Maryland Dietitian-Nutritionist
Licensing Exam Practice Questions And
Correct Answers (Verified Answers) Plus
Rationale 2026 Q&A| Instant Download
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1. A 52-year-old man with newly diagnosed type 2 diabetes mellitus
attends a nutrition counseling appointment after laboratory findings
reveal a fasting plasma glucose of 162 mg/dL and an HbA1c of 8.1%.
He reports consuming large portions of refined carbohydrates, sugar-
sweetened beverages, and fast food meals while leading a sedentary
lifestyle. The dietitian-nutritionist develops an individualized meal plan
emphasizing carbohydrate consistency, fiber intake, and caloric
moderation. Which of the following interventions is most appropriate
for improving glycemic control in this patient?
A. Encouraging unrestricted intake of fruit juices because they contain
natural sugars
B. Replacing refined grains with whole grains and increasing non-starchy
vegetable intake
C. Eliminating all carbohydrate-containing foods permanently from the diet
D. Increasing saturated fat intake to improve insulin sensitivity
B. Replacing refined grains with whole grains and increasing non-starchy
vegetable intake
Rationale: Whole grains and non-starchy vegetables provide dietary fiber,
promote satiety, improve postprandial glucose control, and support long-
,term glycemic management in patients with diabetes. Eliminating all
carbohydrates is unnecessary and potentially harmful, while excessive
saturated fat intake increases cardiovascular risk.
2. A dietitian is counseling a pregnant woman in her second trimester
who follows a strict vegan diet. The patient expresses concern about
obtaining adequate nutrients necessary for fetal development. Which
nutrient requires the greatest attention because of its limited
availability in plant-based diets and its essential role in neurologic
development?
A. Vitamin C
B. Potassium
C. Vitamin B12
D. Magnesium
C. Vitamin B12
Rationale: Vitamin B12 is found primarily in animal products and is
essential for neurologic function and red blood cell formation. Pregnant
women following vegan diets are at increased risk for deficiency and
generally require fortified foods or supplementation.
3. A hospitalized patient with severe pancreatitis is receiving enteral
nutrition through a nasojejunal feeding tube. The physician asks the
dietitian to recommend the most appropriate formula composition.
Which characteristic is most suitable for this patient’s nutritional
support?
A. High-fat polymeric formula with intact proteins
B. Elemental or semi-elemental formula with moderate fat restriction
C. Fiber-free formula containing only simple sugars
D. High-residue formula with concentrated saturated fats
B. Elemental or semi-elemental formula with moderate fat restriction
,Rationale: Patients with pancreatitis often tolerate elemental or semi-
elemental formulas better because these formulas require less digestive
effort. Moderate fat restriction helps reduce pancreatic stimulation while
still providing essential nutrients.
4. During a community nutrition assessment, a dietitian identifies a
neighborhood with limited access to grocery stores selling fresh
produce, lean proteins, and whole grains. Residents rely heavily on
convenience stores and fast-food restaurants. This situation is best
described by which term?
A. Nutritional ketosis
B. Food desert
C. Dietary supplementation
D. Macronutrient imbalance
B. Food desert
Rationale: A food desert refers to an area where residents have limited
access to affordable, nutritious foods such as fresh fruits, vegetables, and
whole grains. Such environments contribute to poor dietary quality and
increased chronic disease risk.
5. A patient with chronic kidney disease stage 4 is referred for medical
nutrition therapy. Laboratory findings reveal elevated serum
phosphorus and potassium levels. Which dietary recommendation is
most appropriate?
A. Increase intake of bananas, potatoes, and dairy products
B. Restrict foods high in potassium and phosphorus
C. Consume unrestricted protein to prevent muscle wasting
D. Encourage high sodium intake to maintain fluid balance
B. Restrict foods high in potassium and phosphorus
Rationale: Patients with advanced chronic kidney disease often have
impaired excretion of potassium and phosphorus, placing them at risk for
, hyperkalemia and hyperphosphatemia. Dietary restriction of these
minerals is an essential component of nutrition therapy.
6. A dietitian evaluating a patient’s anthropometric data calculates a
body mass index (BMI) of 32 kg/m². According to standard BMI
classifications for adults, this patient is categorized as:
A. Underweight
B. Normal weight
C. Overweight
D. Obese
D. Obese
Rationale: A BMI of 30 kg/m² or greater is classified as obesity in adults.
BMI is commonly used as a screening tool for weight-related health risks,
though additional assessments are often necessary.
7. A dietitian in a long-term care facility observes that several residents
experience unintentional weight loss, muscle wasting, and poor
wound healing. Which protein marker is most likely to decrease in
prolonged protein-energy malnutrition?
A. Hemoglobin A1c
B. Serum albumin
C. Serum sodium
D. Blood urea nitrogen
B. Serum albumin
Rationale: Serum albumin may decrease in prolonged protein-energy
malnutrition, although it is also influenced by inflammation and hydration
status. Poor protein intake contributes to impaired healing and muscle
wasting.
