Deck 3: Urinalysis

Question 1

Which of the following describes the process in which fluids and dissolved substances in the blood are forced through the pores of the glomerulus into Bowman's capsule by hydrostatic pressure?

A) Filtration
B) Reabsorption
C) Secretion
D) Renal threshold

Answer 1

A

Question 2

Which of the following statements is true?

A) Reagent strips do not require extra care in storage or protection from strong chemicals.
B) Urine controls are necessary with manual, but not automated, urinalysis.
C) Urine controls are known-value specimens that test the accuracy of urine procedures, reagents, and equipment.
D) Urine controls come in only one level-abnormal.

Answer 2

C

Question 3

Which of the following statements regarding chemical urinalysis strip procedures is incorrect?

A) The chemical strip bottle must be kept tightly sealed when not in use.
B) Do not use expired strips.
C) The moistened strips should be held horizontally to prevent urine and reagents from running into another test area.
D) The strips must be stored in the refrigerator.

Answer 3

D

Question 4

What are two substances that are too large to be filtered from the blood in the glomerulus? (Hint: They are not normally found in urine due to their large size.)

A) Urea and creatinine
B) Water and electrolytes
C) Proteins and RBCs
D) Water and sugar

Question 5

The normal pH of urine is:

A) 4.5 to 8.0.
B) 2.0 to 9.0.
C) 7.5 to 9.0
D) 3.0 to 5.0

Question 6

Which of the tests on a chemical strip should be held for2 minutes (after removal from the urine) before reading the results?

A) Specific gravity
B) Leukocytes
C) Protein
D) pH

Question 7

Which of the following urine colors is abnormal?

A) Amber
B) Greenish-brown
C) Light yellow
D) Straw colored

Question 8

Which of the following statements about RBCs found in a urine microscopic examination is incorrect?

A) RBCs are highly refractile in unstained urine and can be difficult to differentiate from structures such as yeasts and oil droplets.
B) RBCs will shrink (crenate) in concentrated urine because the water in the RBC moves into the urine.
C) RBCs that have hemolyzed will appear on the microscopic examination.
D) A few RBCs can be normal.

Question 9

A Clinitest is correlated with the glucose strip test to determine which of the following conditions?

A) Galactose in the urine of children
B) Emotional stress
C) Vigorous exercise
D) Ketones in the urine

Question 10

Which of the following is incorrect about urine specimen collection?

A) The volume needed is usually between 25 and 50 mL.
B) If a woman is having a menstrual period, and collection of a urine sample must be done during this time, it should be noted on the requisition that the patient is in her menstrual cycle.
C) After collection, a urine specimen can sit for up to 4 hours before being refrigerated or before adding preservatives.
D) The method of collection for urine specimens is dictated by the type of test that is being ordered.

Question 11

The specific gravity of urine is compared to what other liquid (that has a specific gravity of1.000)?

A) Blood
B) Saliva
C) Sweat
D) Water

Question 12

Which of the following best describes a first morning urine specimen?

A) It is the most concentrated and has the greatest amount of dissolved substances.
B) It is a random specimen.
C) The probability of detecting abnormalities decreases, and the microscopic elements remain intact for a long period of time.
D) It is most often collected in the medical office.

Question 13

Which statement is incorrect regarding a24-hour urine collection?

A) After the patient has completed the procedure and returned the container, you should check the label for completeness and ask the patient whether there were any problems during the collection procedure.
B) Instruct the patient to empty the bladder into the toilet when arising on the first day of the 24-hour procedure.
C) Instruct the patient to empty the bladder into the toilet when arising on the second day of the 24-hour procedure.
D) If at any time during the procedure some urine is not collected, the test must be started again.

Question 14

Urine that is allowed to sit for too long at room temperature will undergo which of the following changes?

A) Glucose will increase in the urine because of bacteria metabolism.
B) Casts and crystals will begin to increase.
C) Cells in the urine will lyse open and no longer be visible under the microscope.
D) Bilirubin, if present, will begin to increase.

Question 15

Which of the following proteins may be found in small (micro) amounts in the urine when screening patients who have diabetes mellitus, hypertension, heart attack, stroke, and pregnancy? (Hint: Their presence is compared to excreted creatinine in a ratio.)

A) Albumin
B) Myoglobin
C) Bence Jones protein
D) Hemoglobin

Question 16

Which of the following urinary system functions is incorrect?

A) Removes unwanted wastes
B) Stabilizes blood volume, acidity, and electrolytes
C) Regulates extracellular fluids of the body and the absorption of calcium ions by activating vitamin D
D) Secretes the hormone renin, which controls the rate of red blood cell (RBC) formation, and the hormone erythropoietin, which regulates blood pressure

Question 17

Which of the following is an incorrect association?

A) Urinary bladder | a hollow, muscular organ that holds urine until it is expelled
B) Glomerulus | the secreting tubule of the nephron
C) Urethra | a tube that carries urine to the outside of the body
D) Ureter | a slender, muscular tube 10 to 12 inches long that carries the urine formed in the kidneys to the bladder

Question 18

Which of the following is the correct flow of urine?

Question 19

Which of the following substances is/are not normally found in urine?

A) Urea, uric acid
B) Creatinine
C) Ammonia
D) Glucose

Question 20

Which of the statements regarding the nitrite test for bacteria is incorrect?

A) E.coli from the digestive tract can convert nitrates to nitrites.
B) The urine specimen must not be left standing at room temperature for a long period of time because this could cause a false-positive result.
C) The first morning urine is not used because the urine has been in the urinary bladder for at least 4 hours.
D) A positive nitrite test should be correlated with a positive leukocyte test.

