INDIANA QMA INSULIN
ADMINISTRATION ACTUAL EXAM
QUESTIONS AND ANSWERS
1. A QMA in Indiana is authorized to administer insulin under which of the following
conditions?
A. Independently based on the resident’s glucose reading.
B. If the resident is stable and has been on the same dose for a year.
C. Only if the facility administrator gives verbal permission.
D. Only after completing an IDOH-approved insulin certification program and under RN
supervision.
Answer: D
Conceptual Explanation: In Indiana, a QMA must complete a specific state-approved
training and competency evaluation to administer insulin, and they must always function
under the supervision of a licensed nurse.
2. Which type of insulin is characterized by an onset of 15 minutes and should be
administered immediately before a meal?
A. NPH (Humulin N)
,B. Regular (Humulin R)
C. Glargine (Lantus)
D. Lispro (Humalog)
Answer: D
Conceptual Explanation: Lispro is a rapid-acting insulin with an onset of approximately
15 minutes, requiring the resident to eat shortly after administration to prevent
hypoglycemia.
3. When mixing Regular and NPH insulin in the same syringe, what is the correct sequence of
drawing them up?
A. Cloudy (NPH) first, then Clear (Regular).
B. It does not matter as long as the total dose is correct.
C. Clear (Regular) first, then Cloudy (NPH).
D. They should never be mixed in the same syringe.
Answer: C
Conceptual Explanation: The ‘Clear to Cloudy’ rule prevents contaminating the fast-acting
(Clear) insulin vial with the longer-acting (Cloudy) protein-bound insulin.
4. Which of the following is a classic symptom of hyperglycemia?
A. Cold, clammy skin.
B. Excessive thirst (Polydipsia).
, C. Sudden onset of shakiness.
D. Slurred speech.
Answer: B
Conceptual Explanation: Hyperglycemia (high blood sugar) typically presents with the ‘3
Ps’: Polydipsia (thirst), Polyphagia (hunger), and Polyuria (frequent urination).
5. What is the primary reason for rotating insulin injection sites?
A. To prevent the resident from becoming bored with one site.
B. To increase the speed of insulin onset.
C. To prevent lipodystrophy, which can interfere with insulin absorption.
D. To ensure the QMA practices using different muscle groups.
Answer: C
Conceptual Explanation: Repeatedly using the same site can cause lipodystrophy (fatty
lumps), which significantly alters the rate at which insulin is absorbed into the
bloodstream.
6. A resident is found sweaty, confused, and trembling two hours after receiving rapid-acting
insulin. What is the most likely cause?
A. Hyperglycemic Hyperosmolar State.
B. Ketoacidosis.
C. Normal reaction to insulin.
ADMINISTRATION ACTUAL EXAM
QUESTIONS AND ANSWERS
1. A QMA in Indiana is authorized to administer insulin under which of the following
conditions?
A. Independently based on the resident’s glucose reading.
B. If the resident is stable and has been on the same dose for a year.
C. Only if the facility administrator gives verbal permission.
D. Only after completing an IDOH-approved insulin certification program and under RN
supervision.
Answer: D
Conceptual Explanation: In Indiana, a QMA must complete a specific state-approved
training and competency evaluation to administer insulin, and they must always function
under the supervision of a licensed nurse.
2. Which type of insulin is characterized by an onset of 15 minutes and should be
administered immediately before a meal?
A. NPH (Humulin N)
,B. Regular (Humulin R)
C. Glargine (Lantus)
D. Lispro (Humalog)
Answer: D
Conceptual Explanation: Lispro is a rapid-acting insulin with an onset of approximately
15 minutes, requiring the resident to eat shortly after administration to prevent
hypoglycemia.
3. When mixing Regular and NPH insulin in the same syringe, what is the correct sequence of
drawing them up?
A. Cloudy (NPH) first, then Clear (Regular).
B. It does not matter as long as the total dose is correct.
C. Clear (Regular) first, then Cloudy (NPH).
D. They should never be mixed in the same syringe.
Answer: C
Conceptual Explanation: The ‘Clear to Cloudy’ rule prevents contaminating the fast-acting
(Clear) insulin vial with the longer-acting (Cloudy) protein-bound insulin.
4. Which of the following is a classic symptom of hyperglycemia?
A. Cold, clammy skin.
B. Excessive thirst (Polydipsia).
, C. Sudden onset of shakiness.
D. Slurred speech.
Answer: B
Conceptual Explanation: Hyperglycemia (high blood sugar) typically presents with the ‘3
Ps’: Polydipsia (thirst), Polyphagia (hunger), and Polyuria (frequent urination).
5. What is the primary reason for rotating insulin injection sites?
A. To prevent the resident from becoming bored with one site.
B. To increase the speed of insulin onset.
C. To prevent lipodystrophy, which can interfere with insulin absorption.
D. To ensure the QMA practices using different muscle groups.
Answer: C
Conceptual Explanation: Repeatedly using the same site can cause lipodystrophy (fatty
lumps), which significantly alters the rate at which insulin is absorbed into the
bloodstream.
6. A resident is found sweaty, confused, and trembling two hours after receiving rapid-acting
insulin. What is the most likely cause?
A. Hyperglycemic Hyperosmolar State.
B. Ketoacidosis.
C. Normal reaction to insulin.
