Test Bank for Bates’ Guide to Physical
Examination and History Taking, 13th Edition
by Lynn S. Bick Exam
Unit I: Foundations of Health Assessment
1. A 68-year-old patient with a history of hypertension and diabetes presents
with complaints of intermittent chest discomfort that occurs with exertion and
is relieved by rest. What type of data is this?
A) Objective data
B) Subjective data
C) Biophysical data
D) Laboratory data
Correct Answer: B
Rationale: Subjective data are what the patient tells you. The history of chest
discomfort is subjective. Objective data are measurable findings like vital signs or
lab results .
2. The step of the clinical reasoning process that involves generating a list of
possible diagnoses based on the patient’s presenting problem is called:
A) Differential diagnosis
B) Working diagnosis
C) Final diagnosis
D) Pathophysiologic diagnosis
Correct Answer: A
Rationale: A differential diagnosis is a list of possible conditions that could explain
the patient’s symptoms, prioritized by likelihood and seriousness .
3. A 54-year-old patient arrives for a follow-up visit and begins describing a new,
unrelated concern. What is the most appropriate patient-centered response?
A) "Let's first finish reviewing your lab results before addressing new concerns."
B) "We'll have to reschedule to discuss that issue in a different visit."
C) "Tell me more about this new concern. We’ll figure out how to prioritize
everything."
D) "You should have mentioned that earlier so we could prepare."
,Correct Answer: C
Rationale: This response aligns with patient-centered care by validating the
patient’s concern and encouraging open dialogue. It demonstrates flexibility and
empathy while also allowing the clinician to set collaborative priorities .
4. A 45-year-old patient reports a “sharp, stabbing” pain in the right lower chest
that worsens with deep inspiration. Which of the following is the most likely
etiology for this description?
A) Angina pectoris
B) Pleuritic pain (pleural irritation)
C) Pericardial pain
D) Musculoskeletal pain
Correct Answer: B
Rationale: Pain that is sharp, stabbing, and exacerbated by inspiration is
characteristic of pleural irritation (pleuritis). Angina is typically pressure-like and
not pleuritic .
5. Which of the following is an example of a “ruling out” diagnostic strategy?
A) Performing a chest x-ray to confirm pneumonia in a patient with fever and
crackles
B) Using the Wells score to exclude pulmonary embolism in a low-risk patient
C) Ordering a D-dimer to confirm DVT in a high-risk patient
D) Starting antibiotics for suspected bacterial pneumonia
Correct Answer: B
Rationale: “Ruling out” (using high-sensitivity tests) is appropriate when the
clinician wants to confidently exclude a diagnosis. The Wells score helps stratify
risk and can rule out PE .
6. The technique of “active listening” in patient communication includes all of
the following EXCEPT:
A) Interrupting to ask clarifying questions
B) Nodding and maintaining eye contact
C) Paraphrasing what the patient said
D) Avoiding distractions during the interview
Correct Answer: A
Rationale: Active listening involves allowing the patient to speak without
, interruption. Interrupting can disrupt rapport and shut down the patient’s
narrative .
7. A clinician writes, “Plan: CBC, CMP, and chest x-ray today.” This plan is
documented in which section of a SOAP note?
A) Subjective
B) Objective
C) Assessment
D) Plan
Correct Answer: D
Rationale: The Plan section includes diagnostic tests, treatments, referrals, and
patient education .
8. Which of the following is the most accurate description of “sensitivity” of a
diagnostic test?
A) The ability to correctly identify those with the disease (true positive rate)
B) The ability to correctly identify those without the disease (true negative rate)
C) The proportion of positive results that are true positives
D) The proportion of negative results that are true negatives
Correct Answer: A
Rationale: Sensitivity = TP/(TP+FN). It measures how well a test detects the
disease when it is present .
9. What is the most ethical response when a patient refuses a recommended
life-saving treatment?
A) Proceed with treatment despite the refusal
B) Ask the patient's family for consent
C) Respect the decision and document the discussion thoroughly
D) Contact hospital legal services to override the refusal
Correct Answer: C
Rationale: The principle of autonomy requires that clinicians respect a competent
patient's right to refuse care, even if it leads to harm .
10. A clinician leans in while a patient shares a concern and repeats their last
few words as a prompt. What communication technique is being used?