Question 21

A tuft of capillaries in the nephron that filter the blood is called the ____________________.

Question 22

Analyze the following urinalysis chemical report by circling the abnormal results, and then state the possible condition:
Glucose: Negative
Ketones: Negative
Bilirubin: Negative
Specific gravity:1.025
Blood:2+
pH:7.5
Protein:2+
Urobilinogen: Negative
Nitrite:2+
Leukocytes:2+

Question 23

__________ is a decrease in urine volume

Question 24

Ketones in the urine is called ____________________.

Question 25

Which of the following statements about bacteria in urine is incorrect?

A) Presence of bacteria could indicate either contamination or a urinary tract infection (UTI).
B) If WBCs are present with bacteria, this could be significant for a UTI.
C) Bacteria are viewed on high power and are reported as few, moderate, or many, or 1+, 2+, 3+, or 4+.
D) Even though contaminant bacteria reproduce rapidly if the urine is kept at room temperature for a prolonged period, it is not important that the testing and microscopic examination be done on fresh urine.

Question 26

The doctor orders a clean-catch midstream urine specimen to be collected for a urine culture and sensitivity test to be done on a female patient.Identify the missing instructions for steps5 through10 that you would give to this patient regarding the collection of this specimen, including the reasons that each step is important.
First, you must determine that you are instructing the correct patient by having the patient state her name.Then you should sanitize your hands and assemble the correct specimen collection equipment.
For a female patient:
Step1.Wash your hands and gather the equipment.
Step2.Greet and identify your patient, provide her with the clean-catch urine supplies, and explain the following instructions.
Step3.Instruct the patient to sanitize her hands and remove her underwear.
Step4.Instruct the patient to spread apart her labia with one hand to expose the urinary meatus.She should be told to keep this area spread apart with her nondominant hand during the entire cleaning procedure.
Step5.Instruct the patient to take one antiseptic towelette and clean one side of the urinary meatus from _______ to _______ on one side.It is important that you instruct her to clean from _____ to _____ so that _______________________________.
Step6.Instruct the patient to repeat the same procedure using another antiseptic towelette, wiping from ________ to _______ on the other side of the urinary meatus.
Step7.Instruct the patient to use a third antiseptic towelette to wipe from ______ to ________ directly across the urinary meatus.
Step8.Instruct the patient to continue to keep the labia spread apart and to void _________________ in order to ________________.Tell her to be careful not to touch the inside of the sterile container at any time during the procedure.
Step9.Instruct the patient to void ______________.This is the ___________ of urine.
Step10.Instruct the patient to void _____________.This will ensure ______________________________________.
Step11.Instruct the patient to dry the area with a tissue and wash her hands.
Step12.Instruct the patient to carefully cap the specimen container and to put it in a specified place if collected in the office or refrigerate it if collected at home.
Step13.Gloves should be worn when receiving the specimen from the patient.The sample container (not the lid) should be labeled correctly, and a requisition should be completed if required.
Step14.The person receiving the sample should remove the gloves and sanitize his or her hands after the urine has been placed in the testing area.
Step15.The procedure should be charted correctly.The charting should include that midstream clean-catch urine collection instructions were given and that the specimen was received from the patient.

Question 27

Which of the following statements is true?

A) Detection of renal casts, uric acid crystals, and epithelial cells are among the tests found on a reagent strip.
B) All casts and crystals indicate a disease state.
C) Crystal formation is affected by the temperature and pH of the urine.
D) When a urine reagent strip tests positive for blood, RBCs will always be seen under the microscope.

Question 28

Elements excreted in the urine in the shape of the renal tubules and ducts are called ____________________.

Question 29

Which of the following statements about the formation of crystals in urine is incorrect?

A) Crystals are formed by the precipitation of urine salts when there are changes in pH.
B) Crystals are formed by the precipitation of urine salts when there are changes in temperature.
C) Crystals are formed by the precipitation of urine salts when there are changes in concentration.
D) The most important aid in the identification of urine crystals is the urine temperature.

Question 30

Which crystals are commonly seen as colorless octahedron crystals that resemble envelopes? (Hint: They have the appearance of an X on them.)

A) Calcium oxalates
B) Uric acid crystals
C) Calcium carbonates
D) Leucine crystals

Question 31

Part of the nephron that contains the glomerulus and glomerular capsule is the ____________________.

Question 32

_____________ is an increase in the volume of urine output.

Question 33

___________ is defined as red cells breaking open and releasing hemoglobin.

Question 34

The blood reabsorption limit of a substance and the point at which the substance will then appear in the urine is referred to as the ____________________.

Question 35

No urine flow is called ____________________.

Question 36

Which crystals are yellow-brown granules without any distinctive shape that are often found in clumps that give the urine a macroscopic (large enough to see with the eyes) pink, "brick dust" color and are found in acid urines with pH levels under7?

A) Calcium oxalates
B) Uric acid crystals
C) Amorphous urates
D) Leucine crystals

Question 37

The functional unit of the kidney is the ____________________.

Question 38

Which statement regarding cells found in microscopic urine is incorrect?

A) White blood cells (WBCs) found in the urine will appear smaller than epithelial cells.
B) Pyuria can be temporarily caused by fever or strenuous exercises.
C) Squamous epithelial cells are rarely seen and are the most significant of the epithelial cells found in urine.
D) Renal tubular epithelial cells are the most significant of the epithelial cells and can indicate tubular necrosis.

Question 39

Which of the following crystals resemble coffin lids?

A) Calcium oxalates
B) Uric acid crystals
C) Amorphous urates
D) Triple phosphate crystals