 Question 1

0 out of 1.5 points

The coupled enzymatic method for urea (BUN) measures a decrease in absorbence at
340 nm as ______ is formed.

Selected Answer:

NADH

Answers:
indophenol

NADH

NAD+

allantoin

 Question 2

1.5 out of 1.5 points

The principle excretory form of nitrogen is:

Selected Answer:

urea

Answers:
 urea

amino acids

uric acid

creatinine

 Question 3

1.5 out of 1.5 points

Urea synthesis in the liver is the major pathway for removal of:

Selected Answer:

ammonia

Answers:
creatine

ammonia

uric acid

creatinine
 Question 4

1.5 out of 1.5 points

Which compound constitutes nearly half of the NPN substances in the blood?

Selected Answer:

urea

Answers:
ammonia

urea

uric acid

creatine

 Question 5

0 out of 1.5 points

An analyte that may be quantitated with glutamate dehydrogenase:

Selected Answer:

Creatinine

Answers:
Creatinine
 uric acid

bilirubin

ammonia

 Question 6

1.5 out of 1.5 points

Creatinine clearance is used to estimate the:

Selected Answer:

glomerular filtration rate

Answers:

glomerular filtration rate

renal glomerular and tubular mass

tubular secretion of Creatinine

glomerular secretion of Creatinine

 Question 7

1.5 out of 1.5 points

 Serum urea nitrogen and serum creatinine determinations are frequently requested
together so that their ratio may be evaluated. What is the range of the normal ratio of
urea nitrogen to creatinine?

Selected Answer:

10/1 and 20/1

Answers:

10/1 and 20/1

25/1 and 30/1

1/1 and 10/1

20/1 and 30/1

 Question 8

0 out of 1.5 points

The following is elevated in muscle disease:

Selected Answer:

uric acid

Answers:
ammonia

uric acid
 creatinine

creatine

 Question 9

0 out of 1.5 points

___________ is used by the liver in the production of urea.

Selected Answer:

creatine

Answers:
creatinine

uric acid

creatine

ammonia

 Question 10

1.5 out of 1.5 points

 Which test may be performed to assess the average plasma glucose level that an
individual maintained during a previous 2 to 3 month period?

Selected Answer:

glycosylated hemoglobin

Answers:

glycosylated hemoglobin

2-hour postprandial glucose

urine glucose

plasma glucose

oral glucose tolerance

 Question 11

1.5 out of 1.5 points

Uricase acts on urea as a substrate to form the product:

Selected Answer:

ammonium carbonate

Answers:
dimercuric iodine
 ammonium carbonate

diacetyl monoxime

indophenol

 Question 12

0 out of 1.5 points

A patient with glomerulonephritis would present the following serum results:

Selected Answer:

calcium increased

Answers:
phosphorus decreased

calcium increased

creatinine decreased

BUN increased

 Question 13

1.5 out of 1.5 points

 Which of the following is not a NPN substance?

Selected Answer:

allantoin

Answers:

allantoin

creatinine

urea

ammonia

 Question 14

0 out of 1.5 points

Substances which are antigenic only when coupled to a protein carrier are:

Selected Answer:

allergens

Answers:

haptens

adjuvants
 allergens

opsonins

 Question 15

1.5 out of 1.5 points

Which situation would be expected to falsely increase measured blood ammonia

concentration?

Selected
Answer:
the patient smoked two cigarettes 15 minutes prior to collection

Answers:
the patient ate a steak dinner the night before the specimen was
collected

the specimen was placed on ice immediately after collection

the patient was fasting for 8 hours prior to the collection

the patient smoked two cigarettes 15 minutes prior to collection

 Question 16

0 out of 1.5 points

 the concentration of uric acid in the serum found using the phosphotungstic acid
method is directly proportional to the:

Selected
Answer:
amount of CO2 generated, which combines with phosphotungstic
acid to form a blue color complex

Answers:
allantoin color complex formed when uric acid is oxidized in the
presence of cyanide or carbonate

amount of CO2 generated, which combines with phosphotungstic

acid to form a blue color complex

reduction of phosphotungstic acid to phosphate, which combines

with uric acid to form a blue color complex

color complex formed by the reduction of phosphotungstic acid to

tungsten blue

 Question 17

0 out of 1.5 points

Type I diabetes mellitus may be described as:

Selected Answer:

insuline dependent

Answers:
insuline dependent
 ketosis prone

juvenile diabetes

all of the above

none of the above

 Question 18

1.5 out of 1.5 points

Normal values for urea are generally expressed as urea nitrogen. If it is necessary to
convert urea nitrogen values to urea, the concentration may be calculated easily by
multiplying the urea nitrogen value by:

Selected Answer:

2.14

Answers:
1.45

0.47
 2.14

60

28

 Question 19

1.5 out of 1.5 points

Gout is a pathologic condition that is characterized by the accumulation of which of

the following in joints and other body tissues?

Selected Answer:

uric acid

Answers:
urea nitrogen

uric acid

calcium

phosphorus

 Question 20

1.5 out of 1.5 points

 A spectrophotometer measures _________________.

Selected Answer:

the light transmitted

Answers:
the light scattered

the light transmitted

the light absorbed

the concentration of an analyte

 Question 21

0 out of 1.5 points

In automated methods utilizing a bichromatic analyzer, dual wavelengths are

employed to:

Selected Answer:

improve precision

Answers:

minimize the effect of interference

improve precision
 monitor temperature changes

increase throughout

 Question 22

0 out of 1.5 points (Extra Credit)

The reference range for urea nitrogen is:

Selected Answer:

15-45 ug/dl

Answers:
5-20 g/dl

15-45 ug/dl

6-20 mg/dl

14-45 mg/dl

 Question 23

1.5 out of 1.5 points

 When mixed with phosphotungstic acid, what compound causes the reduction of the
former to a tungsten blue complex?

Selected Answer:

uric acid

Answers:
ammonia

uric acid

glucose

urea

creatinine

 Question 24

0 out of 1.5 points

All of the following may cause azotemia except:

Selected Answer:

stones obstructing urinary flow

Answers:
stones obstructing urinary flow
 congestive heart failure

severe liver disease

high protein diet

 Question 25

0 out of 1.5 points

The following will falsely increase the results for the Jaffe method.

Selected Answer:

ketones (alpha keto acids or acetone)

Answers:
ketones (alpha keto acids or acetone)

cephalosporins

Vitamin C

all of the above

none of the above

 Question 26

1.5 out of 1.5 points

Precautions that should be exercised in the collection, handling, and use of a

specimen for ammonia analysis included:

Selected
Answer:
all of the above

Answers:
avoiding use of a hemolyzed specimen

collecting blood in an EDTA or heparin evacuated tube

placing the specimen in ice immediately

prohibiting the patient from smoking for 8 hours before blood

collection

all of the above

 Question 27

0 out of 1.5 points

___________ is entirely removed from the plasma by glomerular filtration and

excreted in the urine.

Selected Answer:
 urea

Answers:
uric acid

creatine

creatinine

urea

 Question 28

1.5 out of 1.5 points

A BUN/Creatinine ratio of 25:1 indicates a ____________ cause of azotemia.

Selected Answer:

pre-renal

Answers:

pre-renal

renal

post-renal
 all of the above

 Question 29

1.5 out of 1.5 points

If a BUN was reported as 12 mg/dl, what would the urea value be?

Selected Answer:

26 mg/dl

Answers:
28.8 mg/dl

12 mg/dl

2.70 mg/dl

26 mg/dl

 Question 30

1.5 out of 1.5 points

Exists in the muscle in the phosphorylated form and serves as a source of energy:

Selected Answer:
 creatine

Answers:
urea

uric acid

creatinine

creatine

 Question 31

0 out of 1.5 points

What is the proper pH for the buffered solution used to perform serum protein
electrophoresis?

