In the urinalysis laboratory the primary source in the chain of infection would be: A. Patients B. Needlesticks C. Specimens D. Biohazardous waste

2. The best way to break the chain of infection is: A. Hand sanitizing B. Personal protective equipment C. Aerosol prevention D. Decontamination

The current routine infection control policy developed by CDC and followed in all health-care settings is: A. Universal Precautions B. Isolation Precautions C. Blood and Body Fluid Precautions D. Standard Precautions

An employee who is accidentally exposed to a possible blood-borne pathogen should immediately: A. Report to a supervisor B. Flush the area with water C. Clean the area with disinfectant D. Receive HIV prophylaxis

Personnel in the urinalysis laboratory should wear lab coats that: A. Do not have buttons B. Are fluid-resistant C. Have short sleeves D. Have full-length zippers

All of the following should be discarded in biohazardous waste containers except: A. Urine specimen containers B. Towels used for decontamination C. Disposable lab coats D. Blood collection tubes

An employer who fails to provide sufficient gloves for the employees may be fined by the: A. CDC B. NFPA C. OSHA D. FDA

An acceptable disinfectant for blood and body fluid decontamination is: A. Sodium hydroxide B. Antimicrobial soap C. Hydrogen peroxide D. Sodium hypochlorite

Proper handwashing includes all of the following except: A. Using warm water B. Rubbing to create a lather C. Rinsing hands in a downward position D. Turning on the water with a paper towel

Centrifuging an uncapped specimen may produce a biologic hazard in the form of: A. Vectors B. Sharps contamination C. Aerosols D. Specimen contamination

An employee who accidentally spills acid on his arm should immediately: A. Neutralize the acid with a base B. Hold the arm under running water for 15 minutes C. Consult the MSDSs D. Wrap the arm in gauze and go to the emergency department

When combining acid and water, ensure that: A. Acid is added to water B. Water is added to acid C. They are added simultaneously D. Water is slowly added to acid

An employee can learn the carcinogenic potential of potassium chloride by consulting the: A. Chemical hygiene plan B. Material safety data sheets C. OSHA standards D. Urinalysis procedure manual

Employees should not work with radioisotopes if they are: A. Wearing contact lenses B. Allergic to iodine C. Sensitive to latex D. Pregnant

All of the following are safe to do when removing the source of an electric shock except: A. Pulling the person away from the instrument B. Turning off the circuit breaker C. Using a glass container to move the instrument D. Unplugging the instrument

The acronym PASS refers to: A. Presence of vital chemicals B. Operation of a fire extinguisher C. Labeling of hazardous material D. Presence of radioactive substances

The system used by firefighters when a fire occurs in the laboratory is: A. MSDS B. RACE C. NFPA D. PASS

A class ABC fire extinguisher contains: A. Sand B. Water C. Dry chemicals D. Acid

The first thing to do when a fire is discovered is to: A. Rescue persons in danger B. Activate the alarm system C. Close doors to other areas D. Extinguish the fire if possible

If a red rash is observed after removing gloves, the employee: A. May be washing her hands too often B. May have developed a latex allergy C. Should apply cortisone cream D. Should not rub the hands so vigorously

Pipetting by mouth is: A. Acceptable for urine but not serum B. Not acceptable without proper training C. Acceptable for reagents but not specimens D. Not acceptable in the laboratory

The NPFA classification symbol contains information on all of the following except: A. Fire hazards B. Biohazards C. Reactivity D. Health hazards

The classification of a fire that can be extinguished with water is: A. Class A B. Class B C. Class C D. Class D

Employers are required to provide free immunization for: A. HIV B. HTLV-1 C. HBV D. HCV

A possible physical hazard in the hospital is: A. Wearing closed-toed shoes B. Not wearing jewelry C. Having short hair D. Running to answer the telephone

Quality assessment refers to: A. Analysis of testing controls B. Increased productivity C. Precise control results D. Quality of specimens and patient care

During laboratory accreditation inspections, procedure manuals are examined for the presence of: A. Critical values B. Procedure references C. Procedures for specimen D. All of the above

