Indiana QMA State Test | COMPREHENSIVE INDIANA
QMA STATE TEST EXAMINATION
COMPREHENSIVE INDIANA QMA STATE TEST EXAMINATION
Medication Administration, Classifications, Side Effects, and Nursing
Considerations
Total Questions: 100
Time Allowed: 150 minutes
SECTION 1: ANTIHISTAMINES AND RESPIRATORY MEDICATIONS
Questions 1-10
Question 1
A resident has been prescribed diphenhydramine (Benadryl) for an allergic
reaction. Which side effect should the QMA monitor for and report to the nurse?
A. Hypertension and insomnia
B. Drowsiness, dizziness, and dry mouth
C. Increased appetite and weight gain
D. Diarrhea and abdominal cramping
Correct Answer-: B. Drowsiness, dizziness, and dry mouth
,Rationale: Antihistamines such as diphenhydramine (Benadryl) commonly cause
anticholinergic side effects including drowsiness, dizziness, loss of appetite, dry
mouth, and urinary retention. The QMA should monitor for these effects and
report significant drowsiness or urinary retention to the nurse, as this may
increase fall risk or indicate need for medication adjustment.
• A: Hypertension is not a typical antihistamine side effect; insomnia may
occur but is less common than drowsiness
• C: Weight gain is not associated with antihistamines
• D: Diarrhea is not a typical side effect; constipation is more common
Question 2
When administering an antihistamine to a male resident with benign prostatic
hyperplasia (BPH), which nursing consideration is most important for the QMA to
remember?
A. Encourage caffeine intake to counteract drowsiness
B. Administer with a full glass of water only
C. Use with caution due to risk of urinary retention
D. Crush the medication for easier swallowing
Correct Answer-: C. Use with caution due to risk of urinary retention
Rationale: Antihistamines have anticholinergic effects that can cause urinary
retention. This is particularly problematic for men with prostate conditions such
as BPH, as they already have difficulty with urination. The QMA should monitor
for decreased urine output, bladder distension, or complaints of difficulty
urinating, and report these to the nurse immediately.
• A: Caffeine may increase diuresis but does not address the underlying
concern and may cause other side effects
• B: While adequate fluids are encouraged, this is not the primary
consideration for BPH patients
, • D: Crushing medications should only be done if approved by the
pharmacist/nurse and if the medication is safe to crush
Question 3
A resident is taking rifampin (Rifadin) for tuberculosis. The resident's family
member notices an orange color in the resident's urine and becomes concerned.
What should the QMA tell the family member?
A. "This indicates liver damage and I will notify the nurse immediately."
B. "This is a harmless side effect of the medication and is expected."
C. "The resident must be dehydrated; I will encourage more fluids."
D. "This means the medication is not working properly."
Correct Answer-: B. "This is a harmless side effect of the medication and is
expected."
Rationale: Rifampin (Rifadin) and other TB medications can cause body fluids
including urine, feces, sputum, sweat, and tears to turn orange-red. This is a
harmless, expected side effect and does not indicate harm. The QMA should
educate the resident and family about this effect to prevent unnecessary concern.
However, the QMA should also monitor for signs of hepatitis (yellowing skin/eyes,
dark urine that is not orange, fatigue) as this is a serious adverse effect requiring
intervention.
• A: Orange urine from rifampin is not a sign of liver damage; jaundice
(yellow) would be concerning
• C: Dehydration does not cause orange urine from rifampin
• D: Discoloration does not indicate effectiveness or lack thereof
Question 4
A resident taking isoniazid (INH) for tuberculosis reports numbness and tingling in
the feet and hands. What should the QMA do?
, A. Document the finding and reassure the resident this is normal
B. Report this finding to the nurse immediately
C. Encourage the resident to exercise more to improve circulation
D. Administer aspirin for the discomfort
Correct Answer-: B. Report this finding to the nurse immediately
Rationale: Numbness and tingling in the extremities (peripheral neuropathy) is a
known side effect of isoniazid (INH). This occurs due to vitamin B6 deficiency
caused by the medication. The nurse should be notified immediately because the
resident may need pyridoxine (vitamin B6) supplementation or a medication
adjustment. Untreated peripheral neuropathy can become permanent.
• A: This is not normal and requires intervention, not reassurance
• C: Exercise will not correct medication-induced neuropathy
• D: Aspirin does not treat neuropathy and the QMA cannot independently
administer medication for this symptom without an order
Question 5
Which instruction should the QMA give to a resident taking a decongestant such
as Sudafed?
A. "Take this medication at bedtime to help you sleep."
B. "Prolonged use can cause nasal irritation or damage."
C. "This medication will make you very drowsy."
D. "You should stop taking it immediately if you feel better."
Correct Answer-: B. "Prolonged use can cause nasal irritation or damage."
