FUNDAMENTALS OF URINE AND
BODY FLUID ANALYSIS
5TH EDITION
AUTHOR(S)NANCY A. BRUNZEL
TEST BANK
1️⃣
Reference
Ch. 1 — Quality Assessment and Safety — Quality indicators
and corrective action
Stem
A high-volume urinalysis lab notices a steady increase in false-
positive nitrite dipstick results over two weeks. The reagent
strips are within expiry, and positive controls were acceptable
,this morning. Patient rates of bacteriuria have not changed
clinically. Which is the best laboratory action to identify and
address the root cause?
A. Replace the entire lot of reagent strips immediately and
continue routine testing.
B. Run repeat nitrite testing using a different reagent lot and
perform microbial culture correlation on a subset of specimens.
C. Report a laboratory-wide advisory to clinicians that nitrite
results are unreliable until further notice.
D. Recalibrate the spectrophotometer used for microscopic
sediment quantification.
Correct answer
B
Rationale — Correct (B)
Repeat testing with a different reagent lot distinguishes lot-
related reagent failure from other causes. Correlating with
culture on a subset assesses clinical vs. analytical discrepancy
and informs corrective action. This approach follows QA: isolate
variables, confirm failure, and use clinical correlation.
Rationales — Incorrect
A — Replacing strips without verification wastes resources and
may not identify the real cause (storage, operator technique, or
interference).
C — Issuing advisories prematurely harms clinical care and fails
to locate the source of error.
,D — Spectrophotometer calibration is unrelated to dipstick
nitrite chemistry and won’t address reagent or workflow issues.
Teaching point
Compare reagent lots and correlate with clinical culture before
broad corrective action.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2️⃣
Reference
Ch. 1 — Quality Assessment and Safety — Internal quality
control
Stem
During morning shift, QC for urine protein pad returns a value
just outside the lab’s ±2 SD acceptable range although the
previous day’s QC was within limits. The technologist examined
strip storage and technique and found no deviations. Which is
the most appropriate immediate step?
A. Accept the run and continue testing since deviation is small.
B. Repeat the QC and, if still out, investigate instrument/reagent
lot and block patient reporting for that analyte.
C. Discard the QC result, document nothing, and continue
testing to avoid workflow interruption.
, D. Call the manufacturer immediately and request a site visit
before any action.
Correct answer
B
Rationale — Correct (B)
Repeating QC distinguishes random QC error from a persistent
bias; if repeat remains out-of-range, the lab must investigate
instrument/reagent/technique and suspend patient reporting
for the affected analyte until resolved — standard QA practice
to protect patient safety.
Rationales — Incorrect
A — Accepting out-of-control QC risks reporting erroneous
patient results.
C — Ignoring QC violates QA and regulatory requirements and
endangers patients.
D — Manufacturer involvement may be necessary later but is
not the immediate first step; local troubleshooting should
precede escalation.
Teaching point
Repeat out-of-range QC immediately; suspend reporting for
affected test until resolved.
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
1️⃣
Reference
Ch. 1 — Quality Assessment and Safety — Quality indicators
and corrective action
Stem
A high-volume urinalysis lab notices a steady increase in false-
positive nitrite dipstick results over two weeks. The reagent
strips are within expiry, and positive controls were acceptable
,this morning. Patient rates of bacteriuria have not changed
clinically. Which is the best laboratory action to identify and
address the root cause?
A. Replace the entire lot of reagent strips immediately and
continue routine testing.
B. Run repeat nitrite testing using a different reagent lot and
perform microbial culture correlation on a subset of specimens.
C. Report a laboratory-wide advisory to clinicians that nitrite
results are unreliable until further notice.
D. Recalibrate the spectrophotometer used for microscopic
sediment quantification.
Correct answer
B
Rationale — Correct (B)
Repeat testing with a different reagent lot distinguishes lot-
related reagent failure from other causes. Correlating with
culture on a subset assesses clinical vs. analytical discrepancy
and informs corrective action. This approach follows QA: isolate
variables, confirm failure, and use clinical correlation.
Rationales — Incorrect
A — Replacing strips without verification wastes resources and
may not identify the real cause (storage, operator technique, or
interference).
C — Issuing advisories prematurely harms clinical care and fails
to locate the source of error.
,D — Spectrophotometer calibration is unrelated to dipstick
nitrite chemistry and won’t address reagent or workflow issues.
Teaching point
Compare reagent lots and correlate with clinical culture before
broad corrective action.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
2️⃣
Reference
Ch. 1 — Quality Assessment and Safety — Internal quality
control
Stem
During morning shift, QC for urine protein pad returns a value
just outside the lab’s ±2 SD acceptable range although the
previous day’s QC was within limits. The technologist examined
strip storage and technique and found no deviations. Which is
the most appropriate immediate step?
A. Accept the run and continue testing since deviation is small.
B. Repeat the QC and, if still out, investigate instrument/reagent
lot and block patient reporting for that analyte.
C. Discard the QC result, document nothing, and continue
testing to avoid workflow interruption.
, D. Call the manufacturer immediately and request a site visit
before any action.
Correct answer
B
Rationale — Correct (B)
Repeating QC distinguishes random QC error from a persistent
bias; if repeat remains out-of-range, the lab must investigate
instrument/reagent/technique and suspend patient reporting
for the affected analyte until resolved — standard QA practice
to protect patient safety.
Rationales — Incorrect
A — Accepting out-of-control QC risks reporting erroneous
patient results.
C — Ignoring QC violates QA and regulatory requirements and
endangers patients.
D — Manufacturer involvement may be necessary later but is
not the immediate first step; local troubleshooting should
precede escalation.
Teaching point
Repeat out-of-range QC immediately; suspend reporting for
affected test until resolved.
Citation
Brunzel, N. A. (2023). Fundamentals of Urine and Body Fluid
Analysis (5th ed.). Ch. 1.
