Urinalysis 101
98. Case 5.1 A routine urinalysis on a urine specimen collected from a hospitalized patient revealed a specific gravity greater than 1.050 with the use of refractometry. 1. The best explanation for this specific gravity result is that the urine specimen A. is old and has deteriorated. B. contains radiographic contrast media. C. is concentrated because the patient is ill and dehydrated. D. contains abnormally high levels of sodium and other electrolytes because the patient is taking diuretics. 2. Which of the following actions should be taken? A. Report the urinalysis results; no further action is needed. B. Report the urinalysis results and suggest that the patient be instructed to increase fluid intake. C. Contact the patient care unit to determine whether the patient is taking a diuretic; if so, report the urinalysis results. D. Do not report the urinalysis results; request that a urine specimen be recollected after several hours.
1. B 2. D
99. case 5.2 A prenatal examination including a routine urinalysis is performed on a 28-year-old female. Her physical examination is unremarkable. When asked about her health, she states that it is generally good, except for several urinary tract infections in the past. In fact, she thinks she might be getting one now and has been taking an over-the-counter product that lessens her discomfort. The following urinalysis results are obtained: Color: bright orange (like soda pop) Clarity: clear 1. Which of the following statements best explains the orange color of the urine? A. She has a liver disorder, and bilirubin is present in the urine. B. The urine is concentrated, which can be confirmed by the urine specific gravity. C. She has recently eaten fresh beets and is genetically disposed to produce this abnormally colored urine. D. The over-the-counter product contains phenazopyridine, which imparts this characteristic color to urine. 2. The urine specimen was placed in a refrigerator while the laboratory determined whether the physician wanted a microscopic examination performed (i.e., the request slip was not appropriately completed). When the specimen was later removed to prepare an aliquot for microscopic analysis, the specimen was still orange but was now cloudy. Which of the following statements best explains this increase in urine turbidity? A. The delay in analysis has allowed bacteria to proliferate. B. Squamous epithelial cells in the urine have degenerated. C. Because of the temperature change, normal urine solutes have precipitated. D. The specimen was contaminated with vaginal secretions and yeast has propagated.
1. D 2. C
80. 5-11. Classify each substance that can be present in urine as indicating a (1) pathologic or (2) nonpathologic condition. __ A. Bacteria (fresh urine) __ B. Bacteria (old urine) __ C. Fat __ D. Powder __ E. Radiographic contrast media __ F. Red blood cells __ G. Renal epithelial cells __ H. Spermatozoa __ I. Squamous epithelial cells __ J. Urate crystals __ K. White blood cells __ L. Yeast
A 1 B 2 C 1 D 2 E 2 F 1 G 1 H 2 I 2 J 2 K 1 L 1
87. 5-18. Match the principle to the appropriate specific gravity method. A principle can be used more than once. Specific Gravity Method __ A. Harmonic oscillation densitometry __ B. Reagent strip __ C. Refractometry __ D. Urinometry Method 1. Density 2. Refractive index 3. pKa changes
A 1 B 3 C 2 D 1
74. 5-5. Match the colors to the urine pigment/substance. Note that more than one color can be selected for a pigment/substance. Urine Pigment/Substance __ A. Bilirubin __ B. Biliverdin __ C. Hemoglobin __ D. Myoglobin __ E. Porphobilinogen __ F. Urobilin __ G. Urobilinogen __ H. Urochrome __ I. Uroerythrin Color of Pigment/Substance 1. Colorless 2. Yellow 3. Orange 4. Red 5. Pink 6. Purple 7. Brown 8. Green
A 2, 3 B 8 C 4, 7 D 7 (4) E 6 (4) F 3, 7 G 1 H 2 I 5
51. 1-15 Match the mode of transmission with the laboratory activity.term-50 Laboratory Activity __ A. Not wearing gloves when handling specimens __ B. Centrifuging uncovered specimens __ C. Smoking in the laboratory __ D. Being scratched by a broken beaker __ E. Having a specimen splashed into the eyes __ F. Pipetting by mouth Mode of Transmission 1. Inhalation 2. Ingestion 3. Direct contact
A 3 B 1 C 2 D 3 E 3 F 2
83. 5-14. Match the urine odor to the condition or substance that can cause it. You may select more than one odor for a condition. Condition/Substance __ A. Diabetes mellitus __ B. Normal urine __ C. Old, improperly stored urine __ D. Specimen adulteration __ E. Starvation __ F. Urinary tract infection Urine Odor 1. Ammonia-like 2. Bleach 3. Faintly aromatic 4. Pungent, fetid 5. Sweet, fruity
A 5 B 3 C 1 D 1, 2 E 5 F 1, 4
1. biological hazard
A biological material or an entity contaminated with biological material that is potentially capable of transmitting disease.
