APEA PREDICTOR EXAM TEST BANK 300 QUESTIONS & CORRECT ANSWERS WITH RATIONALES 2024 EDITION, Exams of Nursing

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APEA PREDICTOR EXAM TEST BANK 300

QUESTIONS & CORRECT ANSWERS WITH

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• Stenotic valves don't – ans Stenotic valves don't OPEN properly 1-week history of fever and pain over the left scrotum. It is accompanied by frequency and dysuria. The scrotum is edematous and tender to touch. He denies flank pain, nausea, and vomiting. He reports that the pain is lessened when he uses scrotal- support briefs. The urinalysis shows 2+ blood and a large number of leukocytes. What is the most likely diagnosis? – ans Acute epididymitis 2nd htn – ans renal stenosis adrenal tumors A 35-year-old sexually active man presents with a 1-week history of fever and pain over the left scrotum. It is accompanied by frequency and dysuria. The scrotum is edematous and tender to touch. He denies flank pain, nausea, and vomiting. He reports that the pain is lessened when he uses scrotal-support briefs. The urinalysis shows 2+ blood and a large number of leukocytes. What is the most likely diagnosis? – ans Acute epididymitis Explanation Acute epididymitis is the infection presented here. Scrotal edema and pain with palpation do not occur in urinary tract infection or pyelonephritis. Acute orchitis symptoms include testicular pain and edema, are usually associated with the mumps, but do not have frequency and dysuria. A 40-year-old White woman with a body mass index (BMI) of 32 complains of colicky pain in the right upper quadrant of her abdomen that gets worse if she eats fried food. During the physical exam, the nurse practitioner presses deeply on the left lower quadrant of the abdomen and the patient complains of pain on the right side of the lower abdomen. What is the name of this finding? – ans Rovsing's sign A bruit is a murmur heard over the carotid artery in the neck, suggesting arterial narrowing and atherosclerosis. It may increase risk of – ans cerebrovascular disease A normal result in the Rinne test is air conduction (AC) greater than bone conduction (BC). When there is a conductive hearing loss (i.e., ceruminosis, otitis media), the result will be BC greater than AC. The reason is that the sound waves are blocked (i.e.,

cerumen, fluid in middle ear). Therefore, the patient cannot hear them as well as through bone conduction. - ans A proton pump inhibitor (PPI) trial for 8 weeks is preferred for the treatment of moderate/severe GERD whose symptoms are not responding to lifestyle changes. Given the frequency of symptoms, a step-down approach should be considered in this patient. - ans A split S2 heart sound is best heard at which of the following areas? – ans The pulmonic area A UTI is defined as the presence of 100,000 organisms per milliliter of urine in asymptomatic patients or greater than 100 organisms per milliliter of urine with pyuria (>7 WBCs/mL) in a symptomatic patient - ans AAA screening - ans-all men 65-75 who have ever smoked -abdominal US 1 time only abi - anspad An ABI score of 1.0 to 1.4 is normal. Any value less than 1.0 is abnormal. A score of 0. or less is indicative of severe PAD. ABI <0.9 or >1.3 is highly suggestive of - anspad An abdominal wall mass will become more prominent when the abdominal wall muscles are tense. - ans Arteriovenous nicking (AV nicking), copper wire arterioles, and flame hemorrhages are associated with hypertensive retinopathy. - ans bag of worms – ans varicocele Balanitis is caused by: - ans Candida albicans best hypothyroidism screen - anstsh Black Patient With or Without DM – ans Thiazide diuretic Calcium channel blocker boggy - ansedema and tumor BPH prostate - ansSymmetrically enlarged, firm, and smooth

Prostate feels rubbery and uniformly enlarged bright-red-colored spot that has been present in his left eye for 2 days. - ansSubconjunctival hemorrhage calf pain with walking. What's going on? - ansblockage in lower vessels intermittent claudication peripheral artery disease Cdiff 1st line - ansVancomycin https: CF - anspersistent productive cough colic - ans4-6 weeks cones - anscolor Cullen's sign is commonly seen in acute pancreatitis - ans cushing - anscortisol Dawn phenomenon - ansEarly morning glucose elevation produced by the release of growth hormone, which decreases peripheral uptake of glucose resulting in elevated morning glucose levels. Admin of insulin at a later time in day will coordinate insulin peak with the hormone release. digoxin (Lanoxin) for 10 years. Her EKG is showing a new onset of atrial fibrillation. Her pulse is 64 beats/min - ansOrder a serum thyroid-stimulating hormone (TSH), digoxin level, and an electrolyte panel Diverticulosis/diverticulitis - ansDiverticulosis may lead to Diverticulitis DIVERTICULOSIS: pouch-like herniations of colon into muscularis layer, esp. sigmoid colon; symptoms minimal, possible rectal bleeding DIVERTICULITIS: inflammation of diverticula, may cause abscess; pain, cramping of lower left Q, nausea/vomiting, slight fever, increased WBC; complications - bowel obstruction, perforation with peritonitis, hemorrhage Red flag: back pain During a routine physical exam of a 90-year-old woman, a low-pitched diastolic murmur grade 2/6 is auscultated. It is located on the fifth intercostal space (ICS) on the left side

