QMAP Certification Exam — Questions and Answers

Question 1: A QMAP is organizing the medication cart. To prevent administration errors, how must medications for internal use (oral) be stored in relation to medications for external use (topical)?

They can be stored together if they are for the same resident.
They must be stored in completely different medication carts.
They can be stored on the same shelf if they are in different colored packaging.
They must be stored separately from each other within the locked medication area. (Correct answer)

Correct answer: They must be stored separately from each other within the locked medication area.

To prevent the accidental ingestion of a topical or other external-use-only product, regulations require that internal and external medications be stored in separate, designated areas within the locked cart or room.

Question 2: A QMAP observes redness and drainage at a resident's medication patch application site. What is the appropriate infection control and reporting action?

Ignore it unless the resident complains of pain
Remove the old patch, clean the site, and report the observed signs to the supervising nurse immediately (Correct answer)
Apply an over-the-counter antibiotic ointment before placing the new patch
Apply the new patch over the same site and document it on the MAR

Correct answer: Remove the old patch, clean the site, and report the observed signs to the supervising nurse immediately

Signs of local infection at a patch site require the QMAP to remove the old patch, clean the area, and promptly report to a supervising nurse for clinical assessment.

Question 3: What is the primary purpose of the controlled substance count at shift change?

To verify the physical count matches documentation and detect diversion (Correct answer)
To determine if more medication needs to be ordered
To check expiration dates
To update the prescriber on remaining supply

Correct answer: To verify the physical count matches documentation and detect diversion

The count verifies that physical inventory matches documentation, helping detect missing medications that could indicate diversion.

Question 4: A resident has an order for a liquid medication with a dose of 300 mg. The medication's label states the strength is '100 mg per 5 mL'. How many milliliters (mL) should the QMAP pour?

10 mL
5 mL
20 mL
15 mL (Correct answer)

Correct answer: 15 mL

This is a ratio and proportion problem. You know that 5 mL contains 100 mg. You need to administer 300 mg. Set up the equation: (100 mg / 5 mL) = (300 mg / X mL). To find X, you can see that 300 mg is 3 times 100 mg, so you need 3 times the volume: 3 x 5 mL = 15 mL.

Question 5: Immediately after realizing a medication error has occurred, what is the QMAP's first and most critical priority?

Call the resident's family to inform them of the mistake.
Correct the error on the Medication Administration Record (MAR).
Assess the resident for any adverse reactions or changes in their condition. (Correct answer)
Fill out an incident report to document the error.

Correct answer: Assess the resident for any adverse reactions or changes in their condition.

The absolute first priority after a medication error is the resident's safety. The QMAP must immediately assess the resident's condition to check for any adverse effects or harm caused by the error. All other steps, such as notifying supervisors, documenting, and informing family, come after ensuring the resident is safe.

Question 6: A resident with an order for a PRN (as-needed) controlled substance for pain refuses the dose when it is offered. Which of the following describes the correct actions by the QMAP?

Crush the medication and mix it in food to ensure the resident receives the needed pain relief.
Leave the medication at the resident's bedside in case they change their mind later.
Document the refusal on the MAR, return the medication to the double-locked storage, and ensure the count on the controlled substance record remains accurate. (Correct answer)
Discard the medication in a sharps container and document it as given to keep the count correct.

Correct answer: Document the refusal on the MAR, return the medication to the double-locked storage, and ensure the count on the controlled substance record remains accurate.

The QMAP must respect the resident's right to refuse medication. The refusal must be documented on the MAR. For a controlled substance, the medication must not be discarded or left out; it must be returned to secure storage, and the controlled substance count sheet must accurately reflect that the dose was not administered, leaving the physical count unchanged.

Question 7: Which is a common sign of opioid overdose?

Extremely slow or stopped breathing with pinpoint pupils (Correct answer)
Increased alertness and tremors
Rapid breathing and agitation
High blood pressure and flushed skin

Correct answer: Extremely slow or stopped breathing with pinpoint pupils

The classic triad: respiratory depression, pinpoint pupils (miosis), and decreased consciousness.

