DTR: Check

Holy cow, I passed the DTR exam.  This post will be me brain dumping any advice I can think of since it is all very fresh in my mind.

1.  Scoring
I still don't understand how this test is scored.  To pass, you must receive at least 25 out of 50 on a scaled score, "scaled scores represent an adjustment to the raw score that compensates for any slight variation in the difficulty of the examination."  I guess this is because each person that takes the test gets different questions.  Who knows! All I know is I got 28 points which means I passed and don't have to take it again!

2.  Cost
The test is made by the Commission on Dietetic Registration and it costs $120 to take the exam.  You can purchase a study guide for about $60.  The study guide is a binder containing an 8 page very detailed outline of topics that can be covered on the exam.  I attempted to go through the detailed outline defining and studying the topics listed but made it halfway through page 2 before I stopped.  The study guide does contain a practice test that is available on paper and online.  You are able to take the online test 3 times. 

Although the paper and online tests have all the same questions, it is helpful.  You are able to see the style of questions asked and also can become comfortable taking the test on a computer since that is what you do for the real exam. It's up to you if this is worth the extra cost.  Personally, I wanted to take the test knowing I had exhausted all resources so purchasing the study guide gave me a better piece of mind.  I think it is worth it though.

3.  Preparation
Again, you can use the CDR study guide.  I also had a study guide made by a student, found here.  I basically used both and was able to pass.  Plus I made about 500 flashcards. I was really concerned I wouldn't remember information I learned in school since I graduated 5 months ago.  However, when you know something well it should be able to stick with you for a long period of time.  You may be asking yourself what to study and the answer I'm afraid is EVERYTHING!

You can be asked everything from a basic accounting question, to the temperature of a beef patty, to what is age appropriate to feed a toddler for lunch, to handling employees, to how to remodel a kitchen.  I found the broadness very frustrating.  I have trained as a diet tech at our hospital where the job is limited to modifying diets, taking temperatures of food, ordering supplements, and communicating with patients, doctors, nurses, and dietitians.  They do not have to calculate FTE's, accept food deliveries, discipline employees, or counsel patients.  However, in the big picture this knowledge will be needed for the RD exam so I decided to grin and bear it. Also, techs at different facilities may have different responsibilities. 

So to summarize; you need some sort of study guide or outline to go off of so you know all of the topics you are responsible for.  You can purchase the CDR study guide.  You can ask me about the student study guide I used.  Or if you search online there are additional resources you can purchase.  Flashcards are helpful!  Practice tests are helpful!

4.  Other Tips
I did notice a couple of patterns with answers for questions.  Don't rely on what I say, it is something I think may be true

-Questions asking you about seeing patients (i.e. they have dentures and aren't eating, they have lost weight and may need to be put on parenteral nutrition) with answers such as place patient on tube feed, give patient pureed food, ask about food preferences, refer to dietitian.  Since techs are not allowed to prescribe diet orders, it would never be to put the patient on a tube feed or pureed diet.  You can ask about food preferences, but usually the patient will get referred to a dietitian.

-Questions about disciplining employees (i.e. the clerk has been leaving early or the cook has been leaving the food out over the heaters for 2 hours when they are only allowed out for 30 minutes) with answers such as report to supervisor, conduct an in service, record the incident, instruct/counsel employee in private/individually.  The answer was always talk to the employee personally about the issue.

-Questions about patients not eating, having low intakes, or losing weight.  The answers varied from monitoring through daily weights, plate wastes, calorie counts, and asking about food preferences.  Honestly, I relied on calorie counts, but this wasn't always the answer.  I wouldn't put daily weights since a tech usually wouldn't weigh a patient everyday, that would be up to a nurse. 

Example of a ridiculous question from my CDR study guide:

"A noon meal at a nutrition site for senior citizens consists of baked chicken, mashed potatoes and gravy, and asparagus with hollandaise sauce.  To improve plate presentation and appeal, the tech should substitute:

A.  Broccoli with cheese sauce for the asparagus with hollandaise sauce
B.  Steamed broccoli for the asparagus with hollandaise sauce
C.  Fried chicken for the baked chicken, and tomato slices for the mashed potatoes and gravy
D.  Fried chicken for the baked chicken, and broccoli with cheese sauce for the asparagus with hollandaise sauce"

The answer? B.  This is because you want varied colors and textures.  There is already gravy on the potatoes, so having a similar colored sauce over the green veggies makes the plate look rather beige.  Subbing in broccoli brings in green to a plate of whites and browns.