of the midclavicular line. Which of the following identifications is correct? - ansMitral stenosis During cardiac murmur assessment, which is the first grade intensity that a thrill can be palpated? - ansg dysuria - ansOrder a urinalysis and urine for culture and sensitivity (C&S), and treat the patient with antibiotics enterobiasis infection in a 6-year-old girl pin worms - ansscotch tape Evidence of blood in the urine can be seen with kidney stones, bladder cancer, and acute pyelonephritis. - ans Evidence of blood in the urine can be seen with kidney stones, bladder cancer, and acute pyelonephritis. - ans Extreme tenderness and involuntary guarding at McBurney's point is a significant finding for possible: - ansAcute appendicitis For prediabetes, look for an A1C between. - ans5.7% to 6.4%, fasting plasma glucose (FPG) of 100 to 125 mg/dL, and/or 75-g oral glucose tolerance test (OGTT) 2-hour postprandial glucose of 140 to 199 mg/dL Grey-Turner's sign is highly suggestive of which of the following conditions? Acute pancreatitis - ans Hashimoto's thyroiditis? - ansAnti-thyroid peroxidase and anti-thyroglobulin antibodies Heart Failure Clinical Signs and Symptoms - ansCrackles S3 and/or S4 • Peripheral edema may be present heart murmurs are caused by - ansturbulent blood flow through the great vessels or across a heart valve occurs HEAVY chest pressure - anscall 911

hf med - ansace arb htn stop - ansnsaids naproxen hyperbilirubinemia - ans2-3 days after birth Hypocalcemia - ansChvostek's sign i IBS (irritable bowel syndrome) - ansDiarrhea and/or constipation Abdominal pain relief after defecation Mucus with stools If left untreated, Zollinger-Ellison syndrome can cause which of the following? Severe ulceration of the stomach or duodenum - ans If Mrs. Boudreaux were to develop heart failure, which medications would be most beneficial to discontinue? Select all that apply - ansamlodopine naproxine If pravastatin is chosen for Mr. Thibodeaux, how would you manage this? Select all that apply. - ansCheck liver enzymes prior to initiation of statin. Start him on 40 mg today and recheck lipids/LFTs in 8 weeks. intermittent claudication, he or she would first: - ansCheck the ankle and brachial blood pressures before and after exercise Koilonychia is also known as spoon-shaped nails. The finger nails are thin and have a concave shape. Koilonychia is associated with severe iron-deficiency anemia. - ans labyrinthitis or vestibular neuritis except: - ansSymptoms provoked by changes in head position Vertigo with nausea and vomiting Nystagmus Microaneurysms are seen with diabetic retinopathy. Arteriovenous (AV) nicking, copper wire arterioles, and flame hemorrhages are seen with uncontrolled hypertension. - ans Murphy's sign is suggestive of acute cholecystitis and gallbladder disease. It is elicited by palpating the subcostal region on the right upper abdomen; in response, the patient abruptly stops inspiration because of the severe pain. - ans

mvp - anspalpitations dizziness A systolic murmur that is accompanied by a mid systolic click located at the apical area is a classic finding of mitral valve prolapse (MVP) MVP (mitral valve prolapse) - ansSevere mitral regurgitation Endocarditis Increased risk of stroke and transient ischemic attack Myeloma is a cancer of the plasma cells (or mature B-cells/ lymphocytes) that affects the bone marrow. Plasma cells produce antibodies and reside mainly in the bone marrow. Signs and symptoms are bone pain, fractures, hypercalcemia, depressed immunity, and anemia. The bone marrow produces white blood cells (neutrophils, lymphocytes, eosinophils, basophils), red blood cells, and platelets. The typical patient is an adult who is age 60 years or older. - ans non infectious edidymitis - ansprolonged sitting truck driver reflux of urine into epididymitis non old dm - ans150/ Nonblack Patient With or Without DM - ansThiazide diuretic Calcium channel blocker ACE ARB Of the primary hepatitis viruses, only B and C are associated with hepatocellular cancer