Question 8: A QMAP is uncertain about a medication order that appears unclear. What is the correct action?

Ask a coworker what they would do
Use best judgment and administer the most likely intended dose
Withhold the medication and clarify the order with the supervising nurse before administering (Correct answer)
Skip the dose and document it without reporting

Correct answer: Withhold the medication and clarify the order with the supervising nurse before administering

Any unclear medication order must be clarified with the supervising nurse before administration to prevent medication errors.

Question 9: At what temperature should medications labeled "store at room temperature" be kept?

80-90 F
68-77 F (20-25 C) (Correct answer)
50-60 F
Any temperature

Correct answer: 68-77 F (20-25 C)

Room temperature for medication storage is 68-77 F (20-25 C) per USP standards.

Question 10: A resident refuses their prescribed medication. What should the QMAP do?

Document the refusal and notify the supervising nurse (Correct answer)
Explain they are required to take it by law
Disguise the medication in food
Skip documentation and try again later

Correct answer: Document the refusal and notify the supervising nurse

Residents have the right to refuse medication. Document the refusal and notify the supervising nurse.

Question 11: A resident taking an ACE inhibitor develops a persistent dry cough. The QMAP should:

Assume the cough is due to a cold and does not need reporting
Stop the medication without consulting the nurse
Give the resident cough drops and continue medication without reporting
Document and report the cough to the nurse, as it is a common side effect of ACE inhibitors that may require a medication change (Correct answer)

Correct answer: Document and report the cough to the nurse, as it is a common side effect of ACE inhibitors that may require a medication change

A persistent dry cough is a well-known side effect of ACE inhibitors and should be reported to the nurse so a medication change can be considered.

Question 12: What does "PRN" mean on a medication order?

Take as needed (Correct answer)
Take daily
Take at bedtime
Take with food

Correct answer: Take as needed

PRN means "pro re nata" - as needed. Given only when specific conditions or symptoms are present.

Question 13: A medication order says "apply to affected area BID." What does this tell the QMAP about the route?

It is an oral medication
It is sublingual
It is a rectal medication
It is a topical medication applied to a specific area twice daily (Correct answer)

Correct answer: It is a topical medication applied to a specific area twice daily

"Apply to affected area" indicates topical, and BID means twice daily.

Question 14: What are the 2 main categories of Medication:

Liquid and Solid
Prescribed and Over the Counter (Correct answer)
Injectable and Oral
Brand-name and Generic

Correct answer: Prescribed and Over the Counter

Explanation: Medications are typically categorized into two main categories: prescribed medications, which are prescribed by healthcare providers, and over-the-counter medications, which can be purchased without a prescription. These categories help distinguish between medications that require professional medical guidance and those that can be self-administered.

Question 15: A QMAP is preparing to administer 9:00 AM medications. They notice the physician's order for a resident's medication does not specify the route of administration. Which of the 'Seven Rights' is missing and requires clarification before proceeding?

Right Time
Right Dose
Right Medication
Right Route (Correct answer)

Correct answer: Right Route

The 'Right Route' is a critical component of the Seven Rights, specifying how the medication is to be given (e.g., by mouth, topically). Without this information, the QMAP cannot safely administer the drug and must seek clarification.

Question 16: How should controlled substances be physically stored in a residential care facility?

In a separately locked container within the locked medication area with limited key access (Correct answer)
In the facility safe
In each resident's personal drawer
In the same locked cabinet as other medications

Correct answer: In a separately locked container within the locked medication area with limited key access

Controlled substances require double-lock: a separately locked container inside the locked medication storage area.

Question 17: When administering ear drops, what should the QMAP do to straighten the ear canal in an adult resident before instilling the drops?