Licensing Exam Practice Questions And
Correct Answers (Verified Answers) Plus
Rationale 2026 Q&A| Instant Download
1. A 52-year-old man with newly diagnosed type 2 diabetes mellitus
attends a nutrition counseling appointment after laboratory findings
reveal a fasting plasma glucose of 162 mg/dL and an HbA1c of 8.1%.
He reports consuming large portions of refined carbohydrates, sugar-
sweetened beverages, and fast food meals while leading a sedentary
lifestyle. The dietitian-nutritionist develops an individualized meal plan
emphasizing carbohydrate consistency, fiber intake, and caloric
moderation. Which of the following interventions is most appropriate
for improving glycemic control in this patient?
A. Encouraging unrestricted intake of fruit juices because they contain
natural sugars
B. Replacing refined grains with whole grains and increasing non-starchy
vegetable intake
C. Eliminating all carbohydrate-containing foods permanently from the diet
D. Increasing saturated fat intake to improve insulin sensitivity
B. Replacing refined grains with whole grains and increasing non-starchy
vegetable intake
Rationale: Whole grains and non-starchy vegetables provide dietary fiber,
promote satiety, improve postprandial glucose control, and support long-
,term glycemic management in patients with diabetes. Eliminating all
carbohydrates is unnecessary and potentially harmful, while excessive
saturated fat intake increases cardiovascular risk.
2. A dietitian is counseling a pregnant woman in her second trimester
who follows a strict vegan diet. The patient expresses concern about
obtaining adequate nutrients necessary for fetal development. Which
nutrient requires the greatest attention because of its limited
availability in plant-based diets and its essential role in neurologic
development?
A. Vitamin C
B. Potassium
C. Vitamin B12
D. Magnesium
C. Vitamin B12
Rationale: Vitamin B12 is found primarily in animal products and is
essential for neurologic function and red blood cell formation. Pregnant
women following vegan diets are at increased risk for deficiency and
generally require fortified foods or supplementation.
3. A hospitalized patient with severe pancreatitis is receiving enteral
nutrition through a nasojejunal feeding tube. The physician asks the
dietitian to recommend the most appropriate formula composition.
Which characteristic is most suitable for this patient’s nutritional
support?
A. High-fat polymeric formula with intact proteins
B. Elemental or semi-elemental formula with moderate fat restriction
C. Fiber-free formula containing only simple sugars
D. High-residue formula with concentrated saturated fats
B. Elemental or semi-elemental formula with moderate fat restriction
,Rationale: Patients with pancreatitis often tolerate elemental or semi-
elemental formulas better because these formulas require less digestive
effort. Moderate fat restriction helps reduce pancreatic stimulation while
still providing essential nutrients.
4. During a community nutrition assessment, a dietitian identifies a
neighborhood with limited access to grocery stores selling fresh
produce, lean proteins, and whole grains. Residents rely heavily on
convenience stores and fast-food restaurants. This situation is best
described by which term?
A. Nutritional ketosis
B. Food desert
C. Dietary supplementation
D. Macronutrient imbalance
B. Food desert
Rationale: A food desert refers to an area where residents have limited
access to affordable, nutritious foods such as fresh fruits, vegetables, and
whole grains. Such environments contribute to poor dietary quality and
increased chronic disease risk.
5. A patient with chronic kidney disease stage 4 is referred for medical
nutrition therapy. Laboratory findings reveal elevated serum
phosphorus and potassium levels. Which dietary recommendation is
most appropriate?
A. Increase intake of bananas, potatoes, and dairy products
B. Restrict foods high in potassium and phosphorus
C. Consume unrestricted protein to prevent muscle wasting
D. Encourage high sodium intake to maintain fluid balance
B. Restrict foods high in potassium and phosphorus
Rationale: Patients with advanced chronic kidney disease often have
impaired excretion of potassium and phosphorus, placing them at risk for
, hyperkalemia and hyperphosphatemia. Dietary restriction of these
minerals is an essential component of nutrition therapy.
6. A dietitian evaluating a patient’s anthropometric data calculates a
body mass index (BMI) of 32 kg/m². According to standard BMI
classifications for adults, this patient is categorized as:
A. Underweight
B. Normal weight
C. Overweight
D. Obese
D. Obese
Rationale: A BMI of 30 kg/m² or greater is classified as obesity in adults.
BMI is commonly used as a screening tool for weight-related health risks,
though additional assessments are often necessary.
7. A dietitian in a long-term care facility observes that several residents
experience unintentional weight loss, muscle wasting, and poor
wound healing. Which protein marker is most likely to decrease in
prolonged protein-energy malnutrition?
A. Hemoglobin A1c
B. Serum albumin
C. Serum sodium
D. Blood urea nitrogen
B. Serum albumin
Rationale: Serum albumin may decrease in prolonged protein-energy
malnutrition, although it is also influenced by inflammation and hydration
status. Poor protein intake contributes to impaired healing and muscle
wasting.