• ans Ofloxacin ear drops are not considered to be ototoxic. However, aminoglycoside otic drops (gentamycin, tobramycin) are ototoxic and should not be used to treat otitis media or perforation of the tympanic membrane (TM). - ans older dm - ans140/ Papiledema - ansOcclusion of the ophthalmic vein, swollen optic nerves Papilledema is optic disc swelling cause by increased intracranial pressure. The swelling is usually bilateral. Signs include venous engorgement, loss of venous pulsation, hemorrhages over and/or adjacent to the optic disc, blurring of optic margins, and elevation of the optic disc. - ans

Patients who exercise vigorously in the afternoon may have hypoglycemic episodes in the evening or at night if they do not eat - ans Potential complications of mitral valve prolapse (MVP) include all of the following - ans Prophylaxis treatment for endocarditis is no longer recommended for patients with mitral valve prolapse (MVP). - ans Pterygium is a triangular growth on the white part of the eye that also extends onto the cornea. - ans pulse deficit - ansdifference between the apical and radial pulse rates radial - apical Pulsus paradoxus is best described as: - ansA decrease in systolic blood pressure on inspiration Regurgitant valves don't - ansRegurgitant valves don't CLOSE properly s2 - ansSecond intercostal space, left sternal border sensitive test for evaluating renal function? - ansEstimated glomerular filtration rate (eGFR) shows a triglyceride level of 950 mg/dL, - ansInitiate a prescription of fenofibrate (Tricor) Statin medications, such as rosuvastatin (Crestor), can affect liver function and increase liver enzymes as well as cause the patient to feel weak, fatigued, and have muscle aches. Therefore, checking the liver function profile is recommended. - ans statins - ansliver involvement muscle cramps Suppose his triglycerides were 550 mg/dL? How would you treat? - ansfibrates lifestyle Symogi effect - ansIn diabetic BS will tank at 3am and spike in morning. Symogi effect v dawn phenomenon: - ansSymogi: hypoglycemia causes hyperglycemia Dawn phenomen: increase in insulin due to growth hormones, cortisol etc symogi is what kind of effect - ansreboun hyperglycemia

Symptoms of ulcerative colitis include bloody diarrhea mixed with mucus, nausea/vomiting, abdominal pain, and possible weight loss with long-term diarrhea. - ans Synthroid starting dose - ans25 mcg check in 6 weeks test visual fields by confrontation is used to evaluate for: - ansPeripheral vision The best test for diagnosing glaucoma is - ansTonometry 10 22 The classic triad of symptoms of Meniere's disease are episodic vertigo, tinnitus, and sensorineural hearing loss (low frequency). Tinnitus is usually low pitch (like listening to a conch shell). - ans The cover/uncover test screens for strabismus. - ans The goal for patients aged 60 years or older is blood pressure less than - ans150/ The gold standard for diagnosis of thalassemia (or sickle cell anemia) is the hemoglobin electrophoresis. - ans The most common cause of nongonococcal urethritis is Chlamydia trachomatis, - ans The most important clue for ulcerative colitis is bloody stools that are covered with mucus and pus along with the systemic symptoms (fatigue, low-grade fever). - ans The nurse practitioner would test the obturator and iliopsoas muscle to evaluate for: - ansAcute appendicitis The posterior fontanel normally closes by 3 months of age. The anterior fontanelle closes between 12 and 18 months of age - ans The prostate should feel rubbery and uniformly enlarged in BPH. A boggy and warm prostate with tenderness is suggestive of acute prostatitis. Hard nodules and indurated areas are highly suggestive of prostate cancer. - ans The red reflex examination is used to screen for: Cataracts - ans The Rovsing sign is right lower quadrant pain intensified by left lower quadrant abdominal pressure. It is associated with peritoneal irritation and appendicitis. - ans The S1 heart sound is caused by: - ansClosure of the atrioventricular valves

