uses an insulin-to-carbohydrate ratio of 1 unit per 12 g. How much rapid-acting insulin covers a 72 g carbohydrate meal?

   • A.6 units
   • B.7 units
   • C.8 units
   • D.12 units

   Answer: A. Divide the meal's carbohydrate by the ratio: 72 / 12 = 6 units. Reading the ratio as 1 unit per 6 g would give 12 units, a dangerous overdose. Any correction dose for a high pre-meal glucose is added separately.

4. 4. A conscious adult's blood glucose is 58 mg/dL. What is the first step?

   • A.Give 2 units of insulin
   • B.Wait 30 minutes, then recheck it
   • C.Give 15 g fast-acting carbohydrate
   • D.Give a high-protein snack

   Answer: C. The 15-15 rule: give 15 g of glucose or other fast carbohydrate, recheck in 15 minutes and repeat if still below 70 mg/dL, then eat a snack or meal. Protein and fat slow the response.

5. 5. Which grain is safe for a patient with celiac disease?

   • A.Rye
   • B.Spelt
   • C.Buckwheat
   • D.Barley

   Answer: C. Despite its name, buckwheat is not wheat and is gluten-free, as are rice, corn, quinoa and millet. Barley, rye and spelt (a wheat) contain gluten; oats are safe only if certified uncontaminated.

6. 6. A child with phenylketonuria should avoid which sweetener?

   • A.Aspartame
   • B.Stevia leaf extract
   • C.Monk fruit extract
   • D.Sucralose

   Answer: A. Aspartame is broken down into phenylalanine, which people with PKU cannot metabolize. Products containing it carry a warning for phenylketonurics.

7. 7. A patient with cirrhosis has hepatic encephalopathy. What is the current advice on protein?

   • A.Animal protein only, 2 g/kg a day
   • B.Restrict it to 0.4 g/kg a day
   • C.Give no protein until alert
   • D.Do not restrict it; 1.2 to 1.5 g/kg

   Answer: D. Protein restriction worsens muscle loss and is no longer advised. Patients with cirrhosis need about 1.2 to 1.5 g/kg, with small frequent meals and a late-evening snack; lactulose treats the encephalopathy.

8. 8. A patient has diarrhea, cramping and flushing 20 minutes after meals following a gastric bypass. What diet change helps most?

   • A.More sweet desserts at night
   • B.Fewer sugars, fluids between meals
   • C.Add fruit juice with each meal
   • D.Eat three large meals a day

   Answer: B. Early dumping syndrome is caused by rapid emptying of concentrated sugars into the small bowel. Small meals with protein and fiber, few simple sugars and liquids taken 30 minutes apart from solids help.

9. 9. Which pattern of advice fits a patient with diabetic gastroparesis?

   • A.Raw vegetables with each meal
   • B.Small meals, low fat and fiber
   • C.Large meals high in fiber
   • D.High-fat meals twice a day

   Answer: B. Fat and fiber slow gastric emptying, and large meals sit longer. Small frequent low-fat, low-fiber meals, with liquid or pureed foods if needed, are the usual first step.

10. 10. A patient with Crohn's disease had most of the terminal ileum removed. Which vitamin will need lifelong monitoring and replacement?

    • A.Folate
    • B.Niacin
    • C.Vitamin C
    • D.Vitamin B12

    Answer: D. The terminal ileum is the only site of B12 absorption with intrinsic factor, so removal of more than about 60 cm usually requires injections or high-dose replacement. Bile salt losses also affect fat absorption.