Urinalysis and Body Fluids 6th Edition By Susan King Strasinger – Test Bank

Complete Test Bank With Answers

 

 

Sample Questions Posted Below

 

Chapter 5: Chemical Examination of Urine

Multiple Choice

1. Proper care of reagent strips includes all of the following except:

A. Checking the expiration date

B. Storing in a clear container

C. Preventing exposure to toxic fumes

D. Storing with a desiccant

ANS: B

DIF: Level 1

OBJ: 2

TOP: Reagent strips

2. Quality control on reagent strips must be performed whenever a/an:

A. Abnormal result is obtained

B. Different person performs the test

C. New bottle of strips is opened

D. Student is training in the laboratory

ANS: C

DIF: Level 1

OBJ: 3

TOP: Quality control reagent strips

3. The reagent strip reaction that should be read last is the:

A. Nitrite

B. Bilirubin

C. Protein

D. Leukocyte esterase

ANS: D

DIF: Level 1

OBJ: 1

TOP: Reagent strip technique 

4. Failure to blot the edge of the reagent strip may result in errors in color interpretation caused by:

A. Excess dilution

B. Runover

C. Reagent leaching

D. Chemical concentration

ANS: B

DIF: Level 1

OBJ: 1

TOP: Reagent strip technique 

5. Reagent strip chemical tests may be inaccurate if the specimen is:

A. Mixed before delivery

B. Tested immediately after refrigeration

C. Tested immediately after it is voided

D. Collected by catheter

ANS: B

DIF: Level 2

OBJ: 1

TOP: Improper technique or reagent strip technique

6. When performing reagent strip quality control, the:

A. Positive readings should match the reference value by plus or minus one color block

B. Negative readings should match within one color block of the reference value

C. Positive readings except protein and bilirubin should match the reference value

D. Negative values except glucose and nitrite should be negative

ANS: A

DIF: Level 2

OBJ: 3

TOP: Quality control reagent strips

7. The principle of the reagent strip test for pH is:

A. A double indicator reaction

B. The protein error of indicators

C. The diazo reaction

D. A Greiss reaction

ANS: A

DIF: Level 1

OBJ: 5

TOP: pH

8. All of the following will produce an alkaline urine except:

A. Lettuce

B. Cranberry juice

C. Green beans

D. Tomatoes

ANS: B

DIF: Level 1

OBJ: 4

TOP: pH

9. The normal range of urine pH is:

A. 4.5 to 6.0

B. 5.0 to 7.0

C. 4.5 to 8.0

D. 4.5 to 9.0

ANS: C

DIF: Level 1

OBJ: 4

TOP: pH

10. A urine specimen with a pH of 9.0 indicates that the patient should be:

A. Tested further for metabolic or respiratory alkalosis

B. Changed to a high meat diet to lower the pH

C. Placed on medication to lower the pH

D. Asked to collect a new specimen

ANS: D

DIF: Level 2

OBJ: 4

TOP: pH

11. Urinary pH provides valuable information for the:

A. Identification of urinary crystals

B. Controlling of antidiuretic hormone production

C. Monitoring of diabetes mellitus

D. Evaluation of renal concentration

ANS: A

DIF: Level 2

OBJ: 4

TOP: pH

12. A urine with a high pH reading can contain a:

A. High concentration of chloride ions

B. High concentration of hydrogen ions

C. Low concentration of chloride ions

D. Low concentration of hydrogen ions

ANS: D

DIF: Level 2

OBJ: 4

TOP: pH

13. Which of the following results is not typical of a urine specimen from an uncontrolled diabetic?

A. Positive ketones

B. Positive glucose

C. Increased specific gravity

D. High pH

ANS: D

DIF: Level 3

OBJ: 4

TOP: pH

14. Which of the following is a cause of prerenal proteinuria?

A. Prostatitis

B. Multiple myeloma

C. Pre-eclampsia

D. Diabetes mellitus

ANS: B

DIF: Level 1

OBJ: 6

TOP: Protein

15. The protein section of the reagent strip is most sensitive to:

A. Albumin

B. Mucoprotein

C. Bence Jones protein

D. Globulin

ANS: A

DIF: Level 1

OBJ: 7

TOP: Protein

16. When performing a reagent strip test for protein, false-positive results may be obtained in the presence of:

A. Ketones bodies

B. Alkali specimen

C. Glucose present

D. Radiographic contrast media

ANS: B

DIF: Level 1

OBJ: 7

TOP: Protein

17. When using the reagent strip microalbumin method, false-negative results may occur in the presence of:

A. Large amounts of glucose

B. Radiographic contrast media

C. Bence Jones protein

D. Highly dilute urine

ANS: D

DIF: Level 1

OBJ: 8

TOP: Protein

18. To detect the presence of early renal disease, diabetic patients are tested for:

A. Bence Jones protein

B. Microalbuminuria

C. Orthostatic protein

D. Glucose and ketones

ANS: B

DIF: Level 1

OBJ: 8

TOP: Protein

19. A possible cause of postrenal proteinuria is:

A. Prostatitis

B. Multiple myeloma

C. Glomerulonephritis

D. Posture

ANS: A

DIF: Level 1

OBJ: 6

TOP: Protein

20. The principle of the reagent strip test for protein is the:

A. Acid precipitation of protein

B. Salting out of proteins

C. pH affect on bromothymol blue

D. Protein “error of indicators”

ANS: D

DIF: Level 1

OBJ: 7

TOP: Protein

21. All of the following descriptions apply to orthostatic proteinuria except:

A. Most commonly appears in young adults

B. Usually occurs without apparent disease

C. Urinary proteins are excreted only when the patient is lying down

D. Is considered to be a functional, transitory proteinuria

ANS: C

DIF: Level 1

OBJ: 6

TOP: Protein

22. All of the following can be used to detect the presence of microalbuminuria except the:

A. Multistix Pro

B. Sulfosalicylic acid (SSA) test

C. Micral-Test

D. Clinitek 50

ANS: B

DIF: Level 1

OBJ: 8

TOP: Protein

23. The microalbumin test should be performed on:  

A. All negative reagent strip proteins

B. A 24 urine collection

C. Urine that has been refrigerated

D. A first morning collection

ANS: D

DIF: Level 1

OBJ: 8

TOP: Testing for microalbumin

24. The type of proteinuria least likely to be detected by reagent strip is:

A. Orthostatic

B. Prerenal

C. Renal

D. Postrenal

ANS: B

DIF: Level 2

OBJ: 6

TOP: Protein

25. Following a pre-hospital rotation physical, a medical laboratory science student is requested to collect a first morning urine specimen. The physician is checking for:

A. Bence Jones proteinuria

B. Nocturnal proteinuria

C. Orthostatic proteinuria

D. Glomerulonephritis

ANS: C

DIF: Level 2

OBJ: 6

TOP: Protein

26. The type of protein that precipitates at 60^oF and dissolves at 100^oF is a/an:

A. Abnormal protein associated with urinary tract infection

B. Abnormal protein associated with hemolysis

C. Abnormal globulin associated with multiple myeloma

D. Normal serum albumin–type protein

ANS: C

DIF: Level 2

OBJ: 6

TOP: Protein

27. Which of the following best describes the chemical principle of the protein reagent strip?

A. Protein reacts with an immune complex on the pad, which results in a color change.

B. Protein causes a pH change on the reagent strip pad that results in a color change.

C. Protein accepts hydrogen ions from an indicator dye, which results in a color change.

D. Protein causes protons to be released from a polyelectrolyte, resulting in a color change.

ANS: C

DIF: Level 2

OBJ: 7

TOP: Protein

28. The albumin to creatinine ratio may be elevated in patients whose urine contains:

A. Leukocytes

B. Glucose

C. Blood

D. Bilirubin

ANS: B

DIF: Level 2

OBJ: 6

TOP: Protein

29. The pseudoperoxidase reaction is the principle for the reagent strip test(s) for:

A. Blood

B. Nitrite

C. Specific gravity

D. Urobilinogen

ANS: A

DIF: Level 2

OBJ: 15

TOP: Blood

30. Microalbumin tests are frequently used to screen patients with:

A. Fanconi’s syndrome

B. Porphyrinuria

C. Diabetes mellitus

D. Diabetes insipidus

ANS: C

DIF: Level 2

OBJ: 8

TOP: Protein | Glucose

31. A random urine specimen and plasma glucose test that are to be drawn and collected at the same time can be used to confirm:

A. Glomerulonephritis

B. Nonpathogenic glycosuria

C. Urinary tract infection

D. Fanconi’s syndrome

ANS: B

DIF: Level 2

OBJ: 9

TOP: Glucose

32. Which of the following chemical compounds makes a test for glucose in the urine reagent strip testing specific?

A. Glucose oxidase

B. Iron ions

C. Sodium hydroxide

D. Citrate buffers

ANS: A

DIF: Level 1

OBJ: 10

TOP: Glucose

33. The appearance of glucose in the urine of a patient with an elevated blood sugar indicates:

A. Diabetes mellitus

B. Renal tubular damage

C. Diabetes insipidus

D. Cylindroiduria

ANS: A

DIF: Level 1

OBJ: 9

TOP: Glucose

34. The chemical reaction in the reagent strip reaction for glucose uses a:

A. Double sequential enzyme reaction 

B. Sodium nitroprusside reaction 

C. Diazonium salt reaction

D. Pyrrole amino acid ester reaction

ANS: A

DIF: Level 2

OBJ: 10

TOP: Glucose

35. Pediatric urine specimens are additionally tested for the presence of:

A. Glucose using Clinitest

B. Galactose using Multistix

C. Lactose using Multistix Pro

D. Galactose using Clinitest

ANS: D

DIF: Level 1

OBJ: 11

TOP: Glucose

36. A urine specimen is analyzed for glucose by a glucose oxidase reagent strip and a copper reduction test. If both results are positive, which of the following interpretations is correct?

A. Galactose only is present

B. Glucose only is present

C. Lactose only is present

D. Ascorbic acid only is present

ANS: B

DIF: Level 2

OBJ: 10

TOP: Glucose

37. A laboratory error that can result in an infant developing severe mental retardation could be attributed to failure to perform a/an:

A. Acetest

B. SSA test

C. Ictotest

D. Clinitest

ANS: D

DIF: Level 2

OBJ: 11

TOP: Glucose

38. All of the following may interfere with glucose detection in a urine specimen except:

A. Galactose

B. Ascorbic acid

C. Bleach

D. The sample sits at room temperature for 4 hours

ANS: A

DIF: Level 2

OBJ: 10

TOP: Glucose

39. Glucosuria occurring in conjunction with myocardial infarction may be caused by:

A. Epinephrine inhibiting insulin secretion

B. Epinephrine increasing insulin secretion

C. Norepinephrine inhibiting insulin secretion

D. Norepinephrine increasing insulin secretion

ANS: A

DIF: Level 2

OBJ: 9

TOP: Glucose

40. Glucosuria not accompanied by hyperglycemia is seen in patients with:

A. Renal disease

B. Gestational diabetes

C. Cushing’s syndrome

D. Hyperthyroidism

ANS: A

DIF: Level 2

OBJ: 9

TOP: Glucose

41. Which of the following statements is/are correct for glucose testing by reagent strip?
I. Glucose oxidase reacts with glucose in the urine.
II. Non-glucose–reducing substances fail to react.
III. Ascorbic acid may cause a false-negative reaction.
IV. Hydrogen peroxide and peroxidase react to oxidize a chromogen.

A. I only

B. I, II, and III

C. I, II, and IV

D. I, II, III, and IV

ANS: D

DIF: Level 2

OBJ: 10

TOP: Glucose

42. Galactose will react with:

A. Multistix but not Clinitest

B. Multistix but not Chemstrip

C. Multistix and Chemstrip

D. Clinitest but not Chemstrip

ANS: D

DIF: Level 2

OBJ: 11

TOP: Glucose

43. While performing a Clinitest, you observe that the color changes rapidly from blue to orange and then back to blue. You should:

A. Report the test as negative, because the final reaction color is blue

B. Report the test as negative, because the brief orange color probably was from detergent in the tube

C. Repeat the test using fewer drops of urine to check for “pass through”

D. Repeat the test using more drops of urine to prevent “pass through”

ANS: C

DIF: Level 2

OBJ: 11

TOP: Glucose

44. A 1+ reagent strip reaction and a 4+ Clinitest reaction could indicate the presence of:

A. Glucose and other reducing substances

B. Glucose only

C. Non-glucose–reducing substances only

D. Contamination by a strong oxidizing agent

ANS: A

DIF: Level 2

OBJ: 11

TOP: Glucose

45. A negative reagent strip test for glucose with a positive Clinitest indicates the possibility of:

A. Juvenile diabetes

B. Glycosuria

C. Galactosuria

D. Peroxide contamination

ANS: C

DIF: Level 2

OBJ: 11

TOP: Glucose

46. The ketones that are produced in normal adult metabolism include all of the following except:

A. Acetone

B. Phenylketones

C. Acetoacetic acid

D. Beta-hydroxybutyric acid

ANS: B

DIF: Level 1

OBJ: 12

TOP: Ketones

47. Which of the following will not cause ketonuria?

A. Inability to use carbohydrates

B. Inadequate intake of carbohydrates

C. Increased metabolism of carbohydrates

D. Excessive loss of carbohydrates

ANS: C

DIF: Level 1

OBJ: 12

TOP: Ketones

48. Reagent strip reactions for ketones react primarily with:

A. Acetone

B. Acetoacetic acid

C. Beta-hydroxybutyric acid

D. Phenylacetone

ANS: B

DIF: Level 1

OBJ: 13

TOP: Ketones

49. Excessive fat metabolism is indicated by the urinary presence of:

A. Cholesterol

B. Glucose

C. Ketones

D. Protein

ANS: C

DIF: Level 1

OBJ: 12

TOP: Ketones

50. The reagent strip test for ketones may detect the urinary presence of:

A. Acetoacetic acid and beta-hydroxybutyric acid

B. Acetone and beta-hydroxybutyric acid

C. Beta-hydroxybutyric acid and diacetic acid

D. Acetoacetic acid and acetone

ANS: D

DIF: Level 1

OBJ: 13

TOP: Ketones

51. An advantage in using the Acetest tablet test for ketones is the ability to:

A. Detect beta-hydroxybutyric acid

B. Quantitate positive reagent strip ketones results

C. Test serum for increased ketones

D. Confirm a positive Clinitest result

ANS: C

DIF: Level 1

OBJ: 13

TOP: Ketones

52. Sodium nitroprusside and an alkaline buffer are used to test for:

A. Bilirubin

B. Ketones

C. Glucose

D. Protein

ANS: B

DIF: Level 1

OBJ: 13

TOP: Ketones

53. A urine sample that tests positive for ketones and negative for glucose is most likely from a patient suffering from:

A. Diabetes insipidus

B. Diabetes mellitus

C. Polydipsia

D. Starvation

ANS: D

DIF: Level 2

OBJ: 12

TOP: Ketones

54. Reagent strip reactions for blood are based on the:

A. Peroxidase activity of hemoglobin

B. Oxidation of hemoglobin peroxidase

C. Reaction of hemoglobin with bromothymol blue

D. Reduction of a chromogen by hemoglobin

ANS: A

DIF: Level 1

OBJ: 14

TOP: Blood

55. Myoglobinuria may be caused by:

A. A “crushing” injury

B. Incompatible blood transfusions

C. Chronic renal disease

D. Biliary obstruction

ANS: A

DIF: Level 1

OBJ: 14

TOP: Blood

56. Ammonium sulfate is added to a red colored urine. The urine had a positive reaction for blood, but there were no red blood cells in the sediment. After centrifugation, the sedimented ammonium sulfate is red. The abnormal color is caused by:

A. Pyridium

B. Hemoglobin

C. Porphyrins

D. Myoglobin

ANS: B

DIF: Level 2

OBJ: 14

TOP: Blood

57. The detection of hemosiderin in the urine can be associated with:

A. Myoglobinuria

B. Hematuria

C. Albuminuria

D. Hemoglobinuria

ANS: D

DIF: Level 2

OBJ: 14

TOP: Blood

58. A spotted reaction on the reagent strip reaction for blood can indicate:

A. Hematuria

B. Hemoglobinuria

C. Myoglobinuria

D. Porphyrinuria

ANS: A

DIF: Level 2

OBJ: 14

TOP: Blood

59. A reagent strip test for blood is reported positive. No red blood cells are seen on the microscopic examination. The patient’s condition is called:

