Test Bank for Bates’ Guide To Physical Examination and
History Taking 14th (LWW2026) New Edition All Chapters
1-27 Covered With Questions And Verified Solutions With
Rationales And Case Study.
Question
You are assessing a patient with joint pain and are trying to decide whether it is
inflammatory or noninflammatory in nature. Which one of the following symptoms is
consistent with an inflammatory process?
A) Tenderness
B) Cool temperature
C) Ecchymosis
D) Nodules
Expert Rationale: Tenderness is consistent with an inflammatory process. Inflammatory
joint pain is characterized by tenderness, warmth, redness, and swelling. Cool
temperature, ecchymosis, and nodules are more consistent with noninflammatory or
traumatic causes.
Question
You are assessing a patient with diffuse joint pains and want to make sure that only the
joints are the problem, and that the pain is not related to other diseases. Which of the
following is a systemic cause of joint pain?
A) Gout
B) Osteoarthritis
C) Lupus
D) Spondylosis
Expert Rationale: Lupus is a systemic cause of joint pain. It is an autoimmune disease that
can affect multiple organs, including the joints. Gout, osteoarthritis, and spondylosis are
primarily joint-specific conditions.
Question
A 19-year-old college sophomore comes to the clinic for evaluation of joint pains. She
notes that she had a red spot shaped like a target, but then it started spreading, and then
,the joint pains started. She used insect repellant but was in an area known to have ticks.
What is the most likely cause of her joint pain?
A) Lyme disease
B) Rocky Mountain spotted fever
C) Gout
D) Rheumatoid arthritis
Expert Rationale: Lyme disease is the most likely cause. The target-shaped rash (erythema
migrans) followed by joint pains is classic for Lyme disease, which is transmitted by ticks.
Rocky Mountain spotted fever presents with a different rash pattern.
Question
An 85-year-old retired housewife comes with her daughter to establish care. Her daughter
is concerned because her mother has started to fall more. As part of her physical
examination, you ask her to walk across the examination room. Which of the following is
not part of the stance phase of gait?
A) Foot arched
B) Heel strike
C) Mid-stance
D) Push-off
Expert Rationale: Foot arched is not part of the stance phase of gait. The stance phase
includes heel strike, mid-stance, and push-off. Foot arched is part of the swing phase.
Question
A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a
sudden onset of pain after lifting a set of boxes that were heavier than usual. He also states
that he has numbness and tingling in the left leg. What test should you perform to assess
for a herniated disc?
A) Straight leg-raise
B) FABER test
C) Thomas test
D) McMurray test
Expert Rationale: The straight leg-raise test is used to assess for a herniated disc. It
reproduces pain by stretching the sciatic nerve. The FABER test assesses the hip, the
,Thomas test assesses hip flexor contracture, and the McMurray test assesses meniscal
tears.
Question
A 33-year-old construction worker comes for evaluation and treatment of acute onset of
low back pain. He notes that the pain is an aching located in the lumbosacral area. It has
been present intermittently for several years; there is no known trauma or injury. On
physical examination, you note muscle spasm, with normal deep tendon reflexes and
muscle strength. What is the most likely cause of this patient's low back pain?
A) Mechanical low back pain
B) Herniated disc
C) Cauda equina syndrome
D) Spinal stenosis
Expert Rationale: Mechanical low back pain is the most likely cause. It is characterized by
aching in the lumbosacral area, often related to activity, with normal neurologic
examination. Herniated disc would present with radiating pain and neurologic deficits.
Question
A 50-year-old realtor comes to your office for evaluation of neck pain. She was in a motor
vehicle collision 2 days ago. On physical examination, you note pain and spasm over the
paraspinous muscles on the left side of the neck, and pain when you make the patient do
active range of motion of the cervical spine. What is the most likely cause of this neck pain?
A) Cervical sprain
B) Cervical fracture
C) Meningitis
D) Torticollis
Expert Rationale: Cervical sprain is the most likely cause. It is characterized by pain and
spasm over the paraspinous muscles after trauma, with pain on active range of motion.
Cervical fracture would present with more severe findings and requires imaging.
Question
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." She
relates that the pain is worse in the neck, shoulders, hands, low back, and knees. She
, denies swelling in her joints; she states that the pain is worse in the morning; there is no
limitation in her range of motion. On physical examination, she has several points on the
muscles of the neck, shoulders, and back that are tender to palpation. Which of the
following is likely the cause of her pain?
A) Fibromyalgia
B) Rheumatoid arthritis
C) Osteoarthritis
D) Lupus
Expert Rationale: Fibromyalgia is the most likely cause. It is characterized by widespread
pain, multiple tender points, and normal range of motion. Rheumatoid arthritis would
present with joint swelling and limited motion.
Question
A 68-year-old retired banker comes to your clinic for evaluation of left shoulder pain. He
notes a sharp, catching pain and a sensation of something grating when he tries overhead
movements of his arm. On physical examination, you note tenderness just below the tip of
the acromion in the area of the tendon insertions. The drop arm test is negative. What is the
most likely cause of his shoulder pain?
A) Rotator cuff tendinitis
B) Adhesive capsulitis
C) Acromioclavicular joint arthritis
D) Biceps tendinitis
Expert Rationale: Rotator cuff tendinitis is the most likely cause. It presents with pain and
tenderness just below the acromion, especially with overhead movements. The drop arm
test is negative, which rules out a full rotator cuff tear.
Question
A high school soccer player "blew out his knee" when the opposing goalie's head and
shoulder struck his flexed knee. All of the following structures were involved in some way in
his injury, but which of the following is actually an extra-articular structure?