The Somogyi effect is characterized by - anshigh fasting blood glucose in the morning that is caused by the secretion of glucagon The Somogyi phenomenon or Somogyi effect occurs when nocturnal hypoglycemia ( a.m.-3 a.m.) stimulates the pancrease to secrete glucagon, which causes the liver to convert glycogen to glucose. Fasting blood glucose then becomes elevated. It is also known as the "rebound effect." - ans The urine culture and sensitivity (C&S) is the best evaluation for diagnosing a UTI. - anspositive for a large amount of leukocytes and ketones. He has a trace amount of protein treatment for nongonococcal urethritis? - ansAzithromycin 1 g PO in a single dose TSH (thyroid stimulating hormone) value - ans1.0 and 3. tsh 10 check - ansCheck the thyroid profile Type 2 diabetes mellitus screening tests include fasting plasma glucose level (> mg/dL), random plasma glucose level (>200 mg/dL), and oral glucose tolerance testing (2-hour blood glucose level >200 mg/dL) with a 75-g glucose load. Normal A1C levels are less than 6%. - ans Vitamin B12-deficiency adversely affects myelin, leading to neuropathy. - ans What interventions should be initiated to help decrease his triglyceride level ( mg/dL)? Select all that apply. - ans. Decreased carbohydrate consumption. What is the best procedure for evaluating a corneal abrasion - ansFluorescein stain What is the cutoff value when treatment for hyperlipidemia is recommended? - ans7. or higher What type of murmur can radiate to the left axilla? - ansMitral regurgitation The murmur of mitral regurgitation occurs during systole (holosystolic) and is located in the mitral area of the chest. The location of the mitral area (fifth intercostal space on the left side of the midclavicular line) is near the left axilla, so that a loud murmur can radiate to the left axilla. The causes can be congenital or it may a be sequela of rheumatic fever, mitral valve prolapse, or papillary muscle dysfunction secondary to acute or prior myocardial infarction. When performing an abdominal exam, what is the best method to differentiate an abdominal wall mass from an intra-abdominal mass? - anslift her head off the table

while tensing her abdominal muscles to visualize any masses and then palpate the abdominal wall Which bacterium is the most common pathogen seen in otitis externa infections? Pseudomonas aeruginosa - ans Which of the following clusters indicates the target organ damage commonly seen in hypertensive patients? - ansArteriovenous (AV) nicking, left ventricular hypertrophy, and stroke Which of the following eye findings is seen in patients with diabetic retinopathy? - ansNeovascularization Which of the following is correct regarding the best site to listen for mitral regurgitation?

• ansIt is best heard at the apex during S Which of the following laboratory tests is a sensitive test for evaluating renal function? - ansEstimated glomerular filtration rate (eGFR) Which of the following laboratory tests is the most sensitive test for evaluating an active Helicobacter pylori infection of the stomach or duodenum: - ansUrea breath test Which of the following laboratory values may be elevated on the liver function panel of patients who are alcohol abusers? Serum GGT (gamma glutamyl transaminase) - ans While performing a funduscopic exam, the nurse practitioner notices arteriovenous (AV) nicking on the patient's retina. What causes AV nicking? It is caused by an arteriole crossing a venule, which compresses the venule and causes it to bulge on each side - ans white - ansace Wilms tumor - ansThe most frequent clinical sign is a palpable abdominal mass It is a congenital tumor of the kidney Microscopic or gross hematuria is sometimes present With the patient in the supine position, the examiner palpates deep into the left lower quadrant of the abdomen. The maneuver is positive if pain is referred to the right lower quadrant. - ans Women with polycystic ovary syndrome (PCOS) are at higher risk for the following:

Heart disease and endometrial cancer - ans Women with polycystic ovary syndrome (PCOS) are at higher risk for the following: - ansHeart disease and endometrial cancer You note a high-pitched and blowing pansystolic murmur while assessing a 70-year-old male patient. It is grade 2/6 and is best heard at the apical area. Which of the following is most likely? - ansmr You notice a medium-pitched harsh systolic murmur during an episodic examination of a 37-year-old woman. It is best heard at the right upper border of the sternum. What is most likely? - ansAortic stenosis You palpate a tender and warm cystic mass on the lower edge of the left labia minora, which is red. - ansBartholin's glands are located in the base of the labia minora at about the 4 o'clock and 8 o'clock positions. Their function is to provide moisture for the vestibule. They are small (about pea sized) unless they become clogged or infected. If this occurs, an abscess may form and glands will enlarge and become painful. ans A 2-year-old child had a positive urine ketone. This would most likely be caused by: A. vomiting B. anemia C. hypoglycemia D. biliary tract obstruction - ansA A 17-year-old girl decided to go on a starvation diet. After 1 week of starving herself, what substance would most likely be found in her urine? A. protein B. ketones C. glucose D. blood - ansB A 21-year-old woman had glucose in her urine with a normal blood sugar. These findings are most consistent with: A. renal glycosuria B. diabetes insipidus C. diabetes mellitus D. alkaline tide - ansA

