INDIANA QMA CERTIFICATION EXAM -
ADVANCED PRACTICE AND THEORY
QUESTIONS AND ANSWERS
1. According to the Indiana State Department of Health, which of the following tasks is strictly
prohibited for a QMA to perform?
A. Calling a physician to obtain a new medication order for a resident
B. Applying a physician-ordered dressing to a stage 1 pressure ulcer
C. Administering a medication via a G-tube
D. Administering a PRN medication after obtaining nurse approval
Answer: A
Conceptual Explanation: QMAs in Indiana are not permitted to receive or take new verbal
or telephone orders from a physician; this must be done by a licensed nurse.
2. When administering Digoxin (Lanoxin), the QMA must check the apical pulse. At what rate
should the medication be withheld and the nurse notified?
A. Below 70 beats per minute
B. Below 50 beats per minute
C. Above 90 beats per minute
,D. Below 60 beats per minute
Answer: D
Conceptual Explanation: Digoxin is a cardiac glycoside that slows the heart rate; it is
standard clinical practice to withhold the dose and notify the nurse if the heart rate is
below 60 bpm.
3. A resident is prescribed an enteric-coated medication. The resident has difficulty
swallowing large pills. What action should the QMA take?
A. Crush the pill and mix it with applesauce
B. Dissolve the pill in warm water before administration
C. Cut the pill in half to make it easier to swallow
D. Ask the nurse to request a liquid form from the physician
Answer: D
Conceptual Explanation: Enteric-coated medications are designed to be absorbed in the
small intestine and should never be crushed, cut, or dissolved as this destroys the coating
and affects absorption.
4. Which of the following describes the ‘first pass effect’ in pharmacology?
A. The initial increase in blood pressure after taking a stimulant
B. The metabolism of a drug by the liver before it reaches systemic circulation
C. The rapid excretion of a drug through the kidneys
, D. The allergic reaction occurring immediately after the first dose
Answer: B
Conceptual Explanation: The first pass effect refers to the concentration of a drug being
greatly reduced before it reaches the systemic circulation due to metabolism in the liver.
5. When applying a transdermal nitroglycerin patch, which action by the QMA is correct?
A. Apply the new patch to the same site as the previous one
B. Shave the area before applying the patch to ensure adhesion
C. Date, time, and initial the patch before application
D. Massage the patch after application to increase absorption
Answer: C
Conceptual Explanation: Transdermal patches must be labeled with the date, time, and
initials of the person administering. Sites should be rotated, and massaging is
contraindicated as it may cause rapid absorption.
6. What is the medical term for a life-threatening, immediate allergic reaction?
A. Urticaria
B. Anaphylaxis
C. Angioedema
D. Stomatitis
ADVANCED PRACTICE AND THEORY
QUESTIONS AND ANSWERS
1. According to the Indiana State Department of Health, which of the following tasks is strictly
prohibited for a QMA to perform?
A. Calling a physician to obtain a new medication order for a resident
B. Applying a physician-ordered dressing to a stage 1 pressure ulcer
C. Administering a medication via a G-tube
D. Administering a PRN medication after obtaining nurse approval
Answer: A
Conceptual Explanation: QMAs in Indiana are not permitted to receive or take new verbal
or telephone orders from a physician; this must be done by a licensed nurse.
2. When administering Digoxin (Lanoxin), the QMA must check the apical pulse. At what rate
should the medication be withheld and the nurse notified?
A. Below 70 beats per minute
B. Below 50 beats per minute
C. Above 90 beats per minute
,D. Below 60 beats per minute
Answer: D
Conceptual Explanation: Digoxin is a cardiac glycoside that slows the heart rate; it is
standard clinical practice to withhold the dose and notify the nurse if the heart rate is
below 60 bpm.
3. A resident is prescribed an enteric-coated medication. The resident has difficulty
swallowing large pills. What action should the QMA take?
A. Crush the pill and mix it with applesauce
B. Dissolve the pill in warm water before administration
C. Cut the pill in half to make it easier to swallow
D. Ask the nurse to request a liquid form from the physician
Answer: D
Conceptual Explanation: Enteric-coated medications are designed to be absorbed in the
small intestine and should never be crushed, cut, or dissolved as this destroys the coating
and affects absorption.
4. Which of the following describes the ‘first pass effect’ in pharmacology?
A. The initial increase in blood pressure after taking a stimulant
B. The metabolism of a drug by the liver before it reaches systemic circulation
C. The rapid excretion of a drug through the kidneys
, D. The allergic reaction occurring immediately after the first dose
Answer: B
Conceptual Explanation: The first pass effect refers to the concentration of a drug being
greatly reduced before it reaches the systemic circulation due to metabolism in the liver.
5. When applying a transdermal nitroglycerin patch, which action by the QMA is correct?
A. Apply the new patch to the same site as the previous one
B. Shave the area before applying the patch to ensure adhesion
C. Date, time, and initial the patch before application
D. Massage the patch after application to increase absorption
Answer: C
Conceptual Explanation: Transdermal patches must be labeled with the date, time, and
initials of the person administering. Sites should be rotated, and massaging is
contraindicated as it may cause rapid absorption.
6. What is the medical term for a life-threatening, immediate allergic reaction?
A. Urticaria
B. Anaphylaxis
C. Angioedema
D. Stomatitis
