CNA Using Adaptive Devices 3 — Questions and Answers
Question 1: A patient with dysphagia has been prescribed a thickened liquid diet. Which adaptive device helps ensure they receive consistently thickened fluids?
- A weighted utensil set
- A specialized thickening agent and clearly labeled thickened liquid containers (Correct answer)
- A standard straw
- A divided plate
Correct answer: A specialized thickening agent and clearly labeled thickened liquid containers
Thickening agents added to liquids change the consistency to the prescribed level (nectar, honey, or pudding thick) to reduce aspiration risk in patients with swallowing difficulty.
Dysphagia (difficulty swallowing) places patients at risk of aspiration. The speech-language pathologist prescribes a specific liquid consistency level. The CNA uses commercial thickening agents to achieve the correct consistency and ensures all fluids provided — including water, juice, coffee, medications dissolved in liquid — meet the prescribed level. Offering unthickened liquids to a dysphagia patient is a serious safety error.
Question 2: A non-verbal patient uses a communication board. What is the CNA's responsibility when interacting with this patient?
- Speak for the patient based on what the CNA thinks they need
- Offer the communication board, allow time for the patient to indicate their message, and respond accordingly (Correct answer)
- Use the board only when the speech therapist is present
- Assume the patient's needs based on the daily schedule and avoid using the board
Correct answer: Offer the communication board, allow time for the patient to indicate their message, and respond accordingly
The communication board is the patient's voice. Offering it consistently and patiently allowing the patient to communicate respects autonomy and prevents unmet needs.
Non-verbal patients who use communication boards require consistent access to the device and a communication partner willing to allow adequate response time. Bypassing the board and speaking for the patient denies their autonomy and can lead to misunderstood needs. The CNA should keep the board within reach, point to or offer it at the start of each interaction, and wait patiently for responses.
Question 3: A patient's eyeglasses are part of their daily care plan. When should the CNA ensure glasses are applied?
- Only for outdoor activities or therapy sessions
- Before meals, activities, and any time the patient is awake and in a situation where vision is needed (Correct answer)
- Only when requested by the patient
- Only during the day shift
Correct answer: Before meals, activities, and any time the patient is awake and in a situation where vision is needed
Glasses should be applied consistently whenever the patient is awake and in situations where vision supports safety, orientation, and participation.
Poor vision affects orientation, fall risk, ability to self-feed, and participation in activities. Glasses should be cleaned daily and applied before meals (to see food), during ambulation (to navigate safely), and during any activity where the patient needs to see. The CNA should clean the lenses with a soft cloth and check the frames for damage at each use.
Question 4: A patient uses a mechanical lift for all transfers. The CNA must first check which of the following before performing the lift?
- That the lift is charged and the sling is the correct size and is undamaged (Correct answer)
- That the physician has written a new order for the transfer today
- That a family member is present to observe
- That the patient has eaten within the past hour
Correct answer: That the lift is charged and the sling is the correct size and is undamaged
Before using a mechanical lift, the CNA must verify the battery charge, sling integrity (no tears, fraying), and correct sling size for the patient.
Mechanical lift failures — dead batteries, torn sling fabric, incorrect sling size — are a leading cause of patient falls and injuries during transfers. Pre-use inspection includes checking battery charge, inspecting sling for wear or damage, confirming the correct sling type (hammock, seat, standing) and size, and verifying proper attachment points. Two staff members are typically required for mechanical lift transfers.
Question 5: What does a raised toilet seat (commode riser) help accomplish for a patient with hip precautions after joint replacement?
- It reduces hip flexion beyond 90 degrees, protecting the new joint from dislocation (Correct answer)
- It prevents urinary tract infections
- It makes the toilet more comfortable for tall patients
- It reduces the need for a gait belt during toileting
Correct answer: It reduces hip flexion beyond 90 degrees, protecting the new joint from dislocation
After hip replacement, patients typically have a restriction against bending the hip beyond 90 degrees. A raised toilet seat reduces the depth of the sit, keeping the hip angle within safe limits.
Total hip arthroplasty (THA) post-operative precautions commonly include: no hip flexion >90°, no internal rotation, no adduction beyond midline. A standard toilet is low enough to violate the 90° restriction during sitting. A raised toilet seat or commode riser elevates the seated position, reducing hip flexion angle and protecting the new prosthesis from dislocation. The CNA should ensure this device is in place for all toilet transfers.
Question 6: A CNA finds that a patient's prescribed adaptive device (a hand splint) has not been applied per the care plan schedule. What should the CNA do?
- Apply the splint immediately without assessing the hand first
- Apply the splint according to the care plan after inspecting the skin and hand, and report any concerns to the nurse (Correct answer)
- Skip it since it was missed — the next scheduled application is soon enough
- Ask the occupational therapist to come and apply it
Correct answer: Apply the splint according to the care plan after inspecting the skin and hand, and report any concerns to the nurse
Splints should be applied per the care plan schedule. Before application, the skin should be inspected for breakdown, and any concerns reported to the nurse.
Hand splints maintain joint alignment, prevent contracture, or reduce tone in patients with neurological or orthopedic conditions. Before applying a splint, the CNA should inspect the skin for redness, breakdown, or blistering that could be worsened by the device. The splint should be applied as instructed (orientation, tightness, lining position) and the patient monitored for discomfort after application. All skin findings are reported to the nurse.
CNA Using Adaptive Devices 3
A patient with dysphagia has been prescribed a thickened liquid diet.
Which adaptive device helps ensure they receive consistently thickened fluids?