A 24-hour urine from a man who had no evidence of kidney impairment was sent to the laboratory for hormone determination. The volume was 600 mL, but there was some question as to the completeness of the 24-hour collection. The next step would be to: A. perform the hormone determination, since 600 mL is a normal urine 24-hour volume B. check the creatinine level; if it is less than 1 g do the procedure C. report the hormone determination in milligrams per deciliter in case the specimen was incomplete D. check the creatinine level; if it is greater than 1 g do the procedure - ansD A 24-year-old obese diabetic woman had the following blood and urine test results from specimens obtained at the same time: pH = 7. Protein =30 mg/dL Glucose = negative Ketones = 15 mg/dL Bilirubin = negative Blood = negative Nitrite = negative Urobilinogen = 1 EU/dL Specific gravity = 1. Microscopic: Epithelial cells = 3- Bacteria = many Yeast = many Amorphous = moderate Blood sugar = 195 mg/dL Which of the following is the MOST likely explanation for the negative urine glucose finding? A. There is a false-negative glucose due to oxidizing contaminants. B. There is a false-negative glucose due to the alkaline pH. C. The specimen is probably old and the bacteria and yeast have consumed the glucose. D. Glucose would not be present in the urine specimen since the blood sugar was normal. - ansC A 42-year-old man is admitted to the emergency room with multiple abrasions, several broken bones, a fractured pelvis, and a crushed femur. The following urinalysis results are obtained: Clarity - Hazy Color - Red-brown Specific gravity - 1. pH - 6. Protein - 300 mg/dL Glucose - Negative

Ketones - Negative Blood - 4+ Bilirubin - Negative Nitrite - Negative Urobilinogen - 0.1 EU/dL Microscopic: Hemoglobin granular casts 3- What is the MOST likely explanation for the discrepancy between the 4+ blood result, hemoglobin granular casts, and the complete absence of red cells on the microscopic? A. There is a false-positive reaction for blood on the urine strip due to the large amount of protein. B. The blood portion of the urine reagent strip is more sensitive to hemoglobin than intact red cells. C. Red blood cells have been lysed due to the pH and the specific gravity. D. The hemoglobin granular casts which were re - ansB A 59-year-old man is evaluated for back pain. Urine studies (urinalysis by multiple reagent strip) include: Urinalysis Specific gravity - 1. pH - 6. Protein - Negative Glucose - Negative Blood - Negative Microscopic - Rare epithelial cells Urine protein electrophoresis: Monoclonal spike in gamma globulin region Which of the following statements best explains these results? A. The urine protein is falsely negative due to the specific gravity. B. The urine protein is falsely negative because the method is not sensitive for Bence Jones protein. C. The microscopic examination is falsely negative due to the specific gravity. D. The electrophoresis is incorrect and should be repeated. - ansB A 62-year-old patient with hyperlipoproteinemia has a large amount of protein in his urine. Microscopic analysis yields moderate to many fatty, waxy, granular, and cellular casts. Many oval fat bodies are also noted. This is most consistent with: A. nephrotic syndrome B. viral infection C. acute pyelonephritis D. acute glomerulonephritis - ansA

A centrifuge head has a diameter of 60 cm and spins at 3000 rpm. What is the maximum achievable g force (g = 0.00001 x radius in cm x rpm2)? A. 1.8g B. 2700g C. 27,000g D. 90,000g - ansB A clean-catch urine sample is submitted to the laboratory for routine urinalysis and culture. The routine urinalysis is done first, and the specimen is then sent to microbiology for culture. The specimen should: A. be centrifuged and the supernatant cultured B. be rejected due to possible contamination from routine urinalysis C. not be cultured if no bacteria are seen D. be immediately processed for culture regardless of urinalysis results - ansB A component seen during a microscopic urinalysis stains positively with Sudan III stain but does not polarize. This most likely is a: A. cholesterol ester B. neutral fat C. lipid D. leucine - ansB A micropipet graduated to the tip and calibrated to contain should: A. be drained B. be rinsed C. not be blown out D. not be rinsed - ansB A milky colored urine from a 24-year-old woman would most likely contain: A. spermatozoa B. many white blood cells C. red blood cells D. bilirubin - ansB A patient has glucosuria, hyperglycemia, and polyuria. These findings would be associated with: A. renal glucosuria B. diabetes mellitus C. emotional stress D. eating a heavy meal - ansB A patient with renal tubular acidosis would most likely excrete a urine with a: A. low pH B. high pH C. neutral pH D. variable pH - ansB

