The Ultimate Indiana QMA
Certification Exam Compendium:
State-Approved Questions, Correct
Answers, and Clinical Rationales for
2026
A QMA is permitted to administer medications via which routes?
Answer: Oral, topical, ophthalmic, otic, nasal, vaginal, rectal, and via G-tube
or J-tube .
Rationale: Indiana law strictly defines the QMA scope of practice to
exclude parenteral routes (injections) to ensure patient safety.
Administering medications through a Gastrostomy tube (G-tube) or
Jejunostomy tube (J-tube) is permitted as it is a non-invasive enteral route.
A QMA is prohibited from administering medication by which route?
Answer: Intramuscular (IM), intravenous (IV), intradermal, or subcutaneous
injection .
Rationale: The administration of medications by injection is considered an
invasive procedure that requires the advanced clinical judgment and skill of
a licensed nurse, and is thus outside the QMA scope of practice .
The Qualified Medication Aide (QMA) program was established in which
year?
Answer: 1977 .
,Rationale: The program was created to train medication aides specifically
for safe medication administration in long-term care settings under the
supervision of licensed nurses.
Which of the following tasks is a QMA permitted to perform?
Answer: Perform hemoccult testing on stool specimens as ordered by a
physician .
Rationale: The QMA's scope of practice includes performing simple, non-
invasive diagnostic tests like hemoccult testing. A QMA is prohibited from
conducting independent assessments or contacting a physician directly.
A QMA may apply topical medications to which of the following
conditions?
Answer: Stage I decubitus ulcers .
Rationale: A QMA is limited to applying topical medications to minor skin
conditions, including Stage I pressure ulcers. Treatment of open wounds
(Stage III or IV, surgical wounds) requires the assessment and skill of a
licensed nurse.
What is the first action a QMA must take upon discovering a medication
error?
Answer: Report the error to the licensed nurse immediately .
Rationale: The priority is to ensure the resident's safety through prompt
assessment and intervention by a licensed nurse. Documentation and
physician notification are secondary steps directed by the nurse .
Medication error reports are reviewed by whom?
Answer: The Medical Director and the Director of Nursing .
Rationale: These administrative and medical leaders review error reports to
identify systemic issues and design plans to prevent future errors.
The five traditional rights of medication administration include the right
resident, right drug, right dose, right route, and:
,Answer: Right time .
Rationale: The foundation of safe medication administration is based on
these five core principles. Many facilities add a sixth right, such as "right
documentation" or "right to refuse."
The sixth right of medication administration often cited by facilities is:
Answer: Right documentation .
Rationale: Documentation is a critical final step that provides a legal record
of administration and ensures accountability.
Before administering a medication, the QMA should verify the resident's
identity using at least:
Answer: Two identifiers, such as name and date of birth .
Rationale: Using at least two unique identifiers, compared against the
Medication Administration Record (MAR), is a national patient safety goal
to prevent medication errors. Relying solely on a room number is unsafe .
The "Right Resident" component ensures that the QMA:
Answer: Confirms the resident's name, birth date, and room number
against the MAR and ID band .
Rationale: This step is essential to prevent administering a medication to
the wrong resident.
The "right to refuse" medication means that the QMA:
Answer: Must respect the resident's refusal and document it .
Rationale: Competent residents have the legal right to refuse treatment.
The QMA must document the refusal and notify the nurse/physician for
follow-up.
How many checks of the MAR should a QMA perform before administering
a medication?
Answer: Three checks .
Rationale: The three checks occur: (1) when removing the medication from
, storage, (2) when preparing the medication, and (3) immediately before
administering it to the resident.
A physician orders a medication to be given "BID." This means the
medication should be administered:
Answer: Twice daily .
Rationale: "BID" is the abbreviation for the Latin "bis in die," meaning twice
daily.
A physician orders a medication to be given "TID." This means the
medication should be administered:
Answer: Three times daily .
Rationale: "TID" is the abbreviation for "ter in die," meaning three times
daily.
A physician orders a medication to be given "PRN." This means the
medication should be administered:
Answer: As needed .
Rationale: The abbreviation "PRN" stands for "pro re nata," which means
the medication is administered based on the resident's symptoms and
clinical need.
Before administering a PRN medication, the QMA must:
Answer: Obtain authorization from the licensed nurse .
Rationale: A licensed nurse must assess the resident to determine if the
PRN medication is clinically indicated. The QMA cannot exercise
independent clinical judgment .
What is required in the documentation of a PRN medication?
Answer: The need for the medication, the time symptoms occurred, and
that the nurse was contacted .
Rationale: This documentation provides a complete clinical record,
justifying the administration and ensuring nurse oversight.
