Michigan Dietitian Specialty Exam
Practice Questions And Correct Answers
(Verified Answers) Plus Rationale 2026
Q&A| Instant Download Pdf
1. A patient with uncontrolled type 1 diabetes mellitus is admitted with
polyuria, polydipsia, and weight loss. Which of the following lab
findings is most consistent with diabetic ketoacidosis (DKA)?
A. Serum glucose 150 mg/dL, bicarbonate 28 mEq/L, pH 7.42
B. Serum glucose 600 mg/dL, bicarbonate 10 mEq/L, pH 7.15
C. Serum glucose 850 mg/dL, bicarbonate 8 mEq/L, pH 7.10
D. Serum glucose 250 mg/dL, bicarbonate 24 mEq/L, pH 7.38
DKA is characterized by severe hyperglycemia, metabolic acidosis
with low bicarbonate and low pH, making choice C the most
consistent with DKA.
2. A patient with celiac disease must avoid which of the following?
A. Rice
B. Barley
C. Corn
D. Quinoa
Barley contains gluten and must be avoided in celiac disease,
whereas rice, corn, and quinoa are gluten-free.
3. A 65-year-old patient with chronic kidney disease stage 4 (GFR ~20
mL/min) should have which dietary modification?
A. Increase protein to 1.5 g/kg
B. High sodium diet
C. Restrict phosphorus and moderate protein
D. High potassium diet
, In advanced CKD, protein intake is often moderated and phosphorus
restricted to lessen uremic symptoms and mineral disturbances.
4. Which of the following vitamins is most likely to be deficient in a
patient with bariatric surgery such as Roux-en-Y gastric bypass?
A. Vitamin C
B. Vitamin B12
C. Vitamin E
D. Vitamin K
Vitamin B12 deficiency is common after Roux-en-Y due to reduced
intrinsic factor and loss of absorption sites.
5. The primary goal of Medical Nutrition Therapy (MNT) for
hypertension is to:
A. Increase saturated fat intake
B. Encourage processed foods
C. Lower sodium and improve overall dietary pattern
D. Reduce water intake
MNT for hypertension focuses on lowering sodium and improving
dietary quality to help reduce blood pressure.
6. A lactating woman needs increased intake of which mineral compared
to non-pregnant, non-lactating women?
A. Iron
B. Sodium
C. Calcium
D. Phosphorus
Calcium needs increase slightly during lactation to support milk
production and maternal bone health.
7. The best indicator of long-term glycemic control in a patient with
diabetes is:
A. Fasting glucose
B. Postprandial glucose
C. Hemoglobin A1c
D. Random glucose
Hemoglobin A1c reflects average blood glucose over approximately 3
months and is the best indicator of long-term glycemic control.
, 8. A patient with phenylketonuria (PKU) must restrict which amino acid?
A. Tyrosine
B. Leucine
C. Phenylalanine
D. Methionine
PKU requires restriction of phenylalanine due to deficiency in its
metabolism.
9. A high nitrogen balance indicates:
A. Catabolic state
B. Anabolic state
C. Unchanged protein status
D. Negative protein synthesis
A positive nitrogen balance reflects an anabolic state with more
protein being retained than lost.
10. A 50-year-old patient with irritable bowel syndrome with
diarrhea (IBS-D) may benefit from limiting:
A. Fiber
B. FODMAPs
C. High-fat foods only
D. Protein
A low-FODMAP diet can reduce symptoms in IBS-D by decreasing
fermentable carbohydrates that cause gas and diarrhea.
11. A patient has been diagnosed with sarcopenia. The nutrition
recommendation includes:
A. Decrease protein intake
B. Increase high-quality protein and resistance exercise
C. Avoid strength training
D. Limit calories drastically
Managing sarcopenia includes adequate high-quality protein and
resistance exercise to preserve muscle mass.