A. Hematuria

B. Oliguria

C. Hemoglobinuria

D. Hemosiderinuria

ANS: C

DIF: Level 2

OBJ: 14

TOP: Blood

60. The finding of a 2+ reagent strip reaction for blood in the urine of a patient with severe lower back pain can aid in confirming a diagnosis of:

A. Pyelonephritis

B. Appendicitis

C. Renal calculi

D. Multiple myeloma

ANS: C

DIF: Level 2

OBJ: 14

TOP: Blood

61. The chemical principle of the reagent strip test for bilirubin is that bilirubin:

A. Causes a color change when it binds to a buffered pH indicator

B. Combines with a diazonium salt to form a colored complex

C. Is oxidized to biliverdin

D. Causes a pH change detected by the reagent pad indicator

ANS: B

DIF: Level 1

OBJ: 18

TOP: Bilirubin

62. When bilirubin is detected in the urine, it can be assumed that:

A. It is attached to protein

B. It has passed through the small intestine

C. The patient is diabetic

D. It has been conjugated in the liver

ANS: D

DIF: Level 1

OBJ: 16

TOP: Bilirubin

63. Ascorbic acid interferes with the reactions for bilirubin and nitrite by:

A. Reducing the oxidized chromogen

B. Binding with the diazonium salt

C. Neutralizing the buffer

D. Oxidizing the aromatic amine

ANS: B

DIF: Level 2

OBJ: 18

TOP: Bilirubin

64. Which of the following is not true about the Ictotest?

A. Bilirubin is concentrated on the surface of an absorbent pad.

B. Interfering pigments can be washed into the pad.

C. It uses the same principle as the reagent strip.

D. It is less sensitive than the reagent strip test.

ANS: D

DIF: Level 2

OBJ: 18

TOP: Bilirubin

65. The Ictotest is a more sensitive test for urinary bilirubin because:

A. The tablets contain a more sensitive diazonium salt

B. Sulfosalicylic acid is included in the tablets

C. Bilirubin remains on the surface of the mat

D. Water is used to dissolve the tablet

ANS: C

DIF: Level 2

OBJ: 18

TOP: Bilirubin

66. With biliary duct obstruction, it is common for reagent strip tests to show which of the following scenarios?

A. Bilirubin: 0          Urobilinogen: 0.1 EU

B. Bilirubin: ++        Urobilinogen: 0.1 EU

C. Bilirubin: 0          Urobilinogen: 4 EU

D. Bilirubin: ++        Urobilinogen: 4 EU

ANS: B

DIF: Level 2

OBJ: 17

TOP: Bilirubin

67. Urobilinogen is formed from the:

A. Conjugation of bilirubin in the liver

B. Reduction of conjugated bilirubin in the bile

C. Reduction of bilirubin by intestinal bacteria

D. Oxidation of urobilin by intestinal bacteria

ANS: C

DIF: Level 1

OBJ: 19

TOP: Urobilinogen

68. Specimens for urobilinogen testing are collected between 2 p.m. and 4 p.m. because:

A. They have a higher volume

B. An alkaline tide occurs following lunch

C. Protein is less likely to be present

D. The urine will be more acidic

ANS: B

DIF: Level 1

OBJ: 19

TOP: Urobilinogen

69. Reagent strip results associated with hemolytic disease would correspond with which of the following?

A. Bilirubin = 0       Urobilinogen = 1 EU

B. Bilirubin = ++     Urobilinogen = 1 EU

C. Bilirubin = 0        Urobilinogen = 8 EU

D. Bilirubin = ++     Urobilinogen = 8 EU

ANS: C

DIF: Level 2

OBJ: 17

TOP: Urobilinogen

70. A positive nitrite test suggests the presence of a minimum of:

A. 10³ organisms/mL

B. 10⁴ organisms/mL

C. 10⁵ organisms/mL

D. 10⁶ organisms/mL

ANS: C

DIF: Level 1

OBJ: 20

TOP: Nitrite

71. The reagent strip test for nitrite is based on the:

A. Use of nitrite by bacteria present in the urine

B. Reaction of nitrite with the cell wall of gram-negative bacteria

C. Reduction of nitrate in urine to nitrite by bacteria

D. Reaction of bacterial nitrite with an aromatic amine to produce a pH change

ANS: C

DIF: Level 1

OBJ: 20

TOP: Nitrite

72. Which of the following can produce a negative nitrite test in the presence of significant bacteriuria?

A. The presence of many non-nitrate reducing bacteria

B. Performing the test on a first morning specimen

C. Increased dietary nitrate

D. Decreased ascorbic acid

ANS: A

DIF: Level 2

OBJ: 21

TOP: Nitrite

73. Which of the following will be detected by the reagent strip nitrite reaction?

A. Staphylococcus saprophyticus

B. Candida albicans

C. Streptococcus faecalis

D. Escherichia coli

ANS: D

DIF: Level 3

OBJ: 21

TOP: Nitrite

74. All of the following will produce a positive leukocyte esterase (LE) reaction except:

A. Monocytes

B. Trichomonas

C. Neutrophils

D. Lymphocytes

ANS: D

DIF: Level 1

OBJ: 23

TOP: Leukocyte esterase

75. Major advantages of the leukocyte esterase reagent strip test include all of the following except:

A. It will detect the presence of lysed leukocytes

B. It can be used to screen specimens before bacterial culturing

C. It is a more standardized method for detecting leukocytes than the microscopic method

D. It will accurately quantitate the leukocytes present

ANS: D

DIF: Level 1

OBJ: 22

TOP: Leukocyte esterase

76. Reagent strip reactions for white blood cells are based on the detection of:

A. Bacterial peroxidase activity

B. Esterase activity

C. Reduction of indoxyl blue

D. Binding of a diazonium salt

ANS: B

DIF: Level 1

OBJ: 22

TOP: Leukocyte esterase

77. The cells most frequently associated with urinary tract infection are:

A. Monocytes

B. Basophils

C. Neutrophils

D. Lymphocytes

ANS: C

DIF: Level 2

OBJ: 22

TOP: Leukocyte esterase

78. A false-negative LE reaction may be caused by:

A. The presence of eosinophils and basophils

B. Increased bacteria

C. Lysed leukocytes

D. Failure to wait 2 minutes to read the reaction

ANS: D

DIF: Level 2

OBJ: 23

TOP: Leukocyte esterase

79. The principle of the reagent strip test for specific gravity is:

A. Ionization of the indicator bromothymol blue, producing a pH change

B. Ionization of a polyelectrolyte, producing a pH change detected by bromothymol blue

C. Reaction of dissociated polyelectrolyte with bromothymol blue to produce a pH change

D. Change in the pKa of bromothymol blue to produce a pH change

ANS: B

DIF: Level 1

OBJ: 24

TOP: Specific gravity

80. The method of choice for performing a specific gravity following administration of radiographic dye is:

A. Reagent strip

B. Refractometer

C. Urinometer

D. Densitometer

ANS: A

DIF: Level 1

OBJ: 25

TOP: Specific gravity

81. A specific gravity of greater than 1.040 by refractometer is 1.025 when checked using a reagent strip. The technologist should:

A. Report the result as 1.025

B. Dilute the specimen and retest by refractometer

C. Request a new specimen

D. Report the result as greater than 1.040

ANS: A

DIF: Level 2

OBJ: 25

TOP: Specific gravity

82. All of the following reagent strip tests use a diazonium salt except:

A. Bilirubin

B. Nitrite

C. Specific gravity

D. Leukocyte esterase

ANS: C

DIF: Level 2

OBJ: 24

TOP: Reagent strips

83. A specific gravity reading of 1.040 by refractometer and 1.015 by reagent strip is indicative of:

A. Reagent strip deterioration

B. Radiographic dye

C. Low urine pH

D. Refrigerated urine

ANS: B

DIF: Level 2

OBJ: 25

TOP: Specific gravity

84. A dark blue color in the reagent strip pad for specific gravity indicates:

A. A low specific gravity

B. A contaminated specimen

C. Increased protein is interfering

D. A high specific gravity

ANS: A

DIF: Level 2

OBJ: 25

TOP: Specific gravity

85. The reagent strip reaction most critically affected by failure to blot the strip is the:

A. pH

B. Protein

C. Blood

D. Bilirubin

ANS: A

DIF: Level 1

OBJ: 26

TOP: Improper technique

86. Which of the following is not affected by increased intake of ascorbic acid?

A. Blood

B. Bilirubin

C. Nitrite

D. Ketones

ANS: D

DIF: Level 1

OBJ: 26

TOP: Reagent strips | Ketones

87. A burn injury may occur if incorrect technique is used when performing the:

A. SSA test

B. Clinitest

C. Acetest

D. Ictotest

ANS: B

DIF: Level 1

OBJ: 26

TOP: Improper technique

88. The urinalysis result most closely associated with renal disease is a positive:

A. Bilirubin

B. Glucose

C. Nitrite

D. Protein

ANS: D

DIF: Level 1

OBJ: 26

TOP: Protein clinical significance 

89. What action would you take with the following results?

A. Call the floor because the urobilinogen is over the panic value

B. Notify the floor that the specimen is too old

C. Recheck the sediment

D. Report the result

ANS: D

DIF: Level 3

OBJ: 26

TOP: Urinalysis case study

90. What do the following results suggest?

A. Diabetes mellitus

B. Unsatisfactory specimen

C. Urinary tract infection

D. Normal female specimen

ANS: C

DIF: Level 3

OBJ: 26

TOP: Urinalysis case study

NARRBEGIN: 05-nar-01

Determine whether each of the following patients is expected to produce this urine.

Urinalysis produces the following results:

NARREND

91. A 7-year-old girl with uncontrolled diarrhea and vomiting for 3 days.

A. Yes

B. No

ANS: A

NAR: 05-nar-01

DIF: Level 3

OBJ: 26

TOP: Urinalysis case study

92. An uncontrolled diabetic patient who is 2 hours postprandial.

A. Yes

B. No

ANS: B

NAR: 05-nar-01

DIF: Level 3

OBJ: 26

TOP: Urinalysis case study

93. A 42-year-old man taking diuretics and maintaining adequate fluid intake.

A. Yes

B. No

ANS: B

NAR: 05-nar-01

DIF: Level 3

OBJ: 26

TOP: Urinalysis case study

94. A 25-year-old woman on a high-protein, low-carbohydrate diet.

A. Yes

B. No

ANS: A

NAR: 05-nar-01

DIF: Level 3

OBJ: 26

TOP: Urinalysis case study

NARRBEGIN: 05-nar-02

The following urinalysis results are obtained from a female vegetarian who supplements her diet with megavitamins:

NARREND

95. Why is there a discrepancy between the urine color and specific gravity?

A. An old specimen

B. Diabetes mellitus

C. Increased beta carotene

D. Increased bacteria

ANS: C

NAR: 05-nar-02

DIF: Level 3

OBJ: 26

TOP: General case study

96. What is the most probable cause of the discrepancies in the chemical and microscopic results?

A. Dilute specimen

B. Increased ascorbic acid

C. Specimen color

D. Specimen clarity

ANS: B

NAR: 05-nar-02

DIF: Level 3

OBJ: 26

TOP: General case study

97. What is the probable nonpathologic cause of the elevated urobilinogen?

A. Constipation

B. Increased ascorbic acid

C. Leafy green vegetables

D. Strenuous exercise

ANS: A

NAR: 05-nar-02

DIF: Level 3

OBJ: 26

TOP: General case study

98. The elevated pH may be caused by:

A. Bacterial metabolism

B. Vitamins

C. Inadequate fluid intake

D. Increased fluid intake

ANS: A

NAR: 05-nar-02

DIF: Level 3

OBJ: 26

TOP: General case study

98. What is the patient’s probable diagnosis?

A. Renal calculi

B. Glomerulonephritis

C. Allergic reaction

D. Urinary tract infection

ANS: D

NAR: 05-nar-02

DIF: Level 3

OBJ: 26

TOP: General case study

NARRBEGIN: 05-nar-03

State the most probable cause for each of the following scenarios:

NARREND

99. A student is having difficulty interpreting the reagent strip color reactions on a thick orange specimen.

A. Vegetarian diet

B. Elevated urobilinogen

C. Phenazopyridium

D. Cloudy specimen

ANS: C C SS

NAR: 05-nar-03

DIF: Level 3

OBJ: 26

TOP: Clinical significance

100. A laboratory that routinely screens all infants with the Clinitest is accused of missing a case of galactosuria.

A. “Pass through” was not observed

B. Specimen was too old

C. High level of ketones

D. High level of glucose

ANS: A

NAR: 05-nar-03

DIF: Level 3

OBJ: 26

TOP:  Improper technique | Glucose

101. Excessive fizzing is observed when using Clinitest tablets.

A. Decreased reducing substances

B. Contaminated water

C. Tablets deteriorated

D. A plastic tube being used

ANS: C

NAR: 05-nar-03

DIF: Level 3

OBJ: 11

TOP: Improper technique | Glucose

102. A vegetarian consistently has false-positive readings for blood on routine specimens.

A. Ketone interference

B. Dilute specimen

C. Increased leukocytes

D. Vegetable peroxidase

ANS: D

NAR: 05-nar-03

DIF: Level 3

OBJ: 15

TOP: Clinical significance

103. A test on a yellow-green specimen from a jaundiced patient is negative for bilirubin.

A. Bilirubin oxidized to biliverdin

B. Glucose interference

C. Bilirubin reduced to urobilinogen

D. Presence of Lodine

ANS: A

NAE: 05-nar-03

DIF: Level 3

OBJ: 16

TOP: Bilirubin 

104. A student reports a positive urobilinogen using Multistix and a negative urobilinogen using Chemstrip on the same specimen.

A. Outdated reagent strip

B. Porphobilinogen present

C. Failure to mix specimen

D. Refrigerated specimen

ANS: A

NAR: 05-nar-03

DIF: Level 3

OBJ: 26

TOP: Reagent strips

Delete urobilin in all of these and renumber. SS

NARRBEGIN: 05-nar-04

The following questions relate to the substances formed in the degradation of heme:

NARREND

105. Which of the following substances recirculates to the liver?

A. Urobilinogen

B. Unconjugated bilirubin

C. Stercobilinogen

D. Conjugated bilirubin

ANS: A

NAR: 05-nar-04

DIF: Level 2

OBJ: 17

TOP: Urobilinogen

106. The substance converted to urobilin is:

A. Urobilinogen

B. Unconjugated bilirubin

C. Stercobilinogen

D. Conjugated bilirubin

ANS: D

NAR: 05-nar-04

DIF: Level 2

OBJ: 17

TOP: Urobilinogen

107. The substance bound to albumin is:

A. Urobilinogen

B. Unconjugated bilirubin

C. Stercobilinogen

D. Conjugated bilirubin

ANS: B

NAR: 05-nar-04

DIF: Level 2

OBJ: 17

TOP: Urobilinogen

108. The substance produced in the liver is:

A. Urobilinogen

B. Unconjugated bilirubin

C. Stercobilinogen

D. Conjugated bilirubin

ANS: E

NAR: 05-nar-04

DIF: Level 2

OBJ: 17

TOP: Urobilinogen

109. The substance that produces the brown color associated with normal feces is:

A. Urobilinogen

B. Unconjugated bilirubin

C.. Stercobilinogen

D. Conjugated bilirubin

ANS: C

NAR: 05-nar-04

DIF: Level 2

OBJ: 17

TOP: Urobilinogen

True/False

110. Reagent strips provide quantitative urine chemistry results.

ANS: False

DIF: Level 1

OBJ: 1

TOP: Reagent strips

111. The Multistix and Chemstrip color charts are interchangeable.

ANS: False

DIF: Level 1

OBJ: 1

TOP: Reagent strips

112. A person with respiratory acidosis is expected to have a low urine pH.

ANS: True

DIF: Level 2

OBJ: 4

TOP: pH

113. Orthostatic proteinuria is a form of renal proteinuria.

ANS: True

DIF: Level 2

OBJ: 6

TOP: Protein

114. Myoglobin is removed from the blood more rapidly than hemoglobin.

ANS: True

DIF: Level 1

OBJ: 14

TOP: Blood

115. The nitrite test is not reliable unless specimens are collected using the midstream clean-catch technique.

ANS: False

DIF: Level 1

OBJ: 20

TOP: Nitrite

116. When performing a reagent strip specific gravity on an alkaline urine, 0.005 should be subtracted from the reading.

ANS: False

DIF: Level 1

OBJ: 24

TOP: Specific gravity

117. Ascorbic acid will bind with diazonium salts.

ANS: True

DIF: Level 1

OBJ: 26

TOP: Reagent strips