26. colligative property
A characteristic of a solution that depends only on the number of solute particles present, regardless of the molecular size or charge. The four colligative properties are freezing point depression, vapor pressure depression, osmotic pressure elevation, and boiling point elevation. These properties form the basis of methods and instrumentation used to measure the concentration of solutes in body fluids (e.g., serum, urine, fecal supernates). (See freezing point osmometer and vapor pressure osmometer.)
24. urine preservative
A chemical substance or process used to prevent composition changes in a urine specimen (e.g., loss or gain of chemical substances, deterioration of formed elements). The most common form of urine preservation is refrigeration.
34. urochrome
A lipid-soluble yellow pigment that is produced continuously during endogenous metabolism. Present in plasma and excreted in the urine, urochrome gives urine its characteristic yellow color.
3. critical value
A patient test result representing a life-threatening condition that requires immediate attention and intervention.
35. uroerythrin
A pink (or red) pigment in urine that is thought to derive from melanin metabolism. Uroerythrin deposits on urate crystals to produce a precipitate described as "brick dust."
7.infectious waste disposal policy
A procedure outlining the equipment, materials, and steps used in the collection, storage, removal, and decontamination of infectious materials and substances.
4. decontamination
A process to remove a potential chemical or biological hazard from an area or entity (e.g., countertop, instrument, materials) and render the area or entity "safe." One may use various processes in decontamination, such as autoclaving, incineration, chemical neutralization, and disinfecting agents
22. suprapubic aspiration
A technique used to collect urine directly from the bladder by puncturing the abdominal wall and distended bladder using a sterile needle and syringe. Aspiration is used primarily to obtain sterile specimens for bacterial cultures from infants and occasionally from adults.
21. random urine specimen
A urine specimen collected at any time, day or night, without prior patient preparation.
23. timed collection
A urine specimen collected throughout a specific timed interval. The patient voids at the beginning of the collection and discards this urine and then collects all subsequent urine. At the end of the time interval, the patient voids and includes this urine in the collection. This technique is used primarily for quantitative urine assays because it allows comparison of excretion patterns from day to day; the most common are 12-hour and 24-hour collections.
20. midstream "clean catch" specimen
A urine specimen obtained after thorough cleansing of the glans penis in the male or the urethral meatus in the female. After the cleansing procedure, the patient passes the first portion of the urine into the toilet, stops and collects the midportion in the specimen container, then passes any remaining urine into the toilet. Used for routine urinalysis and urine culture, the specimen is essentially free of contaminants from the genitalia and distal urethra.
18. catheterized specimen
A urine specimen obtained using a sterile catheter (a flexible tube) inserted through the urethra and into the bladder. Urine flows directly from the bladder by gravity and collects in a plastic reservoir bag.
12. safety data sheet (SDS)
A written document provided by the manufacturer or distributor of a chemical substance listing information about the characteristics of that chemical. An SDS includes the identity and hazardous ingredients of the chemical, its physical and chemical properties (including reactivity), any physical or health hazards, and precautions for safe handling, storage, and disposal of the chemical.
5. documentation
A written record. In the laboratory, documentation includes written policies and procedures, quality control, and maintenance records. Documentation may encompass the recording of any action performed or observed, including verbal correspondence, observations, and corrective actions taken.
