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
and specimen acceptance
Stem
A 58-year-old inpatient’s urine specimen arrives unlabeled but
accompanied by a handwritten requisition showing the
patient’s name and medical record number. The LIS flags a
,missing specimen ID. The urinalysis technologist notes the
container appears recently collected and refrigeration was not
used. Which is the best laboratory action?
A. Accept the specimen and proceed with testing after entering
identifiers from the requisition.
B. Reject the specimen and request a new, properly labeled
specimen from nursing.
C. Accept and freeze the specimen immediately to preserve
analytes, documenting the missing label.
D. Perform the dipstick and microscopic exam but mark results
“specimen ID unverified.”
Correct answer
B
Rationale — Correct
Rejecting and requesting a properly labeled specimen protects
patient identification and result integrity. Quality indicators
require specimen-ID completeness; testing an unlabeled tube
risks reporting results to the wrong patient and violates safety
and accreditation standards. Requesting recollection preserves
chain of custody and ensures accurate clinical correlation.
Rationales — Incorrect
A. Entering identifiers from the requisition substitutes
documentation for specimen labeling and risks mismatches
between requisition and tube; not acceptable.
C. Freezing an unlabeled specimen does not fix the primary ID
issue and may alter some analytes; freezing is unnecessary and
,not corrective.
D. Performing tests on an unlabeled specimen and annotating
results still risks reporting errors and fails acceptance criteria.
Teaching point
Specimen labeling is a non-waivable acceptance criterion —
reject unlabeled urine samples.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment and Safety — Preanalytical
variables
Stem
A clinic uses a 24-hour urine collection to measure total protein.
The patient used a collection container missing preservative
and left the container at room temperature for 36 hours before
delivery. Which is the most likely laboratory concern affecting
the test result?
A. Bacterial overgrowth causing decreased measured protein.
B. Proteolytic degradation causing falsely low total protein.
C. Concentration of protein due to evaporation causing falsely
high result.
D. Preservation absence has negligible effect on protein assays.
, Correct answer
B
Rationale — Correct
Proteolytic enzymes from bacteria or native proteases can
degrade proteins in unpreserved urine left at ambient
temperature, causing falsely low measured total protein. Proper
preservative or refrigeration is required for accurate 24-hour
protein determinations.
Rationales — Incorrect
A. Bacterial overgrowth more commonly alters nitrite, pH, and
cell elements; it does not typically decrease total protein by
itself except via protease activity (covered in B).
C. Evaporation in a closed container over 36 hours is unlikely to
markedly concentrate protein compared with proteolysis.
D. Absence of preservative is significant for protein stability and
is not negligible.
Teaching point
Use proper preservative/refrigeration for timed protein
collections to prevent proteolysis.
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
and specimen acceptance
Stem
A 58-year-old inpatient’s urine specimen arrives unlabeled but
accompanied by a handwritten requisition showing the
patient’s name and medical record number. The LIS flags a
,missing specimen ID. The urinalysis technologist notes the
container appears recently collected and refrigeration was not
used. Which is the best laboratory action?
A. Accept the specimen and proceed with testing after entering
identifiers from the requisition.
B. Reject the specimen and request a new, properly labeled
specimen from nursing.
C. Accept and freeze the specimen immediately to preserve
analytes, documenting the missing label.
D. Perform the dipstick and microscopic exam but mark results
“specimen ID unverified.”
Correct answer
B
Rationale — Correct
Rejecting and requesting a properly labeled specimen protects
patient identification and result integrity. Quality indicators
require specimen-ID completeness; testing an unlabeled tube
risks reporting results to the wrong patient and violates safety
and accreditation standards. Requesting recollection preserves
chain of custody and ensures accurate clinical correlation.
Rationales — Incorrect
A. Entering identifiers from the requisition substitutes
documentation for specimen labeling and risks mismatches
between requisition and tube; not acceptable.
C. Freezing an unlabeled specimen does not fix the primary ID
issue and may alter some analytes; freezing is unnecessary and
,not corrective.
D. Performing tests on an unlabeled specimen and annotating
results still risks reporting errors and fails acceptance criteria.
Teaching point
Specimen labeling is a non-waivable acceptance criterion —
reject unlabeled urine samples.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment and Safety — Preanalytical
variables
Stem
A clinic uses a 24-hour urine collection to measure total protein.
The patient used a collection container missing preservative
and left the container at room temperature for 36 hours before
delivery. Which is the most likely laboratory concern affecting
the test result?
A. Bacterial overgrowth causing decreased measured protein.
B. Proteolytic degradation causing falsely low total protein.
C. Concentration of protein due to evaporation causing falsely
high result.
D. Preservation absence has negligible effect on protein assays.
, Correct answer
B
Rationale — Correct
Proteolytic enzymes from bacteria or native proteases can
degrade proteins in unpreserved urine left at ambient
temperature, causing falsely low measured total protein. Proper
preservative or refrigeration is required for accurate 24-hour
protein determinations.
Rationales — Incorrect
A. Bacterial overgrowth more commonly alters nitrite, pH, and
cell elements; it does not typically decrease total protein by
itself except via protease activity (covered in B).
C. Evaporation in a closed container over 36 hours is unlikely to
markedly concentrate protein compared with proteolysis.
D. Absence of preservative is significant for protein stability and
is not negligible.
Teaching point
Use proper preservative/refrigeration for timed protein
collections to prevent proteolysis.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
3