As supervisor of the urinalysis laboratory, you have just adopted a new procedure. You should: A. Put the package insert in the procedure manual B. Put a complete, referenced procedure in the manual C. Notify the microbiology department D. Put a cost analysis study in the procedure manual

Indicate whether each of the following would be considered a 1) pre examination, 2) examination, or 3)post examination factor by placing the appropriate number in the blank: Reagent expiration date

Indicate whether each of the following would be considered a 1) pre examination, 2) examination, or 3)post examination factor by placing the appropriate number in the blank: Rejecting a contaminated specimen

Indicate whether each of the following would be considered a 1) pre examination, 2) examination, or 3)post examination factor by placing the appropriate number in the blank: Constructing a Levy-Jennings chart

Indicate whether each of the following would be considered a 1) pre examination, 2) examination, or 3)post examination factor by placing the appropriate number in the blank: Telephoning a positive Clinitest result on a newborn

Indicate whether each of the following would be considered a 1) pre examination, 2) examination, or 3)post examination factor by placing the appropriate number in the blank: Calibrating the centrifuge

Indicate whether each of the following would be considered a 1) pre examination, 2) examination, or 3)post examination factor by placing the appropriate number in the blank: Collecting a timed specimen

The testing of sample from an outside agency and the comparison of results with participating laboratories is called: A. External QC B. Electronic QC C. Internal QC D. Proficiency testing

A color change that indicates that a sufficient amount of patient’s specimen or reagent is added correctly to the test system would be an example of: A. External QC B. Equivalent QC C. Internal QC D. Proficiency testing

What steps are taken when the results of reagent strip QC are outside of the stated confidence limits? A. Check the expiration date of the reagent strip B. Run a new control C. Open a new reagent strips container D. All of the above

When a new bottle of QC material is opened, what information is placed on the label? A. The supervisor’s initials B. The lot number C. The date and the laboratory worker’s initials D. The time the bottle was opened

When a control is run, what information is documented? A. The lot number B. Expiration date of the control C. The test results D. All of the above

The average daily output of urine is: A. 200 mL B. 500 mL C. 1200 mL D. 2500 mL

An unidentified fluid is received in the laboratory with a request to determine whether the fluid is urine or another body fluid. Using routine laboratory tests, what tests would determine that the fluid is most probably urine? A. Glucose and ketones B. Urea and creatinine C. Uric acid and amino acids D. Protein and amino acids

The primary inorganic substance found in urine is: A. Sodium B. Phosphate C. Chloride D. Calcium

A patient presenting with polyuria, nocturia, polydipsia, and a low urine specific gravity is exhibiting symptoms of: A. Diabetes insipidus B. Diabetes mellitus C. Urinary tract infection D. Uremia

A patient with oliguria might progress to having: A. Nocturia B. Polyuria C. Polydipsia D. Anuria

All of the following are characteristics of recommended urine containers except: A. A flat bottom B. A capacity of 50 mL C. A snap-on lid D. Are disposable

Labels for urine containers are: A. Attached to the container B. Attached to the lid C. Placed on the container prior to collection D. Not detachable

A urine specimen may be rejected by the laboratory for all of the following reasons except the fact that the: A. Requisition states the specimen is catheterized B. Specimen contains toilet paper C. Label and requisition do not match D. Outside of the container has fecal material contamination

. A cloudy specimen received in the laboratory may have been preserved using: A. Boric acid B. Chloroform C. Refrigeration D. Formalin

Prolonged exposure of a preserved urine specimen to light will cause: A. Decreased glucose B. Increased cells and casts C. Decreased bilirubin D. Increased bacteria

Which of the following would be least affected in a specimen that has remained unpreserved at room temperature for more than 2 hours? A. Urobilinogen B. Ketones C. Protein D. Nitrite

For general screening the most frequently collected specimen is a: A. Random one B. First morning C. Midstream clean-catch D. Timed

Bacterial growth in an unpreserved specimen will: A. Decrease clarity B. Increase bilirubin C. Decrease pH D. Increase glucose

The primary advantage of a first morning specimen over a random specimen is that it: A. Is less contaminated B. Is more concentrated C. Is less concentrated D. Has a higher volume