Selected Answer:

7.6

Answers:
5.6

9.6

7.6
 8.6

 Question 32

1.5 out of 1.5 points

In the enzyme-linked immunosorbent assay (ELISA) system, the visible reaction is

due to a reaction between:

Selected Answer:

enzyme and substrate

Answers:
group-specific red cells and antibody

latex particles and antibody

enzyme and substrate

sheep cells and hemolysin

fluorescent dye and bacteria

 Question 33

1.5 out of 1.5 points

 The closeness of repeated measurements to the true result is called:

Selected Answer:

accuracy

Answers:
sensitivity

specificity

accuracy

precision

 Question 34

1.5 out of 1.5 points

When blood sugar level is low, the condition is referred to as:

Selected Answer:

hypoglycemia

Answers:
glucosuria

glucose intolerance
 diabetes

hyperglycemia

hypoglycemia

 Question 35

1.5 out of 1.5 points

To ensure an accurate ammonia level result, the specimen should be:

Selected Answer:

iced, spun immediately, separated and tested immediately

Answers:
incubated at 37° prior to testing

stored at room temperature until tested

spun and separated immediately, tested as routine

iced, spun immediately, separated and tested immediately

 Question 36

0 out of 1.5 points

 Urease is an enzyme that is used as part of the reagent system in some urea methods
to catalyze the hydrolysis of urea. The enzymatic action of urease is inhibited when
blood for analysis is drawn in a tube containing what anticoagulant?

Selected Answer:

ethylenediaminetetraacetic acid (EDTA)

Answers:

sodium fluoride

sodium heparin

ammonium oxalate

sodium oxalate

ethylenediaminetetraacetic acid (EDTA)

 Question 37

1.5 out of 1.5 points

Which of the following hormones is the only one to decrease blood glucose?

Selected Answer:

insulin

Answers:
somatotropin
 thyroxine

glucagons

insulin

 Question 38

1.5 out of 1.5 points

Uric acid is a reducing agent and is readily oxidized to:

Selected Answer:

allantoin

Answers:
NAD+

allantoin

phosphotungstic acid

uricase
 Question 39

1.5 out of 1.5 points

Which of the following is not a major cause of elevated uric acid?

Selected Answer:

Wilson's disease

Answers:

Wilson's disease

increased nuclear breakdown

gout

renal disease

 Question 40

0 out of 1.5 points

_____ is commonly elevated in Reye's sundrome.

Selected Answer:

creatinine

Answers:
 ammonia

uric acid

creatinine

urea

 Question 41

0 out of 1.5 points

Which of the following is characteristic of ammonia?

Selected Answer:

all of the above

Answers:

a waste product of amino acid and protein metabolism

obtained from hydrolysis of urea in the kidney

obtained from ingested carbohydrates

all of the above

 Question 42

1.5 out of 1.5 points

A serum sample demonstrates an elevated result when tested with the Jaffe reaction.
This indicates:

Selected Answer:

renal function impairment

Answers:

renal function impairment

arrhythmia

pregnancy

prolonged hypothermia

 Question 43

0 out of 1.5 points

Which of the following represents the end product of purine metabolism in humans?

Selected Answer:

AMP and GMP

Answers:
AMP and GMP
 uric acid

allantoin

DNA and RNA

 Question 44

1.5 out of 1.5 points

The color developed in one creatinine method is due to the complexing of creatinine
with:

Selected Answer:

alkaline picrate

Answers:

alkaline picrate

diacetyl monoxime

sodium nitroprusside

sodium hypochlorite
 sodium aluminum silicate

 Question 45

4 out of 4 points

When is the next scheduled break (no student classes) here at Tri County Tech?

Selected Answer:

tomorrow! faculty professional development day

Answers:

tomorrow! faculty professional development day

spring break

memorial day

Thanksgiving

 Question 46

0 out of 1.5 points

 The Jaffe reaction is the basis for msot commonly performed methods for the
quantitation of:

Selected Answer:

urea

Answers:
ammonia

protein

uric acid

creatinine

urea

 Question 47

1.5 out of 1.5 points (Extra Credit)

the reference range for ammonia is:

Selected Answer:

19-60 ug/dl

Answers:
 19-60 ug/dl

4-45 mg/dl

5-20 mg/dl

5-20 ug/dl

 Question 48

4.5 out of 12 points

Match the following.

The choices may be used once, more than once, or not at all.

