QMA Insulin Types and Administration Techniques 3 — Questions and Answers
Question 1: Rapid-acting insulin analogs such as lispro, aspart, and glulisine are typically administered:
- 30–60 minutes before meals
- 0–15 minutes before or immediately after meals (Correct answer)
- Only at bedtime
- Once per day regardless of meals
Correct answer: 0–15 minutes before or immediately after meals
Rapid-acting analogs have a quick onset (5–15 minutes) and are given just before or right after eating to match the postprandial glucose rise.
Question 2: Which site of insulin injection generally produces the fastest absorption rate?
- Thigh
- Buttock
- Abdomen (Correct answer)
- Upper arm
Correct answer: Abdomen
The abdomen has the fastest insulin absorption rate due to greater subcutaneous blood flow in that area.
Question 3: A resident who uses an insulin pen leaves the needle attached after injection. The QMA should explain that this can cause:
- Faster insulin absorption
- Insulin leakage or air entering the cartridge (Correct answer)
- Stronger insulin potency
- Reduced hypoglycemia risk
Correct answer: Insulin leakage or air entering the cartridge
Leaving a needle attached allows insulin to leak out or air to enter the cartridge, affecting subsequent dose accuracy.
Question 4: What is the recommended maximum volume for a single subcutaneous insulin injection at one site?
- 0.5 mL
- 1 mL (Correct answer)
- 2 mL
- 5 mL
Correct answer: 1 mL
No more than 1 mL should be injected at a single subcutaneous site to minimize discomfort and ensure proper absorption.
Question 5: Lipohypertrophy at injection sites is most commonly caused by:
- Using too-thin needles
- Rotating injection sites too frequently
- Repeatedly injecting into the same small area (Correct answer)
- Injecting insulin that is too cold
Correct answer: Repeatedly injecting into the same small area
Lipohypertrophy (fatty tissue buildup) results from injecting repeatedly into the same spot, which can cause erratic insulin absorption.
Question 6: A QMA notes that insulin that is normally clear appears cloudy. The correct action is to:
- Warm the vial between the palms to clear it
- Administer it as cloudy insulin still works
- Hold it up to light and invert gently to clarify
- Discard it and obtain a new vial (Correct answer)
Correct answer: Discard it and obtain a new vial
Cloudiness in insulin that should be clear (e.g., regular, glargine, detemir) indicates degradation or contamination and it must be discarded.
Question 7: When performing a subcutaneous insulin injection, the QMA should release the skin fold:
- Before inserting the needle
- Immediately after inserting the needle
- After injecting the insulin and before withdrawing the needle
- After withdrawing the needle (Correct answer)
Correct answer: After withdrawing the needle
The skin fold should be released after needle withdrawal to prevent the needle from being redirected into muscle during injection.
QMA Insulin Types and Administration Techniques 3
Rapid-acting insulin analogs such as lispro, aspart, and glulisine are typically administered: