QMA Insulin QMA Scope of Practice 3 — Questions and Answers
Question 1: Which type of insulin is NOT within QMA scope to administer without additional facility-specific authorization?
- Long-acting basal insulin such as glargine
- Rapid-acting insulin such as lispro
- Intravenous insulin infusions (Correct answer)
- Intermediate-acting insulin such as NPH
Correct answer: Intravenous insulin infusions
Intravenous insulin infusions require registered nurse administration and are outside QMA scope in virtually all states.
Question 2: A QMA's supervising nurse is unavailable and a resident's blood glucose reading is critically high. What should the QMA do?
- Use clinical judgment to administer extra insulin
- Contact another available licensed nurse or supervisor immediately (Correct answer)
- Wait until the assigned nurse returns before taking any action
- Ask a family member what to do
Correct answer: Contact another available licensed nurse or supervisor immediately
In an emergency or urgent situation, the QMA must seek another licensed nurse or supervisor immediately rather than acting outside their scope.
Question 3: A QMA is delegated insulin administration for a new resident. What must occur before the first dose is given?
- The QMA must observe the nurse administer the first dose
- A current, valid written medication order must be reviewed and confirmed (Correct answer)
- The resident's family must provide written consent to the QMA specifically
- The QMA must obtain a separate certification from the facility medical director
Correct answer: A current, valid written medication order must be reviewed and confirmed
A valid written medication order is a prerequisite that must be confirmed before any medication, including insulin, is administered.
Question 4: What is the QMA's responsibility regarding injection site rotation?
- Choose injection sites based solely on personal preference
- Follow the resident's individualized care plan for site rotation (Correct answer)
- Always use the same site for consistency
- Let the resident independently choose the site without documentation
Correct answer: Follow the resident's individualized care plan for site rotation
The QMA must follow the individualized care plan specifying the site rotation schedule to prevent lipodystrophy and ensure absorption consistency.
Question 5: A QMA is certified in one state and begins working in a neighboring state. Can they immediately administer insulin?
- Yes, QMA certification is nationally reciprocal
- Not until they verify and comply with the new state's specific QMA and insulin administration requirements (Correct answer)
- Yes, if their training included insulin administration
- Only if their previous employer provides a letter of authorization
Correct answer: Not until they verify and comply with the new state's specific QMA and insulin administration requirements
QMA scope and requirements vary by state, and the QMA must meet the new state's specific regulations before administering insulin.
Question 6: Which of the following best describes the QMA's role within the healthcare team for insulin management?
- Independent clinician responsible for all insulin decisions
- Supportive paraprofessional who administers insulin under licensed nurse supervision (Correct answer)
- Equal partner with the nurse in prescribing insulin adjustments
- Replacement for the nurse when the nurse is on break
Correct answer: Supportive paraprofessional who administers insulin under licensed nurse supervision
The QMA is a paraprofessional who administers medications under nurse supervision and does not make independent clinical decisions.
Question 7: A QMA working in an assisted living facility notices the medication administration record has conflicting insulin orders. What should they do?
- Administer the most recently dated order without consulting anyone
- Administer the lower dose to be safe
- Withhold the insulin and notify the supervising nurse to clarify the order (Correct answer)
- Call the pharmacy to pick which order to follow
Correct answer: Withhold the insulin and notify the supervising nurse to clarify the order
Conflicting orders must be clarified by a licensed nurse before administration; the QMA should withhold and report, not interpret orders independently.
QMA Insulin QMA Scope of Practice 3
Which type of insulin is NOT within QMA scope to administer without additional facility-specific authorization?