Pull the earlobe downward and forward
Press firmly on the tragus (the small flap in front of the ear opening)
Pull the outer ear upward and backward (Correct answer)
Tilt the resident's head toward the affected ear

Correct answer: Pull the outer ear upward and backward

In adults, gently pulling the outer ear (pinna) upward and backward straightens the ear canal, allowing drops to reach the eardrum more effectively.

Question 18: A new medication is added mid-month. When should the QMAP begin documenting it?

After the pharmacy delivers it
At the start of next month
Immediately on the current MAR (Correct answer)
After the next physician visit

Correct answer: Immediately on the current MAR

New orders should be added to the MAR immediately so there is no documentation gap.

Question 19: Which abbreviation means "twice a day" on a medication order?

QID
QD
TID
BID (Correct answer)

Correct answer: BID

BID stands for "bis in die," Latin for twice a day.

Question 20: A resident takes a statin medication. Statins are primarily used for what purpose?

Treating infections
Pain relief
Lowering cholesterol levels (Correct answer)
Reducing blood sugar

Correct answer: Lowering cholesterol levels

Statins lower LDL cholesterol, reducing the risk of heart attack and stroke.

Question 21: Single-dose (unit-dose) medication packaging supports infection control primarily because it:

Allows medications to be shared between residents if needed
Reduces the risk of cross-contamination by providing a sterile, sealed package for each dose (Correct answer)
Makes it easier to count controlled substances
Eliminates the need for hand hygiene before administration

Correct answer: Reduces the risk of cross-contamination by providing a sterile, sealed package for each dose

Unit-dose packaging keeps each dose in a sealed, sterile environment until the moment of administration, minimizing the risk of contamination from handling or environmental exposure.

Question 22: What term describes a medication that is used to prevent or treat nausea and vomiting?

Antipyretic
Antispasmodic
Antiemetic (Correct answer)
Antihypertensive

Correct answer: Antiemetic

Antiemetics are the class of drugs used to control nausea and vomiting. The prefix 'emetic' refers to vomiting, so 'antiemetic' means against vomiting. Examples include ondansetron (Zofran) and promethazine.

Question 23: What is the "Swiss cheese model" as it applies to medication error prevention?

A dietary consideration
A method for organizing medications
A training program
A model showing errors occur when holes in multiple safety layers align (Correct answer)

Correct answer: A model showing errors occur when holes in multiple safety layers align

Each safety measure is like a slice of Swiss cheese with holes. Errors reach residents only when gaps in all layers align.

Question 24: A resident refuses medication due to religious beliefs. How should the QMAP respond?

Ignore the objection and administer
Tell the resident their beliefs are wrong
Respect the beliefs, document the refusal with stated reason, and notify the supervising nurse (Correct answer)
Only respect if the religion is well-known

Correct answer: Respect the beliefs, document the refusal with stated reason, and notify the supervising nurse

Religious beliefs are a valid and protected basis for medication refusal.

Question 25: A resident with a mental health condition refuses psychiatric medication. The QMAP should know that:

Psychiatric residents lose refusal rights
Residents retain refusal rights except in very limited court-ordered circumstances (Correct answer)
Only prescribers can force medication
QMAPs can force medication if the resident seems unstable

Correct answer: Residents retain refusal rights except in very limited court-ordered circumstances

Even residents with mental health conditions retain medication refusal rights. Forced medication requires specific legal processes.

Question 26: A physician's order states to give a resident 1 ounce of a liquid medication. The medication cup is marked only in milliliters (mL). How many mL should the QMAP pour to administer the correct dose?

5 mL
30 mL (Correct answer)
50 mL
15 mL

Correct answer: 30 mL

The standard medical conversion is 1 ounce (oz) is equivalent to 30 milliliters (mL).

Question 27: A QMAP discovers they initialed the 8:00 AM medication slot for a resident who actually refused the medication. What is the correct procedure to fix this documentation error on the MAR?