75. 5-6. Which of the following criteria should one use to consistently evaluate urine color and clarity? 1. Mix all specimens well. 2. Use the same depth or volume of a specimen. 3. Evaluate the specimens at the same temperature. 4. View the specimens against a dark background with good lighting. A. 1, 2, and 3 are correct. B. 1 and 3 are correct. C. 4 is correct. D. All are correct.
A. 1, 2, and 3 are correct.
90. 5-21. Refractometry is preferred for specific gravity measurements because it 1. uses a small amount of sample. 2. is fast and easy to perform. 3. automatically compensates for temperature. 4. measures only ionic solutes. A. 1, 2, and 3 are correct. B. 1 and 3 are correct. C. 4 is correct. D. All are correct.
A. 1, 2, and 3 are correct.
86. 5-17. Which of the following specific gravity values is physiologically impossible? A. 1.000 B. 1.010 C. 1.020 D. 1.030
A. 1.000
62. 2-6. A 35-year-old diabetic woman is suspected of developing renal insufficiency. Which of the following specimens should be obtained to determine the amount of creatinine being excreted in the urine? A. 2-hour postprandial B. 12-hour timed collection C. 24-hour timed collection D. Midstream "clean catch"
A. 2-hour postprandial
78. 5-9. Which of the following substances can change the color of a urine and its foam? A. Bilirubin B. Hemoglobin C. Myoglobin D. Urobilin
A. Bilirubin
67. 2-11. Which of the following urine preservatives is acceptable for both urinalysis and urine culture? A. Boric acid B. Chlorhexidine C. Dowicil 200 D. Formalin
A. Boric acid
72. 5-3. Which of the following urine characteristics provides the best rough indicator of urine concentration and body hydration? A. Color B. Clarity C. Foam D. Volume
A. Color
39. 1-3 Which of the following is a postanalytical component of a QA program? A. Critical values B. Procedures C. Preventive maintenance D. Test utilization
A. Critical values
50. 1-14 Which agency is responsible for defining, establishing, and monitoring safety and health hazards in the workplace? A. Occupational Safety and Health Administration B. Centers for Disease Control and Prevention C. Chemical Hygiene Agency D. National Fire Protection Association
A. Occupational Safety and Health Administration
60. 2-4. Which of the following will not cause erroneous results in a 24-hour timed urine collection? A. The collection starts and ends in the evening. B. Two first morning specimens are included in the collection. C. Multiple collection containers are not mixed together before specimen testing. D. A portion of the collection is removed before total volume measurement.
A. The collection starts and ends in the evening.
53. 1-17 Which of the following actions represents a good laboratory practice? A. Washing or sanitizing hands frequently B. Wearing lab coats outside the laboratory C. Removing lab coats from the laboratory for laundering at home in 2% bleach D. Wearing the same gloves to perform venipuncture on two different patients because the patients are in the same room
A. Washing or sanitizing hands frequently
95. 5-26. Osmolality measurements are considered to be a more accurate assessment of solute concentration in body fluids than are specific gravity measurements because A. all solutes contribute equally. B. heavy molecules do not interfere. C. they are not temperature dependent. D. they are less time-consuming to perform.
A. all solutes contribute equally.
82. 5-13. A white or beige precipitate in a "normal" alkaline urine most likely is caused by A. amorphous phosphates. B. amorphous urates. C. uric acid crystals. D. radiographic contrast media.
A. amorphous phosphates.
79. 5-10. The clarity of a well-mixed urine specimen that has visible particulate matter and through which newsprint can be seen but not read should be described as A. cloudy. B. flocculated. C. slightly cloudy. D. turbid.
A. cloudy.
40. 1-4 Analytical components of a QA program are procedures and policies that affect the A. technical testing of the specimen. B. collection and processing of the specimen. C. reporting and interpretation of results. D. diagnosis and treatment of the patient.
