QMA Insulin Legal and Ethical Considerations 2 — Questions and Answers
Question 1: A resident refuses their insulin injection. What is the QMA's legal obligation?
- Administer it anyway to prevent harm
- Document the refusal and notify the nurse immediately (Correct answer)
- Wait an hour and try again without notifying anyone
- Contact the family first before notifying the nurse
Correct answer: Document the refusal and notify the nurse immediately
Residents have the right to refuse treatment, and the QMA must document the refusal and promptly notify the supervising nurse.
Question 2: Which action by a QMA constitutes medication fraud?
- Documenting insulin given after a brief delay
- Recording insulin as administered when it was not given (Correct answer)
- Asking a colleague to witness a refusal
- Notifying the nurse of a missed dose
Correct answer: Recording insulin as administered when it was not given
Charting a medication as given when it was not administered is falsification of medical records and constitutes fraud.
Question 3: A QMA suspects a coworker is diverting insulin. What should they do?
- Confront the coworker directly
- Ignore it unless they witness it themselves
- Report the suspicion to a supervisor or nurse immediately (Correct answer)
- Wait to confirm before taking any action
Correct answer: Report the suspicion to a supervisor or nurse immediately
Suspected diversion of medications must be reported immediately to a supervisor to protect residents and comply with legal obligations.
Question 4: Under HIPAA, a QMA may share a resident's insulin dosage information with:
- The resident's neighbor who asks out of concern
- A member of the care team directly involved in the resident's care (Correct answer)
- Any staff member who works in the same facility
- The press if there is public interest
Correct answer: A member of the care team directly involved in the resident's care
HIPAA permits sharing protected health information only with members of the care team who have a need to know for treatment purposes.
Question 5: What does 'scope of practice' mean for a QMA administering insulin?
- The QMA can perform any task the nurse requests
- The QMA may only perform tasks authorized by state law and their training (Correct answer)
- The QMA can delegate insulin tasks to CNAs
- The QMA's scope is defined solely by facility policy
Correct answer: The QMA may only perform tasks authorized by state law and their training
Scope of practice defines the legally permitted boundaries of a QMA's duties as established by state regulations and verified training.
Question 6: A family member demands to see the full medication administration record for their adult relative. The QMA should:
- Provide the records immediately as family have full access
- Refer the family member to the nurse or administrator per facility policy (Correct answer)
- Refuse because family members have no rights
- Email the records to the family member directly
Correct answer: Refer the family member to the nurse or administrator per facility policy
Release of medical records involves privacy considerations and must be handled by authorized staff per facility policy, not the QMA independently.
Question 7: What ethical principle requires a QMA to act in the resident's best interest?
- Autonomy
- Justice
- Beneficence (Correct answer)
- Veracity
Correct answer: Beneficence
Beneficence is the ethical principle of acting in the best interest of the patient or resident to promote their well-being.
QMA Insulin Legal and Ethical Considerations 2
A resident refuses their insulin injection.
What is the QMA's legal obligation?