chapter 13 - urine sample collection

Question 1

What are some reasons providers order urine samples?

Answer 1

For laboratory analysis, diagnosis, or treatment of a health condition.

Question 2

Why is therapeutic communication important when acquiring a urine sample?

Answer 2

It helps explain the procedure to the patient and observe for indications of confusion.

Question 3

What should a medical assistant do in case of a language barrier during urine sample collection?

Answer 3

Be creative but respectful to ensure the patient understands the instructions.

Question 4

What is the minimum volume of urine required for routine urine analysis?

Answer 4

12 mL, with a preferred volume of 50 mL.

Question 5

What is a Random Specimen in urine collection?

Answer 5

The collection of freshly voided urine in clean containers.

Question 6

What is a First-Morning Specimen and why is it significant?

Answer 6

It is collected when the patient wakes up; it is most concentrated and useful for various tests like nitrite and protein determination.

Question 7

What is the purpose of a 2-Hour Postprandial Urine Specimen?

Answer 7

To screen for diabetes using home testing programs.

Question 8

What does a 24-Hour Urine Specimen provide?

Answer 8

A quantitative chemical analysis, such as hormone levels and creatinine clearance rates.

Question 9

What is the purpose of a Clean-Catch Midstream Specimen?

Answer 9

To collect urine when there is suspicion of a urinary tract infection and when a culture is needed.

Question 10

What is the procedure for collecting a 24-hour urine specimen?

Answer 10

Void into the toilet the first time in the morning, then collect all urine in a large container for the next 24 hours.

Question 11

How should a female patient collect a Clean-Catch Midstream Specimen?

Answer 11

Cleanse the urinary meatus with antiseptic wipes, void a little urine in the toilet, then collect the next portion in the container.

Question 12

What is the procedure for a male patient collecting a Clean-Catch Midstream Specimen?

Answer 12

Cleanse the urinary meatus with antiseptic wipes, void a little urine in the toilet, then collect the next portion in the container.

Question 13

What should patients be instructed regarding the collection container?

Answer 13

Do not touch the inside of the container or lid to avoid contamination.

Question 14

What type of containers should be used for urine culture specimens?

Answer 14

Sterile containers.

Question 15

What is the importance of washing hands before and after urine collection?

Answer 15

To prevent contamination of the specimen.

Question 16

What should be avoided when collecting a 24-hour urine specimen?

Answer 16

Voiding directly into the container to prevent splashing of the preservative.

Question 17

What is the role of the medical assistant during urine sample collection?

Answer 17

To ensure proper collection techniques and maintain cleanliness.

Question 18

What is the significance of a Clean-Catch Midstream Specimen?

Answer 18

It minimizes contamination and provides a more accurate culture result.

Question 19

Why should patients not bring jars from home for urine collection?

Answer 19

To ensure that the collection containers are thoroughly clean and appropriate for testing.

Question 20

What is the recommended cleansing method for both male and female patients before a Clean-Catch Midstream Specimen?

Answer 20

Cleanse in a front-to-back motion using three antiseptic wipes.

Question 21

What is the consequence of touching the inside of the collection container?

Answer 21

It could introduce germs and lead to false results.

Question 22

What type of specimen is useful for pregnancy testing?

Answer 22

First-Morning Specimen.

Question 23

What are the types of urine collection containers?

Answer 23

Nonsterile containers, sterile containers, special pliable polyethylene bags with adhesive, large wide-mouth plastic containers with screw-cap tops, and evacuated transport tubes.

Question 24

What are nonsterile containers used for?

Answer 24

Random specimens, first-morning specimens, 24-hour urine specimens, and 2-hour postprandial specimens, as well as routine UA testing, pregnancy testing, and tests for abnormal analytes.

Question 25

What is the purpose of sterile containers in urine collection?

Answer 25

They are used for collecting a clean-catch midstream specimen.

Question 26

What are evacuated transport tubes used for?

Answer 26

Transporting specimens to a referral laboratory, with sterile tubes available for urine specimens intended for culture.

Question 27

What should a patient do when instructed to collect a urine specimen?

Answer 27

Void a small amount of urine into the toilet, then fill the container halfway, and cleanse the area around the urinary meatus or tip of the penis before voiding.

Question 28

What is adulteration of a urine specimen?

Answer 28

The intentional manipulation of a urine sample, which can include using another person's or animal's urine, diluting the sample, or adding substances.

Question 29

What substances are commonly used to adulterate urine?

Answer 29

Vinegar, eye drops, baking soda, drain openers, soft drinks, or hydrogen peroxide.

