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Exam Code: RDN
Exam Name: CDR Registered Dietitian Nutritionist
Exam Format: Computer-based- multiple-choice questions
Number of Questions: 125–145 (scored questions- plus 25 unscored pilot questions)
Total exam Time: 2.5 hours (150 minutes)
Passing Score: Scaled score of 25 (on a scale of 1–50)
Passing Rate: ~70% (varies slightly each year)

DOMAIN I – PRINCIPLES OF DIETETICS
TOPIC A – Food- Nutrition and Supporting Sciences
- Food science
- Physical and chemical properties of food
- Water
- Vegetables and fruits
- Sugars
- Flours- grains- and cereals
- Milk and dairy products
- Eggs
- Meats- fish- poultry- meat alternatives
- Fats and oils
- Beverages
- Functional foods
- Sensory evaluation of food
- Food safety- processing- preservation- and packaging
- Food biotechnology and genetic engineering

- Scientific basis for preparation and storage
- Function of ingredients
- Techniques of food preparation
- Leavening agents- batters- and doughs
- Effects of techniques and methods on
- Sensory properties
- Nutrient retention
- Roles of food additives

- Composition of food
- Labeling and packaging claims
- Macro and micronutrients sources
- Phytochemicals
- Nutrient databases
- Nutrient analysis
- Principles of normal nutrition
- Function of nutrients and non-nutritive substances
- Macro and micronutrients
- Water
- Fiber- prebiotics and probiotics
- Non-nutritive sweeteners and sugar alcohols
- Herbals- botanicals- and supplements
- Nutrient and energy needs throughout the life span
- Developmental stages and feeding patterns throughout the life span

- Principles of human anatomy- physiology- microbiology- and biochemistry
- Gastrointestinal
- Renal
- Pulmonary
- Cardiovascular
- Neurological
- Musculoskeletal
- Reproductive
- Social determinants of health (e.g.- income- culture- social status- education- physical environment- social network- genetics- gender- race- and sexual orientation)
- Nutrition requirements for health promotion and disease prevention

- Education- Communication and Technology
- Components of the educational plan
- Targeted setting/clientele
- Cultural competencies and diversity
- In-service education (e.g.- students and health and rehabilitative service providers)
- Patient/client counseling
- Group/individual education
- Goals and objectives (e.g.- collaborate with partners and stakeholders)
- Needs exam (e.g.- external constraints- competing programs- illness- and learning needs)
- Individual
- Group
- Content (e.g.- community resources- learning activities/methodology- references- handouts- and instructional materials)
- Evaluation criteria
- Budget development
- Program promotion

- Education Theories
- Educational readiness
- Human behavior and change management theory
- Implementation
- Communication
- Interpersonal
- Group process (e.g.- interprofessional)
- Teach classes (e.g.- culinary demonstrations and grocery tours)
- Interviewing (e.g.- techniques of questioning: open-ended- closed-ended- leading)
- Counseling (e.g.- techniques: motivation interviewing- behavioral- other)
- Methods of communication
- Verbal/non-verbal
- Written (e.g.- reports- grant proposals- other)
- Media (e.g.- print- electronic- and social media)

- Evaluation of educational outcomes
- Measurement of learning
- Formative
- Summative
- Evaluation of effectiveness of educational plan
- Documentation
- Client information
- Records
- Confidentiality
- Healthcare and nutrition informatics systems/technologies
- Telehealth and remote health monitoring systems
- Electronic health records (e.g.- meaningful use- privacy and protection for Protected Health Information (PHI)- use for outcomes and use for National Consumer Panel (NCP))
- Food and nutrient analysis software and databases
- Public policy advocacy and legislation

- Research Applications
- Types of research
- Research process (e.g.- secure funding- hypothesis testing- study design- Institutional Review Board (IRB)- statistical analysis- results- and discussion)
- Data collection- analysis- interpretation- and outcomes to make decisions
- Application of statistical analysis (e.g.- analysis- interpretation- and integration of evidence-based research findings)
- Presentation of research data and outcomes
- Report research findings (e.g.- write manuscripts- translation of results for diverse uses)
- Use of grading systems (e.g.- Evidence Analysis Library) and the application of evidence analysis as the basis for practice decisions.


