NR509 Health Assessment
Bates Questions
(MIDTERM)
1. A 23-year-old physician assistant (PA) student found that she felt nervous when called
B B B B B B B B B B B B B
upon to examine men in her age group. On one occasion, she encountered a young male
B B B B B B B B B B B B B B B B
patient who appeared embarrassed to see her walk into the room. What should the PA do to
B B B B B B B B B B B B B B B B B
minimize their mutual discomfort?
B B B B
a. Adjust lighting so it is tangential to the patient's body.
B B B B B B B B B B
b. Explain how the examination will proceed.
B B B B B B
c. Ask the patient where he comes from.
B B B B B B B
d. Explain that she is a PA student.
B B B B B B B
e. Provide ongoing interpretation of findings. - ANSb. Explain how the examination will
B B B B B B B B B B B B
proceed
B
A 34-year-old male with a history of complex social and medical needs (including current
B B B B B B B B B B B B B
substance abuse) presents to a primary care teaching clinic. The patient has experienced a
B B B B B B B B B B B B B B
number of adversarial relationships with prior clinicians, including voluntarily leaving two
B B B B B B B B B B B
practices within the previous year and being asked to leave care at a third clinic due to
B B B B B B B B B B B B B B B B B
misbehavior. The attending physician desires to utilize the approaches to this patient that
B B B B B B B B B B B B B
are most likely lead to comprehensive care and patient compliance. Which of the following
B B B B B B B B B B B B B B
is the most appropriate interview style for the attending physician to use?
B B B B B B B B B B B B
a. Focusing on the need for immediate diagnostic certainty over personal connection
B B B B B B B B B B B
,b. Taking charge of the interaction to meet the clinician's desire to acquire diagnostic
B B B B B B B B B B B B B
information
B
c. Following the patient's lead to understand their thoughts, ideas, concerns, and requests
B B B B B B B B B B B B
d. Deferring respect, empat - ANSc. Following the patient's lead to understand their
B B B B B B B B B B B B
thoughts, ideas, concerns, and requests
B B B B B
A 17-year-old male presents to a sexually transmitted disease clinic at the behest of his
B B B B B B B B B B B B B B
brother, who convinced the patient to attend the clinic after he disclosed that he prefers
B B B B B B B B B B B B B B B
homosexual partners but is afraid that his last partner may have given him an infection. The
B B B B B B B B B B B B B B B B
patient expresses to the intake nurse that he is unashamed of his sexual orientation and will
B B B B B B B B B B B B B B B B
not stay through the visit if he feels that he is dismissed or discriminated against because of
B B B B B B B B B B B B B B B B B
it. The nurse practitioner receives this communication prior to entering the examination
B B B B B B B B B B B B
room and decides to employ active listening to best connect with the patient at this critical
B B B B B B B B B B B B B B B B
juncture in his care with the clinic. Which of the following is an example of an active listening
B B B B B B B B B B B B B B B B B B
technique?
B
a. Ignoring visual cues to focus on the patient's exact words
B B B B B B B B B B
b. Setting aside the patient's emotional state to focus on his medical needs
B B B B B B B B B B B B
c. Paring down the patient's - ANSd. Using nonverbal communication to encourage the
B B B B B B B B B B B B
patient to expand their narrative
B B B B B
A 42-year-old female mathematician presents for follow-up care regarding a new diagnosis
B B B B B B B B B B B
of systemic lupus erythematosus 6 months ago after a lengthy diagnostic process during
B B B B B B B B B B B B B
which she was debilitated with fatigue and joint pain. Since her diagnosis, she has been
B B B B B B B B B B B B B B B
minimally compliant with medications and has switched her rheumatology provider twice.
B B B B B B B B B B B
She continues to feel ill, and, in explanation for her lack of adherence to the prescribed
B B B B B B B B B B B B B B B B
treatment, she simply says, "I don't like it." At this initial visit with her third rheumatology
B B B B B B B B B B B B B B B B
provider, the clinician elects to explore the issues behind her noncompliance before
B B B B B B B B B B B B
engaging in diagnostics and treatment using the FIFE model. Which of the following best
B B B B B B B B B B B B B B
defines the elements of the FIFE model?
