Nutrition Care: CDRE Study Guide & Sample Questions

What Nutrition Care covers on the CDRE

Nutrition Care is ICDEP competency domain 5, and it is the single largest area on the Canadian Dietetic Registration Examination (CDRE) — roughly a quarter of the exam by weight. If your study time is limited, this domain returns the most marks per hour. It is also the clinical heart of dietetic practice: the reasoning that runs from the first chart review to the follow-up visit that confirms the plan is working.

The domain maps almost exactly onto the Nutrition Care Process (NCP) you used throughout your practicum: Assessment → Diagnosis → Intervention → Monitoring and Evaluation. The five practice competencies follow that same arc. You conduct the nutrition assessment (5.01), determine the nutrition diagnosis (5.02), plan the nutrition intervention or interventions (5.03), implement those interventions (5.04), then monitor them and evaluate whether the nutrition goals were achieved (5.05). The exam tests your ability to move through those steps in order and to know which step a given question is actually asking about — the correct action for an assessment question is rarely the correct action for a monitoring one.

Key topics to know

Nutrition assessment (5.01). The ABCD framework organizes almost everything here:

Anthropometrics. Height, weight, weight history and rate of change, BMI, growth patterns in children — interpret trends, not single points, and flag unintended loss.
Biochemical / laboratory data. Electrolytes, glucose and A1C, renal indices, lipids, albumin and prealbumin (as inflammatory markers, not standalone protein status), and micronutrient markers — read them in clinical context.
Clinical and nutrition-focused physical exam (NFPE). Signs of muscle and fat wasting, edema, dentition, hydration, and functional status that labs miss.
Dietary / diet history. Usual intake, recent changes, food security, allergies, cultural and religious food practices, supplements, and feeding route.
Client history. Medical and surgical history, medications and nutrient interactions, psychosocial and financial context.

Nutrition diagnosis and PES statements (5.02). Name the nutrition problem, not the medical one. A PES statement reads "Problem related to Etiology as evidenced by Signs/symptoms." The problem is the diagnostic label, the etiology is the root cause you can act on, and the signs/symptoms are the measurable evidence you will later monitor. "Diabetes" is not a nutrition diagnosis; "excessive carbohydrate intake related to limited nutrition knowledge as evidenced by A1C and food records" is.

High-yield clinical areas. Each shows up repeatedly:

Gastrointestinal. Malabsorption, IBD, celiac disease, short bowel, dysphagia, and post-surgical feeding — texture, tolerance, and nutrient absorption drive care.
Renal. CKD stages, dialysis, and the electrolyte balancing act of potassium, phosphate, sodium, fluid, and protein (which increases, not decreases, on dialysis).
Diabetes. Carbohydrate consistency and counting, glycemic patterns, and coordinating nutrition with insulin or oral agents.
Cardiovascular. Sodium, dietary fat quality, and evidence-based patterns such as DASH and Mediterranean-style eating.
Critical illness and metabolic stress. Hypermetabolism, early enteral feeding, and refeeding-syndrome risk in the depleted patient.
Oncology. Treatment-related symptoms, weight and muscle preservation, and managing intake through nausea, mucositis, and taste change.
Malnutrition. Screening and diagnosis using validated criteria, distinguishing intake-related from inflammation-related loss.
Enteral and parenteral nutrition support. Route selection, formula choice, advancing feeds, monitoring tolerance, and reserving PN for a non-functional gut.
Pediatrics. Growth-chart interpretation, catch-up growth, and age-appropriate energy and fluid needs.

Intervention planning (5.03) and implementation (5.04). Estimating energy, protein, and fluid needs using accepted equations or per-kilogram principles; selecting therapeutic diets and food-texture or fluid modifications; and applying behaviour-change counselling that respects the client's goals and setting.

Monitoring and evaluation (5.05). Choose the outcome indicator that matches the goal and the timeframe — the sign or symptom named in your PES statement is usually the one to re-measure. Ground your choices in Canadian evidence: PEN (Practice-based Evidence in Nutrition) is Dietitians of Canada's authoritative resource and the kind of source the exam expects you to trust.

How the CDRE tests this domain

This is where Miller's pyramid of competence — knows, knows how, shows how, does — matters most. Recalling a clinical fact is only the base knows rung. The CDRE lives at knows how and, through its cases, shows how: given a real patient, can you choose the right next step? A written exam cannot assess does (your actual performance with clients); that is what supervised practice confirms. So the clinical questions are decisions, not recall, and studying has to train the decision.

Nutrition Care is heavily case-based. A stem gives you a patient and asks "what would you do next," "what is the most appropriate intervention," or "what is the best indicator that the plan is working." It rewards application over recall — you rarely recite a number, you decide what to do with one. Watch for three recurring traps. First, naming a medical diagnosis where a nutrition diagnosis is required. Second, restricting protein inappropriately — for example cutting protein in a dialysis or wound-healing patient who needs more, not less. Third, choosing a monitoring indicator that does not match the goal, such as tracking weight when the goal was glycemic control. Before reading the options, decide which NCP step the question sits in; that alone eliminates half the distractors.

Sample questions

Try this the way you would on the exam: pick the best answer, then check the rationale.

A 68-year-old man on maintenance hemodialysis three times weekly is seen in clinic. His serum potassium and phosphate are elevated, and his dietary recall shows low overall intake with recent unintentional weight loss. Which is the most appropriate nutrition priority?

Pick an answer to check yourself.

For the sample question from each of the other six domains, and a method for getting more out of free practice, see free CDRE practice questions.

How to study this domain

Read chapters once for reference, then spend your real time on cases — the reasoning lives in the options, not the summaries. For every practice question, say out loud which NCP step it sits in: assessment, diagnosis, intervention, or monitoring. That single habit narrows four plausible answers to one or two, because the exam is testing whether you know where you are in the process. Build a short reference sheet of the numbers and principles you keep forgetting — per-kilogram energy and protein ranges, which conditions raise protein needs versus lower them, and the electrolytes to watch in renal and refeeding scenarios. Practise writing PES statements until the problem–etiology–signs structure is automatic, and check each one by asking whether the etiology is something nutrition can act on. Deliberately drill your weak sub-areas — renal, enteral and parenteral support, critical care, and pediatrics are the usual soft spots — rather than re-reading the topics you already enjoy. When you miss a question, name the trap you fell into (medical diagnosis, wrong NCP step, mismatched monitor) instead of memorizing the answer. Finally, learn to navigate PEN so that in practice your first instinct is to reach for the Canadian evidence base.

For the reasoning-first walkthrough of how these cases are worded, read the companion blog post on nutrition care and the CDRE. Then continue with the sibling domain, Food and Nutrition Expertise, return to the complete CDRE study guide, or check your baseline with the free 20-question assessment.