If a routine urinalysis and a culture are requested on a catheterized specimen, then: A. Two separate containers must be collected B. The routine urinalysis is performed first C. The patient must be recatheterized D. The culture is performed first

The most sterile specimen collected is a: A. Catheterized B. Midstream clean-catch C. Three-glass D. Suprapubic

Which of the following would not be given to a patient prior to the collection of a midstream clean-catch specimen? A. Sterile container B. Iodine cleanser C. Antiseptic towelette D. Instructions

If a patient fails to discard the first specimen when collecting a timed specimen the: A. Specimen must be recollected B. Results will be falsely elevated C. Results will be falsely decreased D. Both A and B

The primary cause of unsatisfactory results in an unpreserved routine specimen not tested for 8 hours is: A. Bacterial growth B. Glycolysis C. Decreased pH D. Chemical oxidation

Urine specimen collection for drug testing requires the collector to do all of the following except: A. Inspect the specimen color B. Perform reagent strip testing C. Read the specimen temperature

The type of nephron responsible for renal concentration is the: A. Cortical B. Juxtaglomerular

The function of the peritubular capillaries is: A. Reabsorption B. Filtration C. Secretion D. Both A and C

Blood flows through the nephron in the following order: A. Efferent arteriole, peritubular capillaries, vasa recta, afferent arteriole B. Peritubular capillaries, afferent arteriole, vasa recta, efferent arteriole C. Afferent arteriole, peritubular capillaries, vasa recta, efferent arteriole D. Efferent arteriole, vasa recta, peritubular capillaries, afferent arteriole

Filtration of protein is prevented in the glomerulus by: A. Hydrostatic pressure B. Oncotic pressure C. Renin D. The glomerular filtration barrier

The renin-angiotensin-aldosterone system is responsible for all of the following except: A. Vasoconstriction of the afferent arteriole B. Vasoconstriction of the efferent arteriole C. Reabsorbing sodium D. Releasing aldosterone

The primary chemical affected by the renin-angiotensin aldosterone system is: A. Chloride B. Sodium C. Potassium D. Hydrogen

Secretion of renin is stimulated by: A. Juxtaglomerular cells B. Angiotensin I and II C. Macula densa cells D. Circulating angiotensin-converting enzyme

The hormone aldosterone is responsible for: A. Hydrogen ion secretion B. Potassium secretion C. Chloride retention D. Sodium retention

The fluid leaving the glomerulus has a specific gravity of: A. 1.005 B. 1.010 C. 1.015 D. 1.020

For active transport to occur, a chemical: A. Must combine with a carrier protein to create electrochemical energy B. Must be filtered through the proximal convoluted tubule C. Must be in higher concentration in the filtrate than in the blood D. Must be in higher concentration in the blood than in the filtrate

Which of the tubules is impermeable to water? A. Proximal convoluted tubule B. Descending loop of Henle C. Ascending loop of Henle D. Distal convoluted tubule

Glucose will appear in the urine when the: A. Blood level of glucose is 200 mg/dL B. Tm for glucose is reached C. Renal threshold for glucose is exceeded D. All of the above

Concentration of the tubular filtrate by the countercurrent mechanism depends on all of the following except: A. High salt concentration in the medulla B. Water-impermeable walls of the ascending loop of Henle C. Reabsorption of sodium and chloride from the ascending loop of Henle D. Reabsorption of water in the descending loop of Henle

ADH regulates the final urine concentration by controlling: A. Active reabsorption of sodium B. Tubular permeability C. Passive reabsorption of urea D. Passive reabsorption of chloride

Decreased production of ADH: A. Produces a low urine volume B. Produces a high urine volume C. Increases ammonia excretion D. Affects active transport of sodium

Bicarbonate ions filtered by the glomerulus are returned to the blood: A. In the proximal convoluted tubule B. Combined with hydrogen ions C. By tubular secretion D. All of the above

If ammonia is not produced by the distal convoluted tubule, the urine pH will be: A. Acidic B. Basic

The largest source of error in creatinine clearance tests is: A. Secretion of creatinine B. Improperly timed urine specimens C. Refrigeration of the urine D. Time of collecting blood sample