A. technical testing of the specimen.
91. 5-22. The principle of the reagent strip method for measuring specific gravity is based on A. the pKa of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen. B. the pH of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen. C. the pKa of a polyelectrolyte increasing in proportion to the ionic concentration of the specimen. D. the pH of a polyelectrolyte increasing in proportion to the ionic concentration of the specimen.
A. the pKa of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen.
2. Chemical Hygiene Plan (CHP)
An established protocol developed by each facility for the identification, handling, storage, and disposal of all hazardous chemicals. The Occupational Safety and Health Administration established the plan in January 1990 as a mandatory requirement for all facilities that deal with chemical hazards.
10. quality assessment (QA)
An established protocol of policies and procedures for all laboratory actions performed to ensure the quality of services (i.e., test results) rendered.
27. density
An expression of concentration in terms of the mass of solutes present per volume of solution.
28. diuresis
An increase in urine excretion. Various causes of diuresis include increased fluid intake, diuretic therapy, hormonal imbalance, renal dysfunction, and drug ingestion (e.g., alcohol, caffeine).
32. refractometry
An indirect measurement of specific gravity based on the refractive index of light.
29. freezing point osmometer
An instrument that measures osmolality based on the freezing point depression of a solution compared to that of pure water. An osmometer consists of a mechanism to supercool the sample below its freezing point. Subsequently, freezing of the sample is induced, and as ice crystals form, a sensitive thermistor monitors the temperature until an equilibrium is attained between solid and liquid phases. This equilibrium temperature is the freezing point of the sample, from which the osmolality of the sample is determined. One osmole of solutes per kilogram of solvent (1 Osm/kg) depresses the freezing point of water by 1.86 °C.
36. vapor pressure osmometer
An instrument that measures osmolality based on the vapor pressure depression of a solution compared to that of pure water. The dew point of the air in a closed chamber containing a small amount of a sample is measured and compared to that obtained using pure water. A calibrated microprocessor converts the change observed in the dew point into osmolality, which is read directly from the instrument readout.
88. 5-19. Which of the following methods is an indirect measure of specific gravity? 1. Reagent strip 2. Urinometry 3. Refractometry 4. Harmonic oscillation densitometry A. 1, 2, and 3 are correct. B. 1 and 3 are correct. C. 4 is correct. D. All are correct.
B. 1 and 3 are correct.
68. 2-12. How much urine is usually required for a manually performed routine urinalysis? A. 5 to 10 mL B. 10 to 15 mL C. 20 to 30 mL D. 50 to 100 mL
B. 10 to 15 mL
96. 5-27. The freezing point of a urine specimen is determined to be − 0.90°C. What is the osmolality of the specimen? A. 161 mOsm/kg B. 484 mOsm/kg C. 597 mOsm/kg D. 645 mOsm/kg
B. 484 mOsm/kg
44. 1-8 Which of the following sources should include a protocol for the way to proceed when quality control results exceed acceptable tolerance limits? A. A reference book B. A procedure C. A preventive maintenance manual D. A specimen-processing protocol
B. A procedure
56. 1-20 Which of the following information is not found on a safety data sheet (SDS)? A. Exposure limits B. Catalog number C. Hazardous ingredients D. Flammability of the chemical
B. Catalog number
69. 2-13. Which of the following substances is higher in urine than in any other body fluid? A. Chloride c C. Glucose D. Protein
B. Creatinine
58. 2-2. Which of the following specimens usually eliminates contamination of the urine with entities from the external genitalia and the distal urethra? A. First morning specimen B. Midstream "clean catch" specimen C. Random specimen D. 4-hour timed collection
B. Midstream "clean catch" specimen
57. 2-1. Which of the following is the urine specimen of choice for cytology studies? A. First morning specimen B. Random specimen C. Midstream "clean catch" collection D. Timed collection
B. Random specimen
84. 5-15. Which of the following methods used to determine the specific gravity of urine does not detect the presence of urine protein or glucose? A. Harmonic oscillation densitometry B. Reagent strip C. Refractometry D. Urinometry
B. Reagent strip
38. 1-2 Which of the following is a preanalytical component of a QA program? A. Quality control B. Turnaround time C. Technical competence D. Preventive maintenance
B. Turnaround time
46. 1-10 Quality control materials should have A. a short expiration date. B. a matrix similar to patient samples. C. their values assigned by an external and unbiased commercial manufacturer. D. the ability to test preanalytical variables.