DOMAIN II – NUTRITION CARE FOR INDIVIDUALS AND GROUPS
TOPIC A – Screening and Assessment
- Nutrition screening
- Purpose
- Selection and use of risk factors and evidence-based tools
- Parameters and limitations
- Methodology
- Participation in interdisciplinary nutrition screening teams
- Cultural competence
- Prioritize nutrition risk
- Nutrition exam of individuals
- Dietary intake exam- analysis- and documentation
- Medical and family history
- Obtain and assess physical findings
- Anthropometric data
- Nutrition-focused physical exam
- Intake and output
- Medication management
- Prescriptions- over-the-counter medications- and supplements
- Medication/food/supplement interactions
- Obtain and assess biochemical data- diagnostic tests- and procedures
- Assessment of energy and nutrient requirements
- Physical activity habits and restrictions
- Comparative standards (e.g.- energy requirements and growth)
- Economic/social
- Psychosocial and behavioral factors
- Socioeconomic factors
- Functional factors
- Educational readiness exam
- Motivational level and readiness to change
- Educational level
- Situational (e.g.- environmental- economic- and cultural
- General wellness exam
- Nutrition exam of populations and community needs exam
- Obtain and assess community and group nutrition status indicators
- Demographic data
- Incidence and prevalence of nutrition-related status indicator
- Prevalence of food insecurity
- Review and utilize nutrition screening and surveillance systems (e.g.- national- state- and local reference data- NHANES- BRFSS and YRBSS)
- Availability of community resources
- Food and nutrition assistance programs
- Consumer education resources
- Health services
- Studies on food systems- local marketplace- food economics
- Public health programs

- Relationship between nutrition diagnoses and medical diagnoses
- Pathophysiology
- Identifying medical diagnoses affecting nutrition care
- Determining nutrition risk factors for current medical diagnoses
- Determining nutrition factors for groups
- Data sources and tools for nutrition diagnosis
- Organizing exam data
- Using standardized language
- Diagnosing nutrition problems for individuals and groups
- Making inferences
- Prioritizing
- Differential diagnosing
- Etiologies (e.g.- cause/contributing risk factors)
- Identifying underlying causes and contribution risk factors of nutrition diagnoses
- Making cause and effect linkages
- Signs and symptoms (e.g.- defining characteristics)
- Linking signs and symptoms to etiologies
- Using subjective (symptoms) and/or objective (signs) data

- Nutrition care for health promotion and disease prevention
- Identification of desired outcomes/actions
- Evidence-based practice for nutrition intervention
- Evaluation of nutrition information
- Food fads
- Health fraud
- Health and wellness promotion and risk reduction programs
- Implementing care plans
- Nutrition recommendations to promote wellness
- Communication and documentation
- Medical Nutrition Therapy
- Identify desired outcomes and actions
- Relationship of pathophysiology to treatment of nutrition-related disorders
- Critical care and hypermetabolic states
- Disordered eating and eating disorders
- Food allergies and intolerance
- Immune system disorders- infections- and fevers
- Malnutrition (e.g.- protein- calorie- vitamin and mineral)
- Metabolic
- Endocrine
- Inborn errors of metabolism
- Oncologic and hematologic conditions
- Organ system dysfunction
- Gastrointestinal
- Renal
- Pulmonary
- Cardiovascular
- Nervous system
- Musculoskeletal
- Reproductive
- Orthopedic
- Wounds
- Obesity
- Mental/Behavioral health and addiction
- Gastrointestinal and bariatric surgery
- Determine energy/nutrient needs specific to condition
- Determine specific feeding methods
- Oral
- Composition/texture of foods and liquids
- Chewing difficulty
- Swallowing difficulty (International Dysphagia Diet Standardization Initiative)
- Diet patterns/schedules
- Diet modification for diagnostic test
- Modified diet products and food supplements
- Adaptive equipment
- Breastfeeding
- Enteral and Parenteral nutrition
- Formulas and calculations
- Routes- techniques- equipment
- Complications
- Integrative and functional care- herbal therapy
- Implementing care plans
- Nutrition therapy for specific nutrition-related problems
- Basis for quality practice (e.g.- evidence-based guidelines- standardized processes – National Consumer Panel (NCP)- regulatory and patient safety issues)
- Counseling and training (e.g.- nutrition plans- medical devices and formula preparation
- Communication and documentation
- Patient rounds
- Care conference
- Coordination of care/interprofessional coordination
- Discharge planning
- Recommend appropriate physical- social- behavioral or psychological services
- Referral to community resources (e.g.- WIC and home-delivered meals)
- Implementation and promotion of national dietary guidance
- MyPlate and other diet instructional tools
- Dietary Guidelines for Americans and Healthy People
- State and community resources and nutrition-related programs
- Block grants to states
- Federal and state funded food and nutrition programs
- Community-based interventions
- Development of programs and services
- Identification and attainment of funding
- Resource allocation and budget development
- Provision of food and nutrition services to groups

