QMA Insulin Hypoglycemia and Hyperglycemia 2 — Questions and Answers
Question 1: A resident with diabetes becomes pale, sweaty, and confused during morning activities. Their blood glucose reads 58 mg/dL. What is the FIRST action the QMA should take?
- Administer the next scheduled insulin dose
- Provide 15 grams of fast-acting carbohydrate (Correct answer)
- Call 911 immediately
- Have the resident lie down and wait
Correct answer: Provide 15 grams of fast-acting carbohydrate
A blood glucose of 58 mg/dL with symptoms indicates hypoglycemia; the immediate treatment is 15 grams of fast-acting carbohydrate (the '15-15 rule').
Question 2: Which blood glucose level is generally considered the threshold for hypoglycemia in most diabetic care protocols?
- Less than 100 mg/dL
- Less than 80 mg/dL
- Less than 70 mg/dL (Correct answer)
- Less than 60 mg/dL
Correct answer: Less than 70 mg/dL
Most clinical protocols define hypoglycemia as a blood glucose level below 70 mg/dL.
Question 3: A resident with type 2 diabetes skipped lunch but still received their usual insulin dose. The QMA should monitor this resident closely for signs of:
- Hyperglycemia
- Hypoglycemia (Correct answer)
- Ketoacidosis
- Hypernatremia
Correct answer: Hypoglycemia
Skipping a meal after receiving insulin removes the carbohydrate needed to balance the insulin, greatly increasing the risk of hypoglycemia.
Question 4: After treating a hypoglycemic episode with orange juice, the QMA rechecks blood glucose in 15 minutes and it is still 62 mg/dL. What should the QMA do next?
- Administer insulin to stabilize the level
- Wait another 30 minutes before rechecking
- Repeat the 15 grams of carbohydrate treatment (Correct answer)
- Notify the charge nurse immediately without further treatment
Correct answer: Repeat the 15 grams of carbohydrate treatment
Per the 15-15 rule, if blood glucose remains below 70 mg/dL after 15 minutes, repeat the 15-gram carbohydrate dose.
Question 5: Which of the following is a long-term complication of poorly controlled hyperglycemia in diabetic patients?
- Seizures from low blood sugar
- Peripheral neuropathy and retinopathy (Correct answer)
- Immediate loss of consciousness
- Rapid weight gain from water retention
Correct answer: Peripheral neuropathy and retinopathy
Chronic hyperglycemia damages blood vessels and nerves, leading to long-term complications such as peripheral neuropathy and retinopathy.
Question 6: A resident's blood glucose is 320 mg/dL and they complain of blurry vision and frequent urination. These symptoms are most consistent with:
- Severe hypoglycemia
- Mild hypoglycemia
- Hyperglycemia (Correct answer)
- Normal post-meal glucose response
Correct answer: Hyperglycemia
Blood glucose of 320 mg/dL combined with blurry vision and polyuria are classic signs of hyperglycemia.
Question 7: Which hormone is released by the pancreas to LOWER blood glucose levels?
- Glucagon
- Epinephrine
- Cortisol
- Insulin (Correct answer)
Correct answer: Insulin
Insulin, released by beta cells in the pancreas, facilitates cellular glucose uptake and lowers blood glucose levels.
QMA Insulin Hypoglycemia and Hyperglycemia 2
A resident with diabetes becomes pale, sweaty, and confused during morning activities.
Their blood glucose reads 58 mg/dL.
What is the FIRST action the QMA should take?