BATES UPDATED ACTUAL EXAM
QUESTIONS AND CORRECT ANSWERS
●● A 25-year-old radio announcer comes to the clinic for an annual
examination. His BMI is 26.0 kg/m2. He is concerned about his weight.
Based on this information, what is appropriate counsel for the patient
during the visit?
Answer: Give the patient information about reduction of fat, cholesterol,
and calories because he is overweight.
●● A 30-year-old sales clerk comes to your office wanting to lose
weight; her BMI is 30.0 kg/m2. What is the most appropriate amount for
a weekly weight reduction goal?
Answer: .5 to 1 pound per week
●● 67-year-old retired janitor comes to the clinic with his wife. She
brought him in because she is concerned about his weight loss. He has a
history of smoking 3 packs of cigarettes a day for 30 years, for a total of
90 pack-years. He has noticed a daily cough for the past several years,
which he states is productive of sputum. He came into the clinic
approximately 1 year ago, and at that time his weight was 140 pounds.
Today, his weight is 110 pounds.
Which one of the following questions would be the most important to
ask if you suspect that he has lung cancer?
Answer: Have you tried to lose weight?
,●● Common or concerning symptoms to inquire about in the General
Survey and vital signs include all of the following except:
Answer: Cough
●● You are beginning the examination of a patient. All of the following
areas are important to observe as part of the General Survey except:
Answer: Blood pressure
●● A 55-year-old bookkeeper comes to your office for a routine visit.
You note that on a previous visit for treatment of contact dermatitis, her
blood pressure was elevated. She does not have prior elevated readings
and her family history is negative for hypertension. You measure her
blood pressure in your office today. Which of the following factors can
result in a false high reading?
Answer: Blood pressure cuff is tightly fitted.
●● A 49-year-old truck driver comes to the emergency room for
shortness of breath and swelling in his ankles. He is diagnosed with
congestive heart failure and admitted to the hospital. You are the student
assigned to do the patient's complete history and physical examination.
When you palpate the pulse, what do you expect to feel?
Answer: Small amplitude, weak
,●● An 18-year-old college freshman presents to the clinic for evaluation
of gastroenteritis. You measure the patient's temperature and it is 104
degrees Fahrenheit. What type of pulse would you expect to feel during
his initial examination?
Answer: Large amplitude, forceful
●● A 25-year-old type 1 diabetic clerk presents to the emergency room
with shortness of breath and states that his blood sugar was 605 at home.
You diagnose the patient with diabetic ketoacidosis. What is the
expected pattern of breathing?
Answer: Rapid and deep
●● Mrs. Lenzo weighs herself every day with a very accurate balance-
type scale. She has noticed that over the past 2 days she has gained 4
pounds. How would you best explain this?
Answer: Attribute this to body fluid
●● Mr. Curtiss has a history of obesity, diabetes, osteoarthritis of the
knees, HTN, and obstructive sleep apnea. His BMI is 43 and he has been
discouraged by his difficulty in losing weight. He is also discouraged
that his goal weight is 158 pounds away. What would you tell him?
Answer: "Even a weight loss of 10% can make a noticeable
improvement in the problems you mention."
●● Jenny is one of your favorite patients who usually shares a joke with
you and is nattily dressed. Today she is dressed in old jeans, lacks
, makeup, and avoids eye contact. To what do you attribute these
changes?
Answer: She is depressed.
●● You are seeing an older patient who has not had medical care for
many years. Her vital signs taken by your office staff are: T 37.2, HR 78,
BP 118/92, and RR 14, and she denies pain. You notice that she has
some hypertensive changes in her retinas and you find mild proteinuria
on a urine test in your office. You expected the BP to be higher. She is
not on any medications. What do you think is causing this BP reading,
which doesn't correlate with the other findings?
Answer: It is caused by an "auscultatory gap."
●● Despite having high BP readings in the office, Mr. Kelly tells you
that his readings at home are much lower. He checks them twice a day at
the same time of day and has kept a log. How do you respond?
Answer: You question the accuracy of his measurements.
●● You are observing a patient with heart failure and notice that there
are pauses in his breathing. On closer examination, you notice that after
the pauses the patient takes progressively deeper breaths and then
progressively shallower breaths, which are followed by another apneic
spell. The patient is not in any distress. You make the diagnosis of:
Answer: Cheyne-Stokes breathing
QUESTIONS AND CORRECT ANSWERS
●● A 25-year-old radio announcer comes to the clinic for an annual
examination. His BMI is 26.0 kg/m2. He is concerned about his weight.
