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Chapter 2: Introduction to Urinalysis
Multiple Choice
1. All of the following are components of normal urine except:
A. Urea
B. Chloride
C. Amino acids
D. Creatinine
ANS: C
DIF: Level 1
OBJ: 1
TOP: Urinalysis composition
2. To determine if a specimen is urine, measure the concentrations of:
A. Glucose and protein
B. Urea and creatinine
C. Uric acid and amino acids
D. Protein and amino acids
ANS: B
DIF: Level 2
OBJ: 2
TOP: Urinalysis composition
3. The average daily volume of urine produced by a normal adult is approximately:
A. 200 mL
B. 500 mL
C. 1200 mL
D. 2500 mL
ANS: C
DIF: Level 1
OBJ: 3
TOP: Urine volume
4. A person exhibiting oliguria would have a urine volume of:
A. 200 to 500 mL
B. 600 to 1000 mL
C. 1000 to 1500 mL
D. more than 1500 mL
ANS: A
DIF: Level 2
OBJ: 3
TOP: Urine volume
5. Which of the following terms is correctly matched with urine output?
A. Anuria: 400 mL in 24 hours
B. Oliguria: 1000 mL in 24 hours
C. Polyuria: 3000 mL in 24 hours
D. Nocturia: no urine output
ANS: C
DIF: Level 1
OBJ: 3
TOP: Urine volume
6. The polyuria associated with diabetes mellitus is caused by:
A. The presence of excess glucose in the urine
B. A defect in the production of ADH (antidiuretic hormone)
C. The diuretic effect of insulin
D. Failure of the collecting duct to respond to ADH
ANS: A
DIF: Level 2
OBJ: 3
TOP: Urine volume
7. Urine from a patient with diabetes insipidus has:
A. Decreased volume and decreased specific gravity
B. Decreased volume and increased specific gravity
C. Increased volume and increased specific gravity
D. Increased volume and decreased specific gravity
ANS: D
DIF: Level 2
OBJ: 3
TOP: Urine volume
8. A patient with polyuria shows a high specific gravity in the urine. The patient should be
evaluated for:
A. Renal tubular acidosis
B. Diabetes mellitus
C. Diabetes insipidus
D. Prostatic infection
ANS: B
DIF: Level 2
OBJ: 3
TOP: Urine volume
9. Persons taking diuretics can be expected to produce:
A. Anuria
B. Polyuria
C. Nocturia
D. Oliguria
ANS: B
DIF: Level 2
OBJ: 3
TOP: Urine volume
10. A urine specimen may be rejected by the laboratory for all of the following reasons except:
A. Nonmatching label and requisition form
B. Specimen contaminated with feces
C. Contamination on the exterior of the container
D. The container uses a screw-top lid
ANS: D
DIF: Level 1
OBJ: 4
TOP: Specimen collection/handling
11. An unpreserved urine specimen left at room temperature overnight will have decreased:
A. Bacteria
B. Specific gravity and pH
C. Glucose and ketones
D. Color and specific gravity
ANS: C
DIF: Level 2
OBJ: 6
TOP: Specimen collection/handling
12. Which of the following will be least affected in an unpreserved specimen left at room
temperature overnight?
A. Bilirubin
B. Urobilinogen
C. Red blood cells
D. Protein
ANS: D
DIF: Level 2
OBJ: 7
TOP: Specimen collection/handling
13. Red blood cells will disintegrate more rapidly in urine that is:
A. Concentrated and acidic
B. Concentrated and alkaline
C. Dilute and acidic
D. Dilute and alkaline
ANS: D
DIF: Level 1
OBJ: 7
TOP: Specimen collection/handling
14. The primary cause of the changes that take place in unpreserved urine is:
A. Bacterial growth
B. Excessive exposure to light
C. Oxidation of chemical constituents
D. Precipitation of crystals
ANS: A
DIF: Level 2
OBJ: 8
TOP: Specimen collection/handling
15. Which of the following urine chemicals will deteriorate when exposed to light?
A. pH
B. Leukocytes esterase
C. Bilirubin
D. Specific gravity
ANS: C
DIF: Level 2
OBJ: 7
TOP: Specimen collection/handling
16. Which of the following is least likely to occur if a urine specimen stands at room temperature
for more than 2 hours?
