QMA Insulin Documentation and Reporting 3 — Questions and Answers
Question 1: A QMA draws up insulin and then is interrupted before giving it. What should the QMA do regarding documentation?
- Document the dose as given since it was prepared
- Discard the drawn insulin, document the discard, and start over when able (Correct answer)
- Leave the syringe for the next QMA to administer
- Administer immediately regardless of the interruption cause
Correct answer: Discard the drawn insulin, document the discard, and start over when able
Drawn insulin that cannot be administered promptly must be discarded and the discard documented; it should never be left unattended or given by another staff member.
Question 2: Which report must a QMA complete if a resident receives insulin intended for a different resident?
- A dietary incident form
- A medication error/incident report and immediate nurse notification (Correct answer)
- Only a verbal report at shift change
- No report is needed if no harm occurred
Correct answer: A medication error/incident report and immediate nurse notification
Any medication error, including wrong-patient incidents, requires an incident report and immediate nurse notification regardless of whether harm is apparent.
Question 3: At shift change, the oncoming QMA notices the blood glucose log has a missing entry from the previous shift. What is the priority action?
- Fill in a normal-range value to avoid questions
- Report the missing entry to the charge nurse before proceeding (Correct answer)
- Ignore it and continue with the current shift tasks
- Ask the resident what their glucose was at that time
Correct answer: Report the missing entry to the charge nurse before proceeding
Missing documentation must be reported to the charge nurse immediately so the clinical team can assess whether any follow-up is needed.
Question 4: A QMA must document rotation of injection sites. Which body region is COMMONLY used and must be accurately charted?
- The scalp
- Abdomen, thighs, upper arms, and buttocks (Correct answer)
- Inner elbow only
- Fingers and toes
Correct answer: Abdomen, thighs, upper arms, and buttocks
Approved subcutaneous injection sites include the abdomen, outer thighs, upper arms, and buttocks, and each site used must be documented to ensure proper rotation.
Question 5: How long are medication administration records typically retained in a long-term care facility in the US?
- 30 days only
- At least 5–7 years per state and federal regulations (Correct answer)
- Until the resident is discharged, then discarded
- Only until the next audit
Correct answer: At least 5–7 years per state and federal regulations
Federal and state regulations generally require medical records, including MARs, to be retained for a minimum of 5–7 years.
Question 6: A resident's glucose reading is 420 mg/dL. After administering the sliding-scale insulin ordered, what must the QMA do next regarding documentation?
- Document only the glucose reading; the nurse handles the rest
- Document the glucose, dose given, site, time, nurse notification, and resident response (Correct answer)
- Wait until the end of the shift to document everything at once
- Only document if the resident shows symptoms
Correct answer: Document the glucose, dose given, site, time, nurse notification, and resident response
A critically high glucose value with sliding-scale dosing requires documentation of the reading, dose, site, time, nurse notification, and any observed resident response.
Question 7: Which statement about electronic MARs (eMARs) is TRUE for QMAs?
- Corrections can be deleted without any audit trail
- Each entry is time-stamped and linked to the QMA's login, creating a permanent record (Correct answer)
- eMARs do not require the injection site to be recorded
- Another staff member may document under the QMA's login if needed
Correct answer: Each entry is time-stamped and linked to the QMA's login, creating a permanent record
eMARs automatically time-stamp each entry and associate it with the logged-in user, creating an unalterable audit trail.
QMA Insulin Documentation and Reporting 3
A QMA draws up insulin and then is interrupted before giving it.
What should the QMA do regarding documentation?