FUNDAMENTALS OF URINE AND
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1️⃣
Reference
Ch. 1 — Quality Assessment — Specimen Identification &
Rejection Criteria
Stem
A STAT urinalysis arrives at the laboratory labeled with the
patient's surname and room number but no unique identifier
,(MRN) and no time of collection. The clinician insists testing
proceed immediately. Which action most aligns with quality
assessment policies and patient safety principles?
A. Perform the urinalysis and record the room number as the
unique identifier.
B. Request re-collection with proper patient identification,
delaying analysis.
C. Proceed with the dipstick and microscopic exam but flag
results as “identifier missing.”
D. Perform only chemical testing (dipstick) and request
verification from nursing later.
Correct Answer
B
Rationales
Correct (B): Patient identification is a core pre-analytical QA
control. Re-collection ensures results link to the correct patient
and prevents specimen-to-patient mismatches that could cause
diagnostic or therapeutic errors. Delaying to obtain a properly
identified specimen upholds safety despite clinical urgency.
Incorrect (A): Using room number risks linking results to the
wrong patient; not acceptable per specimen ID policy.
Incorrect (C): Testing without a valid ID creates an unverifiable
result; flagging does not mitigate the safety risk.
Incorrect (D): Partial testing still produces potentially actionable
results that cannot be safely attributed without proper ID.
,Teaching Point
Never accept or report results from specimens lacking proper
unique patient identifiers.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2️⃣
Reference
Ch. 1 — Quality Assessment — Pre-analytical Variables
(Collection & Preservation)
Stem
A urine specimen collected at 0800 is held at room temperature
and delivered to the lab at 1700. On repeat testing the pH is
9.0, nitrite negative, but marked bacterial overgrowth is seen
on microscopy. Which is the most likely contributor to the
findings and the best corrective action to prevent recurrence?
A. Bacterial contamination from midstream technique; instruct
staff to perform clean-catch only.
B. Prolonged unpreserved storage; implement refrigeration or
preservative for delayed transport.
C. Patient on alkaline diet; educate patient about dietary effects
on urine pH.
D. Faulty dipstick; replace reagent lots immediately and repeat
testing.
, Correct Answer
B
Rationales
Correct (B): Prolonged ambient storage permits bacterial
proliferation and urea breakdown, increasing pH and cellular
degradation. QA policy should require refrigeration or an
approved preservative if analysis will be delayed.
Incorrect (A): While collection technique can introduce
contaminants, the timeline (9-hour delay) and pH shift point to
growth during storage, not only collection error.
Incorrect (C): Diet may affect pH modestly but does not explain
heavy bacterial overgrowth after delayed transport.
Incorrect (D): A reagent problem wouldn’t account for
microscopic bacterial proliferation and elevated pH.
Teaching Point
Refrigerate or add preservative if analysis will be delayed >2
hours to prevent bacterial growth.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
3️⃣
Reference
Ch. 1 — Quality Assessment — Internal Quality Control (IQC)
Practices
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1️⃣
Reference
Ch. 1 — Quality Assessment — Specimen Identification &
Rejection Criteria
Stem
A STAT urinalysis arrives at the laboratory labeled with the
patient's surname and room number but no unique identifier
,(MRN) and no time of collection. The clinician insists testing
proceed immediately. Which action most aligns with quality
assessment policies and patient safety principles?
A. Perform the urinalysis and record the room number as the
unique identifier.
B. Request re-collection with proper patient identification,
delaying analysis.
C. Proceed with the dipstick and microscopic exam but flag
results as “identifier missing.”
D. Perform only chemical testing (dipstick) and request
verification from nursing later.
Correct Answer
B
Rationales
Correct (B): Patient identification is a core pre-analytical QA
control. Re-collection ensures results link to the correct patient
and prevents specimen-to-patient mismatches that could cause
diagnostic or therapeutic errors. Delaying to obtain a properly
identified specimen upholds safety despite clinical urgency.
Incorrect (A): Using room number risks linking results to the
wrong patient; not acceptable per specimen ID policy.
Incorrect (C): Testing without a valid ID creates an unverifiable
result; flagging does not mitigate the safety risk.
Incorrect (D): Partial testing still produces potentially actionable
results that cannot be safely attributed without proper ID.
,Teaching Point
Never accept or report results from specimens lacking proper
unique patient identifiers.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2️⃣
Reference
Ch. 1 — Quality Assessment — Pre-analytical Variables
(Collection & Preservation)
Stem
A urine specimen collected at 0800 is held at room temperature
and delivered to the lab at 1700. On repeat testing the pH is
9.0, nitrite negative, but marked bacterial overgrowth is seen
on microscopy. Which is the most likely contributor to the
findings and the best corrective action to prevent recurrence?
A. Bacterial contamination from midstream technique; instruct
staff to perform clean-catch only.
B. Prolonged unpreserved storage; implement refrigeration or
preservative for delayed transport.
C. Patient on alkaline diet; educate patient about dietary effects
on urine pH.
D. Faulty dipstick; replace reagent lots immediately and repeat
testing.
, Correct Answer
B
Rationales
Correct (B): Prolonged ambient storage permits bacterial
proliferation and urea breakdown, increasing pH and cellular
degradation. QA policy should require refrigeration or an
approved preservative if analysis will be delayed.
Incorrect (A): While collection technique can introduce
contaminants, the timeline (9-hour delay) and pH shift point to
growth during storage, not only collection error.
Incorrect (C): Diet may affect pH modestly but does not explain
heavy bacterial overgrowth after delayed transport.
Incorrect (D): A reagent problem wouldn’t account for
microscopic bacterial proliferation and elevated pH.
Teaching Point
Refrigerate or add preservative if analysis will be delayed >2
hours to prevent bacterial growth.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
3️⃣
Reference
Ch. 1 — Quality Assessment — Internal Quality Control (IQC)
Practices