Completely black out the initials with a pen and write 'Refused' next to it.
Draw a single line through the mistaken initials, date and initial the change, then document the refusal on the back of the MAR or in the notes section. (Correct answer)
Use correction fluid to cover the incorrect initials and leave the box blank.
Ask the next shift's QMAP to witness and co-sign the correction.

Correct answer: Draw a single line through the mistaken initials, date and initial the change, then document the refusal on the back of the MAR or in the notes section.

The proper procedure for correcting a documentation error on a MAR is to draw a single line through the error, initial and date the change. You must then add a note, typically on the back of the MAR or in a designated section, explaining the reason for the correction (e.g., resident refusal). Never use correction fluid or obliterate the original entry, as the MAR is a legal document.

Question 28: A QMAP discovers that a resident's medication was not delivered from the pharmacy and is therefore unavailable to administer at the scheduled time. This situation is considered what type of medication error?

Wrong Route
Omission/Unavailable Medication (Correct answer)
Wrong Dose
Wrong Documentation

Correct answer: Omission/Unavailable Medication

A medication error includes any failure in the medication administration process. When a medication is unavailable because it was not reordered or delivered, and this results in a missed dose, it is categorized as an error of omission or an unavailable medication. It is the facility's and QMAP's responsibility to ensure medications are available.

Question 29: The prescribed dose is 10 mg but only 5 mg tablets are available. What should the QMAP do?

Contact pharmacy for 10 mg tablets
Skip the dose
Give two 5 mg tablets to equal 10 mg (Correct answer)
Give one 5 mg tablet as a partial dose

Correct answer: Give two 5 mg tablets to equal 10 mg

Two 5 mg tablets equal the prescribed 10 mg dose. This is standard dosage calculation.

Question 30: Which route of administration involves placing medication under the tongue?

Topical
Enteral
Sublingual (Correct answer)
Buccal

Correct answer: Sublingual

Sublingual means "under the tongue." Medications are absorbed through mucous membranes into the bloodstream.

Question 31: A medication is ordered "PO." What route does this indicate?

By mouth (per os) (Correct answer)
Per ostomy
Per otic (ear)
Placed on (topical)

Correct answer: By mouth (per os)

PO stands for "per os," Latin for "by mouth" - the most common administration route.

Question 32: A QMAP realizes they forgot to document a medication given two hours ago. What is the proper procedure?

Document now with the actual time given, noted as a late entry (Correct answer)
Skip the documentation
Ask another staff member to document it
Document it as if just given

Correct answer: Document now with the actual time given, noted as a late entry

Make a late entry with the actual administration time and mark it as a "late entry."

Question 33: What does the term "biotransformation" refer to in medication administration?

Breaking substances down chemically changes substances (Correct answer)
Absorption of medication into the bloodstream
Applying medication through the skin
Mixing medications with food before ingestion

Correct answer: Breaking substances down chemically changes substances

Explanation: Biotransformation involves the chemical alteration of substances within the body, typically referring to the metabolism of drugs by enzymes in the liver or other organs. This process can lead to the breakdown of drugs into metabolites, which may be further excreted from the body.

Question 34: Which information must be included on the MAR for each PRN medication administration?

Time given, reason for administration, and resident response after an appropriate interval (Correct answer)
Time and a checkmark
Only the complaint
Only the time

Correct answer: Time given, reason for administration, and resident response after an appropriate interval

PRN documentation requires time, reason for giving it, and follow-up on the resident's response.

Question 35: What is the legal scope of practice for a QMAP in Colorado?

Authorized to administer medications as delegated by a licensed nurse within regulatory guidelines (Correct answer)
Can prescribe and administer any medication
Same authority as registered nurses
Can modify medication orders based on assessment

Correct answer: Authorized to administer medications as delegated by a licensed nurse within regulatory guidelines

QMAPs operate under delegation from a licensed nurse within Colorado State Board of Nursing regulations.

Question 36: A QMAP notices a medication has changed color since last given. What should they do?

