CNA Using Adaptive Devices 2 — Questions and Answers
Question 1: A patient has been prescribed a quad cane for ambulation. What is the correct technique for the CNA assisting with its use?
- The cane should be held on the weaker side
- The cane should be held on the stronger side, advancing the cane and the weaker leg together (Correct answer)
- The patient should hold the cane in whichever hand feels most natural
- The cane should be used only on stairs
Correct answer: The cane should be held on the stronger side, advancing the cane and the weaker leg together
A cane is held on the stronger side to offload weight from the weaker limb. The cane and weaker leg advance simultaneously, followed by the stronger leg.
The correct pattern with a cane is: (1) advance cane and weak leg together, (2) bring strong leg forward. By holding the cane on the strong side, the patient shifts their center of gravity toward the cane when the weak leg bears weight. A quad cane (four-point base) provides additional stability compared to a standard cane. The CNA should walk on the patient's weak side with the gait belt secured.
Question 2: When using a walker, in what sequence should a patient advance the device and their feet?
- Advance both feet, then move the walker forward
- Move the walker forward first, then step the weaker leg, then the stronger leg (Correct answer)
- Move the walker and both feet simultaneously
- Alternate feet and walker in any comfortable order
Correct answer: Move the walker forward first, then step the weaker leg, then the stronger leg
The correct sequence is: advance the walker, step the weaker leg into the walker, then bring the stronger leg forward — maintaining the walker as a stable support point.
The standard walker gait pattern: (1) pick up or roll the walker forward approximately one step length, (2) step the weaker or affected leg into the walker frame, (3) bring the stronger leg forward to meet it or slightly past. This ensures the patient always has a stable base of support before committing weight to either leg. The CNA should walk behind or to the side with gait belt in hand.
Question 3: A patient using a wheelchair needs to transfer to a chair. The wheelchair brake must be checked first. Why?
- To prevent the wheelchair from being taken by other patients
- To ensure the wheelchair does not roll during the transfer, which could cause a fall (Correct answer)
- To meet documentation requirements before any transfer
- To confirm the brake is worn and needs replacement
Correct answer: To ensure the wheelchair does not roll during the transfer, which could cause a fall
Wheelchair brakes prevent movement during transfer. An unbraked wheelchair can roll away as the patient pushes off, causing a fall.
Transfer safety depends on a stable base. If the wheelchair rolls during a pivot transfer, the patient loses their support point and falls. Before any wheelchair transfer, the CNA must lock both wheel locks, remove or swing away the footrests, and position the chair at approximately 45 degrees to the target surface. Checking the brakes is the first safety step in every wheelchair transfer.
Question 4: A patient uses a hearing aid. What should the CNA check before inserting the hearing aid?
- That the hearing aid matches the patient's eye color preference
- That the battery is functional, the device is clean, and it is the correct ear (left/right) (Correct answer)
- That the patient has had an audiologist visit in the past year
- That the hearing aid volume is set to maximum for clearest sound
Correct answer: That the battery is functional, the device is clean, and it is the correct ear (left/right)
Before inserting a hearing aid, the CNA verifies the battery works, the device is clean, and it is inserted in the correct ear — typically marked L or R.
Inserting a dead or dirty hearing aid is unhelpful and wastes the patient's time. Left and right hearing aids are customized to individual ear anatomy and are not interchangeable. The CNA should inspect the hearing aid for moisture or debris, replace the battery if needed, and insert gently in the correct ear per the patient's care plan, ensuring a comfortable fit.
Question 5: Which type of adaptive eating utensil benefits a patient with limited grip strength?
- Standard metal utensils with thin handles
- Built-up handle utensils (thick foam or rubber grips) (Correct answer)
- Disposable plastic utensils
- Chopsticks
Correct answer: Built-up handle utensils (thick foam or rubber grips)
Built-up handle utensils have enlarged grips that require less pinch force, enabling patients with arthritis or weakness to hold utensils independently.
Patients with rheumatoid arthritis, post-stroke hand weakness, Parkinson's disease, or other conditions affecting grip benefit from built-up handle utensils. The increased handle diameter distributes the required grip force over a larger surface area, compensating for reduced pinch and grip strength. Occupational therapists prescribe specific adaptive utensils; CNAs ensure they are consistently provided at mealtimes.
Question 6: A patient uses a prosthetic limb. What is the CNA's responsibility regarding its care?
- The CNA has no role — prosthetics are managed entirely by the prosthetist
- Clean the prosthesis as trained, apply it per the care plan, check the skin under it for breakdown, and report any issues to the nurse (Correct answer)
- Soak the prosthetic limb in water nightly for cleaning
- Apply the prosthesis only when the patient is being seen by visitors
Correct answer: Clean the prosthesis as trained, apply it per the care plan, check the skin under it for breakdown, and report any issues to the nurse
CNAs assist with applying prosthetics, clean them per instructions, inspect the underlying skin, and report any skin breakdown or fit issues to the nurse.
A poorly fitted or improperly applied prosthetic limb causes skin breakdown, pressure injuries, and potential infection at the residual limb. The CNA's responsibilities include applying the prosthesis correctly (per the care plan and training), checking the residual limb skin before application and after removal, cleaning the prosthesis as instructed, and promptly reporting any skin redness, irritation, or fit concerns to the nurse.
CNA Using Adaptive Devices 2
A patient has been prescribed a quad cane for ambulation.
What is the correct technique for the CNA assisting with its use?