A) Synovium
B) Joint capsule
C) Juxta-articular bone
D) Tendons
History Taking 14th (LWW2026) New Edition All Chapters
1-27 Covered With Questions And Verified Solutions With
Rationales And Case Study.
Question
You are assessing a patient with joint pain and are trying to decide whether it is
inflammatory or noninflammatory in nature. Which one of the following symptoms is
consistent with an inflammatory process?
A) Tenderness
B) Cool temperature
C) Ecchymosis
D) Nodules
Expert Rationale: Tenderness is consistent with an inflammatory process. Inflammatory
joint pain is characterized by tenderness, warmth, redness, and swelling. Cool
temperature, ecchymosis, and nodules are more consistent with noninflammatory or
traumatic causes.
Question
You are assessing a patient with diffuse joint pains and want to make sure that only the
joints are the problem, and that the pain is not related to other diseases. Which of the
following is a systemic cause of joint pain?
A) Gout
B) Osteoarthritis
C) Lupus
D) Spondylosis
Expert Rationale: Lupus is a systemic cause of joint pain. It is an autoimmune disease that
can affect multiple organs, including the joints. Gout, osteoarthritis, and spondylosis are
primarily joint-specific conditions.
Question
A 19-year-old college sophomore comes to the clinic for evaluation of joint pains. She
notes that she had a red spot shaped like a target, but then it started spreading, and then
,the joint pains started. She used insect repellant but was in an area known to have ticks.
What is the most likely cause of her joint pain?
A) Lyme disease
B) Rocky Mountain spotted fever
C) Gout
D) Rheumatoid arthritis
Expert Rationale: Lyme disease is the most likely cause. The target-shaped rash (erythema
migrans) followed by joint pains is classic for Lyme disease, which is transmitted by ticks.
Rocky Mountain spotted fever presents with a different rash pattern.
Question
An 85-year-old retired housewife comes with her daughter to establish care. Her daughter
is concerned because her mother has started to fall more. As part of her physical
examination, you ask her to walk across the examination room. Which of the following is
not part of the stance phase of gait?
A) Foot arched
B) Heel strike
C) Mid-stance
D) Push-off
Expert Rationale: Foot arched is not part of the stance phase of gait. The stance phase
includes heel strike, mid-stance, and push-off. Foot arched is part of the swing phase.
Question
A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a
sudden onset of pain after lifting a set of boxes that were heavier than usual. He also states
that he has numbness and tingling in the left leg. What test should you perform to assess
for a herniated disc?
A) Straight leg-raise
B) FABER test
C) Thomas test
D) McMurray test
Expert Rationale: The straight leg-raise test is used to assess for a herniated disc. It
reproduces pain by stretching the sciatic nerve. The FABER test assesses the hip, the
,Thomas test assesses hip flexor contracture, and the McMurray test assesses meniscal
tears.
Question
A 33-year-old construction worker comes for evaluation and treatment of acute onset of
low back pain. He notes that the pain is an aching located in the lumbosacral area. It has
been present intermittently for several years; there is no known trauma or injury. On
physical examination, you note muscle spasm, with normal deep tendon reflexes and
muscle strength. What is the most likely cause of this patient's low back pain?
A) Mechanical low back pain
B) Herniated disc
C) Cauda equina syndrome
D) Spinal stenosis
Expert Rationale: Mechanical low back pain is the most likely cause. It is characterized by
aching in the lumbosacral area, often related to activity, with normal neurologic
examination. Herniated disc would present with radiating pain and neurologic deficits.
Question
A 50-year-old realtor comes to your office for evaluation of neck pain. She was in a motor
vehicle collision 2 days ago. On physical examination, you note pain and spasm over the
paraspinous muscles on the left side of the neck, and pain when you make the patient do
active range of motion of the cervical spine. What is the most likely cause of this neck pain?
A) Cervical sprain
B) Cervical fracture
C) Meningitis
D) Torticollis
Expert Rationale: Cervical sprain is the most likely cause. It is characterized by pain and
spasm over the paraspinous muscles after trauma, with pain on active range of motion.
Cervical fracture would present with more severe findings and requires imaging.
Question
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." She
relates that the pain is worse in the neck, shoulders, hands, low back, and knees. She
, denies swelling in her joints; she states that the pain is worse in the morning; there is no
limitation in her range of motion. On physical examination, she has several points on the
muscles of the neck, shoulders, and back that are tender to palpation. Which of the
following is likely the cause of her pain?
A) Fibromyalgia
B) Rheumatoid arthritis
C) Osteoarthritis
D) Lupus
Expert Rationale: Fibromyalgia is the most likely cause. It is characterized by widespread
pain, multiple tender points, and normal range of motion. Rheumatoid arthritis would
present with joint swelling and limited motion.
Question
A 68-year-old retired banker comes to your clinic for evaluation of left shoulder pain. He
notes a sharp, catching pain and a sensation of something grating when he tries overhead
movements of his arm. On physical examination, you note tenderness just below the tip of
the acromion in the area of the tendon insertions. The drop arm test is negative. What is the
most likely cause of his shoulder pain?
A) Rotator cuff tendinitis
B) Adhesive capsulitis
C) Acromioclavicular joint arthritis
D) Biceps tendinitis
Expert Rationale: Rotator cuff tendinitis is the most likely cause. It presents with pain and
tenderness just below the acromion, especially with overhead movements. The drop arm
test is negative, which rules out a full rotator cuff tear.
Question
A high school soccer player "blew out his knee" when the opposing goalie's head and
shoulder struck his flexed knee. All of the following structures were involved in some way in
his injury, but which of the following is actually an extra-articular structure?
A) Synovium
B) Joint capsule
C) Juxta-articular bone
D) Tendons