A patient with uncontrolled diabetes mellitus will most likely have: A. pale urine with a high SG B. concentrated urine with a high SG C. pale urine with a low SG D. dark urine with a high SG - ansA A patient with uncontrolled diabetes mellitus will most likely have: A. pale urine with a high specific gravity B. concentrated urine with a high specific gravity C. pale urine with a low specific gravity D. dark urine with a high specific gravity - ansA A patient's urinalysis revealed a positive bilirubin and a decreased urobilinogen level. These results are associated with: A. hemolytic disease B. biliary obstruction C. hepatic disease D. urinary tract infection - ansB A physician attempts to aspirate a knee joint and obtains 0.1 mL of slightly bloody fluid. Addition of acetic acid results in turbidity and a clot. This indicates that: A. the fluid is synovial fluid B. plasma was obtained C. red blood cells caused a false positive reaction D. the specimen is not adequate - ansA A positive result for bilirubin on a reagent strip should be followed up by: A. notifying the physician B. requesting a new specimen C. performing an IctotestTM D. performing a urobilinogen - ansC A reagent strip area impregnated with stabilized, diazotized 2,4-dichloroaniline will yield a positive reaction with: A. bilirubin B. hemoglobin C. ketones D. urobilinogen - ansA A reagent strip test for hemoglobin has been reported positive. Microscopic examination fails to yield red blood cells. This patient's condition can be called: A. hematuria B. hemoglobinuria C. oliguria D. hemosiderinuria - ansB

A sperm count is diluted 1:20 and 50 sperm are counted in two large squares of the Neubauer counting chamber. The sperm count in mLs is: A. 5000 B. 50, C. 500, D. 5,000,000 - ansD A technologist is having trouble differentiating between red blood cells, oil droplets, and yeast cells on a urine microscopy. Acetic acid should be added to the sediment to: A. lyse the yeast cells B. lyse the red blood cells C. dissolve the oil droplets D. crenate the red blood cells - ansB A test area of a urine reagent strip is impregnated with only sodium nitroprusside. This section will react with: A. acetoacetic (diacetic) acid B. leukocyte esterase C. beta-hydroxybutyric acid D. ferric chloride - ansA A turbid cerebrospinal fluid is most commonly caused by: A. increased white blood cells B. increased protein C. increased glucose D. increased bacterial organisms - ansA A urinalysis performed on a 27-year-old woman yields the following results: Specific gravity = 1. pH = 5. Protein =2+ Glucose = negative Ketones = negative Bilirubin = negative Blood =3+ Nitrite = negative Leukocytes = positive Urobilinogen = 0.1 EU/dL Microscopic: WBC/HPF = 20- RBCIHPF = 30- CastsILPF Hyaline = 5- Epithelial = 1-

Coarse granular = 2- Waxy = 1-3 Uric acid crystals = moderate Uris acid crystals = moderate The above data are consistent with: A. nephrotic syndrome B. gout C. biliary obstruction D. chronic renal disease - ansD A urine specimen collected from an apparently healthy 25-year-old man shortly after he finished eating lunch was cloudy but showed normal results on a multiple reagent strip analysis. The most likely cause of the turbidity is: A. fat B. white blood cells C. urates D. phosphates - ansD A urine specimen comes to the laboratory 7 hours after it is obtained. It is acceptable for culture only if the specimen has been stored: A. at room temperature B. at 4°C-7°C C. frozen D. with a preservative additive - ansB A urine specimen is analyzed for glucose by a glucose oxidase reagent strip and a copp reduction test. If both results are positive, which of the following interpretations is corre A. Galactose is present B. Glucose is present C. Lactose is not present D. sucrose is not present - ansB A urine specimen is analyzed for glucose by a glucose oxidase reagent strip and a copp reduction test. If both results are positive, which of the following interpretations is corre A. Galactose is present. B. Glucose is present. C. Lactose is not present. D. Sucrose is not present. - ansB A urine tested with Clinitest exhibits a pass through reaction and is diluted by adding 2 drops of urine to 10 drops water. This is a dilution of: A. 1 to 4 B. 1 to 5 C. 1 to 6 D. 1 to 8 - ansC

A urine with an increased protein has a high specific gravity. Which of the following would be a more accurate measure of urine concentration? A. osmolality B. ketones C. refractive index D. pH - ansA A urine's specific gravity is directly proportional to its: A. turbidity B. dissolved solids C. salt content D.sugar content - ansB A woman in her ninth month of pregnancy has a urine sugar that is negative with the urine reagent strip but gives a positive reaction with the copper reduction method. The sugar most likely responsible for these results is: A. maltose B. galactose C. glucose D. lactose - ansD After receiving a 24-hour urine sample for quantitative total protein analysis, the technician must first: A. subculture the urine for bacteria B. add the appropriate preservitive C. screen for albumin D. measure the total volume - ansD Ammonium sulfate was added to red urine. The urine had a positive reaction tor blood, but no RBCs were seen on microscopic examination. After centrifugation the supernatant fluid is red. The abnormal color is caused by: A. Pyridium B. hemoglobin C. porphyrins D. myoglobin - ansD An abdominal fluid is submitted from surgery. The physician wants to determine if this fluid could be urine. The technologist should: A. perform a culture B. smell the fluid C. test for urea, creatinine, sodium and chloride D. test for protein, glucose and pH - ansC An acid urine that contains hemoglobin will darken on standing due to the formation of: A. myoglobin B. sulthemoglobin