Withhold it and contact the pharmacist or supervising nurse (Correct answer)
Crush it and mix with juice
Administer it since the prescription hasn't changed
Discard it and give from new supply

Correct answer: Withhold it and contact the pharmacist or supervising nurse

Color changes may indicate deterioration or contamination. Withhold and contact the pharmacist.

Question 37: Which route delivers medication through the skin into the bloodstream via a patch?

Topical
Transdermal (Correct answer)
Sublingual
Intramuscular

Correct answer: Transdermal

Transdermal patches deliver medication through the skin into the bloodstream for systemic effect.

Question 38: Which is the correct sequence for removing (doffing) contaminated PPE to minimize self-contamination?

Gown, gloves, mask, then hand hygiene
Gloves, gown, mask, then hand hygiene (Correct answer)
Hand hygiene, gloves, gown, then mask
Mask, gloves, gown, then hand hygiene

Correct answer: Gloves, gown, mask, then hand hygiene

The correct doffing sequence is gloves first (most contaminated), then gown, then mask, followed by hand hygiene to minimize transfer of pathogens to clean areas.

Question 39: A resident with dementia sometimes agrees to medications and sometimes refuses. How should the QMAP handle this?

Respect each refusal, document it, notify the nurse, and follow advance directives or guardian instructions (Correct answer)
Always force the medication
Only give when the resident agrees, regardless of other instructions
Crush and hide in food without authorization

Correct answer: Respect each refusal, document it, notify the nurse, and follow advance directives or guardian instructions

Respect refusals while following established care plans including advance directives and guardian instructions.

Question 40: A resident is prescribed both eye drops and eye ointment for the same eye. In what order should they be administered?

Drops first, then ointment (Correct answer)
Only one should be given
Both simultaneously
Ointment first

Correct answer: Drops first, then ointment

Eye drops first because ointment creates a barrier that prevents drop absorption.

Question 41: A resident's family member asks for details about the resident's medications. What should the QMAP do?

Refer to the supervising nurse, as sharing may violate privacy regulations (Correct answer)
Tell them to look at the MAR
Provide all information since family has a right to know
Give only medication names

Correct answer: Refer to the supervising nurse, as sharing may violate privacy regulations

Sharing medication information is governed by HIPAA. Refer inquiries to the supervising nurse.

Question 42: When transcribing a new medication order onto the MAR, what is the primary source a QMAP must use?

Verbal instructions from the facility nurse.
The previous month's MAR.
The pharmacy label on the medication bottle.
The written physician's order. (Correct answer)

Correct answer: The written physician's order.

To ensure accuracy and prevent errors, a new medication must always be transcribed onto the MAR directly from the current, written physician's order. Copying from an old MAR or relying on other sources introduces a high risk of perpetuating a past error. QMAPs are not permitted to accept verbal or phone orders.

Question 43: Where would you administer medication that is labeled "ophthalmic"?

In the nose
In the eyes (Correct answer)
In the mouth
In the ears

Correct answer: In the eyes

Explanation: "Ophthalmic" refers to medications that are intended for use in the eyes. These medications can be prescribed by a healthcare provider or available over the counter for certain conditions such as eye irritation or infections.

Question 44: What does "PRN" stand for in medication administration?

Qualified
As needed (Correct answer)
Before bedtime
By mouth

Correct answer: As needed

Explanation: "PRN" is a medical abbreviation that stands for "pro re nata," which means "as needed" in Latin. It indicates that a medication should be administered only when necessary, based on the patient's condition or symptoms.

Question 45: A new resident arrives and refuses several medications. The QMAP should understand that:

New residents must take all medications as a condition of admission
The resident has the same refusal rights as any other resident regardless of admission timing (Correct answer)
Refusal rights do not apply the first week
The admitting physician can override refusal

Correct answer: The resident has the same refusal rights as any other resident regardless of admission timing

Medication refusal rights apply equally from the moment of admission.

Question 46: Which medication administration route involves placing a tablet or liquid under the tongue to dissolve?

