FUNDAMENTALS OF URINE AND
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1
Reference
Ch. 1 — Quality Assessment and Safety — Quality Indicators
Stem
A busy urinalysis lab notices that the percentage of rejected
specimens rose from 1% to 6% over two months, mostly due to
,mislabeled containers and unlabeled collection times. As the
laboratory supervisor, which action best addresses the root
cause while conforming to QA principles?
A. Implement daily audits of labels and record keeping and
provide immediate feedback to the collecting staff.
B. Penalize staff who submit mislabeled specimens to
discourage errors.
C. Restrict specimen acceptance to only those collected in the
laboratory under supervision.
D. Change the rejection threshold to 10% to avoid documenting
nonconformities.
Correct answer
A
Rationale — Correct
Daily audits with immediate feedback target the process
failures causing mislabeling and missing times, enable
corrective action, and generate quality indicator data for
monitoring trends. This follows QA principles of identifying root
causes and using ongoing monitoring and staff education.
Rationale — Incorrect
B — Punitive measures may reduce reporting and don’t identify
system flaws; QA favors systems remediation.
C — Overly restrictive practices impair patient care and don’t
correct upstream collection issues.
D — Raising a threshold masks problems and violates
continuous quality improvement.
,Teaching Point
Audit plus timely feedback targets system causes of specimen
identification errors.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment and Safety — Internal Quality
Control (IQC)
Stem
A technician runs daily urine reagent strip control materials. On
the Levey-Jennings chart the low control value for protein
shows a sudden shift upward by 1.5 SD, sustained for the next
three days. What is the most appropriate immediate laboratory
action?
A. Continue testing; small shifts are expected and clinically
insignificant.
B. Investigate for recent reagent lot change, calibrator error, or
instrument maintenance and withhold reporting until resolved.
C. Manually adjust patient results downward by 1.5 SD to match
historical mean.
D. Discard the low control data and recalculate limits after one
week of tests.
, Correct answer
B
Rationale — Correct
A sustained shift indicates a systematic error; investigating
reagent lot, calibration, or instrument changes is required.
Withholding or flagging patient results prevents reporting
potentially biased results until corrective action is taken,
aligning with QC procedures.
Rationale — Incorrect
A — Ignoring a sustained shift risks reporting inaccurate patient
results.
C — Manual adjustment of patient data is inappropriate
without validated corrective action.
D — Discarding data undermines QC traceability and is
unacceptable.
Teaching Point
Sustained QC shifts require investigation of systematic causes
before reporting patient results.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
3
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1
Reference
Ch. 1 — Quality Assessment and Safety — Quality Indicators
Stem
A busy urinalysis lab notices that the percentage of rejected
specimens rose from 1% to 6% over two months, mostly due to
,mislabeled containers and unlabeled collection times. As the
laboratory supervisor, which action best addresses the root
cause while conforming to QA principles?
A. Implement daily audits of labels and record keeping and
provide immediate feedback to the collecting staff.
B. Penalize staff who submit mislabeled specimens to
discourage errors.
C. Restrict specimen acceptance to only those collected in the
laboratory under supervision.
D. Change the rejection threshold to 10% to avoid documenting
nonconformities.
Correct answer
A
Rationale — Correct
Daily audits with immediate feedback target the process
failures causing mislabeling and missing times, enable
corrective action, and generate quality indicator data for
monitoring trends. This follows QA principles of identifying root
causes and using ongoing monitoring and staff education.
Rationale — Incorrect
B — Punitive measures may reduce reporting and don’t identify
system flaws; QA favors systems remediation.
C — Overly restrictive practices impair patient care and don’t
correct upstream collection issues.
D — Raising a threshold masks problems and violates
continuous quality improvement.
,Teaching Point
Audit plus timely feedback targets system causes of specimen
identification errors.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment and Safety — Internal Quality
Control (IQC)
Stem
A technician runs daily urine reagent strip control materials. On
the Levey-Jennings chart the low control value for protein
shows a sudden shift upward by 1.5 SD, sustained for the next
three days. What is the most appropriate immediate laboratory
action?
A. Continue testing; small shifts are expected and clinically
insignificant.
B. Investigate for recent reagent lot change, calibrator error, or
instrument maintenance and withhold reporting until resolved.
C. Manually adjust patient results downward by 1.5 SD to match
historical mean.
D. Discard the low control data and recalculate limits after one
week of tests.
, Correct answer
B
Rationale — Correct
A sustained shift indicates a systematic error; investigating
reagent lot, calibration, or instrument changes is required.
Withholding or flagging patient results prevents reporting
potentially biased results until corrective action is taken,
aligning with QC procedures.
Rationale — Incorrect
A — Ignoring a sustained shift risks reporting inaccurate patient
results.
C — Manual adjustment of patient data is inappropriate
without validated corrective action.
D — Discarding data undermines QC traceability and is
unacceptable.
Teaching Point
Sustained QC shifts require investigation of systematic causes
before reporting patient results.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
3