B. a matrix similar to patient samples.
85. 5-16. A small ion and a large uncharged molecule have the same effect when urine concentration is determined by A. urinometry. B. osmolality. C. reagent strip. D. refractometry.
B. osmolality.
77. 5-8. A urine that produces a large amount of white foam when mixed should be suspected to contain increased amounts of A. bilirubin. B. protein. C. urobilin. D. urobilinogen.
B. protein.
45. 1-9 Technical competence is displayed when a laboratory practitioner A. documents reports in a legible manner. B. recognizes discrepant test results. C. independently reduces the time needed to perform a procedure (e.g., by decreasing incubation times). D. is punctual and timely.
B. recognizes discrepant test results.
64. 2-8. A urine specimen containing the substance indicated is kept unpreserved at room temperature for 4 hours. Identify the probable change to that substance. Substance __ Bacteria __ Bilirubin __ Glucose __ Ketones __ pH __ Protein __ Urobilinogen Change A. Decrease B. No change C. Increase
C A A A C B A
66. 2-10. If refrigeration is used to preserve a urine specimen, which of the following may occur? A. Cellular or bacterial glycolysis will be enhanced. B. Formed elements will be destroyed. C. Amorphous crystals may precipitate. D. Bacteria will proliferate.
C. Amorphous crystals may precipitate.
63. 2-7. An unpreserved urine specimen collected at midnight is kept at room temperature until the morning hospital shift. Which of the following changes will most likely occur? A. Decrease in urine color and clarity B. Decrease in pH and specific gravity C. Decrease in glucose and ketones D. Decrease in bacteria and nitrite
C. Decrease in glucose and ketones
54. 1-18 Which of the following is not an acceptable disposal practice? A. Discarding urine into a sink B. Disposing of used, empty urine containers with nonhazardous waste C. Discarding a used, broken specimen transfer pipette with noninfectious glass waste D. Discarding blood specimens into a biohazard container
C. Discarding a used, broken specimen transfer pipette with noninfectious glass waste
52. 1-16 Which of the following is not considered personal protective equipment? A. Gloves B. Lab coat C. Disinfectants D. Goggles
C. Disinfectants
61. 2-5. A 25-year-old woman complains of painful urination and is suspected of having a urinary tract infection. Which of the following specimens should be collected for a routine urinalysis and urine culture? A. First morning specimen B. Timed collection C. Midstream "clean catch" specimen D. Random specimen
C. Midstream "clean catch" specimen
93. 5-24. Which of the following as described is not a colligative property? A. Boiling point elevation B. Freezing point depression C. Osmotic pressure depression D. Vapor pressure depression
C. Osmotic pressure depression
42. 1-6 Why are written procedures necessary? A. To assist in the ordering of reagents and supplies for a procedure B. To appropriately monitor the accuracy and precision of a procedure C. To ensure that all individuals perform the same task consistently D. To ensure that the appropriate test has been ordered
C. To ensure that all individuals perform the same task consistently
73. 5-4. Which of the following pigments deposits on urate and uric acid crystals to form a precipitate described as "brick dust"? A. Bilirubin B. Urobilin C. Uroerythrin D. Urochrome
C. Uroerythrin
94. 5-25. An advantage of freezing point osmometry over vapor pressure osmometry is its A. increased turnaround time. B. use of a smaller volume of sample. C. ability to detect volatile substances. D. decreased interference from plasma lipids.
C. ability to detect volatile substances.
41. 1-5 The purpose of quality control materials is to A. monitor instrumentation to eliminate downtime. B. ensure the quality of test results obtained. C. assess the accuracy and precision of a method. D. monitor the technical competence of laboratory staff.
