A 52-year-old man with alcohol use disorder is admitted confused, with an unsteady, wide-based gait and horizontal nystagmus. Admission orders include IV dextrose 5% in water for hydration. What should the RDN recommend FIRST ?

Give IV thiamin before any dextrose-containing fluid is started

Start oral folic acid before the dextrose infusion is started

Give IV pyridoxine to correct the gait and eye-movement signs

Begin a high-calorie oral supplement three times a day with meals

An RDN is preparing an informed consent document for a trial testing a high-protein oral supplement in older adults after hip fracture. Which statement is a required element of the consent document?

Participation is voluntary and withdrawal carries no penalty

The participant agrees to complete every scheduled study visit

Results will be shared with the participant's family

The supplement is expected to shorten the hospital stay

A 45-year-old man has recurrent calcium oxalate kidney stones. His 24-hour urine shows a volume of 1.3 L and high oxalate with normal calcium. Since his last stone he has eliminated all dairy foods. Which recommendation is MOST appropriate?

Resume dairy with meals and drink enough to make 2.5 L of urine daily

Add 1,000 mg/day of vitamin C to acidify the urine and dissolve stones

Increase meat portions to replace the protein formerly supplied by dairy

Continue avoiding all dairy foods to lower urinary calcium excretion

A 72-year-old man with Parkinson's disease takes carbidopa-levodopa and notices "off" periods and worse rigidity after his large, high-protein lunch. Which recommendation is MOST appropriate?

Take levodopa 30–60 minutes before meals; shift most protein to dinner

Limit total daily protein to 0.5 g/kg to avoid transporter competition

Take levodopa together with the iron supplement to reduce stomach upset

Take levodopa with a high-protein meal to improve its absorption

A 61-year-old man with metastatic carcinoid tumor has chronic diarrhea and develops scaly, darkened dermatitis on his neck and the backs of his hands, along with new confusion. Which mechanism BEST explains these findings?

Tryptophan diverted to serotonin, limiting niacin synthesis

Excess serotonin blocking the activation of thiamin

Riboflavin malabsorption caused by rapid intestinal transit

Tumor uptake of pyridoxine, blocking heme synthesis

Parents of a healthy 6-month-old with no eczema or known food allergy want to introduce peanut, as their pediatrician advised. Which form is MOST appropriate?

Smooth peanut butter thinned with warm water or mixed into a purée

No peanut foods until 3 years of age to reduce allergy risk

A spoonful of thick smooth peanut butter offered straight from a spoon

Chopped peanuts sprinkled over soft-cooked vegetables

An RDN receives four referrals for outpatient MNT. Which Medicare Part B beneficiary qualifies for the MNT benefit?

A man with stage 4 CKD who is not yet receiving dialysis

A man with a BMI of 34 and no other chronic diagnoses

A woman on in-center hemodialysis three times a week

A woman with hyperlipidemia who takes a statin daily

Registered Dietitian (RD) Exam

Free RD Exam Practice Questions

10 sample questions for the Registered Dietitian (RD) Exam, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Nutrition Care for Individuals and Groups, Foodservice Systems.

