252. Practice Questions: Key Pediatric Topics, Quality Improvement, Math Tips and more!

Hey there, I'm Dana, a registered dietitian, and registered dietitian exam tutor. And this is my podcast where we go over all of the questions that have been posted to my Facebook page, registered dietitian exam, study group Dana, over the past week. And we not only chat about the answers, but why are they the answers as well as answer any questions that students have posted on the page throughout the week? This is a weekly podcast, so be sure to tune in each week for new questions. And of course, I would love to see any of you guys at the live version of this on Sunday nights at 8 p.m. Eastern time. First question we have is inspired by my perfect little niece, Camden. She's six weeks old, actually, today. And I posted on the Facebook page some super cute pictures of her and her outfits. And I asked the group, I said, what are some key pediatric topics for the exam? What have you seen? And something that's difficult about pediatrics is a lot of us didn't have a lot of pediatric experience. So pediatrics can be really, really hard. And on the flip side, I actually find my students who have more pediatric experience also struggle with this because pediatrics is a relatively small area on the exam. So you want to be thinking about like, what are the key things that you need to know for this topic? So definitely some things that are on the list of what are some key pediatric topics to know are the different types of formula. And when to use cow's milk, elemental formula versus soy based formula. So the soy based formulas are going to be used for when a baby has the inborn area of metabolism called galactosemia. In this case, babies cannot have any galactose or lactose. So they have to have a soy based formula. If a baby has a cow milk allergy, it's tricky because they still have cow milk based formula, but they have elemental cow based formula. They're not going to ask you on the exam like brand names, very similar to how on the tube, the tube V section, they won't ask you brand names. You also want to be really careful with understanding the different growth charts because remember in real life, we can use growth charts of a variety of ways, also BMI is being phased out in pediatrics in real life. Now on the exam, if it's asking you which growth chart you're using for underweight, overweight, normal weight and obese, it's the BMI to age. If they're asking you what would be the best growth chart for failure to thrive, that's going to be the weight to height length stature. Remember, stature is our bigger vocab term. Length is for less than two height is for over two. So watch the age of the baby that they're talking about. Now for malnutrition, the growth chart you're going to use are the two age growth charts. So for chronic malnutrition, you're using length height stature to age, right? Because if it's been going on so long, you're going to have stunted growth. For a cute malnutrition, you're going to be using our weak to age because they might just get it. They might just get a little bit skinny. Other key things to know is for formula and breast milk, 20 calories per ounce and for infants, you're looking for about 100 calories per gig. You can see 98 to 108, but if you know 100 calories per gig, you're going to be able to get a lot of those questions, correct? And another thing they like to ask about is remember that you do not need to delay the start of the top nine allergens. They can have them starting when they're eating, which is four to six months, six months mostly, but technically if at four months, they're ready to go like I always like to give the example of my nephew, he was like ready for a full meal at four months. If my sister really wanted to, she could have given him peanuts for his first meal. She definitely did not right to delay. So watch for how they're asking, how they're asking the question, how they're asking the questions to those are some of the key things to know about. Remember, if you didn't have a strong pediatric rotation, I definitely would check out the pediatric in maternity review. Those are combined classes because similar to pediatric's maternity is also a little bit of a smaller section. So that's definitely a good course if you struggle with the other topic. Next up, we had a question of what is the best course or resource from Dana for math questions? My favorite resource is the math bootcamp. This is the number one place I'm going to direct do if math is a trouble area, which for a lot of you guys, it is. It's a really, really big trouble area. And the way the math bootcamp is set up is it's kind of like a gentle introduction to the equations. So you start out with equations part one and two, where I introduce you to each of the math equations on the exam, not just domain three and four, but also domain one and two math. So I introduce you to the definition, when would this be used, why would this be important, then the equation, then we start out with just an easy math question. Because if we jump into exam level right away, we're going to be running for the hills. So we start out with just an easy equation. And that's what exam equation review one and two is of just kind of introduction, basic level. Then I also have within the course in kind of like that first basic level, whole class on just EPAP, EPAP is really confusing. So we have a whole class to break that down. Once you get through those first three classes, we move into exam level math practice questions. So within the course, there are three exam level math practice questions. So you get your introduction and then you get three different classes to be testing your knowledge. And remember, if you haven't taken any of my practice question classes before, they're recorded, but we're going through them together. So they're recorded off the Wednesday night live group tutoring. So you're feeling like you're in class because it's recorded off the live class. So you're not just getting the equations and explanations