chapter 47

Explain to the patient that no water may be running in the bathroom while he is providing the sample

Which of the following is important when obtaining a urine specimen from a patient for drug and alcohol testing?

Check the expiration date on the reagent strip container

Which of the following is necessary when you are measuring specific gravity with a reagent strip?

bilirubinuria

Which of the following is one of the first signs of liver disease?

wear adequate personal protective equipment

Which of the following is part of the medical assistant's responsibility is collecting and testing urine and stool samples?

Random urine specimen

Which of the following is the most common type of urine sample?

trichomoniasis vaginalis

Which of the following is the most common urinary parasite?

proteinuria

Which of the following may indicate polycystic kidney disease?

specific gravity

Which of the following measures the concentration of substances dissolved in urine?

Oliguria

Which of the following refers to an insufficient production of urine?

It may affect the sediment and specific gravity

Which of the following statements about refrigerating urine specimens is true?

The sample must not be contaminated with urine

Which of the following statements is true about patient collection of a stool sample?

Instruct the patient to keep the specimen covered and in the refrigerator throughout the test

Which of the following would you include in patient instruction about collecting a 24-hour urine specimen?

Wipe down one side of the perineal area with the first towelette, down the other side with the second towelette, and down the middle with the third towelette.

Which of the following would you include in teaching a female patient how to collect a clean-catch midstream urine specimen?

Turn on the light and look into the eyepiece to measure refraction

Which of the following would you include when measuring specific gravity with a refractometer?

splinting

Which type of catheter is inserted after plastic repair of the ureter and must remain in place for at least a week after surgery?

Cystostomy

Which type of catheter is used for drainage through a wound that leads to the bladder?

straight

Which type of catheter is used to collect specimens or to instill medications?

Timed urine specimen

Which type of urine specimen can be used to measure a patient's urinary output or analyze substances collected over a specified period of time?

First morning urine specimen

Which urine specimen is collected after a night's sleep and contains greater concentrations of substances?

24-hour specimen

Which urine specimen is used to complete a quantitative and qualitative analysis of one or more substances such as sodium, chloride, or calcium?

1250

With adequate fluid intake, the average adult daily urine output is __ mL per 24 hours.

proteinuria

An excess of protein in the urine is called ___ and usually indicates renal disease. However, it may occur in pregnant patients or after heavy exercise.

O&P specimen

If the physician suspects a patient has a protozoal or parasitic infection, what type of specimen may she order?

bilirubinuria

Presence of the bile pigment bilirubin in the urine, called ___, is one of the first signs of liver disease or conditions that involve the liver

anuria

Renal or urethral obstruction and renal failure can cause

anuria

Renal or urethral obstruction and renal failure can cause absence of urine production, known as

urine remaining in the bladder after voiding

Residual urine is

a urinary infection or kidney stones

A pregnant patient who tells you that she is having pain during urination or in the kidney area may be experiencing

hemoglobinuria

A rare condition caused by transfusion reactions, malaria, drug reaction, snakebites, or severe burns is

splinting

A ___ catheter is inserted after plastic repair of the ureter and must remain in place for at least a week after surgery.

refractometer

A ___ is an optical instrument that measures the refraction, or bending, of light as it passes through a liquid and is used to measure specific gravity of the liquid.

first morning

A ___ urine specimen contains greater concentrations of substances that collect overnight than do specimens taken during the day.

24-hour

A ___ urine specimen is used to complete a quantitative and qualitative analysis of one or more substances, such as sodium, chloride, and calcium, and is collected over a full day.

hidden

A fecal occult blood test (FOBT) is a test for ___, or occult, blood in the stool.

phenylketonuria

A genetically inherited disorder in which the body cannon properly metabolize the nutrient phenylalanine, resulting in mental retardation, is

phenylketonuria

A genetically inherited disorder in which the body cannot properly metabolize the nutrient phenylalanine is ___. (PKU)

catheter

A sterile plastic tube inserted to provide urinary drainage is called a urinary

uncontrolled diabetes

A urine odor characterized as "fruity" is present in

clean-catch midstream urine specimen

A urine specimen for culture can be obtained either through catheterization or by obtaining a

diabetes mellitus

Abnormally high levels of glucose in the urine may indicate

Relieve urinary retention

Catheterization is performed for which of the following reasons?

drainage

Catheters used to withdraw fluids, including Foley, retention, ureteral, and straight versions, are collectively known as ___ catheters.

