Questions: While pregnancy is the most likely reason for the presence of hCG in urine, elevated hCG concentrations unrelated to a normal pregnancy can occur. These can give you false positives results. (HINT: You may choose more than one answer) A low specific gravity in the patient's urine If the patient has received shots of hCG or gonadotropins A patient with high protein level in their urine A patient with a hCG secreting tumor None of the above All of the above

The answer is: If the patient has received shots of hCG or gonadotropins and A patient with a hCG secreting tumor.

Explanation for each option:

1. A low specific gravity in the patient's urine: This is incorrect. Low specific gravity indicates diluted urine, which might affect the concentration of hCG detected but does not cause elevated hCG levels unrelated to pregnancy.

2. If the patient has received shots of hCG or gonadotropins: This is correct. Administering hCG or gonadotropins can artificially elevate hCG levels, leading to false positive pregnancy test results.

3. A patient with high protein level in their urine: This is incorrect. High protein levels in urine (proteinuria) are not related to hCG production and do not cause elevated hCG levels.

4. A patient with a hCG secreting tumor: This is correct. Certain tumors, such as gestational trophoblastic disease or some germ cell tumors, can secrete hCG, leading to elevated levels unrelated to pregnancy.

5. None of the above: This is incorrect because there are valid reasons listed that can cause elevated hCG levels unrelated to pregnancy.

6. All of the above: This is incorrect because not all the options listed are valid reasons for elevated hCG levels unrelated to pregnancy.

In summary, the correct answers are options 2 and 4, as they both provide valid reasons for elevated hCG levels unrelated to a normal pregnancy.