FUNDAMENTALS OF URINE AND
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
Item 1
Reference
Ch. 1 — Quality Assessment and Safety — Quality Indicators
Stem
A morning-shift urinalysis technologist notes that 18% of
random urine specimens queued that day were hemolyzed or
visibly contaminated, and 12% were mislabeled. The lab’s
acceptable defect rate is <2% for pre-analytical errors. As the
,bench supervisor, which action best addresses these quality
indicator data?
A. Report findings in the monthly quality committee meeting
and continue routine monitoring.
B. Implement a focused root-cause analysis of specimen
collection and labeling practices.
C. Retrain staff on microscopy interpretation to rule out sample
mishandling.
D. Increase the rejection threshold to 25% to avoid frequent
interruptions.
Correct answer
B
Rationale — Correct (B)
A focused root-cause analysis targets pre-analytical sources
(collection, transport, labeling) causing the high defect rates
and will guide corrective actions. It aligns with quality
improvement methodology to identify systemic problems
rather than passively reporting. This approach allows
meaningful process changes that reduce error rates.
Rationale — Incorrect
A. Merely reporting without targeted investigation delays
corrective measures; unacceptable given the large deviation.
C. Microscopy retraining addresses analytical skills but not pre-
analytical errors like labeling or contamination.
D. Raising the threshold masks poor performance and violates
quality standards.
,Teaching point
Root-cause analysis is essential when quality indicators exceed
limits.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
Item 2
Reference
Ch. 1 — Quality Assessment and Safety — Quality Control (QC)
Programs
Stem
During weekly QC review for reagent strip testing, the control
line for specific gravity intermittently reads low while other
parameters are stable. Reagent lot and analyzer maintenance
are unchanged. What is the most appropriate next-step
laboratory action?
A. Replace the entire reagent strip inventory.
B. Run parallel patient samples on a manual refractometer and
review QC performance.
C. Ignore the intermittent low reading since other parameters
are stable.
D. Immediately remove the analyzer from service and halt all
testing.
, Correct answer
B
Rationale — Correct (B)
Running parallel patient samples on a manual refractometer
checks analytical accuracy for specific gravity and helps
determine whether the issue is instrument- or reagent-related.
Comparing QC performance trends with an alternate method is
a standard troubleshooting step before major interventions.
Rationale — Incorrect
A. Replacing inventory without verification is wasteful and
premature.
C. Ignoring an intermittent QC shift risks patient safety and
violates QC policies.
D. Removing the analyzer immediately may be unnecessary if
an alternate method confirms acceptable performance.
Teaching point
Verify QC shifts with an alternate reference method before
major corrective actions.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
Item 3
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
Item 1
Reference
Ch. 1 — Quality Assessment and Safety — Quality Indicators
Stem
A morning-shift urinalysis technologist notes that 18% of
random urine specimens queued that day were hemolyzed or
visibly contaminated, and 12% were mislabeled. The lab’s
acceptable defect rate is <2% for pre-analytical errors. As the
,bench supervisor, which action best addresses these quality
indicator data?
A. Report findings in the monthly quality committee meeting
and continue routine monitoring.
B. Implement a focused root-cause analysis of specimen
collection and labeling practices.
C. Retrain staff on microscopy interpretation to rule out sample
mishandling.
D. Increase the rejection threshold to 25% to avoid frequent
interruptions.
Correct answer
B
Rationale — Correct (B)
A focused root-cause analysis targets pre-analytical sources
(collection, transport, labeling) causing the high defect rates
and will guide corrective actions. It aligns with quality
improvement methodology to identify systemic problems
rather than passively reporting. This approach allows
meaningful process changes that reduce error rates.
Rationale — Incorrect
A. Merely reporting without targeted investigation delays
corrective measures; unacceptable given the large deviation.
C. Microscopy retraining addresses analytical skills but not pre-
analytical errors like labeling or contamination.
D. Raising the threshold masks poor performance and violates
quality standards.
,Teaching point
Root-cause analysis is essential when quality indicators exceed
limits.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
Item 2
Reference
Ch. 1 — Quality Assessment and Safety — Quality Control (QC)
Programs
Stem
During weekly QC review for reagent strip testing, the control
line for specific gravity intermittently reads low while other
parameters are stable. Reagent lot and analyzer maintenance
are unchanged. What is the most appropriate next-step
laboratory action?
A. Replace the entire reagent strip inventory.
B. Run parallel patient samples on a manual refractometer and
review QC performance.
C. Ignore the intermittent low reading since other parameters
are stable.
D. Immediately remove the analyzer from service and halt all
testing.
, Correct answer
B
Rationale — Correct (B)
Running parallel patient samples on a manual refractometer
checks analytical accuracy for specific gravity and helps
determine whether the issue is instrument- or reagent-related.
Comparing QC performance trends with an alternate method is
a standard troubleshooting step before major interventions.
Rationale — Incorrect
A. Replacing inventory without verification is wasteful and
premature.
C. Ignoring an intermittent QC shift risks patient safety and
violates QC policies.
D. Removing the analyzer immediately may be unnecessary if
an alternate method confirms acceptable performance.
Teaching point
Verify QC shifts with an alternate reference method before
major corrective actions.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
Item 3