Based on this information, what is appropriate counsel for the patient
during the visit?
Answer: Give the patient information about reduction of fat, cholesterol,
and calories because he is overweight.
●● A 30-year-old sales clerk comes to your office wanting to lose
weight; her BMI is 30.0 kg/m2. What is the most appropriate amount for
a weekly weight reduction goal?
Answer: .5 to 1 pound per week
●● 67-year-old retired janitor comes to the clinic with his wife. She
brought him in because she is concerned about his weight loss. He has a
history of smoking 3 packs of cigarettes a day for 30 years, for a total of
90 pack-years. He has noticed a daily cough for the past several years,
which he states is productive of sputum. He came into the clinic
approximately 1 year ago, and at that time his weight was 140 pounds.
Today, his weight is 110 pounds.
Which one of the following questions would be the most important to
ask if you suspect that he has lung cancer?
Answer: Have you tried to lose weight?
,●● Common or concerning symptoms to inquire about in the General
Survey and vital signs include all of the following except:
Answer: Cough
●● You are beginning the examination of a patient. All of the following
areas are important to observe as part of the General Survey except:
Answer: Blood pressure
●● A 55-year-old bookkeeper comes to your office for a routine visit.
You note that on a previous visit for treatment of contact dermatitis, her
blood pressure was elevated. She does not have prior elevated readings
and her family history is negative for hypertension. You measure her
blood pressure in your office today. Which of the following factors can
result in a false high reading?
Answer: Blood pressure cuff is tightly fitted.
●● A 49-year-old truck driver comes to the emergency room for
shortness of breath and swelling in his ankles. He is diagnosed with
congestive heart failure and admitted to the hospital. You are the student
assigned to do the patient's complete history and physical examination.
When you palpate the pulse, what do you expect to feel?
Answer: Small amplitude, weak
,●● An 18-year-old college freshman presents to the clinic for evaluation
of gastroenteritis. You measure the patient's temperature and it is 104
degrees Fahrenheit. What type of pulse would you expect to feel during
his initial examination?
Answer: Large amplitude, forceful
●● A 25-year-old type 1 diabetic clerk presents to the emergency room
with shortness of breath and states that his blood sugar was 605 at home.
You diagnose the patient with diabetic ketoacidosis. What is the
expected pattern of breathing?
Answer: Rapid and deep
●● Mrs. Lenzo weighs herself every day with a very accurate balance-
type scale. She has noticed that over the past 2 days she has gained 4
pounds. How would you best explain this?
Answer: Attribute this to body fluid
●● Mr. Curtiss has a history of obesity, diabetes, osteoarthritis of the
knees, HTN, and obstructive sleep apnea. His BMI is 43 and he has been
discouraged by his difficulty in losing weight. He is also discouraged
that his goal weight is 158 pounds away. What would you tell him?
Answer: "Even a weight loss of 10% can make a noticeable
improvement in the problems you mention."
●● Jenny is one of your favorite patients who usually shares a joke with
you and is nattily dressed. Today she is dressed in old jeans, lacks
, makeup, and avoids eye contact. To what do you attribute these
changes?
Answer: She is depressed.
●● You are seeing an older patient who has not had medical care for
many years. Her vital signs taken by your office staff are: T 37.2, HR 78,
BP 118/92, and RR 14, and she denies pain. You notice that she has
some hypertensive changes in her retinas and you find mild proteinuria
on a urine test in your office. You expected the BP to be higher. She is
not on any medications. What do you think is causing this BP reading,
which doesn't correlate with the other findings?
Answer: It is caused by an "auscultatory gap."
●● Despite having high BP readings in the office, Mr. Kelly tells you
that his readings at home are much lower. He checks them twice a day at
the same time of day and has kept a log. How do you respond?
Answer: You question the accuracy of his measurements.
●● You are observing a patient with heart failure and notice that there
are pauses in his breathing. On closer examination, you notice that after
the pauses the patient takes progressively deeper breaths and then
progressively shallower breaths, which are followed by another apneic
spell. The patient is not in any distress. You make the diagnosis of:
Answer: Cheyne-Stokes breathing
