CNA Using Adaptive Devices 2 — Questions and Answers
Question 1: A resident with severe right-sided weakness following a stroke needs to be transferred from their bed to a wheelchair using a transfer board. Which action by the CNA indicates a need for further training?
- Placing the transfer board under the resident's buttocks rather than their thighs. (Correct answer)
- Positioning the wheelchair at a 45-degree angle to the bed on the resident's left (strong) side.
- Instructing the resident to lean left while placing the board under their right side.
- Ensuring the surfaces of the bed and wheelchair are at similar heights before the transfer.
Correct answer: Placing the transfer board under the resident's buttocks rather than their thighs.
The transfer board should be placed under the resident's thighs, not directly under the buttocks. Placing it too far back under the buttocks can cause the resident to slide forward off the board during the transfer, increasing the risk of a fall.
Question 2: When assisting a resident with severe arthritis to eat, they have difficulty holding a standard fork. Which type of adaptive utensil would be MOST appropriate to offer first?
- A weighted utensil with a standard-sized handle.
- A fork with a built-up, soft-grip handle. (Correct answer)
- A swivel spoon to minimize wrist movement.
- A rocker knife for one-handed cutting.
Correct answer: A fork with a built-up, soft-grip handle.
For residents with arthritis, a primary challenge is often a weak or painful grip. A utensil with a large, built-up, and soft handle is designed to be easier to hold, reducing strain on the joints of the hand. While other options may be useful for different conditions (like tremors or limited wrist motion), the built-up handle directly addresses the common issue of grip difficulty in arthritis.
Question 3: A CNA is caring for a resident with severe contractures in their legs who requires a mechanical lift for all transfers. What is a critical safety consideration specific to this resident's condition?
- Ensuring the lift's battery is fully charged before starting.
- Using a smaller sling to accommodate the resident's flexed position.
- Carefully positioning the sling and the resident's limbs to avoid forcing joints into painful positions. (Correct answer)
- Performing the transfer with only one caregiver to be more efficient.
Correct answer: Carefully positioning the sling and the resident's limbs to avoid forcing joints into painful positions.
Residents with contractures have joints that are fixed in a rigid position. It is crucial to support their limbs and position the sling in a way that does not force these joints, which could cause extreme pain or injury. All transfers with a mechanical lift require at least two staff members for safety.
Question 4: A resident is using a rolling walker for the first time on a slight downhill ramp. The CNA should instruct the resident to do which of the following to ensure safety?
- Lean heavily forward into the walker to increase momentum.
- Lift the walker completely with each step to control its movement.
- Walk in a straight line directly down the center of the ramp.
- Apply light, steady pressure on the brakes to control speed. (Correct answer)
Correct answer: Apply light, steady pressure on the brakes to control speed.
When going downhill with a rolling walker, it can pick up speed and get ahead of the resident. Applying gentle, intermittent pressure on the brakes allows the resident to control the speed and maintain stability. Leaning forward, lifting the walker, or going straight down without controlling speed can increase the risk of a fall.
Question 5: Which of the following residents would be the best candidate for using a sock aid, dressing stick, and button hook for upper body dressing?
- A resident with dementia who is often confused by multi-step tasks.
- A resident with severe bilateral hand tremors due to Parkinson's disease.
- A resident with hemiplegia (one-sided paralysis) after a stroke. (Correct answer)
- A resident who is temporarily non-weight-bearing on one leg.
Correct answer: A resident with hemiplegia (one-sided paralysis) after a stroke.
A resident with one-sided paralysis can use their unaffected hand to manipulate these adaptive tools. A sock aid and dressing stick help with reaching and pulling on clothes without bending, while a button hook allows for one-handed buttoning. These tasks would be very difficult for someone with severe bilateral tremors or confusing for a resident with significant dementia.
Question 6: A CNA notices that a resident's alternating pressure mattress pump is set to 'Static' mode. What is the most appropriate immediate action for the CNA?
- Increase the firmness setting on the pump to compensate.
- Document the finding and wait for the nurse to address it.
- Inquire if a procedure was recently performed and, if not, switch the pump back to 'Alternating' mode per the care plan. (Correct answer)
- Unplug the pump for 10 minutes to allow it to reset.
Correct answer: Inquire if a procedure was recently performed and, if not, switch the pump back to 'Alternating' mode per the care plan.
The 'Static' mode on an alternating pressure mattress pump inflates all air cells to a constant firmness, which is typically used for short periods during repositioning, transfers, or specific nursing procedures. Leaving it in static mode negates the pressure-redistributing benefit of the mattress. The CNA should first determine if there is a reason for the setting and, if not, return it to the therapeutic 'Alternating' mode as indicated in the resident's care plan, and inform the nurse.
CNA Using Adaptive Devices 2
A resident with severe right-sided weakness following a stroke needs to be transferred from their bed to a wheelchair using a transfer board.
Which action by the CNA indicates a need for further training?