Given the following information, calculate the creatinine clearance: 24-hour urine volume: 1000 mL; serum creatinine: 2.0 mg/dL; urine creatinine: 200 mg/dL =

Clearance tests used to determine the glomerular filtration rate must measure substances that are: A. Not filtered by the glomerulus B. Completely reabsorbed by the proximal convoluted tubule C. Secreted in the distal convoluted tubule D. Neither reabsorbed or secreted by the tubules

Performing a clearance test using radionucleotides: A. Eliminates the need to collect urine B. Does not require an infusion C. Provides visualization of the filtration D. Both A and C

Variables that are included in the MDRD-IDSM estimated creatinine clearance calculations include all of the following except: A. Serum creatinine B. Weight C. Age D. Gender

An advantage to using cystatin C to monitor GFR is that: A. It does not require urine collection B. It is not secreted by the tubules C. It can be measured by immunoassay D. All of the above

Solute dissolved in solvent will: A. Raise the vapor pressure B. Lower the boiling point C. Decrease the osmotic pressure D. Lower the freezing point

Substances that may interfere with freezing point measurement of urine and serum osmolarity include all of the following except: A. Ethanol B. Lactic acid C. Sodium D. Lipids

Clinical osmometers use NaCl as a reference solution because: A. 1 g molecular weight of NaCl will lower the freezing point 1.86oC B. NaCl is readily frozen C. NaCl is partially ionized similar to the composition of urine D. 1 g equivalent weight of NaCl will raise the freezing point 1.86oC

The normal serum osmolarity is: A. 50 to 100 mOsm B. 275 to 300 mOsm C. 400 to 500 mOsm D. 3 times the urine osmolarity

After controlled fluid intake, the urine-to-serum osmolarity ratio should be at least: A. 1:1 B. 2:1 C. 3:1 D. 4:1

To provide an accurate measure of renal blood flow, a test substance should be completely: A. Filtered by the glomerulus B. Reabsorbed by the tubules C. Secreted when it reaches the distal convoluted tubule D. Cleared on each contact with functional renal tissue

Calculate the free water clearance from the following results: urine volume in 6 hours: 720 mL; urine osmolarity: 225 mOsm; plasma osmolarity: 300 mOsm =

Given the following data, calculate the effective renal plasma flow: urine volume in 2 hours: 240 mL; urine PAH: 150 mg/dL; plasma PAH: 0.5 mg/dL = =

Renal tubular acidosis can be caused by the: A. Production of excessively acidic urine due to increased filtration of hydrogen ions B. Production of excessively acidic urine due to increased secretion of hydrogen ions C. Inability to produce an acidic urine due to impaired production of ammonia D. Inability to produce an acidic urine due to increased production of ammonia

Tests performed to detect renal tubular acidosis after administering an ammonium chloride load include all of the following except: A. Urine ammonia B. Arterial pH C. Urine pH D. Titratable acidity

The concentration of a normal urine specimen can be estimated by which of the following? A. Color B. Clarity C. Foam D. Odor

The normal yellow color of urine is produced by: A. Bilirubin B. Hemoglobin C. Urobilinogen D. Urochrome

The presence of bilirubin in a urine specimen produces a: A. Yellow foam when shaken B. White foam when shaken C. Cloudy specimen D. Yellow-red specimen

A. Yellow foam when shakenA urine specimen containing melanin will appear: A. Pale pink B. Dark yellow C. Blue-green D. Black

Specimens that contain hemoglobin can be visually distinguished from those that contain RBCs because: A. Hemoglobin produces a clear, yellow specimen B. Hemoglobin produces a cloudy pink specimen C. RBCs produce a cloudy red specimen D. RBCs produce a clear red specimen

A patient with a viscous orange specimen may have been: A. Treated for a urinary tract infection B. Taking vitamin B pills C. Eating fresh carrots D. Taking antidepressants

The presence of a pink precipitate in a refrigerated specimen is caused by: A. Hemoglobin B. Urobilin C. Uroerythrin D. Beets

Microscopic examination of a clear urine that produces a white precipitate after refrigeration will show: A. Amorphous urates B. Porphyrins C. Amorphous phosphates D. Yeast