QMA Insulin QMA Scope of Practice 2 — Questions and Answers
Question 1: A QMA is asked to adjust a resident's sliding scale insulin dose based on the nurse's verbal instruction over the phone. What is the correct action?
- Administer the adjusted dose as instructed verbally
- Refuse and wait for a written or verified order before making any change (Correct answer)
- Adjust the dose and document it as a verbal order
- Ask another QMA to confirm the verbal order first
Correct answer: Refuse and wait for a written or verified order before making any change
QMAs must follow written, authorized orders and should not adjust insulin doses based solely on verbal phone instructions without proper documentation.
Question 2: Which of the following tasks falls WITHIN a QMA's scope of practice regarding insulin administration?
- Diagnosing hypoglycemia and prescribing treatment
- Drawing up and administering a prescribed subcutaneous insulin dose (Correct answer)
- Determining that a resident needs a new insulin prescription
- Mixing two types of insulin without a specific order to do so
Correct answer: Drawing up and administering a prescribed subcutaneous insulin dose
Drawing up and administering subcutaneous insulin per a valid written order is within QMA scope after completing required training.
Question 3: A resident refuses their insulin injection. What should the QMA do?
- Administer the insulin anyway to prevent hyperglycemia
- Document the refusal and immediately notify the supervising nurse (Correct answer)
- Try again in 30 minutes without notifying anyone
- Contact the prescribing physician directly to resolve the refusal
Correct answer: Document the refusal and immediately notify the supervising nurse
Residents have the right to refuse treatment; the QMA must document the refusal and notify the nurse promptly.
Question 4: A QMA notices a resident's prescribed insulin is a new brand unfamiliar to them. What is the appropriate action?
- Administer it since it is prescribed and assume it works the same
- Refuse to administer it permanently
- Consult the supervising nurse and review medication information before administering (Correct answer)
- Ask the resident to explain the medication
Correct answer: Consult the supervising nurse and review medication information before administering
When unfamiliar with a medication, the QMA should consult the nurse and review available drug information to ensure safe administration.
Question 5: Which action would place a QMA OUTSIDE their scope of practice?
- Performing a blood glucose check before administering insulin
- Recording the administered dose in the medication administration record
- Independently deciding to hold insulin because blood glucose seems normal (Correct answer)
- Rotating injection sites according to the care plan
Correct answer: Independently deciding to hold insulin because blood glucose seems normal
Independently deciding to hold or modify insulin dosing without nurse direction exceeds QMA scope of practice.
Question 6: Under state QMA regulations, insulin administration by a QMA typically requires completion of which prerequisite?
- A physician-supervised internship of at least one year
- A state-approved insulin administration training program (Correct answer)
- A registered nurse license in addition to QMA certification
- A written exam administered by the resident's physician
Correct answer: A state-approved insulin administration training program
Most states require QMAs to complete a specific, state-approved insulin administration training course before they may administer insulin.
Question 7: A QMA administers insulin to the wrong resident due to a room mix-up. What is the first priority after discovering the error?
- Administer the correct resident's insulin immediately without reporting
- Notify the supervising nurse immediately and complete an incident report (Correct answer)
- Wait to see if the wrong resident shows adverse effects before reporting
- Document the error in personal notes only
Correct answer: Notify the supervising nurse immediately and complete an incident report
A medication error must be reported to the nurse immediately so appropriate clinical intervention can occur and an incident report completed.
QMA Insulin QMA Scope of Practice 2
A QMA is asked to adjust a resident's sliding scale insulin dose based on the nurse's verbal instruction over the phone.
What is the correct action?