Deck 5: Chemical Examination of Urine

Question 1

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"

Answer 1

D

Question 2

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

Answer 2

A

Question 3

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

Answer 3

C

Question 4

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

Question 5

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

Question 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

Question 7

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

Question 8

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

Question 9

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

Question 10

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

A) Albumin
B) Mucoprotein
C) Bence Jones protein
D) Globulin

Question 11

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

Question 12

All of the following will produce an alkaline urine except:

A) Lettuce
B) Cranberry juice
C) Green beans
D) Tomatoes

Question 13

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

Question 14

A possible cause of postrenal proteinuria is:

A) Prostatitis
B) Multiple myeloma
C) Glomerulonephritis
D) Posture

Question 15

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

Question 16

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

A) Nitrite
B) Bilirubin
C) Protein
D) Leukocyte esterase

Question 17

Which of the following is a cause of prerenal proteinuria?

A) Prostatitis
B) Multiple myeloma
C) Pre-eclampsia
D) Diabetes mellitus

Question 18

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

Question 19

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

Question 20

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

Question 21

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

Question 22

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

Question 23

The type of protein that precipitates at 60?F and dissolves at 100?F 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

Question 24

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

Question 25

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

Question 26

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

A) Blood
B) Nitrite
C) Specific gravity
D) Urobilinogen

Question 27

Microalbumin tests are frequently used to screen patients with:

A) Fanconi's syndrome
B) Porphyrinuria
C) Diabetes mellitus
D) Diabetes insipidus

Question 28

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

Question 29

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

Question 30

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

Question 31

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

A) Orthostatic
B) Prerenal
C) Renal
D) Postrenal

Question 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

Question 33

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

A) Leukocytes
B) Glucose
C) Blood
D) Bilirubin

Question 34

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

Question 35

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

Question 36

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

Question 37

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

Question 38

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

Question 39

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.

Question 40

Glucosuria not accompanied by hyperglycemia is seen in patients with:

A) Renal disease
B) Gestational diabetes
C) Cushing's syndrome
D) Hyperthyroidism

Question 41

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"

Question 42

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

Question 43

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

Question 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

Question 45

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

Question 46

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

A) Bilirubin
B) Ketones
C) Glucose
D) Protein

Question 47

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

Question 48

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

Question 49

Galactose will react with:

A) Multistix but not Clinitest
B) Multistix but not Chemstrip
C) Multistix and Chemstrip
D) Clinitest but not Chemstrip

Question 50

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

Question 51

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

A) Hematuria
B) Hemoglobinuria
C) Myoglobinuria
D) Porphyrinuria

Question 52

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

Question 53

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

Question 54

Myoglobinuria may be caused by:

A) A "crushing" injury
B) Incompatible blood transfusions
C) Chronic renal disease
D) Biliary obstruction

Question 55

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

A) Myoglobinuria
B) Hematuria
C) Albuminuria
D) Hemoglobinuria

Question 56

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

Question 57

Excessive fat metabolism is indicated by the urinary presence of:

A) Cholesterol
B) Glucose
C) Ketones
D) Protein

Question 58

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

Question 59

Reagent strip reactions for ketones react primarily with:

A) Acetone
B) Acetoacetic acid
C) Beta-hydroxybutyric acid
D) Phenylacetone

Question 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

Question 61

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

Question 62

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

Question 63

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

Question 64

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

Question 65

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

Question 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

Question 67

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

Question 68

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

Question 69

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

Question 70

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

A) Monocytes
B) Trichomonas
C) Neutrophils
D) Lymphocytes

Question 71

The cells most frequently associated with urinary tract infection are:

A) Monocytes
B) Basophils
C) Neutrophils
D) Lymphocytes

Question 72

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

A) 10³ organisms/mL
B) 10? organisms/mL
C) 10? organisms/mL
D) 10? organisms/mL

Question 73

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

Question 74

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

Question 75

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

Question 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

Question 77

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

A) Reagent strip
B) Refractometer
C) Urinometer
D) Densitometer

Question 78

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

Question 79

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.

Question 80

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