to read. No, you're getting time within the video to do it yourself. We talk about key things people are getting wrong. And this is my favorite thing for people who have map as a trouble area. And another recommendation to is to spread this out. You don't necessarily want to do everything, you know, in three days. I would spread this out. The course has options for both two week, one month, two months and also one week. If your exams coming up and you might need it in one week, but I recommend spreading them out. You want to make sure you're also looking at math every single week because if sometimes if you do only math for one week, you feel really good and then you forget about it. So you want to bring it in early and keep practicing. So even if you bought the course for two weeks, you can still do be practicing the math out of there. And the course also comes with a math test that is like your worst nightmare of only math equations on your test, which would never happen, but it's a really, really great course. And one of the reasons remember that a lot of people get stuck on math is because since the exam is computer adaptive, if you start to get math questions wrong, the exam like perfect, I'm going to give them a ton more. The question is, right, spend some time on math now, get the first few math questions, right? Then you're not going to get any more math questions on your exam. You're going to be like, "Dat, I'm so mad there wasn't math, but I'll be like, that's because you were able to answer them correct." So definitely the math boot camp is a really, really good one too. Okay, next question we have, employment background checks typically include which of the following, marital status, bankruptcy, grade point average or health records. And this one always messes people up. This is domain three HR. And what I like to be thinking about this one is the answer is bankruptcy records because companies will use that to see not only kind of like trustworthiness of like, can you be trusted to pay your bills and take care of things. But if you're coming into a business and you're going to be touching, you're going to be touching their financials, people want to know if you have had any sort of concerning activity in your past. So they actually can do bankruptcy records. Most of us have probably not had them check that, but they could too. Next up we have which hormone is released by the gastric cells in response to food in the stomach. And this is going to be gastrin. Remember, there's a lot of different hormones on the exam to know. And you don't when you're thinking about GI, you don't want to just be thinking about vitamins and minerals. But you want to be thinking about when different hormones are going to be released and where. So definitely if you have difficulty with vitamins and mineral absorption and the GI hormones definitely check out the GI empty review, that is a really great one. Our next one question is also in GI, we're kind of in a GI theme for the moment. What is the correct order of the digestion, digestion from proximal closest, right? Your proximity, your closeness to distal far away of the small intestine. And this is going to be our duodenum, dejunum, and ilium. And if you have difficulty remembering that, I like to think DJ ilium will come to do your DJ at your RD exam pass party. So DJ, DJ ilium, key things to also know here, remember our duodenum, we love our duodenum. It's only 10 inches. It's little, right? Small but mighty. The dejunum is where most of the digestion and absorption are going to be happening followed by the, the ilium. So if we lose our dejunum, our ilium can pick up a lot, a lot of the slack too. Next up we have a review from Jenny, our latest RD passer. And she says, hi everyone, I'm so excited to share with you all that I passed my exam with a 32 on Monday after eight long months of full time studying. Thank you to Dana for creating this study course in the group for all of us. I really couldn't have done it without these tools. I embarked on my studying journey back in 2006 when I did my DPD at UC Davis. After a few years of working as a diet, I went back to school to get my masters and complete my dietetic internship. But right at the finish line, I fell off the RD path and never got signed off to take my exam. After pursuing an entirely different career and climbing that ladder, I decided that I had to go back to finish what I started. So for me, I came back after essentially a decade away from dietetics. I literally felt like I was starting from scratch. I think most people complete Dana's program in much less time than I did, but I gave myself the gift of time to study. I did not want to go into the exam feeling under prepared. For me, Dana's study course was the most comprehensive study tool out there. I used her course as my main study tool, the signature self-paced course, but also supplemented with in-min, chomping down on the dietetics pocket prep and eat right prep. I finally got myself to a place where all the dots were connecting and I was scoring 80 plus on eat right prep practice exams. I saved those from the till the very end to measure how I was. So for those of you who are out there struggling, keep on keeping on Dana's such a great resource. If you are not doing those weekly check-ins, you should really start doing them now. And those are included for people in the membership as well as the signature self-paced course, especially if you're feeling overwhelmed or not confident in yourself. If I can do it, you can do it. You got this. And I love that Jenny shared the message of how she took a long time out of the field because I know there's a lot of you guys listening who for different reasons and for some of you might not be a decade, it could be a year, it could be a few months. But there's so many reasons that we might get pulled away from taking the RD exam, whether it is you did another career, you had a family, you got married, you got sick, you moved, you got a little bit defeated and taking the exam and need a little