Question 30

How do adulteration test strips work?

Answer 30

They detect human immunoglobulins (IgG) in the urine, which indicates whether the sample is adulterated or naturally diluted.

Question 31

What does a low or zero level of creatinine in urine indicate?

Answer 31

It indicates a diluted or substituted non-human sample.

Question 32

What role do nitrites play in urine adulteration?

Answer 32

They are oxidizing substances that can react with drugs or drug metabolites and can be added to voided urine without changing its color or temperature.

Question 33

What pH levels indicate potential adulteration of urine?

Answer 33

pH levels higher than 9.5 or lower than 3 can alter enzymatic rates and affect drug stability.

Question 34

What is the effect of glutaraldehyde in urine testing?

Answer 34

Glutaraldehyde masks the presence of illegal drugs and is found in commercial products intended for urine adulteration.

Question 35

What is the significance of human immunoglobulin G (IgG) in urine testing?

Answer 35

IgG is present only in humans and helps determine if a urine sample is adulterated or naturally diluted.

Question 36

What is the recommended procedure for collecting a clean-catch midstream specimen?

Answer 36

Cleanse the area around the urinary meatus or tip of the penis, void a small amount into the toilet, then collect the midstream urine.

Question 37

What types of urine specimens are mentioned in the notes?

Answer 37

First-morning specimen, 2-hour postprandial specimen, 24-hour urine specimen, second-voided specimen, and clean-catch midstream specimen.

Question 38

What materials should not be used for transporting culture specimens?

Answer 38

Plastic- or paper-coated containers.

Question 39

What is the purpose of using a large, wide-mouth plastic container for urine collection?

Answer 39

It is useful for collecting specimens over a specified period.

Question 40

What are the characteristics of special pliable polyethylene bags with adhesive?

Answer 40

They are useful for collecting urine from infants and children who are not toilet trained.

Question 41

What happens to the urine sample if it is adulterated with bleach?

Answer 41

It changes the pH of the sample.

Question 42

What is the cutoff level for nitrites in urine during adulteration screening tests?

Answer 42

The level of nitrites found in urine is below the cutoff level with gross bacteriuria or from therapeutic drug metabolites.

Question 43

What is the effect of adding nitrates to voided urine?

Answer 43

It does not change the color or temperature of the specimen.

Question 44

What are commercial adulterants mentioned in the notes?

Answer 44

Whizzies, Klear, and UrineLuck.

Question 45

What is the importance of specific gravity in urine testing?

Answer 45

It is usually detected along with creatinine levels to assess sample dilution.

Question 46

What is specific gravity used for in urine analysis?

Answer 46

To determine the presence of adulterants such as table salt.

Question 47

What is the normal range for specific gravity in urine?

Answer 47

1.005-1.030; the specific gravity of distilled water is 1.000.

Question 48

What factors influence the specific gravity of urine?

Answer 48

Fluid intake and the amount of substances dissolved in urine.

Question 49

What does a change in specific gravity indicate?

Answer 49

It may indicate possible kidney disease.

Question 50

What is the importance of chain of custody in urine testing?

Answer 50

To maintain legal integrity and prevent tampering of drug test results.

Question 51

What identification is required for the individual being tested?

Answer 51

A photo identification.

Question 52

What indirect methods can be used to observe urine specimen collection?

Answer 52

Measuring the specimen's temperature, securing water faucets, having the patient remove outer clothing, and not allowing the toilet to flush.

Question 53

What is the acceptable temperature range for freshly voided urine?

Answer 53

32° C to 38° C (90° F to 100° F).

Question 54

What should be done with the urine specimen after collection?

Answer 54

Pour it into a specimen bottle, seal it with a tamper-evident label, and transport it to the laboratory as soon as possible.

Question 55

What is adulteration in the context of urine samples?

Answer 55

The intentional manipulation of a urine sample by adding other substances.

Question 56

What changes in urine can be detected using adulteration test strips?

Answer 56

Creatinine, pH, nitrites, glutaraldehyde, and specific gravity.

Question 57

What information should be included on the label of a urine specimen?

Answer 57

Patient's name, type of specimen, date of specimen collection, and time of specimen collection.

Question 58

What precautions should be taken when handling urine specimens?

Answer 58

Wash hands before and after handling, use gloves, and refrigerate the specimen if not processed within an hour.

Question 59

What is the timeframe for culture and sensitivity (C&S) testing of urine specimens?

Answer 59

Within 72 hours.

Question 60

How should C&S tubes be stored?

Answer 60

At room temperature, not refrigerated.

Question 61

What is required when transporting urine specimens to a remote lab?