B B B B B B B
a. Focus, intensity, function, and evaluation
B B B B B B
b. Facts, intensity, focus, and evidence
B B B B B
c. Feelings, ideas, function, and expectations
B B B B B B
d. Feelings, impression, fantasy, - ANSc. Feelings, ideas, function, and expectations
B B B B B B B B B B
A 39-year-old nurse who is a well-established patient complains of irregular menstrual
B B B B B B B B B B B
periods and pelvic pain. She says that she is having trouble sleeping and asks whether she
B B B B B B B B B B B B B B B B
could be given a "sleeping pill." The patient also says she is thinking of leaving her job. What
B B B B B B B B B B B B B B B B B B
is the best "next step" in caring for this patient?
B B B B B B B B B B
a. Perform a pelvic examination.
B B B B
b. Obtain a urine sample for testing.
B B B B B B
c. Obtain a more complete description of problems.
B B B B B B B B
d. Obtain blood for testing.
B B B B
, e. Ask about recent travel destinations. - ANSc. Obtain a more complete description of
B B B B B B B B B B B B B
problems.
B
A 29-year-old female professional athlete presents to a new primary care provider with
B B B B B B B B B B B B
chronic menstrual complaints. She remarks to the nursing staff that, in the past, she has
B B B B B B B B B B B B B B B
experienced a dismissal of her complaints because of her high level of physical fitness and
B B B B B B B B B B B B B B B
conditioning. She is seeking a care provider who will explore the issue in more detail and
B B B B B B B B B B B B B B B B
work with her particular concerns. Which of the following is the description of the patient-
B B B B B B B B B B B B B B B
centered care this individual seeks? B B B B
a. Structured and clinician-centered with open-ended questions
B B B B B B
b. Validating and empathetic with open-ended questions
B B B B B B
c. Dismissive and concrete with open-ended questions
B B B B B B B
d. Affirming and reassuring with close-ended questions
B B B B B B B
e. Factual and structured with active listening - ANSb. Validating and empathetic with open-
B B B B B B B B B B B B B
ended questions B
A 36-year-old female air traffic controller presents to her primary care provider for a routine
B B B B B B B B B B B B B B
visit 3 months after losing her spouse to a lengthy battle with a neurodegenerative disease.
B B B B B B B B B B B B B B B
The patient denies any psychiatric symptoms on review of systems and, in fact, states that
B B B B B B B B B B B B B B B
she has slept better in the last month than she had in the previous years. She endorses a
B B B B B B B B B B B B B B B B B B
healthy support system, including the extended family of her deceased spouse, with whom
B B B B B B B B B B B B B
she is still close. She becomes wistful and briefly tearful when speaking of the plans that
B B B B B B B B B B B B B B B B
they had when they first married that were never fulfilled; she then changes the subject
B B B B B B B B B B B B B B B
rapidly to whether her Pap smear is due. Which of the following is an example of an
B B B B B B B B B B B B B B B B B
empathetic response to this patient?
B B B B B
a. Assuming that the event caused her to become depressed and expressing the same
B B B B B B B B B B B B B
feeling on behalf of the patient
B B B B B B
b. Recognizing the patient's emotions by asking or c - ANSb. Recognizing the patient's
B B B B B B B B B B B B B
emotions by asking or confirming how she feels about the event
B B B B B B B B B B B
A 63-year-old male presents to establish care at a new primary care clinic to discuss issues
B B B B B B B B B B B B B B B
with pain and fatigue. The clinician conducting the visit begins with general historical
B B B B B B B B B B B B B
questions but quickly becomes suspicious that the patient is suffering from
B B B B B B B B B B B
decompensated heart failure. When the patient mentions that he has had vague chest pain
B B B B B B B B B B B B B B
since last night, the clinician feels that the focus must be redirected to this potentially
B B B B B B B B B B B B B B B
emergent condition. Which of the following interview techniques is the most appropriate to
B B B B B B B B B B B B B
effectively manage this visit?
B B B B
a. Providing serial reassurances such as, "Don't worry, you're going to be fine."
