QMA Insulin - Qualified Medication Aides Insulin QMA Scope of Practice Questions and Answers 1 — Questions and Answers
Question 1: A QMA with an insulin certification is preparing to administer insulin to a resident. The resident's blood glucose level is within the range specified on the sliding scale order. What is the immediate next step for the QMA?
- Administer the insulin dose as indicated on the sliding scale. (Correct answer)
- Contact the licensed nurse to get permission to administer the dose.
- Recalculate the dose based on the resident's meal intake.
- Administer half the dose and recheck the blood glucose in 15 minutes.
Correct answer: Administer the insulin dose as indicated on the sliding scale.
According to the QMA scope of practice for insulin administration, if the physician's order includes a sliding scale and the resident's blood glucose level falls within a specific range on that scale, the QMA is authorized to administer the exact amount of insulin ordered for that range. No additional authorization from the nurse is required for each administration as long as it follows the physician's specific order.
Question 2: Which of the following tasks is explicitly outside the scope of practice for a QMA who has completed the insulin administration module?
- Performing a finger stick blood glucose test.
- Administering a dose of U-100 Lantus via an insulin pen.
- Administering a pre-filled syringe of Trulicity. (Correct answer)
- Documenting the insulin dose administered in the resident's chart.
Correct answer: Administering a pre-filled syringe of Trulicity.
The QMA insulin certification is strictly for administering insulin. QMAs are explicitly not allowed to administer other injectable, non-insulin medications used to treat diabetes, such as Trulicity or Ozempic. Performing blood glucose tests, administering standard insulin, and documenting are all within the QMA's scope.
Question 3: A resident has a new order for insulin. A registered nurse (RN) has completed the initial assessment. Before the QMA can administer insulin to this resident for the first time, what must occur?
- The QMA must be directly supervised by the RN during the administration. (Correct answer)
- The resident's family must provide written consent for a QMA to administer insulin.
- The QMA must take a refresher course on insulin administration.
- The physician must personally observe the QMA's technique.
Correct answer: The QMA must be directly supervised by the RN during the administration.
The regulations state that prior to a QMA administering insulin, the task must be delegated by an RN based on an assessment of the QMA's competency, OR the QMA must be supervised by an RN during the administration. This ensures patient safety and verifies the QMA's ability to perform the task correctly for that specific resident.
Question 4: Under what circumstances must a QMA with insulin certification NOT administer insulin, even if there is a physician's order?
- The resident expresses a fear of needles.
- The facility's policy on insulin administration by a QMA is not available for review. (Correct answer)
- The supervising RN is on a scheduled lunch break within the facility.
- The blood glucose reading is at the higher end of the prescribed range.
Correct answer: The facility's policy on insulin administration by a QMA is not available for review.
It is the responsibility of the QMA to understand and review the facility's policies and procedures related to insulin administration. If the facility does not have these policies available, the QMA must not administer insulin. This is a critical safety measure to ensure the QMA is acting within the facility's established guidelines which are based on state regulations.
Question 5: A QMA is authorized to perform which of the following tasks related to insulin administration?
- Adjusting a resident's sliding scale insulin doses based on their activity level.
- Drawing up and administering a dose of U-500 concentrated insulin.
- Preparing an insulin pen and administering a subcutaneous injection. (Correct answer)
- Independently initiating insulin for a resident with a high blood sugar reading.
Correct answer: Preparing an insulin pen and administering a subcutaneous injection.
The QMA scope of practice for insulin administration clearly includes withdrawing insulin from a vial or preparing an insulin pen and administering it via subcutaneous injection. Adjusting doses, administering highly concentrated U-500 insulin, and initiating insulin without a specific order are all outside the QMA scope of practice and require a licensed nurse or physician.
Question 6: A QMA works at a facility where the RN has delegated the task of insulin administration for a specific resident. The resident reports feeling dizzy and shaky before their scheduled dose. What is the QMA's most appropriate action?
- Administer the insulin as ordered and document the resident's comments.
- Give the resident a glass of orange juice and then administer the insulin.
- Hold the insulin, check the resident's blood glucose, and immediately report the findings and symptoms to the nurse. (Correct answer)
- Tell the resident to lie down and re-evaluate them after 30 minutes.
Correct answer: Hold the insulin, check the resident's blood glucose, and immediately report the findings and symptoms to the nurse.
The resident's symptoms (dizziness, shakiness) are classic signs of hypoglycemia (low blood sugar). Administering insulin could be dangerous. The QMA's scope of practice requires them to report concerns or issues to the licensed nurse immediately and to not administer insulin if such concerns are present. Checking the blood glucose provides critical data for the nurse to assess the situation.
QMA Insulin - Qualified Medication Aides Insulin QMA Scope of Practice Questions and Answers 1
A QMA with an insulin certification is preparing to administer insulin to a resident.
The resident's blood glucose level is within the range specified on the sliding scale order.
What is the immediate next step for the QMA?