ALSO don't worry about memorizing all of the can sizes.  I just memorized the #10 can, and I don't think there was even a question on that.  There were at least 2 scooper questions though.


All in all, don't be intimidated by the broad amount of info you need to study.  Just do it and get through it.  I found a glass of wine and the Mumford and Sons Pandora station to make the studying process a little more enjoyable!  Take the test as many times as you have to to pass.  I trained as a tech before I took the test and it helped me learn food exchanges, renal patterns, and standard food servings really well.  Once you have this certification, when you get a job there won't be much nutrition learning for you to do!  You will be able to focus on how your facility runs (i.e. the computer program, daily routine, staff, etc).  Remember, you can do it!  The feeling of passing has made it all worth it for me! 

Can Confusion

I'm studying for my very upcoming DTR exam and have been avoiding learning about can sizes because I'm scared to memorize the various sizes and how many servings they contain.  So here's me brain dumping all I know about can sizes. 


What I found from Wikipedia, summarized
Different Sizes:
Size 7/8: one serving of 1/2 cup (weighs 4oz)
Size 1 "picnic":  2 or 3 servings totalling 1 1/4 cups (weighs 10 1/2 oz)
Size 303: 4 servings totalling 2 cups (weighs 15½ ounces)
Size 10: most widely used by food services, 25 servings totalling 13 cups (weighing 103½ ounces)
taken from http://en.wikipedia.org/wiki/Tin_can

I wanted to see how much each serving contained in a #10, I divided 25 by 13 and got 1.92 which wasn't helpful. When I converted the 13 c to ounces and divided that by 25 I got 4.16 oz.  So I guess it is safe to assume that each serving from a #10 can is a little over 4 oz or half a cup.  I did the same for a #303 and got a little under 4 oz (3.875 to be exact). 

I think it is also important to know that there are 6 #10 cans per case.  It came up on a practice question on my DTR study guide from the CDR.



Then I found this from fooserviceequipment.com, a very  helpful but scary chart I'm worried I will spend the next 30 hours trying to memorize...until I realized it doesn't tell you how many servings each can contains.  It would appear that most are 4 oz servings, but I don't want to assume that and be wrong.

Can Sizes
8 ounces	8 ounces	1 cup
Picnic	10-1/2 to 12 ounces	1-1/4 cups
12 ounces vacuum	12 ounces	1-1/2 cups
#1	11 ounces	1-1/3 cup
#1 tall	16 ounces	2 cups
#1 square	16 ounces	2 cups
#2	1 pound 4 ounces or 1 pint 2 fluid ounces	2-1/2 cups
#2-1/2	1 pound 13 ounces	3-1/2 cups
#2-1/2 square	31 ounces	scant 4 cups
#3		4 cups
#3 squat		2-3/4 cups
#5		7-1/3 cups
#10		13 cups
#300	14 to 16 ounces	1-3/4 cups
#303	16 to 17 ounces	2 cups
Baby food jar	3-1/2 to 8 ounces	depends on size
Condensed milk	15 ounces	1-1/3 cups
Evaporated milk	6 ounces	2/3 cup
Evaporated milk	14-1/2 ounces	1-2/3 cups
Frozen juice concentrate	6 ounces	3/4 cup

taken from http://www.foodserviceequipment.com/PROLINK-WEB/cookingconversion3.htm#Can Sizes and Equivalents

Then I stumbled upon this beautifully organized rectangle of numbers and measurements on the same website.  I wish I could spend a couple hours in a tattoo parlour getting it inked onto my forearm in about 4 pt Arial font.  I really did.  Until I realized it would be about as attractive as a tramp stamp on my lower back and unless I planned on limiting my dating to fry cooks or dishwashers it would not help my game.  Sigh.  I'll try to mentally ink it into my cranium for now.