Certification Exam Compendium:
State-Approved Questions, Correct
Answers, and Clinical Rationales for
2026
A QMA is permitted to administer medications via which routes?
Answer: Oral, topical, ophthalmic, otic, nasal, vaginal, rectal, and via G-tube
or J-tube .
Rationale: Indiana law strictly defines the QMA scope of practice to
exclude parenteral routes (injections) to ensure patient safety.
Administering medications through a Gastrostomy tube (G-tube) or
Jejunostomy tube (J-tube) is permitted as it is a non-invasive enteral route.
A QMA is prohibited from administering medication by which route?
Answer: Intramuscular (IM), intravenous (IV), intradermal, or subcutaneous
injection .
Rationale: The administration of medications by injection is considered an
invasive procedure that requires the advanced clinical judgment and skill of
a licensed nurse, and is thus outside the QMA scope of practice .
The Qualified Medication Aide (QMA) program was established in which
year?
Answer: 1977 .
,Rationale: The program was created to train medication aides specifically
for safe medication administration in long-term care settings under the
supervision of licensed nurses.
Which of the following tasks is a QMA permitted to perform?
Answer: Perform hemoccult testing on stool specimens as ordered by a
physician .
Rationale: The QMA's scope of practice includes performing simple, non-
invasive diagnostic tests like hemoccult testing. A QMA is prohibited from
conducting independent assessments or contacting a physician directly.
A QMA may apply topical medications to which of the following
conditions?
Answer: Stage I decubitus ulcers .
Rationale: A QMA is limited to applying topical medications to minor skin
conditions, including Stage I pressure ulcers. Treatment of open wounds
(Stage III or IV, surgical wounds) requires the assessment and skill of a
licensed nurse.
What is the first action a QMA must take upon discovering a medication
error?
Answer: Report the error to the licensed nurse immediately .
Rationale: The priority is to ensure the resident's safety through prompt
assessment and intervention by a licensed nurse. Documentation and
physician notification are secondary steps directed by the nurse .
Medication error reports are reviewed by whom?
Answer: The Medical Director and the Director of Nursing .
Rationale: These administrative and medical leaders review error reports to
identify systemic issues and design plans to prevent future errors.
The five traditional rights of medication administration include the right
resident, right drug, right dose, right route, and:
,Answer: Right time .
Rationale: The foundation of safe medication administration is based on
these five core principles. Many facilities add a sixth right, such as "right
documentation" or "right to refuse."
The sixth right of medication administration often cited by facilities is:
Answer: Right documentation .
Rationale: Documentation is a critical final step that provides a legal record
of administration and ensures accountability.
Before administering a medication, the QMA should verify the resident's
identity using at least:
Answer: Two identifiers, such as name and date of birth .
Rationale: Using at least two unique identifiers, compared against the
Medication Administration Record (MAR), is a national patient safety goal
to prevent medication errors. Relying solely on a room number is unsafe .
The "Right Resident" component ensures that the QMA:
Answer: Confirms the resident's name, birth date, and room number
against the MAR and ID band .
Rationale: This step is essential to prevent administering a medication to
the wrong resident.
The "right to refuse" medication means that the QMA:
Answer: Must respect the resident's refusal and document it .
Rationale: Competent residents have the legal right to refuse treatment.
The QMA must document the refusal and notify the nurse/physician for
follow-up.
How many checks of the MAR should a QMA perform before administering
a medication?
Answer: Three checks .
Rationale: The three checks occur: (1) when removing the medication from
, storage, (2) when preparing the medication, and (3) immediately before
administering it to the resident.
A physician orders a medication to be given "BID." This means the
medication should be administered:
Answer: Twice daily .
Rationale: "BID" is the abbreviation for the Latin "bis in die," meaning twice
daily.
A physician orders a medication to be given "TID." This means the
medication should be administered:
Answer: Three times daily .
Rationale: "TID" is the abbreviation for "ter in die," meaning three times
daily.
A physician orders a medication to be given "PRN." This means the
medication should be administered:
Answer: As needed .
Rationale: The abbreviation "PRN" stands for "pro re nata," which means
the medication is administered based on the resident's symptoms and
clinical need.
Before administering a PRN medication, the QMA must:
Answer: Obtain authorization from the licensed nurse .
Rationale: A licensed nurse must assess the resident to determine if the
PRN medication is clinically indicated. The QMA cannot exercise
independent clinical judgment .
What is required in the documentation of a PRN medication?
Answer: The need for the medication, the time symptoms occurred, and
that the nurse was contacted .
Rationale: This documentation provides a complete clinical record,
justifying the administration and ensuring nurse oversight.
