QMA Insulin Types and Administration Techniques 2 — Questions and Answers
Question 1: Which insulin type has the longest duration of action and is typically given once or twice daily for basal coverage?
- NPH insulin
- Regular insulin
- Glargine (Lantus) (Correct answer)
- Lispro (Humalog)
Correct answer: Glargine (Lantus)
Glargine (Lantus) is a long-acting insulin with a duration of approximately 24 hours, used for basal glucose control.
Question 2: When administering insulin, at what angle should a standard 1/2-inch needle be inserted in an average-weight adult?
- 15 degrees
- 30 degrees
- 45 degrees
- 90 degrees (Correct answer)
Correct answer: 90 degrees
A 90-degree angle is used with a standard 1/2-inch needle in average-weight adults to ensure subcutaneous delivery.
Question 3: Insulin detemir (Levemir) differs from insulin glargine in that it:
- Acts faster and peaks more sharply
- May require twice-daily dosing in some patients (Correct answer)
- Cannot be used in type 2 diabetes
- Must always be mixed with regular insulin
Correct answer: May require twice-daily dosing in some patients
Insulin detemir may have a shorter duration in some patients and is sometimes dosed twice daily to achieve full 24-hour coverage.
Question 4: A resident's insulin pen needle has been used for three injections. What action should the QMA take?
- Replace the needle with a new one before the next injection (Correct answer)
- Continue using it until 10 injections are completed
- Recap and store for reuse the next day
- Soak the needle in alcohol before reuse
Correct answer: Replace the needle with a new one before the next injection
Insulin pen needles are single-use; reuse increases infection risk and causes needle barbing that makes injections more painful.
Question 5: When mixing NPH and regular insulin in the same syringe, which is drawn up first?
- NPH insulin
- Regular insulin (Correct answer)
- Either order is acceptable
- They should never be mixed
Correct answer: Regular insulin
Regular (clear) insulin is drawn first to prevent contaminating the regular insulin vial with NPH (cloudy) insulin.
Question 6: Which of the following insulin types should NEVER be given intravenously?
- Regular insulin
- Insulin aspart
- Insulin glargine (Correct answer)
- Insulin lispro
Correct answer: Insulin glargine
Insulin glargine (Lantus) must never be given IV because its acidic pH can cause serious adverse reactions when administered intravenously.
Question 7: A patient requires a 22-unit insulin dose. After drawing air into the syringe equal to the dose, you inject the air into the vial and then withdraw insulin but notice an air bubble. What is the correct next step?
- Administer the insulin with the bubble since small bubbles are harmless subcutaneously
- Discard the syringe and start over completely
- Tap the syringe and push the bubble out, then recheck the dose (Correct answer)
- Add more insulin to compensate for the volume lost by the bubble
Correct answer: Tap the syringe and push the bubble out, then recheck the dose
Tapping the syringe to move air bubbles to the top and then expelling them ensures an accurate dose is delivered.
QMA Insulin Types and Administration Techniques 2
Which insulin type has the longest duration of action and is typically given once or twice daily for basal coverage?