Common American Can Sizes
Size Number	Weight	Cups	Servings
1/4	4 oz	1/2	1
3/8	6 oz	3/4	1
1/2	8 oz	1	2
1 picnic	10 1/2 oz	1 1/4	2 - 3
211	12 oz	1 1/2	3 - 4
300	13 1/2 oz	1 3/4-2	3 - 4
303	15 1/2 oz	2	4
2	20 oz	2 1/2	5
2 1/2	28 1/2 oz	3 1/2	7
3	33 1/2 oz	4 1/4	8
3 cylinder	46 oz	5 3/4	10-12
5	56 oz	7	14
10	103 1/2 oz	13	25

taken from http://www.foodserviceequipment.com/PROLINK-WEB/CookingConversion2.htm

I have a hard time getting myself to memorize this, because form my experience at where I work now, the DTR does not deal with cans and measurements.  There is a food service director that does this instead.  However, I will admit that I have seen one of the DTR's do projects analysing current recipes for kcal counts and she has to go through every ingredient and figure out serving sizes.  Still, she would refer to a chart like this and not her memory.  Even at a previous food service job at the Children's Center we were able to refer to a chart just like this attached to the wall above the prep area. 

ANYWAYS instead of whining, I need to spend my time MEMORIZING and STUDYING.  Here's a practice problem I encountered on the practice test from the CDR:


How many cases of #10 cans of green beans are needed to serve 285 1/2 c portions?

First of all, if you don't know how many #10 cans come in a case, you're screwed.  We know that there are 6 per case, so we can move on with our calculations instead of blindly picking answer C.

Secondly, we know that each can contains 13 cups or 104 oz.  We need a total of 1,140 oz.  1,140/104=10.96 or rounded up 11 #10 cans. That means we need 2 cases since each contain 6 cans.  

(The study guide attacked the problem a little differently, they said that since each can has 25 servings, multiply 6 cans by 25 servings to get 150 servings per case.  Since you need 285 servings total, you would need 2 cases.)

So what do we need to memorize after doing this problem?  
There are 6 #10 cans per case
Each #10 can contains 13 cups or 25 1/2 c servings


How many #10 cans of green beans must be bought to make 200 1/2 c servings?

We know that each can has 25 1/2 c servings, 200/25=8.  8 #10 cans


A 2oz portion of beans is needed per servings.  How many #10 cans should be ordered if making 235 burritos and each can weighs 5 lbs?

We need 470 oz or 29.375 lbs total.  Rounding that up to 30 lbs, we would need 6 #10 cans at 5 lbs each.

This question didn't require anything memorized, just basic math.  How nice!

TEASER: Day in the Life of a Diet Tech

Sorry this blog's posting has become about as reliable as a college aged boy calling you back.  Ok that's a bit harsh, who even calls people anyways?  We'll go with texting back, sometimes boys get around to that.  I have been incredibly busy at work, in fact the last two weeks I've worked 7 day stretches in a row with a one day break in between.  (If you're thinking this isn't possible, it is.  It somehow works and although it is painful, it is also legal.  Thanks for caring though!)  Anyways, besides coming up with some interesting hair do's or lacktherof at 5:45 in the morning I learn more and more everyday.  I am still hostessing but have also been training as the tech.  The tech position requires a lot of knowledge that the exam and certification ensure.  However, the position needs a lot of training and experience because it entails a ton of multitasking.  A lot of responsibility too!  The tech corrects orders and is responsible for patients receving their appropriate diet, or getting possible supplements/tube feeds, or making sure their meal doesn't contain anything they are allergic to.  Techs are also responsible for giving patients a birthday dessert if they happen to be hospitalized on their bday.  Allergens, supplements, tube feeds, birthdays, isolation rooms, carb counting, renal diets, patient 1234 needs 7 splendas and doesn't eat lemon or blueberry yogurt, can you cover this computer while I go to the restroom?, time to take food temperatures, beep beep goes the beeper, is it 4:00 yet?????

