FUNDAMENTALS OF URINE AND
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
Q1
Reference: Ch. 1 — Quality Assessment — Preanalytical
components (specimen acceptability)
Stem (MLS level): A 62-year-old inpatient has a routine
urinalysis ordered. The nurse collects a urine specimen but the
tube is unlabeled, and the requisition lists the patient’s initials
only. The specimen was received in the lab 90 minutes after
collection at room temperature with visible fecal
,contamination. Which action best aligns with quality-
assessment principles?
A. Accept and process the specimen; document the 90-minute
delay in the report.
B. Reject the specimen and request a new, properly identified,
clean-catch specimen.
C. Process the specimen and report results with a comment
recommending clinical correlation because of possible
contamination.
D. Centrifuge and examine sediment; if microscopy is
unremarkable, accept results and file an incident report.
Correct answer: B
Rationale — Correct (B): Preanalytical QA requires two unique
identifiers, specimen acceptability (clean container, no obvious
contamination), and appropriate handling times. An unlabeled
tube and fecal contamination compromise specimen identity
and integrity; rejection and recollection with proper ID
preserves patient safety and result validity. Requesting a
properly identified, uncontaminated specimen is the correct
corrective action.
Rationale — Incorrect:
A: Documenting delay doesn't mitigate missing identifiers or
contamination—results could be misattributed.
C: Reporting contaminated, unlabeled specimens risks patient
misidentification and diagnostic errors.
D: Partial processing with subsequent acceptance violates QA
,policy because identity and contamination issues invalidate the
specimen regardless of microscopy.
Teaching point: Two unique identifiers and specimen
cleanliness are prerequisites for acceptance.
Citation: Brunzel, N. A. (2023). Fundamentals of Urine and Body
Fluid Analysis (5th ed.). Ch. 1.
Q2
Reference: Ch. 1 — Quality Assessment — Turnaround time &
monitoring
Stem (MLS level): Your lab tracks urinalysis turnaround time
(TAT) and finds median TAT increased from 35 to 75 minutes
over two weeks after implementing a new specimen triage step.
Which QA action is most appropriate first?
A. Notify clinicians that TAT increased and advise delayed
reporting.
B. Perform a root-cause analysis focused on the new triage step
and staff workflows.
C. Revert to the prior triage procedure immediately without
investigation.
D. Add overtime staffing to compensate and restore prior TAT.
Correct answer: B
Rationale — Correct (B): QA principles require investigation
(root-cause analysis) when a performance metric degrades.
, Evaluating the new triage step and workflows identifies
whether process change, training deficits, or resource mismatch
caused delays before corrective actions are implemented.
Rationale — Incorrect:
A: Notifying clinicians is communication but doesn't solve
cause; might be needed later.
C: Reverting without analysis risks reintroducing other problems
and loses opportunity to improve process.
D: Adding staffing addresses symptom but not underlying
process inefficiency; costly and potentially unnecessary.
Teaching point: Investigate process changes causing metric
shifts before implementing fixes.
Citation: Brunzel, N. A. (2023). Fundamentals of Urine and Body
Fluid Analysis (5th ed.). Ch. 1.
Q3
Reference: Ch. 1 — Quality Assessment — Analytical
components: quality control & control materials
Stem (MLS level): An automated urinalysis chemistry analyzer
reports control 1 (low) within range but control 2 (high) above
the established mean + 3 SD for two consecutive runs. Operator
notes no maintenance performed overnight. Which
interpretation and action are most appropriate?
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
Q1
Reference: Ch. 1 — Quality Assessment — Preanalytical
components (specimen acceptability)
Stem (MLS level): A 62-year-old inpatient has a routine
urinalysis ordered. The nurse collects a urine specimen but the
tube is unlabeled, and the requisition lists the patient’s initials
only. The specimen was received in the lab 90 minutes after
collection at room temperature with visible fecal
,contamination. Which action best aligns with quality-
assessment principles?
A. Accept and process the specimen; document the 90-minute
delay in the report.
B. Reject the specimen and request a new, properly identified,
clean-catch specimen.
C. Process the specimen and report results with a comment
recommending clinical correlation because of possible
contamination.
D. Centrifuge and examine sediment; if microscopy is
unremarkable, accept results and file an incident report.
Correct answer: B
Rationale — Correct (B): Preanalytical QA requires two unique
identifiers, specimen acceptability (clean container, no obvious
contamination), and appropriate handling times. An unlabeled
tube and fecal contamination compromise specimen identity
and integrity; rejection and recollection with proper ID
preserves patient safety and result validity. Requesting a
properly identified, uncontaminated specimen is the correct
corrective action.
Rationale — Incorrect:
A: Documenting delay doesn't mitigate missing identifiers or
contamination—results could be misattributed.
C: Reporting contaminated, unlabeled specimens risks patient
misidentification and diagnostic errors.
D: Partial processing with subsequent acceptance violates QA
,policy because identity and contamination issues invalidate the
specimen regardless of microscopy.
Teaching point: Two unique identifiers and specimen
cleanliness are prerequisites for acceptance.
Citation: Brunzel, N. A. (2023). Fundamentals of Urine and Body
Fluid Analysis (5th ed.). Ch. 1.
Q2
Reference: Ch. 1 — Quality Assessment — Turnaround time &
monitoring
Stem (MLS level): Your lab tracks urinalysis turnaround time
(TAT) and finds median TAT increased from 35 to 75 minutes
over two weeks after implementing a new specimen triage step.
Which QA action is most appropriate first?
A. Notify clinicians that TAT increased and advise delayed
reporting.
B. Perform a root-cause analysis focused on the new triage step
and staff workflows.
C. Revert to the prior triage procedure immediately without
investigation.
D. Add overtime staffing to compensate and restore prior TAT.
Correct answer: B
Rationale — Correct (B): QA principles require investigation
(root-cause analysis) when a performance metric degrades.
, Evaluating the new triage step and workflows identifies
whether process change, training deficits, or resource mismatch
caused delays before corrective actions are implemented.
Rationale — Incorrect:
A: Notifying clinicians is communication but doesn't solve
cause; might be needed later.
C: Reverting without analysis risks reintroducing other problems
and loses opportunity to improve process.
D: Adding staffing addresses symptom but not underlying
process inefficiency; costly and potentially unnecessary.
Teaching point: Investigate process changes causing metric
shifts before implementing fixes.
Citation: Brunzel, N. A. (2023). Fundamentals of Urine and Body
Fluid Analysis (5th ed.). Ch. 1.
Q3
Reference: Ch. 1 — Quality Assessment — Analytical
components: quality control & control materials
Stem (MLS level): An automated urinalysis chemistry analyzer
reports control 1 (low) within range but control 2 (high) above
the established mean + 3 SD for two consecutive runs. Operator
notes no maintenance performed overnight. Which
interpretation and action are most appropriate?