Question 1 · Nutrition Care for Individuals and Groups
A 52-year-old man with alcohol use disorder is admitted confused, with an unsteady, wide-based gait and horizontal nystagmus. Admission orders include IV dextrose 5% in water for hydration. What should the RDN recommend FIRST?
- A.Start oral folic acid before the dextrose infusion is started
- B.Give IV thiamin before any dextrose-containing fluid is started
- C.Give IV pyridoxine to correct the gait and eye-movement signs
- D.Begin a high-calorie oral supplement three times a day with meals
Show answer and explanation
Answer: B. Give IV thiamin before any dextrose-containing fluid is started
Confusion, ataxia, and nystagmus in a person with heavy alcohol use suggest Wernicke encephalopathy; glucose metabolism consumes thiamin pyrophosphate, so giving dextrose first can precipitate or worsen the syndrome, and parenteral thiamin must come first. Folate deficiency is common in alcohol use but does not cause this triad, pyridoxine does not treat it, and adding calories before thiamin repletion carries the same risk as the dextrose.
Question 2 · Nutrition Care for Individuals and Groups
An RDN is preparing an informed consent document for a trial testing a high-protein oral supplement in older adults after hip fracture. Which statement is a required element of the consent document?
- A.The participant agrees to complete every scheduled study visit
- B.Results will be shared with the participant's family
- C.The supplement is expected to shorten the hospital stay
- D.Participation is voluntary and withdrawal carries no penalty
Show answer and explanation
Answer: D. Participation is voluntary and withdrawal carries no penalty
Federal human-subjects rules require consent documents to state that participation is voluntary and that refusing or withdrawing involves no penalty or loss of benefits to which the person is otherwise entitled. Promising a benefit misrepresents an unproven intervention, requiring completion of all visits conflicts with the right to withdraw, and sharing results with family would breach confidentiality without specific permission.
Question 3 · Nutrition Care for Individuals and Groups
A 45-year-old man has recurrent calcium oxalate kidney stones. His 24-hour urine shows a volume of 1.3 L and high oxalate with normal calcium. Since his last stone he has eliminated all dairy foods. Which recommendation is MOST appropriate?
- A.Add 1,000 mg/day of vitamin C to acidify the urine and dissolve stones
- B.Increase meat portions to replace the protein formerly supplied by dairy
- C.Resume dairy with meals and drink enough to make 2.5 L of urine daily
- D.Continue avoiding all dairy foods to lower urinary calcium excretion
Show answer and explanation
Answer: C. Resume dairy with meals and drink enough to make 2.5 L of urine daily
Dietary calcium (about 1,000–1,200 mg/day) taken with meals binds oxalate in the gut and lowers urinary oxalate, and a urine output of at least 2.5 L/day dilutes stone-forming solutes. Restricting calcium increases oxalate absorption and stone risk, vitamin C is metabolized to oxalate, and extra animal protein raises urinary calcium and uric acid while lowering citrate.
Question 4 · Nutrition Care for Individuals and Groups
A 72-year-old man with Parkinson's disease takes carbidopa-levodopa and notices "off" periods and worse rigidity after his large, high-protein lunch. Which recommendation is MOST appropriate?
- A.Limit total daily protein to 0.5 g/kg to avoid transporter competition
- B.Take levodopa 30–60 minutes before meals; shift most protein to dinner
- C.Take levodopa together with the iron supplement to reduce stomach upset
- D.Take levodopa with a high-protein meal to improve its absorption
Show answer and explanation
Answer: B. Take levodopa 30–60 minutes before meals; shift most protein to dinner
Large neutral amino acids compete with levodopa for intestinal and blood–brain barrier transport, so dosing before meals and redistributing protein toward the evening reduces motor fluctuations while maintaining adequate total protein. Taking it with protein worsens the problem, a 0.5 g/kg limit risks malnutrition, and iron chelates levodopa and lowers absorption.
Question 5 · Nutrition Care for Individuals and Groups
An RDN in outpatient practice provides a 60-minute initial, individual, face-to-face MNT visit to a Medicare Part B beneficiary with type 2 diabetes who was referred by the treating physician. How should the visit be billed?
- A.CPT 97804 × 2 units
- B.CPT 97802 × 4 units
- C.CPT 97803 × 4 units
- D.CPT 97802 × 1 unit
Show answer and explanation
Answer: B. CPT 97802 × 4 units
