The following are practice questions, to help you to prepare for the Qualified Medication Aide Final Examination. Answers, along with explanations, follow the questions. Topics covered on the test include:
- Basic pharmacology
- Medication orders
- Adverse effects/interactions
- Medication preparation
- Medication administration
- Basic CNA skills
- Expanded scope of practice
- Resident issues
- Role and responsibility of the QMA
A brief description of a resident is followed by ten questions related to that resident. Each question has four possible answers. Read each question and all answer choices carefully. Choose the one best answer.
Mrs. Johnson is 76 years old. She has hypertension, glaucoma, type II diabetes and a G-tube. She is comatose following a CVA (stroke) three months ago. Her medications include:
- Vasotec (enalapril) 10 mg q.d. per G-tube
- Glucophage (metformin) 500 mg bid per G-tube
- Surfak (docusate calcium) 125 mg bid per G-tube
- Pilocar (pilocarpine Hcl) gtts OU bid
1. Pharmacology is the study of:
- medication administration
- medications and their effects
2. Mrs. Johnson's Glucophage is ordered bid. She should receive this medication:
- three times a day
- once a day
- four times a day
- two times a day
3. To treat glaucoma, Mrs. Johnson is given:
4. Adverse effects of Vasotec include:
- dry cough
- elevated blood pressure
- joint pain
- memory loss
5. To prepare Mrs. Johnson's medication for administration through the G-tube, you should:
- be certain the tablets are smaller than the tube
- crush the tablets and mix with applesauce
- break the tablets in half
- crush the tablets and dilute in liquid
6. When administering Mrs. Johnson's Pilocar, you should:
- mix it with water and have her drink it slowly
- place medication inside her lower eyelid
- apply it to the skin around her eye
- spray the Pilocar into her eye
7. You document Mrs. Johnson's medications:
- at the end of your shift
- at the end of your med pass
- after administering her medications
- before beginning your med pass
8. Mrs. Johnson is comatose. To provide oral care, you should position her in:
- Fowler's position
- semi-Fowler's position
- lateral position
- supine position
9. Mrs. Johnson has a minor skin tear. Before applying a transparent dressing, you should:
- remove torn skin with scissors
- replace torn but attached skin over the wound
- soak the wound with alcohol
- place a gauze square over the wound
10. Mrs. Johnson has glaucoma, which affects her:
Mr. Carson is 68 years old. He suffers from seizures, dementia, rheumatoid arthritis, and UTI. His medications include:
- Depakene (valproic acid) 250 mg tid po
- Voltaren (diclofenac sodium) 50 mg qid po
- Bactrim suspension (trimethoprim - sulfamethoxazole) 10 ml q12h po
- Ativan (lorazepam) 1 mg hs po
11. Most medications are excreted by the:
- tear ducts
12. Mr. Carson's medications are ordered po. This means you will administer his medications:
- by mouth
- whenever necessary
- after meals
13. Which of Mr. Carson's medications is an anticonvulsant:
14. Adverse effects of Voltaren include:
- gastrointestinal bleeding
- increased appetite
- elevated pulse and blood pressure
15. When preparing Mr. Carson's Bactrim suspension, you should:
- dilute the suspension in 8 oz of water
- shake the bottle before pouring
- estimate the amount
- pour 5 ml into a calibrated cup
16. You know Voltaren:
- may be better tolerated with food
- should be given on an empty stomach
- should be given only after taking the resident's blood pressure
- is better tolerated when crushed
17. The nurse asks you to fill in blanks on Mr. Carson's medication administration record. You should:
- do as the nurse requests
- ask another QMA to fill in the blanks for you
- refuse and tell the nurse you are not allowed to document what you did not do
- report the nurse to the administrator
18. Mr. Carson has a seizure while you are in his room. You should:
- place a padded tongue blade in his mouth
- hold his arms and legs down so he does not hurt himself
- raise the head of his bed 60°
- stay with him and call for the nurse
19. Mr. Carson's doctor orders a Fleet enema to be given this evening. To administer the enema you will position Mr. Carson in:
- Fowler's position
- supine position
- Sims' position
- lateral position
20. A term used to describe a group of symptoms related to a decline in thinking skills is:
- mental retardation
1. D - Pharmacology is the study of medications and their effect on the body.
a. Pharmacists dispense medication according to a physician's written or telephone order.
b. A pharmacy is a place where pharmacists store, prepare, and dispense medications.
c. Medication administration means giving medications to residents/patients.
