FUNDAMENTALS OF URINE AND
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1
Reference
Ch. 1 — Quality Assessment and Safety — Specimen rejection
and pre-analytical integrity
Stem
A technician receives a random urine specimen labeled with the
patient’s name but without collection time or preservative
,noted. The specimen shows marked turbidity and an ammonia
odor after 24 hours at room temperature. Which is the best
laboratory action and rationale?
A. Process the specimen immediately and report results with a
comment about delayed transport.
B. Reject the specimen for pre-analytical degradation and
request a new specimen collected with preservative.
C. Centrifuge and examine sediment; report only sediment
findings but withhold chemical results.
D. Accept specimen but dilute and rerun chemical tests to
correct for bacterial overgrowth.
Correct answer
B
Rationales
• Correct (B): The 24-hour room-temperature delay with
ammonia odor indicates bacterial proliferation and
chemical/physical degradation; rejection and recollection
with instructions (timing, preservative, refrigeration)
preserve analytical validity and patient safety.
• A: Processing a degraded specimen risks reporting
spurious chemical results (e.g., decreased glucose,
increased nitrite/ammonia) and provides misleading
clinical data.
• C: Sediment may still show cells/crystals, but reporting
only sediment without chemical context can mislead
, clinicians; best practice is recollection to ensure full panel
integrity.
• D: Dilution cannot correct for metabolic changes or
bacterial consumption/production of analytes and would
produce invalid results.
Teaching point
Specimen integrity is paramount—reject when pre-analytical
degradation compromises validity.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment and Safety — Specimen labeling
and chain-of-custody
Stem
An ED rush sends three uncapped urine containers in a zip bag
without patient identifiers; triage staff say samples came from
different patients. Which approach best balances patient safety,
regulatory compliance, and laboratory quality?
A. Assign temporary IDs and analyze to avoid losing clinically
urgent information.
B. Reject all three specimens and require recollection with
, proper labeling.
C. Analyze only if a clinician documents patient identities in the
chart post-collection.
D. Retain specimens for 48 hours while attempting to reconcile
identities with nursing.
Correct answer
B
Rationales
• Correct (B): Unlabeled specimens violate patient
identification policies and risk catastrophic pre-analytical
errors; rejection and recollection are required for accurate,
traceable results.
• A: Temporary IDs risk misattribution and medico-legal
consequences—unacceptable.
• C: Post-hoc clinician documentation cannot substitute for
proper, immediate specimen labeling and chain-of-custody.
• D: Retaining and attempting reconciliation increases risk of
misidentification and delays clinically actionable results;
recollection is safer.
Teaching point
Never accept unlabeled or misidentified specimens—
recollection protects patients and lab integrity.
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1
Reference
Ch. 1 — Quality Assessment and Safety — Specimen rejection
and pre-analytical integrity
Stem
A technician receives a random urine specimen labeled with the
patient’s name but without collection time or preservative
,noted. The specimen shows marked turbidity and an ammonia
odor after 24 hours at room temperature. Which is the best
laboratory action and rationale?
A. Process the specimen immediately and report results with a
comment about delayed transport.
B. Reject the specimen for pre-analytical degradation and
request a new specimen collected with preservative.
C. Centrifuge and examine sediment; report only sediment
findings but withhold chemical results.
D. Accept specimen but dilute and rerun chemical tests to
correct for bacterial overgrowth.
Correct answer
B
Rationales
• Correct (B): The 24-hour room-temperature delay with
ammonia odor indicates bacterial proliferation and
chemical/physical degradation; rejection and recollection
with instructions (timing, preservative, refrigeration)
preserve analytical validity and patient safety.
• A: Processing a degraded specimen risks reporting
spurious chemical results (e.g., decreased glucose,
increased nitrite/ammonia) and provides misleading
clinical data.
• C: Sediment may still show cells/crystals, but reporting
only sediment without chemical context can mislead
, clinicians; best practice is recollection to ensure full panel
integrity.
• D: Dilution cannot correct for metabolic changes or
bacterial consumption/production of analytes and would
produce invalid results.
Teaching point
Specimen integrity is paramount—reject when pre-analytical
degradation compromises validity.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment and Safety — Specimen labeling
and chain-of-custody
Stem
An ED rush sends three uncapped urine containers in a zip bag
without patient identifiers; triage staff say samples came from
different patients. Which approach best balances patient safety,
regulatory compliance, and laboratory quality?
A. Assign temporary IDs and analyze to avoid losing clinically
urgent information.
B. Reject all three specimens and require recollection with
, proper labeling.
C. Analyze only if a clinician documents patient identities in the
chart post-collection.
D. Retain specimens for 48 hours while attempting to reconcile
identities with nursing.
Correct answer
B
Rationales
• Correct (B): Unlabeled specimens violate patient
identification policies and risk catastrophic pre-analytical
errors; rejection and recollection are required for accurate,
traceable results.
• A: Temporary IDs risk misattribution and medico-legal
consequences—unacceptable.
• C: Post-hoc clinician documentation cannot substitute for
proper, immediate specimen labeling and chain-of-custody.
• D: Retaining and attempting reconciliation increases risk of
misidentification and delays clinically actionable results;
recollection is safer.
Teaching point
Never accept unlabeled or misidentified specimens—
recollection protects patients and lab integrity.