Correct
Question Selected Match
Match

B. B.
Enzymatic method using creatininase
creatinine creatinine

B. B.
Jaffe reaction
creatinine creatinine

D. E.
Reaction using urease
BUN uric acid and
ammonia
 F. F.
caraway method modified, using
phosphotungstic acid uric acid uric acid

B. C.
picric acid
creatinine ammonia

F. E.
enzymatic using uricase
uric acid uric acid and
ammonia

C. I.
ion selective electrode
ammonia creatine

H. D.
GLDH
ammonia and BUN
BUN

All Answer Choices

A.

BUN and creatinine

B.

creatinine

C.

ammonia

D.
 BUN

E.

uric acid and ammonia

F.

uric acid

G.

creatinine and ammonia

H.

ammonia and BUN

I.

creatine

 Question 49

1.5 out of 1.5 points

In the Jaffe reaction, creatinine reacts with:

Selected
Answer:
alkaline picrate solution to yield an orange-red complex

Answers:
potassium iodide to form a reddish-purple complex
 alkaline sulfasalazine solution to produce an orange-yellow
complex

sodium nitroferricyanide to yield a reddish-brown color

alkaline picrate solution to yield an orange-red complex

 Question 50

0 out of 1.5 points

________ is the final breakdown product of purine metabolism.

Selected Answer:

creatinine

Answers:
creatinine

creatine

uric acid

urea

 Question 51
1.5 out of 1.5 points

The following is dependent not on renal function, but on liver function:

Selected Answer:

ammonia

Answers:
creatine

uric acid

ammonia

creatinine

 Question 52

1.5 out of 1.5 points

In the ultraviolet procedure for quantitating uric acid, what does the reaction between
uric acid and uricase cause.?

Selected Answer:

all of the above

Answers:
a destruction of uric acid
 the formation of allantoin

a decrease in absorbance

all of the above

 Question 53

1.5 out of 1.5 points

Creatinine, a waste product excreted in the urine, is formed from the catabolism of:

Selected Answer:

creatine

Answers:
ammonia

creatine

albumin

urea

glucose
 Question 54

1.5 out of 1.5 points

A high level of ______ in the blood is called azotemia.

Selected Answer:

urea

Answers:
uric acid

urea

amino acids

ammonia

 Question 55

1.5 out of 1.5 points

Which of the following can be used to assess renal function?

Selected Answer: E.

A&B

Answers: A.
 urea

B.

creatinine

C.

creatine

D.

ammonia

E.

A&B

F.

C&D

G.

all of these

H.

none of these

 Question 56

1.5 out of 1.5 points

 The method by which ammonia is converted to glutamate and changes NADPH to
NADP+ is:

Selected Answer:

enzymatic method

Answers:
diffusion method

ammonia electrode method

resin absorption method

enzymatic method

 Question 57

1.5 out of 1.5 points

A compount normally found in urine that may be used to asess the completeness of a
24-hour urine collection is:

Selected Answer:

creatinine

Answers:
urea

uric acid
 glucose

creatine

creatinine

 Question 58

0 out of 1.5 points

After the blood sample is drawn, the enzymatic process of deamination of amides
continues at room temperature. Therefore, when a blood ammonia determination is
performed, the blood specimen must be treated in a manner which will ensure that:

Selected Answer:

the deamination process continues in vitro

Answers:
glutamine formation in vitro is avoided

the deamination process continues in vitro

the transamination process continues in vitro

glutamate formation in vitro is avoided

 ammonia formation in vitro is avoided

 Question 59

1.5 out of 1.5 points

Erroneous ammonia leves can be eliminated by all of the following EXCEPT:

Selected
Answer:
storing the specimen at room temperature until the
analysis performed

Answers:
drawing the specimen in a prechilled tube and immersing the
tube in ice

storing the specimen at room temperature until the

analysis performed

separating plasma from cells and performing test analysis as soon

as possible

assuring water and reagents are ammonia-free

 Question 60

0 out of 1.5 points

Post-renal azotemia is caused by:

Selected Answer:

chronic renal failure

Answers:
chronic renal failure

urinary tract obstruction

acute renal failure

congestive heart failure