C. methemoglobin D. red blood cells - ansC An ammonia-like odor is characteristically associated with urine from patients who: A. are diabetic B. have hepatitis C. have an infection with Proteus sp D. have a yeast infection - ansC An antidiuretic hormone deficiency is associated with a: A. specific gravity around 1. B. low specific gravity C. high specific gravity D. variable specific gravity - ansB Antidiuretic hormone regulates the reabsorption of: A. water B. glucose C. potassium D. calcium - ansA Bilirubinuria may be associated with: A. strenuous exercise B. increased destruction of platelets C. viral hepatitis D. hemolytic anemia - ansC Broad waxy casts are LEAST likely to be associated with: A. advanced tubular atrophy B. end-stage renal disease C. fatty degeneration tubular disease D. formation in a pathologically dilated tubule - ansC Following the addition of acid, white precipitate in a cloudy urine sample dissolves. This most likely indicates the presence of: A. amorphous urates B. WBCs C. amorphous phosphates D. bacteria - ans Glycosuria may be due to: A. hypoglycemia B. increased renal threshold C. renal tubular dysfunction D. increased glomerular filtration rate - ansC

Hyaline casts are usually found: A. in the center of the coverslip B. under subdued light C. under very bright light D. in the supernatant - ans In addition to the sperm count in a fertility study, analysis of seminal fluid should also include: A. time of liquefaction, estimation of motility, morphology B. motility, morphology, test for alkaline phosphatase C. time of liquefaction, test for acid phosphatase, qualitative test for hemoglobin D. time of liquefaction, qualitative test for hemoglobin and motility - ansA In most compound light microscopes, the ocular lens has a magnification of: A. 10x B. 40x C. 50x D. 100x - ansA In which of the following metabolic diseases will urine turn dark brown to black upon standing? A. phenylketonuria B. alkaptonuria C. maple syrup disease D. aminoaciduria - ansB Ketones in urine are due to: A. complete utilization of fatty acids B. incomplete fat metabolism C. high carbohydrate diets D. renal tubular dysfunction - ansB Normal urine primarily consists of: A. water, protein, and sodium B. water, urea, and protein C. water, urea, and sodium chloride D. water, urea, and bilirubin - ansC On bright-light microscopic examination of a urinary sediment, round refractile globules are noted in cells encapsulated within a hyaline matrix. A polarized-light microscopic examination of the urinary structure showed the globules to be birefringent in the shape of Maltese crosses. These urinary structures can be identified as: A. waxy casts associated with advanced tubular atrophy B. granular casts containing plasma protein aggregates C. crystal casts associated with obstruction due to tubular damage D. fatty casts containing lipid-laden renal tubular cells - ansA

Patients with diabetes mellitus have urine with: A. decreased volume and decreased specific gravity B. decreased volume and increased specific gravity C. increased volume and decreased specific gravity D. increased volume and increased specific gravity - ansD Pleural transudates differ from pleural exudates in that transudates have: A. protein values of> 4 g/100 mL B. specific gravity values of> 1.020 C. LD values of> 200 U/L D. relatively low cell counts - ansD Polyuria is usually correlated with: A. acute glomerulonephritis B. diabetes mellitus C. hepatitis D. tubular damage - ansA Red colored urine may be due to: A. bilirubin B. excess urobilin C. myoglobin D. homogentisic acid - ansC Refractive index is a comparison of: A. light velocity in solutions with light velocity in solids B. light velocity in air with light velocity in solutions C. light scattering by air with light scattering by solutions D. light scattering by particles in solution - ansB Round refractile globules noted on bright-light microscopy of a urinary sediment were birefringent with polarized-light and appeared as perfect Maltese crosses. These globules are most likely: A. neutral fats B. starch C. triglycerides D. cholesterol - ansD Routine screening of urine samples for glycosuria is preformed primarily to detect: A. glucose B. galactose C. bilirubin D. ketones - ansA

