MRO Review & Interpretation 2 — Questions and Answers
Question 1: A donor's specimen has a creatinine of 18 mg/dL and specific gravity of 1.002. How should the MRO report this result?
- Report as substituted
- Report as dilute (Correct answer)
- Report as adulterated
- Report as cancelled
Correct answer: Report as dilute
A creatinine between 2 and 20 mg/dL with specific gravity between 1.0010 and 1.0030 meets the criteria for a dilute specimen.
Question 2: During a donor interview, the donor states they took Marinol (dronabinol) by prescription. How does this affect an MRO's review of a THC-positive result?
- The MRO must report the result as negative
- The MRO should verify the prescription and may report negative (Correct answer)
- Marinol is not an accepted medical explanation for a THC-positive
- The MRO cancels the test and orders an immediate retest
Correct answer: The MRO should verify the prescription and may report negative
Prescribed Marinol (synthetic THC) is a legitimate medical explanation, and after verification the MRO may report the result as negative.
Question 3: An MRO receives a lab report showing a positive for opiates with morphine at 8,000 ng/mL. The donor claims poppy seed consumption. What is the MRO's correct action?
- Report negative based on the poppy seed explanation
- Report positive because the concentration exceeds the level typically explained by poppy seeds (Correct answer)
- Cancel the test and order a retest
- Request a split specimen retest before making a determination
Correct answer: Report positive because the concentration exceeds the level typically explained by poppy seeds
At concentrations this high, poppy seed consumption is not a scientifically accepted explanation, and the MRO should report the result as positive.
Question 4: A federal agency employee tests positive for amphetamine. The donor presents a valid prescription for Adderall (mixed amphetamine salts). What should the MRO do?
- Report positive regardless of the prescription
- Verify the prescription and report negative if legitimate (Correct answer)
- Refer the case to the federal agency safety officer before deciding
- Cancel the test and order a retest
Correct answer: Verify the prescription and report negative if legitimate
A valid prescription for a Schedule II amphetamine product is a legitimate medical explanation allowing the MRO to report negative.
Question 5: The MRO receives a lab report indicating a specimen validity test result of pH 3.0. What is the correct result category?
- Substituted
- Dilute
- Adulterated (Correct answer)
- Invalid
Correct answer: Adulterated
A pH below 3 or above 11 indicates the specimen has been adulterated because normal physiological urine cannot have such extreme pH values.
Question 6: When an MRO cannot contact a donor for the donor interview within the required timeframe, what must occur?
- The MRO reports the result as negative by default
- The MRO cancels the test
- The MRO notifies the DER and may report the verified result after the required contact period (Correct answer)
- The MRO must hold the result indefinitely until contact is made
Correct answer: The MRO notifies the DER and may report the verified result after the required contact period
After attempting contact for at least 10 days, the MRO notifies the DER that the donor has not contacted them and may then verify the result as positive.
Question 7: A specimen has a nitrite concentration reported at 500 mcg/mL. What validity result does this indicate?
- Dilute
- Invalid
- Substituted
- Adulterated (Correct answer)
Correct answer: Adulterated
Nitrite concentrations at or above 500 mcg/mL indicate adulteration, as this level cannot occur naturally in human urine.
MRO Review & Interpretation 2
A donor's specimen has a creatinine of 18 mg/dL and specific gravity of 1.002.
How should the MRO report this result?