Renal Function and Laboratory Safety
21. Clearance Tests for Glomerular Filtration Rate (GFR)
- Clearance tests to determine the glomerular filtration rate must measure substances that are:
- D. Neither reabsorbed nor secreted by the tubules.
22. Radionucleotides Clearance Tests
- Performing a clearance test using radionucleotides:
- D. Both A and C.
- A. Eliminates the need to collect urine.
- C. Provides visualization of the filtration.
23. Variables in MDRD-IDSM Calculations
- Variables in the MDRD-IDSM estimated calculations of creatinine clearance include all the following except:
24. Cystatin C for GFR Monitoring
- An advantage of using cystatin C to monitor GFR is that:
- D. All of the above.
- A. It does not require urine collection.
- B. It is not secreted by the tubules.
- C. It can be measured by immunoassay.
25. Effects of Solute in Solvent
- Solute dissolved in solvent will:
- B. Lower the boiling point.
26. Interference with Freezing-Point Measurements
- Substances that may interfere with freezing-point measurement of urine and serum osmolarity include all the following except:
27. Clinical Osmometers and NaCl
- Clinical osmometers use NaCl as a reference solution because:
- A. 1 g molecular weight of NaCl will lower the freezing point by 1.86°C.
28. Normal Serum Osmolarity
- The normal serum osmolarity is:
29. Urine-to-Serum Osmolarity Ratio
- After controlled fluid intake, the urine-to-serum osmolarity ratio should be at least:
30. Calculating Free Water Clearance
- Calculate the free water clearance from the following results:
- Urine volume in 6 hours: 720 mL;
- Urine osmolarity: 225 mOsm;
- Plasma osmolarity: 300 mOsm.
31. Testing for Renal Blood Flow
- To accurately measure renal blood flow, a test substance should be completely:
- C. Secreted when it reaches the distal convoluted tubule.
32. Effective Renal Plasma Flow Calculation
- Calculate the effective renal plasma flow from the following data:
- Urine volume in 2 hours: 240 mL;
- Urine PAH: 150 mg/dL;
- Plasma PAH: 0.5 mg/dL.
33. Renal Tubular Acidosis
- Renal tubular acidosis can be caused by:
- C. Inability to produce an acidic urine due to impaired production of ammonia.
34. Tests for Renal Tubular Acidosis
- Tests performed to detect renal tubular acidosis after administering an ammonium chloride load include all the following except:
1. Nephron Responsible for Renal Concentration
- The type of nephron responsible for renal concentration is:
2. Function of Peritubular Capillaries
- The function of the peritubular capillaries is:
- D. Both A and C.
- A. Reabsorption.
- C. Secretion.
3. Blood Flow through the Nephron
- Order of blood flow through the nephron:
- C. Afferent arteriole, efferent arteriole, peritubular capillaries, vasa recta.
4. Protein Filtration Prevention
- Filtration of protein is prevented in the glomerulus by:
- D. The glomerular filtration barrier.
5. Renin-Angiotensin-Aldosterone System Functions
- The renin-angiotensin-aldosterone system is responsible for all the following except:
- A. Vasoconstriction of the afferent arteriole.
6. Primary Chemical of RAA System
- The primary chemical affected by the renin-angiotensin-aldosterone system is:
7. Renin Secretion Stimulation
- Secretion of renin is stimulated by:
- A. Juxtaglomerular cells.
8. Aldosterone Action
- The hormone aldosterone is responsible for:
9. Fluid Specific Gravity Leaving the Glomerulus
- The fluid leaving the glomerulus has a specific gravity of:
10. Active Transport Requirements
- For active transport to occur, a chemical must:
- D. Be in higher concentration in the blood than in the filtrate.
11. Tubule Impermeability to Water
- Which of the tubules is impermeable to water?
- C. Ascending loop of Henle.
12. Glucose Appearance in Urine
- Glucose will appear in the urine when:
- D. All of the above.
- A. Blood level of glucose is 200 mg/dL.
- B. T for glucose is reached.
- C. Renal threshold for glucose is exceeded.
13. Factors in Countercurrent Mechanism
- Concentration of the tubular filtrate by the countercurrent mechanism depends on all the following except:
- A. High salt concentration in the medulla.
14. ADH Regulation of Urine Concentration
- ADH regulates the final urine concentration by controlling:
15. Decreased ADH Production Effect
- Decreased production of ADH:
- B. Produces a high volume of urine.
16. Bicarbonate Ion Reabsorption
- Bicarbonate ions filtered by the glomerulus are returned to the blood:
- A. In the proximal convoluted tubule.
17. Urine pH without Ammonia
- If ammonia is not produced by the distal convoluted tubule, the urine pH will be:
18. Clearance Substances Categorization
- Place the appropriate letter for the clearance substances:
- A. Exogenous - beta2-microglobulin, 125I-iothalmate
- B. Endogenous - creatinine, cystatin C.
19. Largest Source of Error in Creatinine Clearance Tests
- The largest source of error in creatinine clearance tests is:
- B. Improperly timed urine specimens.
20. Creatinine Clearance Calculation
- 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.
3. Average Daily Urine Output
- The average daily output of urine is:
4. Symptoms of Polyuria and Nocturia
- A patient presenting with polyuria, nocturia, polydipsia, and a low urine specific gravity is exhibiting symptoms of:
5. Possible Progression from Oliguria
- A patient with oliguria might progress to having:
6. Recommended Urine Containers Characteristics
- Characteristics of recommended urine containers except:
7. Labels for Urine Containers
- Labels for urine containers are:
- C. Placed on the container before collection.