Small round objects found in a urine sediment that dissolve after addition of dilute acetic acid and do not polarize most likely are: A. air bubbles B. calcium oxalate C. RBCs D. yeast cells - ansC Some regional and public health laboratories carry out mass screening tests on the urine of newborns for a genetic disorder involving metabolism of: A. fructose B. galactose C. glucose D. lactose - ans The amber yellow color of urine is primarily due to: A. urochrome pigment B. methemoglobin C. bilirubin D. homogentisic acid - ansA The clarity of a urine sample should be determined: A. using glass tubes only, never plastic B. following thorough mixing of the specimen C. after addition of sulfosalicylic acid D. after the specimen cools to room temperature - ansB The confirmatory test for a positive protein result by the reagent strip method uses: A. Ehrlich's reagent B. a diazo reaction C. sulfosalicylic acid D. a copper reduction tablet - ansC The following lab values were obtained on a body fluid sample: Protein - 3 g/dL Albumin - 2.1 g/dL Hyaluronate - 0.4 g/dL Glucose - 80mg/dL Lactate - 10mg/dL The sample is: A. pleural fluid B. synovial fluid C. urine D. cerebrospinal fluid - ansB The following results were obtained on a urine specimen at 8 AM:

pH - 5.5 Protein - 2+ Glucose - 3+ Ketones - 3+ Blood - Negative Bilirubin - Positive Nitrite - Positive If this urine specimen was stored uncapped at 5°C without preservation and retested at 2 PM, which of the following test results would be changed due to these storage conditions? A. glucose B. ketones C. protein D. nitrite - ansB The following urinalysis results were obtained from an 18-year-old woman in labor: pH - 6.5 Protein - 30 mg/dL Glucose - 250 mg/dL Ketones - Negative Bilirubin - Small (color slightly abnormal) Blood - Negative Nitrite - Negative Urobilinogen - 0.1 EU/dL Specific gravity - 1.025 Copper reduction test - 1.0 g/dL Sulfosalicylic acid test for protein - 30 mg/dL Which of the following is the MOST likely explanation for the patient's positive copper reduction test? A. only glucose is present B. only lactose is present C. glucose and possibly other reducing substances/sugars are present D. results are false positive due to the presence of protein - ansC The following urine results were obtained on a 25-year-old female: Color = amber Appearance = cloudy Specific gravity = 1.015 WBC casts = few pH = 5.0 Protein = 1+ Glucose = negative Blood = small Microscopic: Bacteria = many

WBC casts = few WBC/HPF = 30-40 These results are most compatible with: A. glomerulonephritis B. renal calculus C. vaginitis D. pyelonephritis - ansD The knob between the eyepieces on a binocular microscope is used to: A. correct for optical differences between the right and left eyes B. adjust for distances between one's eyes C. change the magnification of the oculars D. improve the equivalent focus of the microscope - ansB The normal pH value for a healthy adult's urine is: A. 4.5 B. 5.0 C. 6.0 D. 8.0 - ansC The presence of leukocytes in urine is known as: A. chyluria B. hematuria C. leukocytosis D. pyuria - ansD The primary constituent of hyaline casts is: A. fat B. cells C. protein D. mucus - ansC The principal mucin in synovial fluid is: A. hyaluronate B. albumin C. orosomucoid D. pepsin - ansA The principle of the reagent strip test for urine protein depends on: A. an enzyme reaction B. protein error of indicators C. copper reduciton D. the toluidine reaction - ansB The results of a urinalysis on a first-morning specimen are: Specific gravity - 1.024

pH - 8.5 Protein - Negative Glucose - Negative Microscopic - Uric acid crystals The next step is to repeat the: A. microscopic examination B. protein and glucose C. specific gravity D. pH and microscopic examination - ansD The sequence of light through a microscope is: A. condenser, stage, objective B. iris diaphragm, condenser, ocular C. stage, condenser, iris, objective, ocular D. diaphragm, condenser, objective, ocular - ansD The synovial fluid easily forms small drops from the aspirating syringe. This viscosity is: A. normal B. increased C. associated with inflammation D. associated with hypothyroidism - ans The type of urinary test that is most characteristically associated with glomerular injury is a(n): A. epithelial cell B. white cell C. red cell D. fatty - ansC To avoid falsely elevated spinal fluid cell counts: A. use an aliquot from the first tube collected B. use only those specimens showing no turbidity C. centrifuge all specimens before counting D. select an aliquot from the last tube collected - ansD To prepare a solution appropriate for quality control of the refractometer, a technician should use: A. urea with a specific gravity of 1.040 B. water with a specific gravity of 1.005 C. sodium chloride with a specific gravity of 1.022 D. calcium chloride with an osmolarity of 460 - ansC To prepare the reagent used in confirmatory protein testing, a technician would: A. dissolve 3 g sulfosalicylic acid in 100 mL of water B. dissolve 5 g trichloracetic acid in 100 mL of water