break. But it is definitely, if this is something you want to do, it is so, so, so worth it to find a study material that really works for you, to find a schedule that really, really works for you because you have to focus on what is going to be the best for you. And everyone's situation is different. This is one of the reasons why I have a big variety of courses, right? For someone like Jenny who was out of the field and needs to start really from scratch, we had the signature self-paced course, right, which gives you access to my entire course library as well as the Wednesday group live classes. Maybe you're someone who needs some more accountability, but wants something with the classroom environment, more touch points, maybe you're doing the eight week group tutoring. Maybe you're someone who has been scoring a 22, 23, 24 and needs to get out of that slump and you want to be doing something like the RD exam mastery membership where you're getting access to some of those key courses, like the situational practice questions vocab. And the crash courses that are going to help bump you up. There's lots of different options because just like when I see people in private practice, there is no one size fits all for the study exam, for how to say for the exam. So you definitely want to be finding something that that really works best for you. This question is a recipe required two pounds of clean slice strawberries. The yield for the whole strawberry is 91%, minimum, how many pounds of strawberries must be ordered? So this is an EPAP. This is one of the most common trouble areas for people because EPAP questions can get confusing on what are they even asking, what's going on. So always when I get an EPAP, I like to start out with just writing out my base equation. Some of you guys might use the triangle that is totally fine. I don't. I like to start with the equation, but you can do whatever works best for you. So when I get an EPAP question, I write out my base equation, which is AP as purchase times percent yield equals EP edible portion. So what I bought at the store times my percent yield equals what I finish with. And then I reread my question and add in what I have. So it says a recipe calls for two pounds of clean slice strawberries. So that is what I finish with. Watch those adjectives cleaned and sliced. So two pounds is that EP, right, that equals two pounds, okay? Then we have the percent yield is 91%. I love percent yield because it's really clear where it is. So I put that in my as my percent yield. And then it's asking me at a minimum how many pounds of strawberries should be ordered. So what I have right now is X times 0.91 right 91% equals two pounds. And before I do any math, and I recommend you do this for if you're someone like myself who is like less math, the better you can do your common sense map here where you're thinking. If I need to finish with two pounds, I have to purchase more than two pounds because what the percent yield is saying is that I'm going to lose 9% of the weight. So I right away can look at my answer options and cross out any that are less than two pounds. And in this case, there's only one. The first option A is 1.82 pounds. And I know I have to buy more than two pounds because it's not a 100% yield. So I'm just going to cross that out because it just helps me with peace of mind to go, okay, I have only three. So now I'm going to do two pounds divided by 91.91% so 2 divided by 0.91. And that's going to tell me that at the store, I have to purchase 2.197. So if I rounded 2.2 pounds in order so that if it's 91% yield, I can finish with two pounds. But what I want to be doing is I want to be picking the best answer, right? Oh, when I look at my answer options, my answer options are 2.2 pounds, 2.91 pounds or 4.4 pounds. So with this one, I did my math, right? And I'm saying great, I can do 2.2 pounds. Now let's say you're someone who's like, oh my God, I hate algebra. No worries, right? You could also take the answer options and times each one by 0.19 to see which one gets you 2 pounds. EPA peaking definitely get tricky and that's why you want to make, that's you are going to be focusing on kind of slowing, slowing down and thinking about what would be the correct answer option. Hang, next up we're heading to quality improvement, domain three. What does the O in focus PDSA stand for? Now what I like to be thinking about with focus PDSA is the fact that focus is literally just extended P. And if you need a refresher on what DCA is right, plan, do check or study, you can see C or S and then act. So focus when I'm saying that focus is just extended PDSA, focus is thinking about find a process to improve, organize a team, verify the problem, understand the variation, the lack the intervention. It's it's planning just really far out that O would be that O would be to organize a team. So in this case, the answer option that's best would be develop, develop team. It doesn't always have to say like exactly what it is, but that focus is that it is going to be that extend that extended PDSA PDSA cycle. So you can be thinking about what that means to next up is what is the union shop steward. So something to be thinking about is the union shop steward is not paid extra, but they have hours available where they are using their like regular hours at work. Let's say they're 40 hours a week to do union thing. So they're going to be elected by the employees to represent them with the union. And they might have like two to three hours a week of their for of their 40 hours. In order to be thinking about what does the union want, but how are we going to be representing our members as well too. Thanks for tuning in for this week's practice question review. Don't forget that we are doing these live on my Facebook page, register, dietician exam tutoring with Dana RD. Every Sunday at 8 p.m. Eastern time and I would love to have you join live. You can also head to my website DanaJF Nutrition.com to find out about the latest classes as well as study tips and services. Thanks for tuning in.