Code 97802 covers initial MNT assessment and intervention, individual, face-to-face, billed per 15 minutes, so a 60-minute visit is 4 units. Billing a single unit undercounts the time, 97803 is for reassessment and follow-up visits, and 97804 is for group MNT billed in 30-minute units.
Question 6 · Nutrition Care for Individuals and Groups
A 61-year-old man with metastatic carcinoid tumor has chronic diarrhea and develops scaly, darkened dermatitis on his neck and the backs of his hands, along with new confusion. Which mechanism BEST explains these findings?
- A.Tryptophan diverted to serotonin, limiting niacin synthesis
- B.Excess serotonin blocking the activation of thiamin
- C.Riboflavin malabsorption caused by rapid intestinal transit
- D.Tumor uptake of pyridoxine, blocking heme synthesis
Show answer and explanation
Answer: A. Tryptophan diverted to serotonin, limiting niacin synthesis
Carcinoid tumors can convert a large share of dietary tryptophan to serotonin, leaving little for endogenous niacin synthesis and producing pellagra (dermatitis on sun-exposed skin, diarrhea, dementia). Riboflavin deficiency causes cheilosis and glossitis, serotonin does not block thiamin activation, and pyridoxine depletion causes microcytic anemia and neuropathy rather than this photosensitive rash.
Question 7 · Nutrition Care for Individuals and Groups
Using the Academy's Evidence Analysis Library grading system, an expert workgroup finds that a conclusion is supported by several well-designed randomized controlled trials with consistent results, adequate sample sizes, and direct relevance to the question. What grade should the conclusion receive?
- A.Grade II: fair
- B.Grade IV: expert opinion only
- C.Grade III: limited/weak
- D.Grade I: good/strong
Show answer and explanation
Answer: D. Grade I: good/strong
Grade I (good/strong) is assigned when the evidence comes from studies of strong design, with consistent results, adequate sample sizes, and direct applicability. Grade II reflects studies with minor methodological concerns or some inconsistency, Grade III reflects few or weakly designed studies, and Grade IV applies when only expert opinion is available.
Question 8 · Nutrition Care for Individuals and Groups
A 29-year-old woman pregnant with a singleton is 5 ft 5 in tall and weighed 172 lb before pregnancy. According to IOM guidelines, what total gestational weight gain should the RDN recommend?
- A.15–25 lb
- B.25–35 lb
- C.11–20 lb
- D.28–40 lb
Show answer and explanation
Answer: A. 15–25 lb
Pre-pregnancy BMI = 172 × 703 ÷ 65² = 120,916 ÷ 4,225 ≈ 28.6, which is overweight (25.0–29.9), so the IOM range is 15–25 lb. The 25–35 lb range applies to normal-weight women, 11–20 lb to obesity (BMI ≥ 30), and 28–40 lb to underweight women.
Question 9 · Nutrition Care for Individuals and Groups
Parents of a healthy 6-month-old with no eczema or known food allergy want to introduce peanut, as their pediatrician advised. Which form is MOST appropriate?
- A.No peanut foods until 3 years of age to reduce allergy risk
- B.Smooth peanut butter thinned with warm water or mixed into a purée
- C.A spoonful of thick smooth peanut butter offered straight from a spoon
- D.Chopped peanuts sprinkled over soft-cooked vegetables
Show answer and explanation
Answer: B. Smooth peanut butter thinned with warm water or mixed into a purée
Peanut can be introduced with other complementary foods around 6 months, and it must be in an age-appropriate form such as thinned smooth peanut butter or peanut powder mixed into a purée. Thick peanut butter and whole or chopped peanuts are choking hazards for infants, and delaying introduction does not prevent allergy.
Question 10 · Nutrition Care for Individuals and Groups
An RDN receives four referrals for outpatient MNT. Which Medicare Part B beneficiary qualifies for the MNT benefit?
- A.A man with a BMI of 34 and no other chronic diagnoses
- B.A woman on in-center hemodialysis three times a week
- C.A man with stage 4 CKD who is not yet receiving dialysis
- D.A woman with hyperlipidemia who takes a statin daily
Show answer and explanation
Answer: C. A man with stage 4 CKD who is not yet receiving dialysis
The Medicare Part B MNT benefit covers beneficiaries with diabetes, non-dialysis chronic kidney disease, or a kidney transplant within the past 36 months, with a referral from the treating physician. Nutrition services for dialysis patients are included in the dialysis facility's ESRD payment rather than billed as MNT, and obesity alone and hyperlipidemia are not covered diagnoses for this benefit.

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