A) Summarization
B) Clarification
Examination and History Taking, 13th Edition
by Lynn S. Bick Exam
Unit I: Foundations of Health Assessment
1. A 68-year-old patient with a history of hypertension and diabetes presents
with complaints of intermittent chest discomfort that occurs with exertion and
is relieved by rest. What type of data is this?
A) Objective data
B) Subjective data
C) Biophysical data
D) Laboratory data
Correct Answer: B
Rationale: Subjective data are what the patient tells you. The history of chest
discomfort is subjective. Objective data are measurable findings like vital signs or
lab results .
2. The step of the clinical reasoning process that involves generating a list of
possible diagnoses based on the patient’s presenting problem is called:
A) Differential diagnosis
B) Working diagnosis
C) Final diagnosis
D) Pathophysiologic diagnosis
Correct Answer: A
Rationale: A differential diagnosis is a list of possible conditions that could explain
the patient’s symptoms, prioritized by likelihood and seriousness .
3. A 54-year-old patient arrives for a follow-up visit and begins describing a new,
unrelated concern. What is the most appropriate patient-centered response?
A) "Let's first finish reviewing your lab results before addressing new concerns."
B) "We'll have to reschedule to discuss that issue in a different visit."
C) "Tell me more about this new concern. We’ll figure out how to prioritize
everything."
D) "You should have mentioned that earlier so we could prepare."
,Correct Answer: C
Rationale: This response aligns with patient-centered care by validating the
patient’s concern and encouraging open dialogue. It demonstrates flexibility and
empathy while also allowing the clinician to set collaborative priorities .
4. A 45-year-old patient reports a “sharp, stabbing” pain in the right lower chest
that worsens with deep inspiration. Which of the following is the most likely
etiology for this description?
A) Angina pectoris
B) Pleuritic pain (pleural irritation)
C) Pericardial pain
D) Musculoskeletal pain
Correct Answer: B
Rationale: Pain that is sharp, stabbing, and exacerbated by inspiration is
characteristic of pleural irritation (pleuritis). Angina is typically pressure-like and
not pleuritic .
5. Which of the following is an example of a “ruling out” diagnostic strategy?
A) Performing a chest x-ray to confirm pneumonia in a patient with fever and
crackles
B) Using the Wells score to exclude pulmonary embolism in a low-risk patient
C) Ordering a D-dimer to confirm DVT in a high-risk patient
D) Starting antibiotics for suspected bacterial pneumonia
Correct Answer: B
Rationale: “Ruling out” (using high-sensitivity tests) is appropriate when the
clinician wants to confidently exclude a diagnosis. The Wells score helps stratify
risk and can rule out PE .
6. The technique of “active listening” in patient communication includes all of
the following EXCEPT:
A) Interrupting to ask clarifying questions
B) Nodding and maintaining eye contact
C) Paraphrasing what the patient said
D) Avoiding distractions during the interview
Correct Answer: A
Rationale: Active listening involves allowing the patient to speak without
, interruption. Interrupting can disrupt rapport and shut down the patient’s
narrative .
7. A clinician writes, “Plan: CBC, CMP, and chest x-ray today.” This plan is
documented in which section of a SOAP note?
A) Subjective
B) Objective
C) Assessment
D) Plan
Correct Answer: D
Rationale: The Plan section includes diagnostic tests, treatments, referrals, and
patient education .
8. Which of the following is the most accurate description of “sensitivity” of a
diagnostic test?
A) The ability to correctly identify those with the disease (true positive rate)
B) The ability to correctly identify those without the disease (true negative rate)
C) The proportion of positive results that are true positives
D) The proportion of negative results that are true negatives
Correct Answer: A
Rationale: Sensitivity = TP/(TP+FN). It measures how well a test detects the
disease when it is present .
9. What is the most ethical response when a patient refuses a recommended
life-saving treatment?
A) Proceed with treatment despite the refusal
B) Ask the patient's family for consent
C) Respect the decision and document the discussion thoroughly
D) Contact hospital legal services to override the refusal
Correct Answer: C
Rationale: The principle of autonomy requires that clinicians respect a competent
patient's right to refuse care, even if it leads to harm .
10. A clinician leans in while a patient shares a concern and repeats their last
few words as a prompt. What communication technique is being used?
A) Summarization
B) Clarification