- Monitoring progress and updating previous care
- Monitoring and determining tolerance to interventions (e.g.- medications- tube feeding- parenteral nutrition- medical nutrition and dietary supplements)
- Measuring outcome indicators using evidence-based guides for practice
- Selecting indicators
- Using reference standards
- Explaining variance
- Evaluating effectiveness and outcomes of nutrition interventions for individuals and populations
- Direct nutrition intervention outcomes
- Clinical and health status outcomes
- Patient-centered outcomes
- Resource utilization outcomes
- Relationship with outcome measurement systems and quality improvement
- Determining continuation and transition of care
- Continuing and updating care
- Discontinuing care

DOMAIN III – MANAGEMENT OF FOOD AND NUTRITION PROGRAMS AND SERVICES (21%)
TOPIC A – Functions of Management
- Functions
- Planning
- Short and long range
- Strategic and operational
- Policies and procedures
- Emergency preparedness
- Organizing
- Schedules and FTE allocations
- Department or unit structure
- Processes- procedures- and improving productivity
- Resources
- Directing
- Coordination
- Delegation
- Communication
- Motivation strategies
- Leadership theories
- Management theories
- Controlling
- Establishing standards
- Monitoring established plans
- Developing corrective actions
- Staffing
- Forecasting personnel needs
- Alignment of personnel
- Management characteristics
- Skills
- Technical
- Human
- Conceptual
- Roles
- Informational
- Conflict resolution
- Problem-solving
- Decision-making
- Other (e.g.- change management)
- Traits
- Management styles
- Leadership styles
- Interpersonal styles
- Managing a diverse workforce
- Emotional intelligence

TOPIC B – Human Resource Management
- Employment laws and regulations
- Compliance (e.g.- Equal Employment Opportunity Commission (EEOC)- Americans with Disabilities Act (ADA)- Occupational Safety and Health Act (OSHA) or other)
- Credentialing and licensure
- Unions and contracts
- Employment standards
- Job analysis
- Job specifications
- Job descriptions
- Employment processes
- Recruitment and selection- interviewing skills
- Orientation and training
- Performance improvement- development- and evaluation
- Discipline
- Grievance
- Compensation
- Retention and turnover
- Personnel records
- Cultural humility/competence (e.g.- diversity and inclusion- equitable workplaces- scheduling implications- training- etc.)

TOPIC C – Financial Management
- Budgeting processes and fiscal periods
- Budget procedures
- Types
- Operational
- Capital
- Methods
- Incremental
- Performance
- Zero-based
- Flexible
- Fixed
- Components
- Types of expenses
- Revenue streams
- Profitability
- Resource allocation
- Financial monitoring
- Accounting principles
- Cash control and auditing
- Financial statements
- Financial analysis

TOPIC D – Marketing and Public Relations
- Marketing analysis
- Process
- Identification of target market
- Determination of needs/wants
- Marketing mix
- Customer satisfaction
- Documentation and evaluation
- Pricing
- Strategies
- Breakeven
- Revenue-generating
- Loss leader
- Rationale
- Public relations
- Media relations
- Social networking
- Campaign development
- Customer service
- Marketing mix principles
- Product
- Place
- Price
- Promotion

TOPIC E – Quality Management and Regulatory Compliance
- Regulatory guidelines (e.g.- federal- state- local and accreditation agencies)
- Food and nutrition policy (e.g.- older adults act legislation- farm bill)
- Federal feeding programs (e.g.- Supplemental Nutrition Assistance Program (SNAP)- National School Breakfast Program and National School Lunch Program- Child and Adult Care Food Program (CACFP))
- Coding and billing- insurance requirements
- Accreditation agencies (e.g.- The Joint Commission- Centers for Medicare & Medicaid Services (CMS)- DNV GL Healthcare)
- Process- implementation- evaluation
- Cost/benefit analysis
- Productivity analysis
- Program and product analysis
- Tools (e.g.- Kaizen- Total Quality Management- Lean Six Sigma)
- Scope of practice and standards of professional performance (SOP- SOPP)
- Code of ethics

