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CERTIFIED DIETARY MANAGER (CDM)
PRACTICE TEST
2026-2027 EDITION | 250+ QUESTIONS WITH
RATIONALES
# DOMAIN 1: NUTRITION AND MEDICAL NUTRITION THERAPY
### Question 1
A 78-year-old patient in a long-term care facility has been diagnosed with
dysphagia and is prescribed a mechanical soft diet with thickened liquids. Which
of the following meal selections is most appropriate for this patient?
A) Grilled chicken breast, steamed broccoli, and thin broth
B) Ground turkey with gravy, mashed potatoes, and pureed green beans
C) Roast beef slices, rice pilaf, and cream of mushroom soup
D) Baked salmon with lemon, roasted asparagus, and orange juice
**Correct Answer: B**
**Rationale:** A mechanical soft diet with thickened liquids requires foods that
are easy to chew and swallow. Ground turkey with gravy provides moist, easily
formed protein; mashed potatoes are smooth and require minimal chewing; and
pureed green beans eliminate texture that could pose a choking risk. This
combination reduces aspiration risk while providing adequate nutrition. Dysphagia
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diets are commonly implemented in long-term care facilities to prevent aspiration
pneumonia and malnutrition .
**Incorrect Answers:**
- **A. Grilled chicken breast, steamed broccoli, and thin broth** – Grilled chicken
breast is too tough for a mechanical soft diet, and thin broth does not meet
thickened liquid requirements. Broccoli is a high-risk food for choking.
- **C. Roast beef slices, rice pilaf, and cream of mushroom soup** – Roast beef
slices are too fibrous, and rice pilaf requires significant chewing. Cream of
mushroom soup may be acceptable but the other components are inappropriate.
- **D. Baked salmon with lemon, roasted asparagus, and orange juice** –
Asparagus is not appropriate for mechanical soft, and orange juice is a thin liquid
that should be thickened.
---
### Question 2
A Certified Dietary Manager is conducting a nutrition assessment on a new
resident. The resident's laboratory results show albumin 2.8 g/dL, prealbumin 12
mg/dL, and unintentional weight loss of 8% over the past 3 months. These findings
indicate:
A) Well-nourished status
B) Moderate malnutrition
C) Severe malnutrition
D) Obesity with protein sparing
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**Correct Answer: C**
**Rationale:** Severe malnutrition is indicated by albumin <3.0 g/dL, prealbumin
<15 mg/dL, and unintentional weight loss >5% over 1 month or >7.5% over 3
months. This resident has albumin of 2.8 g/dL (below 3.0), prealbumin of 12
mg/dL (below 15), and weight loss of 8% over 3 months, exceeding the 7.5%
threshold for severe malnutrition. This patient requires immediate nutrition
intervention .
**Incorrect Answers:**
- **A. Well-nourished status** – Well-nourished status would show albumin >3.5
g/dL, prealbumin >20 mg/dL, and stable weight. These labs indicate significant
malnutrition.
- **B. Moderate malnutrition** – Moderate malnutrition is indicated by weight
loss of 2-5% in 1 month or 5-7.5% in 3 months. This patient's weight loss exceeds
moderate criteria.
- **D. Obesity with protein sparing** – This is incorrect; the laboratory values
indicate protein-energy malnutrition, not protein sparing.
---
### Question 3
A resident with type 2 diabetes is on a consistent carbohydrate diet. The CDM is
reviewing the lunch menu and notes the following choices. Which selection is most
appropriate for this resident?
A) Breaded fried fish, French fries, corn, and sweet tea
B) Baked chicken breast, roasted sweet potatoes, green beans, and unsweetened tea
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C) Meatloaf with gravy, mashed potatoes, carrots, and fruit punch
D) Spaghetti with meat sauce, garlic bread, and regular soda
**Correct Answer: B**
**Rationale:** For a consistent carbohydrate diet, the meal should provide a
controlled amount of carbohydrates with balanced protein and healthy fat. Baked
chicken breast provides lean protein, roasted sweet potatoes provide complex
carbohydrates with fiber, and green beans are low-carbohydrate vegetables.
Unsweetened tea has no carbohydrates. This meal provides consistent
carbohydrates with good nutritional quality .
**Incorrect Answers:**
- **A. Breaded fried fish, French fries, corn, and sweet tea** – This meal contains
excessive carbohydrates (French fries, corn, sweet tea) and high saturated fat from
fried foods. Consistent carbohydrate diet requires controlled carbohydrate intake.
- **C. Meatloaf with gravy, mashed potatoes, carrots, and fruit punch** – Fruit
punch contains significant added sugar, and this meal has multiple high-
carbohydrate items without adequate vegetable variety.
- **D. Spaghetti with meat sauce, garlic bread, and regular soda** – This meal has
excessively high carbohydrate content from pasta, bread, and soda, which would
likely cause significant hyperglycemia.