Buccal
Sublingual (Correct answer)
Oral
Intranasal

Correct answer: Sublingual

Sublingual administration places medication under the tongue, where it absorbs rapidly through the mucous membranes directly into the bloodstream, bypassing the digestive system.

Question 47: Which of the following best explains why QMAPs must document medication administration immediately after giving a dose?

To satisfy insurance billing requirements only
Documentation is optional if the nurse witnessed the administration
To meet a required daily documentation quota
To provide an accurate, real-time record that prevents accidental double dosing and ensures continuity of care (Correct answer)

Correct answer: To provide an accurate, real-time record that prevents accidental double dosing and ensures continuity of care

Immediate documentation after each dose ensures the MAR accurately reflects what was given, preventing double dosing and supporting safe care continuity.

Question 48: A resident is prescribed a Schedule II controlled substance. What is the minimum security requirement for storing this type of medication in a qualified facility?

In a locked medication cart with other residents' medications.
With the facility administrator for direct oversight.
In the original pharmacy bag, stapled shut, inside the locked medication room.
In a separately locked box that is stored inside another locked cabinet or room. (Correct answer)

Correct answer: In a separately locked box that is stored inside another locked cabinet or room.

Controlled substances, especially Schedule II drugs, have a high potential for diversion and abuse. Colorado regulations mandate they be stored under a "double lock," which means they must be in a locked container that is itself kept within a second, separate locked area.

Question 49: A QMAP is new to a facility and is unsure of a specific medication protocol. What is the best course of action?

Consult the facility's policies and procedures and ask the supervising nurse for clarification before proceeding (Correct answer)
Ask a fellow QMAP who has worked there longer
Proceed based on prior training at a different facility
Skip the task until the shift supervisor is available

Correct answer: Consult the facility's policies and procedures and ask the supervising nurse for clarification before proceeding

When uncertain, QMAPs should consult facility-specific policies and seek nurse guidance to ensure safe and compliant medication administration.

Question 50: A QMAP notices a discrepancy in the controlled substance count during shift change. What should they do FIRST?

Search the facility for the missing medication
Immediately notify the supervisor without altering documentation (Correct answer)
Adjust the log to match the physical count
Wait until the next count

Correct answer: Immediately notify the supervisor without altering documentation

Report immediately without altering documentation, as this could be evidence of diversion.

Question 51: If a medication is prescribed at a dosage of 500 mg, how many grams is this?

1 g
0.5 g (Correct answer)
5 g
50 g

Correct answer: 0.5 g

Explanation: Since 1 g equals 1000 mg, dividing 500 mg by 1000 gives us 0.5 g.

Question 52: A QMAP gives a resident their evening dose of medication in the morning. After assessing the resident and notifying their supervisor, what is the next critical step in the reporting process?

Cross out the entry on the MAR and pretend it didn't happen.
Wait to see if the resident develops symptoms before documenting.
Document the error in an incident/occurrence report per facility policy. (Correct answer)
Ask the resident not to tell their family about the error.

Correct answer: Document the error in an incident/occurrence report per facility policy.

Proper and factual documentation is a crucial part of handling medication errors. After ensuring the resident's safety and notifying the supervisor, the QMAP must complete an incident or occurrence report. This formal document provides a factual account of the event for internal review, quality improvement, and required reporting to state agencies if necessary.

Question 53: A resident is prescribed Furosemide (Lasix), which is a diuretic. When planning for the resident's day, which common and expected side effect should the QMAP anticipate?

Increased frequency of urination (Correct answer)
Increased appetite
Constipation
Dry, hacking cough

Correct answer: Increased frequency of urination

Furosemide is a loop diuretic that works by helping the kidneys remove excess salt and water from the body through urine. Therefore, an increased frequency of urination is the most direct and expected effect after administration.

QMAP Certification Exam

The Colorado QMAP exam certifies unlicensed personnel to safely administer medications in approved care settings under the Seven Rights framework.

Questions

60 min

Time Limit

80%

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