QMA Insulin Monitoring and Documentation 2 — Questions and Answers
Question 1: A resident's blood glucose reading is 58 mg/dL before breakfast. What is the FIRST action the QMA should take?
- Administer the scheduled insulin dose immediately
- Notify the nurse and withhold the insulin dose (Correct answer)
- Give the resident a glass of juice and then give insulin
- Document the reading and proceed with the medication pass
Correct answer: Notify the nurse and withhold the insulin dose
A blood glucose of 58 mg/dL is hypoglycemic; the QMA must notify the nurse immediately and withhold insulin until a nurse evaluates the resident.
Question 2: Which of the following is the correct order for documenting insulin administration?
- Document before drawing up the dose
- Document immediately after administration (Correct answer)
- Document at the end of the shift
- Document only if a problem occurs
Correct answer: Document immediately after administration
Documentation should occur immediately after administration to ensure accuracy and prevent double-dosing.
Question 3: A resident who takes insulin complains of feeling shaky and sweaty 30 minutes after the morning dose. The QMA should FIRST:
- Check the resident's blood glucose level (Correct answer)
- Give the resident a large meal
- Administer a correction dose of insulin
- Have the resident lie down and rest
Correct answer: Check the resident's blood glucose level
Shakiness and sweating are signs of hypoglycemia; the QMA should check blood glucose first to confirm before any intervention.
Question 4: When documenting a blood glucose reading, which information is LEAST critical to record?
- The reading value in mg/dL
- The time the reading was taken
- The resident's favorite meal (Correct answer)
- The site used for the finger stick
Correct answer: The resident's favorite meal
The resident's food preferences are not relevant clinical data for blood glucose documentation.
Question 5: A QMA notices a resident's blood glucose logs show consistently high readings (>250 mg/dL) for three days. What is the appropriate action?
- Increase the insulin dose independently
- Skip the next insulin dose to prevent further elevation
- Report the trend to the nurse (Correct answer)
- Continue current documentation without reporting
Correct answer: Report the trend to the nurse
Persistent hyperglycemia is a clinical trend that must be reported to the nurse for evaluation and possible medication adjustment.
Question 6: Which blood glucose range is generally considered the target fasting range for most diabetic residents in a long-term care setting?
- 40–70 mg/dL
- 80–130 mg/dL (Correct answer)
- 200–250 mg/dL
- 300–350 mg/dL
Correct answer: 80–130 mg/dL
A fasting blood glucose of 80–130 mg/dL is typically the target range for diabetic patients, though individual care plans may vary.
Question 7: When using a glucometer, the QMA should verify the device is working correctly by:
- Testing it on themselves first
- Running a quality control solution check as per facility policy (Correct answer)
- Checking that the screen lights up
- Asking another staff member if it looked fine yesterday
Correct answer: Running a quality control solution check as per facility policy
Quality control checks with control solution verify glucometer accuracy and are required per facility policy and manufacturer guidelines.
QMA Insulin Monitoring and Documentation 2
A resident's blood glucose reading is 58 mg/dL before breakfast.
What is the FIRST action the QMA should take?