---
### Question 4
A patient is placed on a low-sodium diet for congestive heart failure. The CDM
should ensure that the patient's meal contains less than:
CERTIFIED DIETARY MANAGER (CDM)
PRACTICE TEST
2026-2027 EDITION | 250+ QUESTIONS WITH
RATIONALES
# DOMAIN 1: NUTRITION AND MEDICAL NUTRITION THERAPY
### Question 1
A 78-year-old patient in a long-term care facility has been diagnosed with
dysphagia and is prescribed a mechanical soft diet with thickened liquids. Which
of the following meal selections is most appropriate for this patient?
A) Grilled chicken breast, steamed broccoli, and thin broth
B) Ground turkey with gravy, mashed potatoes, and pureed green beans
C) Roast beef slices, rice pilaf, and cream of mushroom soup
D) Baked salmon with lemon, roasted asparagus, and orange juice
**Correct Answer: B**
**Rationale:** A mechanical soft diet with thickened liquids requires foods that
are easy to chew and swallow. Ground turkey with gravy provides moist, easily
formed protein; mashed potatoes are smooth and require minimal chewing; and
pureed green beans eliminate texture that could pose a choking risk. This
combination reduces aspiration risk while providing adequate nutrition. Dysphagia
,2|Page
diets are commonly implemented in long-term care facilities to prevent aspiration
pneumonia and malnutrition .
**Incorrect Answers:**
- **A. Grilled chicken breast, steamed broccoli, and thin broth** – Grilled chicken
breast is too tough for a mechanical soft diet, and thin broth does not meet
thickened liquid requirements. Broccoli is a high-risk food for choking.
- **C. Roast beef slices, rice pilaf, and cream of mushroom soup** – Roast beef
slices are too fibrous, and rice pilaf requires significant chewing. Cream of
mushroom soup may be acceptable but the other components are inappropriate.
- **D. Baked salmon with lemon, roasted asparagus, and orange juice** –
Asparagus is not appropriate for mechanical soft, and orange juice is a thin liquid
that should be thickened.
---
### Question 2
A Certified Dietary Manager is conducting a nutrition assessment on a new
resident. The resident's laboratory results show albumin 2.8 g/dL, prealbumin 12
mg/dL, and unintentional weight loss of 8% over the past 3 months. These findings
indicate:
A) Well-nourished status
B) Moderate malnutrition
C) Severe malnutrition
D) Obesity with protein sparing
,3|Page
**Correct Answer: C**
**Rationale:** Severe malnutrition is indicated by albumin <3.0 g/dL, prealbumin
<15 mg/dL, and unintentional weight loss >5% over 1 month or >7.5% over 3
months. This resident has albumin of 2.8 g/dL (below 3.0), prealbumin of 12
mg/dL (below 15), and weight loss of 8% over 3 months, exceeding the 7.5%
threshold for severe malnutrition. This patient requires immediate nutrition
intervention .
**Incorrect Answers:**
- **A. Well-nourished status** – Well-nourished status would show albumin >3.5
g/dL, prealbumin >20 mg/dL, and stable weight. These labs indicate significant
malnutrition.
- **B. Moderate malnutrition** – Moderate malnutrition is indicated by weight
loss of 2-5% in 1 month or 5-7.5% in 3 months. This patient's weight loss exceeds
moderate criteria.
- **D. Obesity with protein sparing** – This is incorrect; the laboratory values
indicate protein-energy malnutrition, not protein sparing.
---
### Question 3
A resident with type 2 diabetes is on a consistent carbohydrate diet. The CDM is
reviewing the lunch menu and notes the following choices. Which selection is most
appropriate for this resident?
A) Breaded fried fish, French fries, corn, and sweet tea
B) Baked chicken breast, roasted sweet potatoes, green beans, and unsweetened tea
, 4|Page
C) Meatloaf with gravy, mashed potatoes, carrots, and fruit punch
D) Spaghetti with meat sauce, garlic bread, and regular soda
**Correct Answer: B**
**Rationale:** For a consistent carbohydrate diet, the meal should provide a
controlled amount of carbohydrates with balanced protein and healthy fat. Baked
chicken breast provides lean protein, roasted sweet potatoes provide complex
carbohydrates with fiber, and green beans are low-carbohydrate vegetables.
Unsweetened tea has no carbohydrates. This meal provides consistent
carbohydrates with good nutritional quality .
**Incorrect Answers:**
- **A. Breaded fried fish, French fries, corn, and sweet tea** – This meal contains
excessive carbohydrates (French fries, corn, sweet tea) and high saturated fat from
fried foods. Consistent carbohydrate diet requires controlled carbohydrate intake.
- **C. Meatloaf with gravy, mashed potatoes, carrots, and fruit punch** – Fruit
punch contains significant added sugar, and this meal has multiple high-
carbohydrate items without adequate vegetable variety.
- **D. Spaghetti with meat sauce, garlic bread, and regular soda** – This meal has
excessively high carbohydrate content from pasta, bread, and soda, which would
likely cause significant hyperglycemia.
---
### Question 4
A patient is placed on a low-sodium diet for congestive heart failure. The CDM
should ensure that the patient's meal contains less than:
