Physical Care SkillsMedium

A CNA is about to feed a resident who had a stroke and has difficulty swallowing. How should the resident be positioned BEFORE the meal begins?

Answer choices

  • ASitting fully upright at a 90-degree angle in a chair or with the head of bed raised
  • BLying on the back with the head of the bed raised to 30 degrees
  • CLying on the right side with pillows behind the back
  • DLying flat in bed with the head on one pillow

About this question

How should a CNA position a stroke resident with swallowing difficulty before feeding? Aspiration-prevention positioning is a frequent Physical Care and skills opener. Exam writers love half-upright traps such as 30-degree HOB that look safe but are not enough for dysphagia feeding. Read the wording and clinical context closely; those details determine the NNAAP competency being tested.

This question asks for the position before the meal begins. Sit the resident fully upright at about a 90-degree angle in a chair or with the head of bed raised as ordered. Lying flat, side-lying for a full meal, or only a mild head elevation are common distractors. Keep the resident upright during the meal and afterward as directed. For position resident before feeding, connect upright posture to lower aspiration risk in one short rule.

Reveal answer & explanationShow

Correct answer

  • ASitting fully upright at a 90-degree angle in a chair or with the head of bed raisedCorrect
  • BLying on the back with the head of the bed raised to 30 degrees
  • CLying on the right side with pillows behind the back
  • DLying flat in bed with the head on one pillow

Basic rationale

Residents with swallowing difficulty should sit fully upright at a 90-degree angle during and after meals to reduce aspiration risk. Stay upright for 30 to 60 minutes after eating as directed.

Option explanations

  • A: Correct. Full upright position supports safe swallowing.
  • B: Incorrect. A 90-degree upright position is required.
  • C: Incorrect. Side-lying increases aspiration during meals.
  • D: Incorrect. Flat positioning is unsafe for feeding.

Deep Analysis

Core logic

Proper positioning is essential for safe feeding. A fully upright 90-degree position uses gravity to help swallowing and reduces aspiration during and after meals.

Distractor analysis

B: Semi-Fowler position is not fully upright and increases aspiration risk. C: Side-lying during meals promotes aspiration. D: Flat supine is the highest aspiration risk position for eating.

Exam trap

Semi-reclined or side-lying positions feel comfortable but increase aspiration risk during feeding.

Memory tip

Feeding with swallow trouble: 90 degrees upright, stay up after meals.

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