BATES' GUIDE TO PHYSICAL
EXAMINATION AND HISTORY TAKING
13TH EDITION
• AUTHOR(S)LYNN S. BICKLEY; PETER
G. SZILAGYI; RICHARD M. HOFFMAN;
RAINIER P. SORIANO
TEST BANK
1)
Reference: Ch. 1 — Approach to the Clinical Encounter — Stage
1: Initiating the Encounter
Stem: A 62-year-old man presents for a new primary care visit.
He appears tense and gives one-word answers. You note his
chart lists limited English proficiency. During the first minute
you must establish rapport and obtain consent for the exam;
what approach best aligns with Bates’ recommendations to
initiate a clinical encounter while respecting communication
barriers?
Options:
A. Begin the medical history immediately, using family members
,to translate.
B. Pause; arrange a trained medical interpreter, introduce
yourself, explain the visit’s structure and obtain consent for the
exam.
C. Continue with focused physical exam first to “get objective
data,” then attempt history with ad hoc translation.
D. Ask the patient yes/no questions only and defer complex
topics to a later visit.
Correct Answer: B
Rationales — Correct (B):
Bates emphasizes beginning with a respectful introduction,
purpose statement, and obtaining consent; for limited English
proficiency, trained medical interpreters are required to ensure
accurate communication and respect. Introducing yourself and
the visit structure reduces anxiety and aligns with Stage 1 goals
of establishing rapport and setting an agenda.
Rationales — Incorrect:
A: Family members may introduce bias, confidentiality
breaches, and inaccuracies; Bates discourages ad hoc
interpretation.
C: Skipping history undermines patient-centered care and may
miss safety risks; objective data without context is incomplete.
D: Yes/no questioning limits diagnostic reasoning and
undermines shared decision making.
Teaching Point: Use trained interpreters, introductions, and a
visit agenda to build rapport and ensure valid history.
,Citation: Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano,
R. P. (2021). Bates’ Guide to Physical Examination & History
Taking (13th Ed.). Ch. 1.
2)
Reference: Ch. 1 — Structure and Sequence of the Clinical
Encounter — Stage 2: Gathering Information
Stem: A 29-year-old pregnant woman presents with
intermittent headaches. You must gather a focused history and
consider red flags. Which line of questioning best synthesizes
Bates’ approach to targeted history taking that distinguishes
benign headache from a dangerous cause?
Options:
A. Ask only about headache frequency and duration, then
schedule routine prenatal labs.
B. Obtain onset, quality, location, associated neurologic
symptoms, hypertension history, and medication use (including
OTC), integrating red-flag triggers.
C. Immediately order noncontrast head CT for any new
headache in pregnancy.
D. Focus solely on psychosocial stressors and reassure if no
fever.
Correct Answer: B
Rationales — Correct (B):
Bates recommends focused symptom analysis (OLDCARTS),
, associated symptoms, past medical history and medication
review. In pregnancy, distinguishing preeclampsia, intracranial
hemorrhage, or medication-related causes requires targeted
questions about blood pressure, visual changes, neurological
deficits, and drug use.
Rationales — Incorrect:
A: Frequency/duration alone miss red flags; incomplete
synthesis per Bates.
C: CT is not first-line for all new headaches in pregnancy; clinical
judgement guides imaging.
D: Psychosocial factors are relevant but cannot substitute for
ruling out urgent organic causes.
Teaching Point: Ask OLDCARTS plus neuro and obstetric red
flags for headaches in pregnancy.
Citation: Bickley et al. (2021). Ch. 1.
3)
Reference: Ch. 1 — Performing the Physical Examination —
General Approach & Techniques
Stem: A 47-year-old with diabetes presents for annual exam.
You plan focused exam of the lower extremities. According to
Bates’ recommended sequence and techniques, which
approach best minimizes missing diabetic foot pathology while
respecting patient comfort?
EXAMINATION AND HISTORY TAKING
13TH EDITION
• AUTHOR(S)LYNN S. BICKLEY; PETER
G. SZILAGYI; RICHARD M. HOFFMAN;
RAINIER P. SORIANO
TEST BANK
1)
Reference: Ch. 1 — Approach to the Clinical Encounter — Stage
1: Initiating the Encounter
Stem: A 62-year-old man presents for a new primary care visit.
He appears tense and gives one-word answers. You note his
chart lists limited English proficiency. During the first minute
you must establish rapport and obtain consent for the exam;
what approach best aligns with Bates’ recommendations to
initiate a clinical encounter while respecting communication
barriers?
Options:
A. Begin the medical history immediately, using family members
,to translate.
B. Pause; arrange a trained medical interpreter, introduce
yourself, explain the visit’s structure and obtain consent for the
exam.
C. Continue with focused physical exam first to “get objective
data,” then attempt history with ad hoc translation.
D. Ask the patient yes/no questions only and defer complex
topics to a later visit.
Correct Answer: B
Rationales — Correct (B):
Bates emphasizes beginning with a respectful introduction,
purpose statement, and obtaining consent; for limited English
proficiency, trained medical interpreters are required to ensure
accurate communication and respect. Introducing yourself and
the visit structure reduces anxiety and aligns with Stage 1 goals
of establishing rapport and setting an agenda.
Rationales — Incorrect:
A: Family members may introduce bias, confidentiality
breaches, and inaccuracies; Bates discourages ad hoc
interpretation.
C: Skipping history undermines patient-centered care and may
miss safety risks; objective data without context is incomplete.
D: Yes/no questioning limits diagnostic reasoning and
undermines shared decision making.
Teaching Point: Use trained interpreters, introductions, and a
visit agenda to build rapport and ensure valid history.
,Citation: Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano,
R. P. (2021). Bates’ Guide to Physical Examination & History
Taking (13th Ed.). Ch. 1.
2)
Reference: Ch. 1 — Structure and Sequence of the Clinical
Encounter — Stage 2: Gathering Information
Stem: A 29-year-old pregnant woman presents with
intermittent headaches. You must gather a focused history and
consider red flags. Which line of questioning best synthesizes
Bates’ approach to targeted history taking that distinguishes
benign headache from a dangerous cause?
Options:
A. Ask only about headache frequency and duration, then
schedule routine prenatal labs.
B. Obtain onset, quality, location, associated neurologic
symptoms, hypertension history, and medication use (including
OTC), integrating red-flag triggers.
C. Immediately order noncontrast head CT for any new
headache in pregnancy.
D. Focus solely on psychosocial stressors and reassure if no
fever.
Correct Answer: B
Rationales — Correct (B):
Bates recommends focused symptom analysis (OLDCARTS),
, associated symptoms, past medical history and medication
review. In pregnancy, distinguishing preeclampsia, intracranial
hemorrhage, or medication-related causes requires targeted
questions about blood pressure, visual changes, neurological
deficits, and drug use.
Rationales — Incorrect:
A: Frequency/duration alone miss red flags; incomplete
synthesis per Bates.
C: CT is not first-line for all new headaches in pregnancy; clinical
judgement guides imaging.
D: Psychosocial factors are relevant but cannot substitute for
ruling out urgent organic causes.
Teaching Point: Ask OLDCARTS plus neuro and obstetric red
flags for headaches in pregnancy.
Citation: Bickley et al. (2021). Ch. 1.
3)
Reference: Ch. 1 — Performing the Physical Examination —
General Approach & Techniques
Stem: A 47-year-old with diabetes presents for annual exam.
You plan focused exam of the lower extremities. According to
Bates’ recommended sequence and techniques, which
approach best minimizes missing diabetic foot pathology while
respecting patient comfort?
