QMA Insulin Sliding Scale Insulin 3 — Questions and Answers
Question 1: Why must the QMA rotate insulin injection sites?
- To reduce the risk of infection only
- To prevent lipohypertrophy and ensure consistent absorption (Correct answer)
- Because regulations require it
- To make documentation easier
Correct answer: To prevent lipohypertrophy and ensure consistent absorption
Rotating sites prevents lipohypertrophy (fatty tissue buildup) which impairs insulin absorption and leads to unpredictable glucose control.
Question 2: A resident's sliding scale order has not been renewed and expired at midnight. It is now 7 AM and the resident's glucose is 280 mg/dL. What should the QMA do?
- Use the previous scale until the nurse responds
- Administer the last documented dose
- Hold insulin and notify the nurse to obtain a new order (Correct answer)
- Contact the pharmacy directly for a renewal
Correct answer: Hold insulin and notify the nurse to obtain a new order
Expired orders are invalid; the QMA must hold the medication and notify the nurse so a new physician order can be obtained.
Question 3: Which symptom would indicate a resident is experiencing hypoglycemia after receiving sliding scale insulin?
- Fruity breath and frequent urination
- Shakiness, sweating, and confusion (Correct answer)
- Flushed dry skin and extreme thirst
- Slow deep breathing and nausea
Correct answer: Shakiness, sweating, and confusion
Shakiness, diaphoresis, and confusion are classic signs of hypoglycemia caused by blood glucose falling too low.
Question 4: Before drawing up insulin from a vial, the QMA should inspect the vial for all of the following EXCEPT:
- Expiration date
- Clarity and color of the solution
- The resident's name printed on the vial label (Correct answer)
- Presence of particles or cloudiness in regular insulin
Correct answer: The resident's name printed on the vial label
Resident names are not printed on vials; the QMA verifies the right resident by checking the MAR and using two identifiers, not the vial label.
Question 5: A QMA administers insulin to the wrong resident. What is the PRIORITY action?
- Complete an incident report and continue the medication pass
- Notify the nurse immediately and monitor the resident closely (Correct answer)
- Document the error and notify the family first
- Recheck the resident's blood glucose and wait for symptoms
Correct answer: Notify the nurse immediately and monitor the resident closely
A medication error requires immediate nurse notification so clinical assessment and intervention can occur to protect the resident's safety.
Question 6: Which body site has the FASTEST absorption rate for subcutaneous insulin?
- Thigh
- Buttocks
- Abdomen (Correct answer)
- Upper arm
Correct answer: Abdomen
The abdomen has the fastest and most consistent insulin absorption rate among subcutaneous injection sites.
Question 7: How long should a QMA hold gentle pressure on the injection site after administering insulin?
- Rub vigorously for 30 seconds
- Apply pressure for 5-10 seconds without rubbing (Correct answer)
- No pressure is needed after subcutaneous injection
- Hold pressure for at least 2 minutes
Correct answer: Apply pressure for 5-10 seconds without rubbing
Gentle pressure for 5-10 seconds stops minor bleeding, while rubbing is avoided because it can accelerate insulin absorption unpredictably.
QMA Insulin Sliding Scale Insulin 3
Why must the QMA rotate insulin injection sites?