2. D - The abbreviation for two times a day is bid.
a. The abbreviation for three times a day is tid.
b. Daily or qd means once a day.
c. The abbreviation for four times a day is qid.
3. D - Pilocar is classified as a miotic which decreases eye pressure and is used to treat glaucoma.
a. Surfak is a laxative (stool softener) used to promote regular bowel function.
b. Vasotec is an antihypertensive (ACE Inhibitor) used to treat high blood pressure.
c. Glucophage is an oral hypoglycemic (anti-diabetic agent) used to treat type II diabetes.
4. A - Adverse effects of Vasotec include hypotension, persistent dry tickling non-productive cough, nausea, and vomiting.
b. Vasotec lowers blood pressure. The medical term for elevated blood pressure is hypertension.
c. Joint pain and memory loss are not included in the list of adverse effects for Vasotec.
d. Joint pain and memory loss are not included in the list of adverse effects for Vasotec.
5. D - When administering medications via G-tube, tablets should be crushed and diluted in liquid.
a. Not all tablets ordered by the physician are manufactured smaller than the G-tube. The larger tablets must be crushed and dissolved in a liquid such as water.
b. Applesauce will coat the medication but not effectively dissolve it. Tablets must be crushed and dissolved in a liquid such as water.
c. Breaking a tablet in half may not allow for passage through a G-tube. Medications must be crushed and dissolved in a liquid such as water.
6. B - Pilocar is an eye drop and is placed inside the lower lid with the tip of the bottle without touching the eye.
a. Pilocar is an eye medication placed inside the lower lid of the eye .
c. Pilocar is an eye medication placed inside the lower lid of the eye.
d. Pilocar is an eye medication placed inside the lower lid of the eye. Spraying medication into the eye may injure delicate tissues of the eye.
7. C - It is very important that documentation be entered accurately and immediately after the administration of any medication.
a. Document as soon as possible after a medication is administered. If the medication is not documented, another dose may be given in error. If the doctor visits, assessments may be made based on the fact that no medication was administered.
b. Document as soon as possible after a medication is administered. Documenting each resident's medications as they are administered reduces the possibility of documentation errors.
d. Medications are documented after they are given, NEVER BEFORE. A resident may refuse to take a medication or an event may occur that results in medication not being administered. Documentation must accurately reflect exactly what was done.
8. C - Lateral position means placing the resident on her side. This position allows for gravity drainage and prevents the resident from choking on secretions or aspirating fluids into the lungs.
a. Fowler's position is sitting up with the head of the bed elevated 45° - 60°. Fluids will drain down the back of the throat and the comatose resident may choke or aspirate fluids into the lungs.
b. Semi-Fowler's position is sitting up 45° - 60°. Fluids will drain down the back of the throat and the comatose resident may choke or aspirate fluids into the lungs.
d. Supine position is lying flat on the back. Fluids will drain down the back of the throat and the comatose resident may choke or aspirate fluids into the lungs.
9. B - If a layer of skin is torn, but still attached, replace the skin over the wound, covering as much of the original surface as possible. Apply a transparent dressing.
a. Removing a skin flap is not within the QMA's scope of practice.
c. Alcohol is not used to clean skin tears because it can damage surrounding tissues.
d. A gauze square is never placed under a transparent dressing.
10. B - Glaucoma is a disorder affecting the eyes causing increased pressure within the eye.
a. Arthritis is a disease that affects the joints.
c. Kidneys filter blood, removing excess fluid and waste in the form of urine.
d. The liver is a highly vascular organ that secrets bile and changes nutrients into usable chemicals for the body.