1 hour

Chemical and microscopic changes that invalidate a urine specimen occur if the urine is kept at room temperature for more than

casts

Cylinder-shaped elements with flat or rounded ends that are formed when protein from the breakdown of cells accumulates and precipitates in the kidney tubules and are washed into the urine are called

preserved

For an O&P test, you should obtain both a fresh and a ___ stool specimen for examination.

blood in the urine

Hematuria is

Inform the physician or your supervisor and ask whether you should process the sample

In your office, patients collect samples using the patient restroom and leave the samples on the back of the toilet. You send April into the restroom after giving her the collection kit, including three towelettes, and instructing her on how to perform a clean-catch midstream urine specimen. After she returns to the exam room and you go into the restroom to collect the specimen, you notice the three towelette packages, unopened, in the trashcan. What should you do?

urinary tract infection

Increased specific gravity occurs in

myoglobinuria

Injured of damaged muscle tissue can cause ____, which is the presence of myoglobin in the urine.

ketone bodies

Intermediary products of fat and protein metabolism in the body are

crystals

Naturally produced solids of definite form that are commonly seen in urine specimens and usually do not indicate a significant disorder are

pale yellow to yellow

Normal urine color ranges from

glycosuria

Occurring in patients with diabetes, ____ is the presence of significant glucose in the urine.

oliguria

Patients that are dehydrated, have a decreased fluid intake, are in shock, or have renal disease may have an insufficient production (or volume) of urine. This is called ___

Tell patients to refrigerate the labeled collection container or keep it in a cooler or pail filled with ice

Which of the following is a general urine collection guideline?

clean catch

The ___ midstream urine specimen may be collected and submitted for culturing to identify the number and the types of pathogens present and requires special cleansing of the external genitalia to avoid contamination.

random

The ___ urine specimen is the most common type of sample and may be obtained at any time of the day.

first morning specimen

The best urine specimen to test for nitrates is a

supernatant

The centrifuge is used to spin the urine to force the solids (cells, casts, and crystals) to the bottom of the tube. Most of the liquid portion, called the ___, is poured off, and the remaining sediment is examined by microscope.

testing urine immediately or covering and refrigerating it until you can test it

The correct procedure for testing for ketones using a reagent strip includes

urinalysis

The evaluation of urine to obtain information about body health and disease is called a __

supernatant

The liquid portion from the tube of urine that is discarded down the drain after the centrifuge stops is called the

negative to trace

The normal urine value for protein is

hematuria

The presence of blood in the urine, or ___, can be caused by cystitis, kidney stones, menstruation, ureteral or bladder catheters, or urethral irritation.

hemoglobinuria

The presence of free hemoglobin in the urine is known as ___, a rare condition caused by transfusion reactions, malaria, drug reactions, snakebites, or severe burns.

Nitrite

The presence of which of the following in the urine suggests a bacterial infection in the urinary tract?

catheterization

The procedure during which a sterile plastic tube is inserted to provide urinary drainage is

catheterization

The procedure in which a sterile plastic tube is inserted into the kidney, ureter, or bladder to provide urinary drainage is called

clean-catch midstream urine specimen

The type of urine specimen that may be submitted for culturing to identify the number and the types of pathogens present is the

Urinary pH

Which of the following is a measure of the degree of acidity or alkalinity of the urine?

proteinuria

Which of the following is commonly found in renal disease, in pregnant patients, or after heavy exercise?

after the centrifuge stops, discard most of the supernatant from the tube

Which of the following is important in processing a urine specimen for microscopic examination of sediment?

Hepatic disease

Tyrone has provided a random urine sample, and you are performing a routine urinalysis. The specific gravity of the urine is 1.043. Which of the following conditions might the physician suspect based on this result?

pH

Urinary ____ is a measure of the degree of acidity or alkalinity of the urine and can provide information about a patient's metabolic status, diet, and medications being taken.

specific gravity

Urine ___ is a measure of the concentration of amount of substances dissolved in urine.

"Did you have asparagus for lunch?"

Wendy has provided a random urine sample and has returned to the examination room. You notice that the sample is a blue-green color. Which of the following questions would you ask Wendy to help rule out nonpathologic causes for the unusual color?

50 mL

What amount of residual urine is considered abnormal?

3

When a physician suspects that a patient has a protozoal or parasitic infection, what is the minimum number of stool specimens that need to be examined?

urobilinogen

When hemoglobin breaks down, it converts into conjugated bilirubin in the liver and then to ___ in the intestines. It is normally present in the urine in small amounts, but high levels may indicate increased red blood cell destruction or liver disease, and a lack of it in the urine may suggest total bile duct obstruction.

60-year-old female patient

When you instruct a patient about how to collect a 24-hour urine specimen, which patient should you ask about possible leakage when laughing or coughing?

chain of custody

When you obtain a urine specimen for drug or alcohol analysis, you must establish a proper

Yeast cells

Which of the following are frequently associated with vaginitis, urethritis, and prostatitis?

Excessive intake of water, beer, and coffee

Which of the following are nonpathologic causes for colorless or pale urine?

white blood cells

Which of the following are present in large amounts in the urine if inflammation is present?

pregnancy

Which of the following conditions is suspected when a reagent urine strip for human chorionic gonadotropin (HCG) shows positive?

preeclampsia

a pregnant patient's urine is checked for abnormal levels of protein during a prenatal visit to detect