Answer 61

Filing a laboratory request form with necessary patient and test information.

Question 62

What type of bag should urine specimens be sent in to the laboratory?

Answer 62

A plastic biohazard bag with zips closed and an outside pocket.

Question 63

Why is it important to process urine specimens within an hour of collection?

Answer 63

To prevent changes in the chemical and cellular components of the specimen.

Question 64

What should be done to prevent spillage when handling urine specimens?

Answer 64

Handle the specimen carefully.

Question 65

What is the role of a medical assistant (MA) in urine specimen collection?

Answer 65

To ensure proper handling, labeling, and transportation of the specimen.

Question 66

What should be done if the specimen temperature is not checked within 4 minutes?

Answer 66

It may compromise the validity of the urine test.

Question 67

What is the purpose of using tamper-evident labels on urine specimens?

Answer 67

To avoid tampering and adulteration of the sample.

Question 68

What should be done with personal belongings during urine testing?

Answer 68

They should be left in the examination room.

Question 69

What is the significance of measuring the specimen's temperature during collection?

Answer 69

It helps verify the authenticity of the urine sample.

Question 70

What is the purpose of washing hands and using gloves when handling urine specimens?

Answer 70

To prevent transmission of germs or infectious bacteria.

Question 71

What is the maximum time urine specimens, other than culture and sensitivity, should be refrigerated and processed after collection?

Answer 71

Within one hour of collection.

Question 72

How should specimens collected for culture and sensitivity be stored?

Answer 72

In evacuated transport tubes at room temperature for not more than 72 hours.

Question 73

What is the proper way to transport urine specimens to a referral laboratory?

Answer 73

In a plastic biohazard bag with zips closed.

Question 74

What are the different types of urine specimens?

Answer 74

First-morning specimen, 2-hour postprandial urine specimen, 24-hour urine specimen, second-voided specimen, and clean-catch midstream specimen (CCMS).

Question 75

What is the minimum volume of urine required for a routine urine analysis?

Answer 75

12 mL.

Question 76

What types of containers are used for urine collection?

Answer 76

Disposable, nonsterile, plastic, or coated paper containers, available in various sizes with tight-fitting lids.

Question 77

Why is labeling the specimen container important?

Answer 77

To prevent the possible mix-up of specimens.

Question 78

What hygiene practices should medical assistants follow when handling urine specimens?

Answer 78

Washing hands and wearing gloves.

Question 79

What is the purpose of using evacuated transport tubes for urine specimens?

Answer 79

To preserve or refer the specimens to another laboratory for analysis.

Question 80

What information is required on a laboratory request form when transporting a specimen?

Answer 80

Patient identification and information vital to the analysis.

Question 81

What specific instructions should be given to patients when collecting urine specimens?

Answer 81

Void a small amount into the toilet, then fill the container halfway, and cleanse the area around the urinary meatus or tip of the penis before voiding.

Question 82

What types of containers can be used for urine collection?

Answer 82

Nonsterile containers, pliable polyethylene bags with adhesive, large wide-mouth plastic containers with screw-cap tops, sterile containers, and evacuated transport tubes.

Question 83

What is adulteration in the context of urine specimens?

Answer 83

The intentional manipulation of a urine sample by adding another person's or animal's urine, water, or other substances.

Question 84

How are changes in urine such as creatinine, pH, and specific gravity tested for adulteration?

Answer 84

Using adulteration test strips.

Question 85

What should medical assistants follow to maintain the integrity of urine specimens?

Answer 85

Chain of custody rules.

Question 86

What information should be included on the labels of all urine specimens?

Answer 86

Patient's name, type of specimen, date of specimen collection, and time of specimen collection.

Question 87

What is the recommended storage condition for urine specimens collected for culture and sensitivity?

Answer 87

Stored in evacuated transport tubes at room temperature for not more than 72 hours.

Question 88

How should urine specimens be handled after collection to prevent contamination?

Answer 88

Containers must remain clean, and proper hygiene practices should be followed.

Question 89

What is the role of the physician office laboratory (POL) in urine specimen collection?

Answer 89

To provide urine collection containers.

Question 90

What is the significance of the first-morning urine specimen?

Answer 90

It is often more concentrated and can provide more accurate results for certain tests.

Question 91

What is the clean-catch midstream specimen (CCMS) method?

Answer 91

A technique used to collect urine that minimizes contamination from the urethra.

Question 92

What is the role of the medical assistant (MA) in urine specimen collection?

Answer 92

To instruct patients on proper collection techniques and ensure specimens are handled correctly.