B B B B B B B B B B B B
b. Asking a series of negative questions such as, "You don't have any swelling in your feet,
B B B B B B B B B B B B B B B B
do you?" c. Nonverbally cuing the patient to focus on his narrative regarding a motor vehicle
B B B B B B B B B B B B B B B B
accident
B
d. (MVA) that led to back pain
B B B B B B
Bates Questions
(MIDTERM)
1. A 23-year-old physician assistant (PA) student found that she felt nervous when called
B B B B B B B B B B B B B
upon to examine men in her age group. On one occasion, she encountered a young male
B B B B B B B B B B B B B B B B
patient who appeared embarrassed to see her walk into the room. What should the PA do to
B B B B B B B B B B B B B B B B B
minimize their mutual discomfort?
B B B B
a. Adjust lighting so it is tangential to the patient's body.
B B B B B B B B B B
b. Explain how the examination will proceed.
B B B B B B
c. Ask the patient where he comes from.
B B B B B B B
d. Explain that she is a PA student.
B B B B B B B
e. Provide ongoing interpretation of findings. - ANSb. Explain how the examination will
B B B B B B B B B B B B
proceed
B
A 34-year-old male with a history of complex social and medical needs (including current
B B B B B B B B B B B B B
substance abuse) presents to a primary care teaching clinic. The patient has experienced a
B B B B B B B B B B B B B B
number of adversarial relationships with prior clinicians, including voluntarily leaving two
B B B B B B B B B B B
practices within the previous year and being asked to leave care at a third clinic due to
B B B B B B B B B B B B B B B B B
misbehavior. The attending physician desires to utilize the approaches to this patient that
B B B B B B B B B B B B B
are most likely lead to comprehensive care and patient compliance. Which of the following
B B B B B B B B B B B B B B
is the most appropriate interview style for the attending physician to use?
B B B B B B B B B B B B
a. Focusing on the need for immediate diagnostic certainty over personal connection
B B B B B B B B B B B
,b. Taking charge of the interaction to meet the clinician's desire to acquire diagnostic
B B B B B B B B B B B B B
information
B
c. Following the patient's lead to understand their thoughts, ideas, concerns, and requests
B B B B B B B B B B B B
d. Deferring respect, empat - ANSc. Following the patient's lead to understand their
B B B B B B B B B B B B
thoughts, ideas, concerns, and requests
B B B B B
A 17-year-old male presents to a sexually transmitted disease clinic at the behest of his
B B B B B B B B B B B B B B
brother, who convinced the patient to attend the clinic after he disclosed that he prefers
B B B B B B B B B B B B B B B
homosexual partners but is afraid that his last partner may have given him an infection. The
B B B B B B B B B B B B B B B B
patient expresses to the intake nurse that he is unashamed of his sexual orientation and will
B B B B B B B B B B B B B B B B
not stay through the visit if he feels that he is dismissed or discriminated against because of
B B B B B B B B B B B B B B B B B
it. The nurse practitioner receives this communication prior to entering the examination
B B B B B B B B B B B B
room and decides to employ active listening to best connect with the patient at this critical
B B B B B B B B B B B B B B B B
juncture in his care with the clinic. Which of the following is an example of an active listening
B B B B B B B B B B B B B B B B B B
technique?
B
a. Ignoring visual cues to focus on the patient's exact words
B B B B B B B B B B
b. Setting aside the patient's emotional state to focus on his medical needs
B B B B B B B B B B B B
c. Paring down the patient's - ANSd. Using nonverbal communication to encourage the
B B B B B B B B B B B B
patient to expand their narrative
B B B B B
A 42-year-old female mathematician presents for follow-up care regarding a new diagnosis
B B B B B B B B B B B
of systemic lupus erythematosus 6 months ago after a lengthy diagnostic process during
B B B B B B B B B B B B B
which she was debilitated with fatigue and joint pain. Since her diagnosis, she has been
B B B B B B B B B B B B B B B
minimally compliant with medications and has switched her rheumatology provider twice.
B B B B B B B B B B B
She continues to feel ill, and, in explanation for her lack of adherence to the prescribed
B B B B B B B B B B B B B B B B
treatment, she simply says, "I don't like it." At this initial visit with her third rheumatology
B B B B B B B B B B B B B B B B
provider, the clinician elects to explore the issues behind her noncompliance before
B B B B B B B B B B B B
engaging in diagnostics and treatment using the FIFE model. Which of the following best
B B B B B B B B B B B B B B
defines the elements of the FIFE model?