C. assess the accuracy and precision of a method.
49. 1-13 The primary purpose of a Standard Precautions policy in the laboratory is to A. ensure a safe and healthy working environment. B. identify processes (e.g., autoclaving) to be used to neutralize infectious agents. C. prevent the exposure and transmission of potentially infectious agents to others. D. identify patients with hepatitis B virus, human immunodeficiency virus, and other infectious diseases.
C. prevent the exposure and transmission of potentially infectious agents to others.
47. 1-11 Within one facility, what is the purpose of performing duplicate testing of a specimen by two different laboratories (i.e., in-house duplicates)? A. It provides little information because the results are already known. B. It saves money by avoiding the need for internal quality control materials. C. It provides a means of evaluating the precision of a method. D. It can detect procedural and technical differences among laboratories.
D. It can detect procedural and technical differences among laboratories.
65. 2-9. Which of the following is the most common method used to preserve urine specimens? A. Acid addition B. Thymol addition C. Freezing D. Refrigeration
D. Refrigeration
43. 1-7 Which of the following is not considered to be an analytical component of QA? A. Reagents (e.g., water) B. Glassware (e.g., pipettes) C. Instrumentation (e.g., microscope) D. Specimen preservation (e.g., refrigeration)
D. Specimen preservation (e.g., refrigeration)
55. 1-19 Which of the following is not part of a Chemical Hygiene Plan? A. To identify and label hazardous chemicals B. To educate employees about the chemicals they use (e.g., providing material safety data sheets) C. To provide guidelines for the handling and use of each chemical type D. To monitor the handling of biological hazards
D. To monitor the handling of biological hazards
37. 1-1 The ultimate goal of a quality assessment program is to A. maximize the productivity of the laboratory. B. ensure that patient test results are precise. C. ensure appropriate diagnosis and treatment of patients. D. ensure the validity of laboratory results obtained.
D. ensure the validity of laboratory results obtained.
48. 1-12 Interlaboratory comparison testing as with proficiency surveys provides a means to A. identify critical values for timely reporting to clinicians. B. ensure that appropriate documentation is being performed. C. evaluate the technical performance of individual laboratory practitioners. D. evaluate the performance of a laboratory compared with that of other laboratories.
D. evaluate the performance of a laboratory compared with that of other laboratories.
92. 5-23. Ionic specific gravity (SGionic) measurements obtained using reagent strips provide useful clinical information because A. all of the urinary solutes present are measured. B. the quantity of nonionic solutes in urine relative to ionic solutes is significant. C. excretion of nonionic solutes (e.g., urea, glucose, protein) does not reflect renal dysfunction. D. the ability of the kidneys to concentrate urine is reflected in the reabsorption and secretion of ionic solutes.
D. the ability of the kidneys to concentrate urine is reflected in the reabsorption and secretion of ionic solutes.
59. 2-3. Substances that show diurnal variation in their urinary excretion pattern are best evaluated using a A. first morning specimen. B. midstream "clean catch" specimen. C. random specimen. D. timed collection.
D. timed collection.
70. 5-1. The color of normal urine is due to the pigment A. bilirubin. B. urobilin. C. uroerythrin. D. urochrome.
D. urochrome.
8.Occupational Safety and Health Administration (OSHA)
Established by Congress in 1970, OSHA is the division of the U.S. Department of Labor that is responsible for defining potential safety and health hazards in the workplace, establishing guidelines to safeguard all workers from these hazards, and monitoring compliance with these guidelines. The intent is to alert, educate, and protect all employees in every environment from potential safety and health hazards.
11. quality control materials
Materials used to assess and monitor the accuracy and precision (i.e., analytic error) of a method.
33. urobilin
Orange-brown pigments responsible for the characteristic color of feces. Specifically, the pigments are stercobilin, mesobilin, and urobilin, which result from spontaneous intestinal oxidation of the colorless tetrapyrroles: stercobilinogen, mesobilinogen, and urobilinogen.
