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 corrective action
Stem
A urinalysis technologist notices a sudden shift in reagent strip
color development across three separate dipstick lots during
the same week. Internal QC records show daily controls within
,acceptable ranges. Patient results include an unexpected rise in
positive nitrite and leukocyte esterase results. Which is the
most appropriate immediate laboratory action?
A. Report the positive results and advise the clinician of possible
infection.
B. Quarantine the current reagent strip lots and perform lot-to-
lot comparison with a known good lot.
C. Discard all patient results from the week and repeat testing
on frozen aliquots.
D. Increase frequency of internal QC to twice daily and continue
using current strips.
Correct answer
B
Rationale — Correct
Quarantining suspect lots and performing a lot-to-lot
comparison identifies lot-related analytical errors. This
approach isolates a potential reagent failure (analytical phase)
while preserving patient samples pending verification and
avoids unnecessary repeat testing.
Rationale — Incorrect
A. Reporting without investigation risks false positives and
inappropriate treatment.
C. Discarding results prematurely is excessive; archived samples
should be evaluated first.
D. Increasing QC frequency may detect but not identify a
,systemic lot issue; it doesn't prevent continued use of
potentially faulty reagent lots.
Teaching point
Quarantine suspect reagent lots; perform lot-to-lot
comparisons before reporting.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment and Safety — Proficiency testing
and external quality assessment
Stem
During a proficiency testing (PT) round, your laboratory’s
microscopic examination of a blinded urine specimen yields
markedly different RBC morphology classification than the
consensus. Internal proficiency passed. What is the best
analytic and regulatory step?
A. Document the discrepancy, perform instrument and
personnel review, and submit corrective action in the PT event
log.
B. Ignore the PT result because internal QC and routine
specimens are concordant.
C. Retrain all staff on microscopy and request a new PT
, specimen from the provider.
D. Report the PT result to clinicians as inconclusive and request
a repeat clinical sample.
Correct answer
A
Rationale — Correct
PT discrepancies require documentation, root-cause analysis
(instrumentation, reagents, personnel), and corrective actions
per regulatory standards. PT is an external check; failure
triggers specific reporting and corrective requirements.
Rationale — Incorrect
B. Ignoring PT undermines accreditation requirements and
patient safety.
C. Retraining all staff and requesting a new PT specimen is
inappropriate—PT providers control specimens and retraining
should be targeted after root-cause analysis.
D. PT results are not clinical specimens; reporting to clinicians is
unnecessary and misleading.
Teaching point
Treat PT failures as regulatory events—document, analyze, and
correct.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1
Reference
Ch. 1 — Quality Assessment and Safety — Quality indicators
and corrective action
Stem
A urinalysis technologist notices a sudden shift in reagent strip
color development across three separate dipstick lots during
the same week. Internal QC records show daily controls within
,acceptable ranges. Patient results include an unexpected rise in
positive nitrite and leukocyte esterase results. Which is the
most appropriate immediate laboratory action?
A. Report the positive results and advise the clinician of possible
infection.
B. Quarantine the current reagent strip lots and perform lot-to-
lot comparison with a known good lot.
C. Discard all patient results from the week and repeat testing
on frozen aliquots.
D. Increase frequency of internal QC to twice daily and continue
using current strips.
Correct answer
B
Rationale — Correct
Quarantining suspect lots and performing a lot-to-lot
comparison identifies lot-related analytical errors. This
approach isolates a potential reagent failure (analytical phase)
while preserving patient samples pending verification and
avoids unnecessary repeat testing.
Rationale — Incorrect
A. Reporting without investigation risks false positives and
inappropriate treatment.
C. Discarding results prematurely is excessive; archived samples
should be evaluated first.
D. Increasing QC frequency may detect but not identify a
,systemic lot issue; it doesn't prevent continued use of
potentially faulty reagent lots.
Teaching point
Quarantine suspect reagent lots; perform lot-to-lot
comparisons before reporting.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment and Safety — Proficiency testing
and external quality assessment
Stem
During a proficiency testing (PT) round, your laboratory’s
microscopic examination of a blinded urine specimen yields
markedly different RBC morphology classification than the
consensus. Internal proficiency passed. What is the best
analytic and regulatory step?
A. Document the discrepancy, perform instrument and
personnel review, and submit corrective action in the PT event
log.
B. Ignore the PT result because internal QC and routine
specimens are concordant.
C. Retrain all staff on microscopy and request a new PT
, specimen from the provider.
D. Report the PT result to clinicians as inconclusive and request
a repeat clinical sample.
Correct answer
A
Rationale — Correct
PT discrepancies require documentation, root-cause analysis
(instrumentation, reagents, personnel), and corrective actions
per regulatory standards. PT is an external check; failure
triggers specific reporting and corrective requirements.
Rationale — Incorrect
B. Ignoring PT undermines accreditation requirements and
patient safety.
C. Retraining all staff and requesting a new PT specimen is
inappropriate—PT providers control specimens and retraining
should be targeted after root-cause analysis.
D. PT results are not clinical specimens; reporting to clinicians is
unnecessary and misleading.
Teaching point
Treat PT failures as regulatory events—document, analyze, and
correct.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