DOMAIN IV – FOODSERVICE SYSTEMS (13%)
TOPIC A – Menu Development
- Menu
- Patient/resident
- Multi facility
- Single site
- Commercial
- Non-commercial
- Menu development
- Master menu
- Guidelines and parameters
- Sensory characteristics
- Nutritional adequacy
- Cost
- Regulations
- Modifications
- Diet/disease states/life span
- Preferences/substitutions
- Nutritional adequacy
- Food allergies and sensitivities
- Cultural/religious
- Vegetarian/vegan
- Demographics
- Satisfaction Indicators
- Customer/patient evaluation
- Sales data
- Employee satisfaction
- Operational influences
- Facility/equipment
- Labor
- Budget
- Organizational philosophy (e.g.- mission- vision- culture- values)
- External influences
- Trends
- Seasonality
- Emergency/disaster management
- Product availability

TOPIC B – Procurement- Production- Distribution- and Service
- Procurement- receiving- and inventory management
- Procurement principles- concepts- and methods
- Bid process and contract implementation
- Specification development
- Group purchasing/prime vendor
- Ethics
- Foodservice management software
- Procurement decisions
- Product selection/yield (e.g.- fresh- frozen- prepackaged)
- Quality standards
- Product packaging
- Cost analysis
- Receiving and storage
- Equipment and methods
- Records
- Security
- Safety and sanitation
- Inventory management
- Control procedures (e.g.- par levels- rotation and minimum/maximum)
- Issuing procedures
- Inventory technology
- Principles of quantity food preparation and processing
- Cooking methods
- Equipment
- Preservation and packaging methods
- Modified food preparation
- Food production control procedures
- Standardized recipes
- Ingredient control
- Portion control and yield analysis
- Forecasting production
- Production scheduling
- Food waste management
- Inventory management
- Safety and sanitation
- Production systems
- Conventional
- Commissary
- Ready-prepared (e.g.- cook-chill- cook-freeze)
- Assembly/serve
- Display cooking
- Distribution and service
- Type of service systems (e.g.- centralized- decentralized and room service)
- Equipment
- Packaging

TOPIC C – Sanitation and Safety
- Sanitation
- Sanitation practices and infection control
- Personal hygiene
- Food and equipment
- Waste disposal
- Food handling techniques
- Food laws and regulations (e.g.- Food Code- government and other agencies)
- Food safety
- Principles
- Contamination and spoilage
- Microbiological control
- Signs and symptoms of food borne illness
- Allergens/cross contact
- Food safety management
- Standard operating procedures
- Time and temperature control
- Documentation and recordkeeping
- Recalls
- Operational emergencies
- Bioterrorism
- Employee behaviors and training
- Inspections and audits
- Hazard Analysis Critical Control Point (HACCP)
- Safety
- Employee
- Universal precautions
- Equipment use and maintenance
- Personal work habits
- Protective equipment
- Practices
- Environmental conditions
- Regulations
- Fire safety
- Accident prevention
- Occupational health and safety guidelines
- Documentation and recordkeeping
- Reporting (e.g.- work restrictions- injuries- accidents- Workers Compensation- spills- falls- exposures)

TOPIC D – Equipment and Facility Planning
- Facility layout
- Equipment and layout planning
- Menu
- Flow of food
- Service systems
- Safety and sanitation
- Privacy and accessibility
- Codes and standards
- Budget (e.g.- equipment- staff- operational inputs)
- Staffing (e.g.- skill and number)
- Planning team
- Composition
- Roles and responsibilities
- Project management schedule
- Equipment
- Specifications
- Selection
- Installation schedule
- Staff training
- Sustainability
- Food and water
- Non-food
- Supplies
- Equipment
- Waste management
- Storage
- Reduce- reuse- recycle
- Disposal
- Emergency preparedness and contingency planning
- Inventory (e.g.- food- water- and supplies)
- Technology
- Operational inputs (e.g.- utilities)
- Staffing
- Safety plan