Indiana QMA — Insulin Administration Exam: Q&A
Indiana QMA
Insulin Administration Exam
Questions & Answers with Rationales| Latest Update
Page 1
, Indiana QMA — Insulin Administration Exam: Q&A
1.QMA Scope of Practice & Authorization
Question 1. In Indiana, a Qualified Medication Aide (QMA) who wishes to
administer insulin must:
A. Complete additional state-approved insulin administration training beyond
basic QMA certification
B. Simply ask the charge nurse for verbal permission each time
C. Administer insulin without any additional training since it is covered under
basic QMA certification
D. Only observe a nurse administer insulin one time
Correct Answer: A
Rationale: Indiana requires QMAs to complete specific additional training and
demonstrate competency in insulin administration beyond the standard QMA
curriculum before they are authorized to administer insulin to residents,
reflecting the higher risk associated with this medication.
Question 2. Which of the following tasks is OUTSIDE the scope of practice for a
QMA administering insulin?
A. Administering the insulin dose as ordered by the prescriber
B. Independently calculating or adjusting the insulin dose based on the blood
glucose result
C. Checking the blood glucose level using an approved point-of-care device
D. Documenting the administration in the medication administration record
Page 2
, Indiana QMA — Insulin Administration Exam: Q&A
Correct Answer: B
Rationale: QMAs may administer insulin exactly as ordered and may perform
blood glucose checks, but they are not licensed to independently calculate,
interpret sliding-scale orders requiring clinical judgment beyond the written order,
or adjust doses; any deviation or clinical decision-making must involve the
supervising nurse.
Question 3. If a QMA is unsure whether a blood glucose reading warrants
notifying the nurse, the QMA should:
A. Assume it is fine and proceed without reporting
B. Always err on the side of caution and notify the supervising nurse promptly
C. Ask another resident for advice
D. Wait until the next scheduled check to see if it changes
Correct Answer: B
Rationale: QMAs must operate under the delegation and supervision of a licensed
nurse. When there is any uncertainty about a reading or a resident's condition,
the QMA should promptly notify the supervising nurse rather than making an
independent clinical judgment.
Question 4. The overarching supervisory relationship for a QMA administering
insulin in a long-term care setting is best described as:
A. Fully independent practice with no nursing oversight
Page 3
, Indiana QMA — Insulin Administration Exam: Q&A
B. Delegated task performance under the supervision of a licensed nurse who
retains accountability for the nursing process
C. Supervision solely by the physician with no nurse involved
D. Supervision only required for oral medications, not injectable ones
Correct Answer: B
Rationale: Insulin administration by a QMA is a delegated nursing task; the
supervising registered nurse or licensed practical nurse retains overall
responsibility for assessment, care planning, and clinical oversight, while the QMA
performs the specific administration task within defined parameters.
Question 5. A QMA should refuse to administer insulin and must notify the
supervising nurse immediately if:
A. The resident's blood glucose reading is within normal expected range
B. The order is unclear, the dose seems inconsistent with the order, or the
resident's condition has changed significantly
C. The insulin vial is a brand the QMA has used many times before
D. The resident asks a routine question about their diabetes
Correct Answer: B
Rationale: Any ambiguity in the order, discrepancy between the order and
available insulin, or a significant change in the resident's condition (such as
altered mental status or signs of severe hypo/hyperglycemia) requires the QMA
Page 4
Indiana QMA
Insulin Administration Exam
Questions & Answers with Rationales| Latest Update
Page 1
, Indiana QMA — Insulin Administration Exam: Q&A
1.QMA Scope of Practice & Authorization
Question 1. In Indiana, a Qualified Medication Aide (QMA) who wishes to
administer insulin must:
A. Complete additional state-approved insulin administration training beyond
basic QMA certification
B. Simply ask the charge nurse for verbal permission each time
C. Administer insulin without any additional training since it is covered under
basic QMA certification
D. Only observe a nurse administer insulin one time
Correct Answer: A
Rationale: Indiana requires QMAs to complete specific additional training and
demonstrate competency in insulin administration beyond the standard QMA
curriculum before they are authorized to administer insulin to residents,
reflecting the higher risk associated with this medication.
Question 2. Which of the following tasks is OUTSIDE the scope of practice for a
QMA administering insulin?
A. Administering the insulin dose as ordered by the prescriber
B. Independently calculating or adjusting the insulin dose based on the blood
glucose result
C. Checking the blood glucose level using an approved point-of-care device
D. Documenting the administration in the medication administration record
Page 2
, Indiana QMA — Insulin Administration Exam: Q&A
Correct Answer: B
Rationale: QMAs may administer insulin exactly as ordered and may perform
blood glucose checks, but they are not licensed to independently calculate,
interpret sliding-scale orders requiring clinical judgment beyond the written order,
or adjust doses; any deviation or clinical decision-making must involve the
supervising nurse.
Question 3. If a QMA is unsure whether a blood glucose reading warrants
notifying the nurse, the QMA should:
A. Assume it is fine and proceed without reporting
B. Always err on the side of caution and notify the supervising nurse promptly
C. Ask another resident for advice
D. Wait until the next scheduled check to see if it changes
Correct Answer: B
Rationale: QMAs must operate under the delegation and supervision of a licensed
nurse. When there is any uncertainty about a reading or a resident's condition,
the QMA should promptly notify the supervising nurse rather than making an
independent clinical judgment.
Question 4. The overarching supervisory relationship for a QMA administering
insulin in a long-term care setting is best described as:
A. Fully independent practice with no nursing oversight
Page 3
, Indiana QMA — Insulin Administration Exam: Q&A
B. Delegated task performance under the supervision of a licensed nurse who
retains accountability for the nursing process
C. Supervision solely by the physician with no nurse involved
D. Supervision only required for oral medications, not injectable ones
Correct Answer: B
Rationale: Insulin administration by a QMA is a delegated nursing task; the
supervising registered nurse or licensed practical nurse retains overall
responsibility for assessment, care planning, and clinical oversight, while the QMA
performs the specific administration task within defined parameters.
Question 5. A QMA should refuse to administer insulin and must notify the
supervising nurse immediately if:
A. The resident's blood glucose reading is within normal expected range
B. The order is unclear, the dose seems inconsistent with the order, or the
resident's condition has changed significantly
C. The insulin vial is a brand the QMA has used many times before
D. The resident asks a routine question about their diabetes
Correct Answer: B
Rationale: Any ambiguity in the order, discrepancy between the order and
available insulin, or a significant change in the resident's condition (such as
altered mental status or signs of severe hypo/hyperglycemia) requires the QMA
Page 4