Can you tell I wrote this at 6:00 in the morning?  Hopefully once I have a day off and rely on a full night's sleep over 5 cups of coffee I will write a full and more detailed post about the tech position before Brad from Bull's texts you back in this lifetime....

A Caramel Apple a Day...Adventures in Mocky Mountain

In honor of Halloween and our dearly beloved friend the apple, I thought it would be "fun" to make caramel apples for Halloween.  I've never made them before, but decided to go all out and do my take on the apples done by the Rocky Mountain Chocolate Factory.  If you've never been to a Rocky Mountain, don't.  You won't know what your missing and you will still be missing the 5 lbs you will gain after visiting.  Just kidding.  Not really.  The store makes fantastic fudges, chocolates, and best of all: the caramel apples.  With flavors like s'mores, apple pie, pecan bar, rocky road, snickers, and cheesecake, you'll forget you're getting a fruit serving!  Needless to say, these are off the charts in Weight Watchers points.  (I was appalled when I found out the kcal count in each apple-do your self a favor and don't look.  That goes against everything I preach about nutrition, but you're more likely to have a heart attack from the shock of discovering the mass amount of calories in each apple than from the amount of fat  clogging your arteries).  Anyways, I decided to make my own "Mocky Mountain" apples.  I pictured artisan apples perfectly coated in homemade caramel, white chocolate, and a spiced graham cracker coat.  I laughed at the thought of paying up to $10 for the same creation at Rocky Mountain.  How hard could dipping apples be?

Let me tell you, this isn't rocket science, but once I was done it left with my kitchen looking like hurricane Sandy had hit it. $10 a pop wasn't sounding too awful.  Here are some tips you should know from my mistakes:

• Use a knife straight down the apple to make it easier to push the lollipop stick through.  I kind of made an X slit if you were looking down where the stem would be.
• I decided to buy caramels and melt them instead of making my own.  Try and get unwrapped caramels if possible.  Also, melt them over a double boiler and add 2Tbsp water to thin it out.  I did not add water at first and only got 3 apples dipped from 1 bag of caramels.  Oops.
• DON'T set dipped apples on wax paper.  It will stick.
• Chill dipped caramel dipped apples before doing the white chocolate coat.  
• I set my apples in cups after doing the crumb coat, stick down.

If that didn't scare you away, here are the steps to a heart attack on a stick.  Don't feel too bad, an apple a day does keep the doctor away...


1.  Remove stems from apples.  Wash well, dry, and chill.  It is important that the apples are washed well so the caramel sticks.  Store- bought apples usually have a wax layer that won't let anything stick.  This goes without saying since you're washing, but take the stickers off too.  No one wants a bite of that.

2.  Use a knife to make a pilot slit for your lollipop stick.  Insert stick.  I guess you can do this before you chill the apples.

3.  Melt the caramels + 2 Tbsp of water together using a microwave or double boiler.  I like the double boiler because it melts slowly and you are less likely to burn them.  If using the microwave, do it in phases.  Melt over the double boiler until it becomes smooth. Remove from heat.

4.  Dip the apples in the caramel.  You can dip the apple in as far as you like.  Try and get the excess off, especially the bottom.  Set down on a plate and chill.

5.  In a food processor, crush 6 graham crackers until  fine and sand-like.  I added in cinnamon (kind of a lot) and brown sugar and pulsed to mix.  Pour into a bowl for dipping.

6.  Melt the white chocolate.  I do this in the microwave in 30 second intervals, stirring each time.  It may sound annoying, but it's not as obnoxious as the smell and sight of burnt white chocolate or driving to the store to get more.  Once the chocolate is smooth, dip the chilled apples in.  Again, dip as far in as you like.



7.  Immediately dip into the crumbs, being careful the chocolate layer doesn't pull off.  I then put the apples in cups, stick down, to set.  This 90% worked because one apple actually stuck to the cup and I ended up having to throw both out (my kitchen was a mess and I was fed up.  I blame Sandy.)

8.  I placed my apples in cute Halloween candy bags and secured them with a tie.  I placed the bags in the refrigerator to chill before I delivered them to my hungry aunts, uncles, and cousins.