QMA Insulin Safety and Emergency Procedures 2 — Questions and Answers
Question 1: A resident receiving insulin is found unconscious and unresponsive. What is the QMA's FIRST action?
- Call for the nurse immediately and do not leave the resident (Correct answer)
- Administer oral glucose gel into the cheek
- Check blood glucose with a fingerstick
- Give the next scheduled insulin dose
Correct answer: Call for the nurse immediately and do not leave the resident
An unconscious resident requires immediate nursing or emergency response — the QMA must call for help and stay with the resident.
Question 2: Which site rotation principle reduces the risk of lipohypertrophy during insulin injection?
- Rotate injections within the same anatomical region each week
- Use only the abdomen to ensure consistent absorption
- Inject at least 1 inch away from the previous injection site (Correct answer)
- Alternate between the arm and thigh every injection
Correct answer: Inject at least 1 inch away from the previous injection site
Spacing injections at least 1 inch from the previous site prevents fatty tissue buildup (lipohypertrophy) that impairs absorption.
Question 3: A resident's blood glucose reads 'HI' (above meter range) before an insulin dose. The QMA should:
- Hold the insulin and notify the nurse immediately (Correct answer)
- Administer the full scheduled dose as ordered
- Administer half the scheduled dose
- Recheck in 15 minutes and then give the dose
Correct answer: Hold the insulin and notify the nurse immediately
An out-of-range 'HI' reading is an emergency finding that requires nurse notification before any insulin is given.
Question 4: When disposing of a used insulin syringe, the QMA must:
- Place it immediately into an approved sharps container without recapping (Correct answer)
- Recap the needle and place it in a regular trash bag
- Break the needle off before disposal
- Leave it on the medication cart for later disposal
Correct answer: Place it immediately into an approved sharps container without recapping
Needles must go directly into a puncture-resistant sharps container to prevent needlestick injuries — recapping is prohibited.
Question 5: A resident reports tingling lips and sudden hunger 30 minutes after receiving insulin. Blood glucose is 62 mg/dL. The appropriate treatment is:
- 15 grams of fast-acting carbohydrate such as 4 oz juice (Correct answer)
- A full meal immediately
- An additional insulin dose to stabilize levels
- Withhold all food until the nurse arrives
Correct answer: 15 grams of fast-acting carbohydrate such as 4 oz juice
The 15-15 rule calls for 15 g of fast-acting carbohydrate for mild hypoglycemia in a conscious, swallowing-capable resident.
Question 6: After treating mild hypoglycemia with juice, when should the QMA recheck blood glucose?
- In 15 minutes (Correct answer)
- In 1 hour
- Immediately after the resident finishes drinking
- Only if symptoms worsen
Correct answer: In 15 minutes
The 15-15 rule requires rechecking blood glucose 15 minutes after treatment to confirm adequate response.
Question 7: Which action by a QMA during insulin administration violates standard safety practice?
- Drawing up insulin in a brightly lit hallway where other staff pass (Correct answer)
- Verifying the resident's identity with two identifiers
- Checking the insulin vial label three times
- Recording the injection site in the MAR
Correct answer: Drawing up insulin in a brightly lit hallway where other staff pass
Preparing medications in a high-traffic, distracting area increases the risk of preparation errors and contamination.
QMA Insulin Safety and Emergency Procedures 2
A resident receiving insulin is found unconscious and unresponsive.
What is the QMA's FIRST action?