14. technical competence
The ability of an individual to perform a skilled task correctly. Technical competence also includes the ability to evaluate results, such as recognizing discrepancies and absurdities.
30. ionic specific gravity
The density of a solution based on ionic solutes only. Nonionizing substances such as urea, glucose, protein, and radiographic contrast media are not detectable using ionic specific gravity measurements (e.g., specific gravity by commercial reagent strips).
19. first morning specimen
The first urine specimen voided after rising from sleep. The night before the collection, the patient voids before going to bed. Usually the first morning specimen has been retained in the bladder for 6 to 8 hours and is ideal to test for substances that may require concentration (e.g., protein) or incubation for detection (e.g., nitrites).
15. test utilization
The frequency with which a test is performed on a single individual and how it is used to evaluate a disease process. Repeat testing of an individual is costly and may not provide additional or useful information. Sometimes a different test may provide more diagnostically useful information.
9. preventive maintenance
The performance of specific tasks in a timely fashion to eliminate equipment failure. These tasks vary with the instrument and include cleaning procedures, inspection of components, and component replacement when necessary.
31. refractive index
The ratio of light refraction in two differing media (n). The refractive index is expressed mathematically using light velocity (V) or the angle of refraction (sin θ) in the two media, as n2/n1 = V1/V2 or n2/n1 = sin θ1/sin θ2. The refractive index is affected by the wavelength of light used, the temperature of the solution, and the concentration of the solution.
25. clarity (also called turbidity)
The transparency of a urine specimen. Clarity varies with the amount of suspended particulate matter in the urine specimen.
6. external quality assessment
The use of materials (e.g., specimens, digital images) from an external unbiased source to monitor and determine whether quality goals (i.e., test results) are being achieved. Results are compared to results from other facilities performing the same function. Proficiency surveys are one form of external quality assessment.
16. turnaround time (TAT)
To the laboratorian, the time that elapses from receipt of the specimen in the laboratory to the reporting of test results on that specimen. Physicians and nursing personnel assign a broader time frame.
17. Universal Precautions (UP)
UP were intended to protect health care workers, primarily from patients with these bloodborne diseases.
81. 5-12. Which of the following urine specimens is considered normal? A. A freshly voided urine that is brown and clear B. A freshly voided urine that is yellow and cloudy C. A clear yellow urine specimen that changes color upon standing D. A clear yellow urine specimen that becomes cloudy upon refrigeration
D. A clear yellow urine specimen that becomes cloudy upon refrigeration
71. 5-2. A single substance can impart different colors to urine depending on the 1. amount of the substance present. 2. storage conditions of the urine. 3. pH of the urine. 4. structural form of the substance. A. 1, 2, and 3 are correct. B. 1 and 3 are correct. C. 4 is correct. D. All are correct.
D. All are correct.
89. 5-20. The refractive index of a solution is affected by the 1. wavelength of light used. 2. size and number of the solutes present. 3. concentration of the solution. 4. temperature of the solution. A. 1, 2, and 3 are correct. B. 1 and 3 are correct. C. 4 is correct. D. All are correct.
D. All are correct.
97. 5-28. Which of the following will not influence the volume of urine produced? A. Diarrhea B. Exercise C. Caffeine ingestion D. Carbohydrate ingestion
D. Carbohydrate ingestion
76. 5-7. Select the urine specimen that does not indicate the possible presence of blood or hemoglobin. A. Clear, red urine B. Cloudy, brown urine C. Clear, brown urine D. Cloudy, amber urine
D. Cloudy, amber urine
13. Standard Precautions
One tier of the Guidelines for Isolation Precautions from the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Centers for Disease Control and Prevention (CDC) that describes procedures to prevent transmission of infectious agents when obtaining, handling, storing, or disposing of all blood, body fluid, or body substances, regardless of patient identity or patient health status. All body fluids including secretions and excretions should be treated as potentially infectious.