8. Reasons for Urine Specimen Rejection
- A urine specimen may be rejected by the laboratory for all the following reasons except:
- A. Requisition form states the specimen is catheterized.
9. Cloudy Specimen Preservation
- A cloudy specimen received in the laboratory may have been preserved using:
10. Most Frequently Collected Specimen
- For general screening, the specimen collected most frequently is a:
11. Advantage of First Morning Specimen
- The primary advantage of a first morning specimen over a random specimen is that it:
12. Procedure for Catheterized Specimens
- If a routine urinalysis and a culture are requested on a catheterized specimen:
- A. Two separate containers must be collected.
13. Timed Specimen Collection Error
- If a patient fails to discard the first specimen when collecting a timed specimen:
- A. Specimen must be re-collected.
14. Primary Cause of Unsatisfactory Results in Unpreserved Specimen
- In an unpreserved routine specimen not tested for 8 hours, the primary cause of unsatisfactory results is:
15. Effect of Light on Preserved Urine Specimen
- Prolonged exposure of a preserved urine specimen to light will cause:
16. Least Affected in Unpreserved Specimen
- Which would be least affected in a specimen that has remained unpreserved for more than 2 hours?
22. Reaction After Removing Gloves
- If a red rash is observed after removing gloves, the employee:
- B. May have developed a latex allergy.
23. Mouth Pipetting
- Pipetting by mouth is:
- D. Not acceptable in the laboratory.
- The NPFA classification symbol contains information on:
25. GHS Requirements for Chemical Labels
- The GHS requires the following on a chemical label:
- B. Hazard pictogram, signal words, hazard statement.
26. Fire Classification Extinguishable with Water
- The classification of a fire that can be extinguished with water is:
27. Required Free Immunization
- Employers are required to provide free immunization for:
28. Physical Hazard in the Hospital
- A possible physical hazard in the hospital is:
- D. Running to answer the telephone.
29. Quality Management Definition
- Quality management refers to:
- D. Quality of specimens and patient care.
30. Documentation During Laboratory Inspections
- During laboratory accreditation inspections, procedure manuals are examined for:
31. Adopting New Procedures in Lab Management
- As the supervisor of the urinalysis laboratory adopting a new procedure, you should:
- B. Put a complete, referenced procedure in the manual.
32. Categorizing Pre, Exam, and Post Examination Factors
- Indicate whether each clearance substance is a preexamination, examination, or postexamination factor:
- Reagent expiration date: 1) Preexamination
- Rejecting a contaminated specimen: 1) Preexamination
- Constructing a Levy-Jennings chart: 3) Postexamination
- Telephoning a positive Clinitest result on a newborn: 3) Postexamination
- Calibrating the centrifuge: 2) Examination
- Collecting a timed urine specimen: 1) Preexamination
33. Testing of Outside Specimens
- The testing of a specimen from an outside agency and comparison of results with participating laboratories is called:
34. Color Change Indication in Test System
- A color change indicating a sufficient amount of a patient's specimen or reagent added correctly to the test system is an example of:
35. Steps for Out-of-Confidence Reagent Strip QC Results
- What steps are taken when the results of reagent strip QC are outside stated confidence limits?
- D. All of the above.
- A. Check the expiration date of the reagent strip.
- B. Run a new control.
- C. Open a new reagent strip container.
5. Organizations Publishing Guidelines for Urinalysis
- Which organization publishes guidelines for writing procedures and policies in the urinalysis?
6. Laboratory Safety Hazards Classification
- Exposure to toxic, carcinogenic, or caustic agents is what type of laboratory safety hazard?
7. Primary Source in Chain of Infection in Urinalysis Lab
- The primary source in the chain of infection in the urinalysis laboratory would be:
8. Breaking the Chain of Infection
- The best way to break the chain of infection is:
9. Infection Control Policy in Health-Care Settings
- The current routine infection control policy developed by CDC followed in all health-care settings is:
10. Action After Exposure to Bloodborne Pathogens
- An employee accidentally exposed to a possible bloodborne pathogen should immediately:
- A. Report to a supervisor.
11. Laboratory Coat Requirements
- Personnel in the urinalysis laboratory should wear laboratory coats that:
12. Biohazardous Waste Disposal
- All the following should be discarded in biohazardous waste containers except:
- D. Blood collection tubes.
13. Employer Liability for Insufficient Gloves
- An employer failing to provide sufficient gloves for employees may be fined by:
14. Acceptable Disinfectant for Decontamination
- An acceptable disinfectant for decontamination of blood and body fluids is:
15. Correct Hand Washing Procedure
- Correct hand washing includes all of the following except:
- C. Rinsing hands in a downward position.
16. Hazard from Uncapped Specimens
- Centrifuging an uncapped specimen may produce a biological hazard in the form of:
17. Acid Spill Response
- An employee who accidentally spills acid on his arm should immediately:
- B. Hold the arm under running water for 15 minutes.
18. Acid and Water Mixing Procedure
- When combining acid and water, ensure that:
- A. Acid is added to water.
- An employee can learn the carcinogenic potential of potassium chloride by consulting the:
20. Safe Removal of Electric Shock Source
- All are safe to do except when removing the source of an electric shock:
- C. Using a glass container to move the instrument.
21. PASS Acronym Meaning
- The acronym PASS refers to:
- B. Operation of a fire extinguisher.
22. Fire Risk Assessment System
- The system used by firefighters to assess the risk potential when a fire occurs in the laboratory is:
23. Class ABC Fire Extinguisher Contents
- A class ABC fire extinguisher contains:
- The first thing to do when a fire is discovered is to:
- A. Rescue people in danger.