FUNDAMENTALS OF URINE AND
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1
Reference
Ch. — Quality Assessment and Safety — Quality assessment
program components
Stem
A urinalysis lab documents an increase in rejected specimens
over six weeks (from 2% to 9%). Root-cause review shows most
rejections are from mislabeled containers and incomplete
,request forms. As the MLS supervisor asked to prioritize
interventions, which action most directly targets the primary
cause and reduces rejection rates while maintaining regulatory
compliance?
A. Implement stricter accessioning checks with immediate
specimen return to the collecting unit for relabeling.
B. Add a second technologist to perform microscopic
confirmation before rejection to avoid unnecessary returns.
C. Begin an educational in-service for clinical units on proper
labeling and form completion, plus implement a labeling
checklist.
D. Stop rejecting borderline specimens and accept all to avoid
delays and complaints.
Correct answer
C
Rationale — Correct (C)
Education combined with a checklist targets the root cause
(collector errors) and provides a sustainable, system-level fix
that reduces rejections and aligns with QA principles. It
addresses pre-analytical error sources and promotes behavior
change rather than only punitive measures. Documentation of
training and checklists also helps demonstrate compliance
during inspections.
Rationale — Incorrect
A: Immediate returns may reduce errors but can delay care and
create workflow friction; it’s a procedural fix without addressing
,underlying cause.
B: Adding confirmatory microscopy is costly and does not
correct pre-analytical labeling issues; it addresses symptom, not
cause.
D: Accepting all specimens increases patient safety risk and
violates quality standards.
Teaching point
Target pre-analytical causes with education and checklists to
sustainably reduce rejections.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. Quality Assessment and Safety.
2
Reference
Ch. — Quality Assessment and Safety — QC and control
materials
Stem
A reagent strip lot is introduced and daily strip QC using
manufacturer liquid control shows a small, persistent bias:
leukocyte pad readings are consistently one grade lower than
expected for two weeks, though patient data are unchanged.
Which is the best next step in laboratory troubleshooting?
A. Continue using the lot because patient results are
unchanged.
, B. Investigate reagent lot documentation, repeat control with
new aliquot, and contact manufacturer if bias persists.
C. Immediately discard the entire lot and order a replacement.
D. Adjust the instrument’s calibration settings to align control
results with expected values.
Correct answer
B
Rationale — Correct (B)
Best practice is to verify the finding (repeat control with fresh
aliquot), review lot documentation and QC trends, and contact
the manufacturer if problem persists. This follows QC
troubleshooting: verify, isolate, and escalate. It avoids
premature waste (C) and prevents inappropriate calibration (D)
without confirming root cause.
Rationale — Incorrect
A: Ignoring a persistent control bias risks undetected systematic
error.
C: Discarding the lot may be unnecessary without confirming
reproducible problem and could waste resources.
D: Adjusting calibration without root-cause analysis risks
introducing new errors and violates QC procedures.
Teaching point
Always verify QC shifts, review lot records, and escalate to
manufacturer before changing instruments or discarding lots.
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1
Reference
Ch. — Quality Assessment and Safety — Quality assessment
program components
Stem
A urinalysis lab documents an increase in rejected specimens
over six weeks (from 2% to 9%). Root-cause review shows most
rejections are from mislabeled containers and incomplete
,request forms. As the MLS supervisor asked to prioritize
interventions, which action most directly targets the primary
cause and reduces rejection rates while maintaining regulatory
compliance?
A. Implement stricter accessioning checks with immediate
specimen return to the collecting unit for relabeling.
B. Add a second technologist to perform microscopic
confirmation before rejection to avoid unnecessary returns.
C. Begin an educational in-service for clinical units on proper
labeling and form completion, plus implement a labeling
checklist.
D. Stop rejecting borderline specimens and accept all to avoid
delays and complaints.
Correct answer
C
Rationale — Correct (C)
Education combined with a checklist targets the root cause
(collector errors) and provides a sustainable, system-level fix
that reduces rejections and aligns with QA principles. It
addresses pre-analytical error sources and promotes behavior
change rather than only punitive measures. Documentation of
training and checklists also helps demonstrate compliance
during inspections.
Rationale — Incorrect
A: Immediate returns may reduce errors but can delay care and
create workflow friction; it’s a procedural fix without addressing
,underlying cause.
B: Adding confirmatory microscopy is costly and does not
correct pre-analytical labeling issues; it addresses symptom, not
cause.
D: Accepting all specimens increases patient safety risk and
violates quality standards.
Teaching point
Target pre-analytical causes with education and checklists to
sustainably reduce rejections.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. Quality Assessment and Safety.
2
Reference
Ch. — Quality Assessment and Safety — QC and control
materials
Stem
A reagent strip lot is introduced and daily strip QC using
manufacturer liquid control shows a small, persistent bias:
leukocyte pad readings are consistently one grade lower than
expected for two weeks, though patient data are unchanged.
Which is the best next step in laboratory troubleshooting?
A. Continue using the lot because patient results are
unchanged.
, B. Investigate reagent lot documentation, repeat control with
new aliquot, and contact manufacturer if bias persists.
C. Immediately discard the entire lot and order a replacement.
D. Adjust the instrument’s calibration settings to align control
results with expected values.
Correct answer
B
Rationale — Correct (B)
Best practice is to verify the finding (repeat control with fresh
aliquot), review lot documentation and QC trends, and contact
the manufacturer if problem persists. This follows QC
troubleshooting: verify, isolate, and escalate. It avoids
premature waste (C) and prevents inappropriate calibration (D)
without confirming root cause.
Rationale — Incorrect
A: Ignoring a persistent control bias risks undetected systematic
error.
C: Discarding the lot may be unnecessary without confirming
reproducible problem and could waste resources.
D: Adjusting calibration without root-cause analysis risks
introducing new errors and violates QC procedures.
Teaching point
Always verify QC shifts, review lot records, and escalate to
manufacturer before changing instruments or discarding lots.
