CNA Feeding and Hydration — Questions and Answers
Question 1: Before assisting a resident with eating, what should the CNA do first?
- Prepare the food tray in the kitchen
- Wash hands and assist the resident in washing theirs (Correct answer)
- Immediately begin spooning food into the resident's mouth
- Check the resident's blood pressure
Correct answer: Wash hands and assist the resident in washing theirs
Before assisting with feeding, the CNA should wash their hands and help the resident wash theirs as well. Proper hand hygiene reduces the transmission of pathogens through food and is a foundational infection control practice.
Question 2: A resident is ordered a thickened-liquid diet. Why is this important for the CNA to follow?
- It is a personal preference of the resident
- It helps control the resident's blood sugar
- It reduces the risk of choking and aspiration in residents with swallowing difficulties (Correct answer)
- It is required for all residents over age 65
Correct answer: It reduces the risk of choking and aspiration in residents with swallowing difficulties
Thickened liquids are ordered for residents with dysphagia (swallowing difficulties) to reduce the risk of aspiration, which occurs when food or liquid enters the airway instead of the esophagus. Aspiration can lead to aspiration pneumonia, a serious and potentially life-threatening complication.
Question 3: What is the safest position for feeding a resident who is unable to sit upright independently?
- Flat on their back (supine)
- On their side (lateral position)
- Head of bed elevated to at least 30–45 degrees (Correct answer)
- Prone (face down) position
Correct answer: Head of bed elevated to at least 30–45 degrees
The head of the bed should be elevated to at least 30–45 degrees (preferably 90 degrees when possible) during feeding. This upright position uses gravity to assist swallowing and significantly reduces the risk of aspiration.
Question 4: How should a CNA offer fluids to a resident throughout the day to maintain adequate hydration?
- Only offer fluids at scheduled meal times
- Wait for the resident to ask for something to drink
- Offer fluids regularly throughout the shift, not only at mealtimes (Correct answer)
- Limit fluids in the afternoon to prevent incontinence at night
Correct answer: Offer fluids regularly throughout the shift, not only at mealtimes
CNAs should routinely offer fluids frequently throughout the shift and during meals, snacks, and medication administration. Many residents, especially elderly ones, do not feel thirsty even when dehydrated, so proactive fluid offering is essential.
Question 5: A resident begins coughing repeatedly during a meal. What should the CNA do?
- Continue feeding but offer smaller bites
- Give the resident more liquid to clear their throat
- Stop feeding, keep the resident upright, and report to the nurse (Correct answer)
- Help the resident lie down to rest
Correct answer: Stop feeding, keep the resident upright, and report to the nurse
Repeated coughing during eating is a sign of possible swallowing difficulty or aspiration. The CNA should stop feeding immediately, keep the resident upright, and report the observation to the nurse for further evaluation.
Question 6: Which observation during feeding should a CNA report to the nurse immediately?
- The resident eats slowly but finishes the meal
- The resident requests a different food option
- The resident chokes, coughs repeatedly, or has a gurgling voice while eating (Correct answer)
- The resident prefers to eat with a spoon instead of a fork
Correct answer: The resident chokes, coughs repeatedly, or has a gurgling voice while eating
Signs such as coughing, choking, gurgling voice, or refusal to eat may indicate dysphagia or other medical issues. These findings must be reported so the nurse and dietitian can evaluate and adjust the care plan, preventing aspiration and malnutrition.
CNA Feeding and Hydration
Before assisting a resident with eating, what should the CNA do first?