B B B B B B B
a. Focus, intensity, function, and evaluation
B B B B B B
b. Facts, intensity, focus, and evidence
B B B B B
c. Feelings, ideas, function, and expectations
B B B B B B
d. Feelings, impression, fantasy, - ANSc. Feelings, ideas, function, and expectations
B B B B B B B B B B
A 39-year-old nurse who is a well-established patient complains of irregular menstrual
B B B B B B B B B B B
periods and pelvic pain. She says that she is having trouble sleeping and asks whether she
B B B B B B B B B B B B B B B B
could be given a "sleeping pill." The patient also says she is thinking of leaving her job. What
B B B B B B B B B B B B B B B B B B
is the best "next step" in caring for this patient?
B B B B B B B B B B
a. Perform a pelvic examination.
B B B B
b. Obtain a urine sample for testing.
B B B B B B
c. Obtain a more complete description of problems.
B B B B B B B B
d. Obtain blood for testing.
B B B B
, e. Ask about recent travel destinations. - ANSc. Obtain a more complete description of
B B B B B B B B B B B B B
problems.
B
A 29-year-old female professional athlete presents to a new primary care provider with
B B B B B B B B B B B B
chronic menstrual complaints. She remarks to the nursing staff that, in the past, she has
B B B B B B B B B B B B B B B
experienced a dismissal of her complaints because of her high level of physical fitness and
B B B B B B B B B B B B B B B
conditioning. She is seeking a care provider who will explore the issue in more detail and
B B B B B B B B B B B B B B B B
work with her particular concerns. Which of the following is the description of the patient-
B B B B B B B B B B B B B B B
centered care this individual seeks? B B B B
a. Structured and clinician-centered with open-ended questions
B B B B B B
b. Validating and empathetic with open-ended questions
B B B B B B
c. Dismissive and concrete with open-ended questions
B B B B B B B
d. Affirming and reassuring with close-ended questions
B B B B B B B
e. Factual and structured with active listening - ANSb. Validating and empathetic with open-
B B B B B B B B B B B B B
ended questions B
A 36-year-old female air traffic controller presents to her primary care provider for a routine
B B B B B B B B B B B B B B
visit 3 months after losing her spouse to a lengthy battle with a neurodegenerative disease.
B B B B B B B B B B B B B B B
The patient denies any psychiatric symptoms on review of systems and, in fact, states that
B B B B B B B B B B B B B B B
she has slept better in the last month than she had in the previous years. She endorses a
B B B B B B B B B B B B B B B B B B
healthy support system, including the extended family of her deceased spouse, with whom
B B B B B B B B B B B B B
she is still close. She becomes wistful and briefly tearful when speaking of the plans that
B B B B B B B B B B B B B B B B
they had when they first married that were never fulfilled; she then changes the subject
B B B B B B B B B B B B B B B
rapidly to whether her Pap smear is due. Which of the following is an example of an
B B B B B B B B B B B B B B B B B
empathetic response to this patient?
B B B B B
a. Assuming that the event caused her to become depressed and expressing the same
B B B B B B B B B B B B B
feeling on behalf of the patient
B B B B B B
b. Recognizing the patient's emotions by asking or c - ANSb. Recognizing the patient's
B B B B B B B B B B B B B
emotions by asking or confirming how she feels about the event
B B B B B B B B B B B
A 63-year-old male presents to establish care at a new primary care clinic to discuss issues
B B B B B B B B B B B B B B B
with pain and fatigue. The clinician conducting the visit begins with general historical
B B B B B B B B B B B B B
questions but quickly becomes suspicious that the patient is suffering from
B B B B B B B B B B B
decompensated heart failure. When the patient mentions that he has had vague chest pain
B B B B B B B B B B B B B B
since last night, the clinician feels that the focus must be redirected to this potentially
B B B B B B B B B B B B B B B
emergent condition. Which of the following interview techniques is the most appropriate to
B B B B B B B B B B B B B
effectively manage this visit?
B B B B
a. Providing serial reassurances such as, "Don't worry, you're going to be fine."
B B B B B B B B B B B B
b. Asking a series of negative questions such as, "You don't have any swelling in your feet,
B B B B B B B B B B B B B B B B
do you?" c. Nonverbally cuing the patient to focus on his narrative regarding a motor vehicle
B B B B B B B B B B B B B B B B
accident
B
d. (MVA) that led to back pain
B B B B B B
