FUNDAMENTALS OF URINE AND
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1
Reference
Ch. 1 — Quality Assessment — Quality indicators
Stem
A busy hospital urinalysis section logs that 8% of urine
specimens in the last month were rejected at accessioning for
pre-analytical problems (insufficient volume, wrong container,
,unlabeled). The lab’s benchmark is ≤2%. As the MLS supervisor,
what is the best next-step quality action to reduce the rejection
rate and address underlying causes?
A. Increase staff speed during accessioning to clear backlog and
reduce handling delays.
B. Implement a focused root-cause analysis for rejected
specimens and train sources (nursing/collection staff) on
correct collection and labeling.
C. Tighten rejection policy to reject any specimen with minor
deviations to force adherence.
D. Outsource accessioning to an external lab with stricter pre-
analytical workflows.
Correct answer
B
Rationale — Correct
Performing a targeted root-cause analysis and providing
education to the specimen sources addresses the pre-analytical
origin of errors (collection, labeling, container choice). This
intervention is a standard QA corrective action to lower
rejection rates by fixing processes, not just symptoms. It aligns
with quality improvement cycles (identify, analyze, act,
monitor).
Rationale — Incorrect
A. Speed alone risks more errors; backlog might be process-
related, not workload only.
C. Stricter rejection without training will increase provider
,frustration and may harm patient care.
D. Outsourcing accessioning ignores the real problem at the
point of collection and is costly.
Teaching point
Use root-cause analysis + targeted education to fix pre-
analytical specimen errors.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment — Internal quality control
Stem
A urinalysis technologist runs daily reagent controls for a
semiquantitative dipstick analyzer. Today's control values are
within expected range except a repeated low nitrite control
while all other analytes are normal. Which interpretation and
action best align with QA principles?
A. Accept run because most analytes passed; nitrite is clinically
rare.
B. Immediately stop patient testing for nitrite, troubleshoot
reagent strip lot and analyzer, document, and rerun controls.
C. Report patient nitrite results as “trace” if any test line faintly
appears to avoid delays.
, D. Ignore control because the instrument flags no mechanical
error.
Correct answer
B
Rationale — Correct
A failing control for a single analyte requires halting patient
reporting for that analyte, investigating causes (reagent strip
lot, storage, analyzer optics, operator technique), documenting
the event, and re-establishing control before resuming
reporting—core QC practice.
Rationale — Incorrect
A. Accepting ignores QC failure; patient safety risk.
C. Altering patient results to match expectation is inappropriate
without validated recovery.
D. Lack of instrument error flag does not replace the need to
act on control failures.
Teaching point
Any control failure for an analyte mandates stop-testing,
investigation, and documentation.
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 — Quality indicators
Stem
A busy hospital urinalysis section logs that 8% of urine
specimens in the last month were rejected at accessioning for
pre-analytical problems (insufficient volume, wrong container,
,unlabeled). The lab’s benchmark is ≤2%. As the MLS supervisor,
what is the best next-step quality action to reduce the rejection
rate and address underlying causes?
A. Increase staff speed during accessioning to clear backlog and
reduce handling delays.
B. Implement a focused root-cause analysis for rejected
specimens and train sources (nursing/collection staff) on
correct collection and labeling.
C. Tighten rejection policy to reject any specimen with minor
deviations to force adherence.
D. Outsource accessioning to an external lab with stricter pre-
analytical workflows.
Correct answer
B
Rationale — Correct
Performing a targeted root-cause analysis and providing
education to the specimen sources addresses the pre-analytical
origin of errors (collection, labeling, container choice). This
intervention is a standard QA corrective action to lower
rejection rates by fixing processes, not just symptoms. It aligns
with quality improvement cycles (identify, analyze, act,
monitor).
Rationale — Incorrect
A. Speed alone risks more errors; backlog might be process-
related, not workload only.
C. Stricter rejection without training will increase provider
,frustration and may harm patient care.
D. Outsourcing accessioning ignores the real problem at the
point of collection and is costly.
Teaching point
Use root-cause analysis + targeted education to fix pre-
analytical specimen errors.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2
Reference
Ch. 1 — Quality Assessment — Internal quality control
Stem
A urinalysis technologist runs daily reagent controls for a
semiquantitative dipstick analyzer. Today's control values are
within expected range except a repeated low nitrite control
while all other analytes are normal. Which interpretation and
action best align with QA principles?
A. Accept run because most analytes passed; nitrite is clinically
rare.
B. Immediately stop patient testing for nitrite, troubleshoot
reagent strip lot and analyzer, document, and rerun controls.
C. Report patient nitrite results as “trace” if any test line faintly
appears to avoid delays.
, D. Ignore control because the instrument flags no mechanical
error.
Correct answer
B
Rationale — Correct
A failing control for a single analyte requires halting patient
reporting for that analyte, investigating causes (reagent strip
lot, storage, analyzer optics, operator technique), documenting
the event, and re-establishing control before resuming
reporting—core QC practice.
Rationale — Incorrect
A. Accepting ignores QC failure; patient safety risk.
C. Altering patient results to match expectation is inappropriate
without validated recovery.
D. Lack of instrument error flag does not replace the need to
act on control failures.
Teaching point
Any control failure for an analyte mandates stop-testing,
investigation, and documentation.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
3