A. Deterioration of formed elements
B. Increased bacteria
C. Decreased pH
D. Decreased glucose
ANS: C
DIF: Level 1
OBJ: 7
TOP: Specimen collection/handling
17. A urine specimen for reagent strip glucose analysis can be preserved using all of the
following methods except:
A. Refrigeration
B. Boric acid
C. Sodium fluoride
D. Commercial tablets
ANS: C
DIF: Level 1
OBJ: 8
TOP: Specimen collection/handling
18. A urine specimen containing a large amount of precipitated amorphous material may have
been preserved using:
A. Refrigeration
B. Phenol
C. Formalin
D. Toluene
ANS: A
DIF: Level 2
OBJ: 7
TOP: Specimen collection/handling
19. In the laboratory, the preferred method of urine preservation is:
A. Refrigeration
B. Boric acid
C. Sodium fluoride
D. Commercial tablets
ANS: A
DIF: Level 1
OBJ: 9
TOP: Specimen collection/handling
20. A specimen for routine urinalysis and culture can be preserved using:
A. Sodium fluoride
B. Boric acid
C. Formalin
D. Toluene
ANS: B
DIF: Level 1
OBJ: 9
TOP: Specimen collection/handling
21. All of the following are good preservatives of urinary cellular elements except:
A. Boric acid
B. Formalin
C. Sodium fluoride
D. Thymol
ANS: C
DIF: Level 1
OBJ: 9
TOP: Specimen collection/handling
22. Before analysis, a refrigerated urine specimen must be:
A. Warmed to 37oC
B. Examined for crystal formation
C. Examined for changes in color
D. Returned to room temperature
ANS: D
DIF: Level 1
OBJ: 9
TOP: Specimen collection/handling
23. The recommended specimen for routine urinalysis testing is the:
A. Random specimen
B. Timed specimen
C. First morning specimen
D. Catheterized specimen
ANS: C
DIF: Level 1
OBJ: 11
TOP: Types of specimens
24. The required specimen for quantitative analysis of urinary constituents is the:
A. Midstream clean-catch specimen
B. First morning specimen
C. Random specimen
D. Timed specimen
ANS: D
DIF: Level 1
OBJ: 11
TOP: Types of specimens
25. A first morning specimen is frequently requested to confirm:
A. Orthostatic proteinuria
B. Fanconiโs syndrome
C. Urinary tract infection
D. Antidiuretic hormone (ADH) deficiency
ANS: A
DIF: Level 1
OBJ: 11
TOP: Types of specimens
26. The first morning specimen from a patient with no history of symptoms for diabetes is
positive for glucose. The patient should:
A. Be given a glucose tolerance test
B. Be asked to collect the second morning specimen
C. Be asked to collect a timed specimen
D. Be tested for renal tubular damage
ANS: B
DIF: Level 2
OBJ: 11
TOP: Types of specimens
27. The specimen of choice for routine urinalysis is the first morning urine because it:
A. Has a high volume
B. Is produced while the body is in a resting state
C. Is more dilute to prevent false-positive reactions
D. Is more concentrated to better detect abnormalities
ANS: D
DIF: Level 2
OBJ: 11
TOP: Types of specimens
28. All of the following specimens are acceptable for a urine culture except:
A. Catheterized specimen
B. Timed specimen
C. Suprapubic aspiration
D. Midstream clean-catch specimen
ANS: B
DIF: Level 1
OBJ: 11
TOP: Types of specimens
29. Quantitation of a substance that varies with daily activities should be performed on a:
A. Timed overnight specimen
B. First morning specimen
C. 24-hour specimen
D. 2-hour postprandial specimen
ANS: C
DIF: Level 2
OBJ: 11
TOP: Types of specimens
30. Failure to empty the bladder before beginning the collection of a timed urine specimen will:
A. Cause falsely increased results
B. Affect the preservation of glucose
C. Cause falsely decreased results
D. Adversely affect culture results
ANS: A
DIF: Level 2
OBJ: 10
TOP: Types of specimens
31. An alternative to the catheterized specimen is the:
A. Fasting specimen
B. First morning specimen
C. Midstream clean-catch specimen
D. Three glass collection
ANS: C
DIF: Level 1
OBJ: 11
TOP: Types of specimens
32. The least contaminated specimen for bacterial culture is the:
A. Catheterized specimen
B. Suprapubic aspiration
C. Three glass collection
D. Midstream clean-catch specimen
ANS: B
DIF: Level 2
OBJ: 11
TOP: Types of specimens
33. The three glass collection is used for the diagnosis of:
A. Bladder cancer
B. Urinary tract infection
C. Diabetes mellitus
D. Prostate infection
ANS: D
DIF: Level 1
OBJ: 11
TOP: Types of specimens
34. Documentation of appropriate handling of specimens for drug analysis is provided by the:
A. Urinalysis supervisor
B. Physician
C. Temperature readings
D. Chain of custody form
ANS: D
DIF: Level 1
OBJ: 11
TOP: Types of specimens
35. The liver breaks down protein to form what waste product?
A. Urea
B. Amino acids
C. Sodium
D. Chloride
ANS: A
DIF: Level 1
OBJ: 1
TOP: Urinalysis composition
36. An increase in urine production during the night is described as:
A. Anuria
B. Oliguria
C. Polyuria
D. Nocturia
ANS: D
DIF: Level 1
OBJ: 3
TOP: Urine volume
37. Where should labels on urine specimen containers be placed?
A. Container
B. Lid
C. Bottom
D. Placement does not matter
ANS: A
DIF: Level 1
OBJ: 6
TOP: Specimen collection/handling
38. Increased turbidity in urine stored at room temperature is usually caused by:
A. Evaporation
B. White blood cells
C. Bacterial growth
D. Protein precipitation
ANS: C
DIF: Level 1
OBJ: 7
TOP: Specimen collection/handling
39. What is the maximum length of time a urine specimen can remain unpreserved at room
temperature before testing?
A. 30 minutes
B. 2 hours
C. 3 hours
D. 6 hours
ANS: B
DIF: Level 1
OBJ: 8
TOP: Specimen collection/handling
40. Which specimen(s) from a three glass collection do(es) not have to be examined
microscopically?
A. #1
B. #2
C. #3
D. All should be examined
ANS: B
DIF: Level 2
OBJ: 11
TOP: Types of specimens
Matching
State whether the following actions will cause false-positive or false-negative test results:
A. False-positive
B. False-negative
41. The temperature of a specimen for drug testing is 25oC when measured within 4 minutes of
collection.
42. The second sample of a three glass collection has a positive urine culture.
43. A patient is deprived of fluids during a 6-hour timed urine collection.
44. Aliquots from 24-hour specimens are being obtained before measuring and mixing the
sample.
41. ANS: B
DIF: Level 2
OBJ: 11
TOP: Types of
42. ANS: A
DIF: Level 2
OBJ: 11
43. ANS: B
DIF: Level 2
OBJ: 11
44. ANS: B
DIF: Level 2
OBJ: 11
specimens case
study
TOP: Types of
specimens case
study
TOP: Types of
specimens case
study
TOP: Types of
specimens case
study
True/False
45. Urine contains organic and inorganic chemicals that can vary with body metabolic functions.
ANS: True
DIF: Level 1
OBJ:1
TOP: Urinalysis composition
46. Physicians performing urinalysis can determine whether a specimen is urine from the
presence of formed elements.
ANS: False
DIF: Level 1
OBJ: 2
TOP: Urinalysis composition
47. Dietary intake does not influence urine volume.
ANS: False
DIF: Level 2
OBJ: 3
TOP: Urinalysis volume
48. Polydipsia is a symptom of both diabetes mellitus and diabetes insipidus.
ANS: True
DIF: Level 1
OBJ: 3
TOP: Urine volume
49. A urine specimen label should include the date and time of collection.
ANS: True
DIF: Level 1
OBJ: 5
TOP: Specimen collection/handling
50. Urine that remains unpreserved at room temperature will show an increase in the
concentrations of nitrate, glucose, and white blood cells.
ANS: False
DIF: Level 1
OBJ: 7
TOP: Specimen collection/handling
51. A specimen delivered to the laboratory in a gray-top Vacutainer is acceptable for urinalysis.
ANS: False
DIF: Level 2
OBJ: 9
TOP: Specimen collection/handling
52. A urine bacterial culture should not be performed on a catheterized specimen.
ANS: False
DIF: Level 2
OBJ: 10
TOP: Types of specimens
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