12. The Dietary Approaches to Stop Hypertension (DASH) diet
emphasizes:
A. High saturated fat
B. Low potassium
C. Fruits, vegetables, low-fat dairy
Practice Questions And Correct Answers
(Verified Answers) Plus Rationale 2026
Q&A| Instant Download Pdf
1. A patient with uncontrolled type 1 diabetes mellitus is admitted with
polyuria, polydipsia, and weight loss. Which of the following lab
findings is most consistent with diabetic ketoacidosis (DKA)?
A. Serum glucose 150 mg/dL, bicarbonate 28 mEq/L, pH 7.42
B. Serum glucose 600 mg/dL, bicarbonate 10 mEq/L, pH 7.15
C. Serum glucose 850 mg/dL, bicarbonate 8 mEq/L, pH 7.10
D. Serum glucose 250 mg/dL, bicarbonate 24 mEq/L, pH 7.38
DKA is characterized by severe hyperglycemia, metabolic acidosis
with low bicarbonate and low pH, making choice C the most
consistent with DKA.
2. A patient with celiac disease must avoid which of the following?
A. Rice
B. Barley
C. Corn
D. Quinoa
Barley contains gluten and must be avoided in celiac disease,
whereas rice, corn, and quinoa are gluten-free.
3. A 65-year-old patient with chronic kidney disease stage 4 (GFR ~20
mL/min) should have which dietary modification?
A. Increase protein to 1.5 g/kg
B. High sodium diet
C. Restrict phosphorus and moderate protein
D. High potassium diet
, In advanced CKD, protein intake is often moderated and phosphorus
restricted to lessen uremic symptoms and mineral disturbances.
4. Which of the following vitamins is most likely to be deficient in a
patient with bariatric surgery such as Roux-en-Y gastric bypass?
A. Vitamin C
B. Vitamin B12
C. Vitamin E
D. Vitamin K
Vitamin B12 deficiency is common after Roux-en-Y due to reduced
intrinsic factor and loss of absorption sites.
5. The primary goal of Medical Nutrition Therapy (MNT) for
hypertension is to:
A. Increase saturated fat intake
B. Encourage processed foods
C. Lower sodium and improve overall dietary pattern
D. Reduce water intake
MNT for hypertension focuses on lowering sodium and improving
dietary quality to help reduce blood pressure.
6. A lactating woman needs increased intake of which mineral compared
to non-pregnant, non-lactating women?
A. Iron
B. Sodium
C. Calcium
D. Phosphorus
Calcium needs increase slightly during lactation to support milk
production and maternal bone health.
7. The best indicator of long-term glycemic control in a patient with
diabetes is:
A. Fasting glucose
B. Postprandial glucose
C. Hemoglobin A1c
D. Random glucose
Hemoglobin A1c reflects average blood glucose over approximately 3
months and is the best indicator of long-term glycemic control.
, 8. A patient with phenylketonuria (PKU) must restrict which amino acid?
A. Tyrosine
B. Leucine
C. Phenylalanine
D. Methionine
PKU requires restriction of phenylalanine due to deficiency in its
metabolism.
9. A high nitrogen balance indicates:
A. Catabolic state
B. Anabolic state
C. Unchanged protein status
D. Negative protein synthesis
A positive nitrogen balance reflects an anabolic state with more
protein being retained than lost.
10. A 50-year-old patient with irritable bowel syndrome with
diarrhea (IBS-D) may benefit from limiting:
A. Fiber
B. FODMAPs
C. High-fat foods only
D. Protein
A low-FODMAP diet can reduce symptoms in IBS-D by decreasing
fermentable carbohydrates that cause gas and diarrhea.
11. A patient has been diagnosed with sarcopenia. The nutrition
recommendation includes:
A. Decrease protein intake
B. Increase high-quality protein and resistance exercise
C. Avoid strength training
D. Limit calories drastically
Managing sarcopenia includes adequate high-quality protein and
resistance exercise to preserve muscle mass.
12. The Dietary Approaches to Stop Hypertension (DASH) diet
emphasizes:
A. High saturated fat
B. Low potassium
C. Fruits, vegetables, low-fat dairy