11. A - Most oral and parenteral medications are excreted by the kidneys through the urine.
b. Most medications are metabolized by the liver.
c. Tear ducts transport a watery saline solution that lubricates the surfaces between the eyeball and eyelid.
d. The islets of Langerhans in the pancreas produce insulin which regulates blood sugar.
12. A - The abbreviation for by mouth/orally is po.
b. Medications administered whenever necessary are ordered PRN.
c. Medications administered after meals are ordered pc.
d. IM is the abbreviation for intra-muscular. QMAs are not allowed to administer IM medication.
13. C - Depakene is an anticonvulsant used to stop or prevent seizures.
a. Voltaren is a nonsteroidal anti-inflammatory agent used to treat arthritis.
b. Bactrim is a urinary anti-infective used to treat resistant urinary infections.
d. Ativan is an anti-anxiety (anxiolytic) drug used primarily to treat nervousness and anxiety.
14. A - Adverse effects of Voltaren include gastrointestinal bleeding.
b. Adverse effects of Voltaren include decreased, not increased, appetite.
c. Other adverse effects include headaches, dizziness, heartburn, rashes, bruising and prolonged bleeding, tinnitus, change in renal function and fatigue; not elevated pulse and blood pressure.
d. Voltaren may also cause nausea, vomiting, and diarrhea, not constipation.
15. B - A suspension is a fluid mixture that needs to be shaken before pouring due to its tendency to separate after a short period of time.
a. If the Bactrim is diluted in 8 oz of water, the resident would have to drink all 8 oz to get the required dose. Many residents may be unable to drink that much fluid or may refuse to drink it.
c. QMAs must concentrate on accuracy while preparing medications. Use a calibrated cup and read the level of medication from the bottom of the meniscus (or curve) of the liquid surface line.
d. Mr. Carson's Bactrim order is for 10 ml.
16. A - Nonsteroidal anti-inflammatory agents (NSAIDS) such as Voltaren may be better tolerated with food.
b. Administering with food may reduce symptoms. Adverse effects include nausea, vomiting, diarrhea, heartburn, abdominal pain, and cramps.
c. Vital signs, including blood pressure, are not required prior to administering NSAID's.
d. Crushing medications should be done only if resident cannot swallow tablets whole. Check the list of medications that should not be crushed and check the physician's order.
17. C - The person who administers the medication is the only one who may document that the medication was given.
a. If you document something that you did not do, you are falsifying the record. Your signature on an entry means that you assume responsibility for the entry (you administered the medication).
b. Only the person who administered the medication may document.
d. The QMA does not report directly to the Administrator. In the chain of command, the QMA reports incidents or errors to the charge nurse. If the charge nurse is involved, report to the supervisor or the director of nursing.
18. D - Never leave a resident who is having a seizure. Stay with him and call for the nurse.
a. During a seizure, anything placed in a resident's mouth as restriction may cause injury.
b. Never restrain a resident during a seizure because restraint may cause injury to you and the resident.
c. Position the resident on his side after a seizure stops, not during a seizure. The resident should be positioned onto the side after a seizure stops to allow saliva to drain from the mouth and prevent choking.
19. C - Sims' position is used for rectal procedures including administering enemas. The resident is positioned on the left side with right knee and thigh drawn up, and the left arm along the resident's back.
a. Fowler's position is sitting up with the head of the bed elevated 45Ã‚° - 60Ã‚°.
b. Supine position is flat on the back, with legs slightly apart.
d. Lateral position is lying on either side with pillows for support at back, between knees and ankles, and under top arm.
20. A - Dementia is a general term used to describe a group of symptoms related to a decline in thinking skills.
b. Psychosis is any severe mental disorder, with or without organic damage, characterized by deterioration of normal intellectual and social functioning, and by partial or complete withdrawal from reality.
c. Mental retardation is a disorder characterized by below-average intellectual capability with defects in the ability to learn and adapt.
d. Depression is an emotional reaction that interferes with leading a normal life. It is characterized by a lack of interest in life, insomnia, loss of appetite, emotional sadness, and withdrawal.