Rationale: Decongestants, particularly nasal sprays, can cause rebound
congestion and with prolonged use may lead to irritation or even perforation of
the nasal septum. The QMA should teach residents to use decongestants only as
QMA STATE TEST EXAMINATION
COMPREHENSIVE INDIANA QMA STATE TEST EXAMINATION
Medication Administration, Classifications, Side Effects, and Nursing
Considerations
Total Questions: 100
Time Allowed: 150 minutes
SECTION 1: ANTIHISTAMINES AND RESPIRATORY MEDICATIONS
Questions 1-10
Question 1
A resident has been prescribed diphenhydramine (Benadryl) for an allergic
reaction. Which side effect should the QMA monitor for and report to the nurse?
A. Hypertension and insomnia
B. Drowsiness, dizziness, and dry mouth
C. Increased appetite and weight gain
D. Diarrhea and abdominal cramping
Correct Answer-: B. Drowsiness, dizziness, and dry mouth
,Rationale: Antihistamines such as diphenhydramine (Benadryl) commonly cause
anticholinergic side effects including drowsiness, dizziness, loss of appetite, dry
mouth, and urinary retention. The QMA should monitor for these effects and
report significant drowsiness or urinary retention to the nurse, as this may
increase fall risk or indicate need for medication adjustment.
• A: Hypertension is not a typical antihistamine side effect; insomnia may
occur but is less common than drowsiness
• C: Weight gain is not associated with antihistamines
• D: Diarrhea is not a typical side effect; constipation is more common
Question 2
When administering an antihistamine to a male resident with benign prostatic
hyperplasia (BPH), which nursing consideration is most important for the QMA to
remember?
A. Encourage caffeine intake to counteract drowsiness
B. Administer with a full glass of water only
C. Use with caution due to risk of urinary retention
D. Crush the medication for easier swallowing
Correct Answer-: C. Use with caution due to risk of urinary retention
Rationale: Antihistamines have anticholinergic effects that can cause urinary
retention. This is particularly problematic for men with prostate conditions such
as BPH, as they already have difficulty with urination. The QMA should monitor
for decreased urine output, bladder distension, or complaints of difficulty
urinating, and report these to the nurse immediately.
• A: Caffeine may increase diuresis but does not address the underlying
concern and may cause other side effects
• B: While adequate fluids are encouraged, this is not the primary
consideration for BPH patients
, • D: Crushing medications should only be done if approved by the
pharmacist/nurse and if the medication is safe to crush
Question 3
A resident is taking rifampin (Rifadin) for tuberculosis. The resident's family
member notices an orange color in the resident's urine and becomes concerned.
What should the QMA tell the family member?
A. "This indicates liver damage and I will notify the nurse immediately."
B. "This is a harmless side effect of the medication and is expected."
C. "The resident must be dehydrated; I will encourage more fluids."
D. "This means the medication is not working properly."
Correct Answer-: B. "This is a harmless side effect of the medication and is
expected."
Rationale: Rifampin (Rifadin) and other TB medications can cause body fluids
including urine, feces, sputum, sweat, and tears to turn orange-red. This is a
harmless, expected side effect and does not indicate harm. The QMA should
educate the resident and family about this effect to prevent unnecessary concern.
However, the QMA should also monitor for signs of hepatitis (yellowing skin/eyes,
dark urine that is not orange, fatigue) as this is a serious adverse effect requiring
intervention.
• A: Orange urine from rifampin is not a sign of liver damage; jaundice
(yellow) would be concerning
• C: Dehydration does not cause orange urine from rifampin
• D: Discoloration does not indicate effectiveness or lack thereof
Question 4
A resident taking isoniazid (INH) for tuberculosis reports numbness and tingling in
the feet and hands. What should the QMA do?
, A. Document the finding and reassure the resident this is normal
B. Report this finding to the nurse immediately
C. Encourage the resident to exercise more to improve circulation
D. Administer aspirin for the discomfort
Correct Answer-: B. Report this finding to the nurse immediately
Rationale: Numbness and tingling in the extremities (peripheral neuropathy) is a
known side effect of isoniazid (INH). This occurs due to vitamin B6 deficiency
caused by the medication. The nurse should be notified immediately because the
resident may need pyridoxine (vitamin B6) supplementation or a medication
adjustment. Untreated peripheral neuropathy can become permanent.
• A: This is not normal and requires intervention, not reassurance
• C: Exercise will not correct medication-induced neuropathy
• D: Aspirin does not treat neuropathy and the QMA cannot independently
administer medication for this symptom without an order
Question 5
Which instruction should the QMA give to a resident taking a decongestant such
as Sudafed?
A. "Take this medication at bedtime to help you sleep."
B. "Prolonged use can cause nasal irritation or damage."
C. "This medication will make you very drowsy."
D. "You should stop taking it immediately if you feel better."
Correct Answer-: B. "Prolonged use can cause nasal irritation or damage."
Rationale: Decongestants, particularly nasal sprays, can cause rebound
congestion and with prolonged use may lead to irritation or even perforation of
the nasal septum. The QMA should teach residents to use decongestants only as
