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
APRN-Level Question Stem
A 34-year-old woman arrives late for a first clinic visit. She
avoids eye contact, speaks tersely, and her partner answers
most questions. On brief observation she has multiple bruises in
various healing stages. Using Bates’ staged approach, which
immediate action best balances patient safety, rapport, and
ethical duty?
,Options
A. Continue the standard intake with the partner present to
avoid conflict.
B. Politely ask the partner to step out and privately inquire
about safety and bruises.
C. Document the injuries and refer to social work without
asking the patient directly.
D. Ask the partner whether the injuries resulted from an
accident.
Correct Answer
B
Rationales
Correct Option — B (3–4 sentences)
Bates emphasizes initiating the encounter with privacy and
establishing safety. Privately asking the patient allows disclosure
without coercion, supports rapport, and meets duty to assess
for intimate partner violence. This step is both clinically
essential and ethically required before documenting or
referring.
Incorrect Options — A (1–3 sentences)
Keeping the partner present may inhibit disclosure and fails
Bates’ recommendation to ensure a private, patient-centered
history when safety concerns exist.
Incorrect Options — C (1–3 sentences)
Documenting without direct patient inquiry misses an
,opportunity to assess danger, obtain consent for reporting, and
violates Bates’ staged, patient-centered information gathering.
Incorrect Options — D (1–3 sentences)
Asking the partner frames the partner as the source of truth,
reduces patient autonomy, and risks escalating danger; Bates
prioritizes private, direct patient questioning.
Teaching Point
Ensure privacy and directly screen for interpersonal violence
when safety cues present.
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
APRN-Level Question Stem
A 68-year-old man with COPD presents for medication review.
He uses multiple OTC supplements and reports “forgetting”
doses. During your history, his answers conflict with medication
bottles brought by his spouse. Which approach best follows
Bates’ guidance to gather accurate information?
, Options
A. Rely on the spouse’s account—family reports are generally
more reliable.
B. Reconcile by reviewing pill bottles together, asking the
patient to describe his routine.
C. Assume nonadherence and stop one medication to simplify
the regimen.
D. Schedule a medication reconciliation with pharmacy without
asking the patient.
Correct Answer
B
Rationales
Correct Option — B (3–4 sentences)
Bates stresses comprehensive information gathering, including
collateral sources, but prioritizes verifying data at the point of
care. Jointly reviewing bottles engages the patient, clarifies
discrepancies, and enables targeted adherence counseling.
Incorrect Options — A (1–3 sentences)
Relying solely on a caregiver introduces bias and can diminish
patient autonomy; Bates advises triangulation, not substitution,
of information sources.
Incorrect Options — C (1–3 sentences)
Stopping meds without synthesis or discussion risks harm;
clinical decisions should follow accurate reconciliation and
shared decision-making per Bates.
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
APRN-Level Question Stem
A 34-year-old woman arrives late for a first clinic visit. She
avoids eye contact, speaks tersely, and her partner answers
most questions. On brief observation she has multiple bruises in
various healing stages. Using Bates’ staged approach, which
immediate action best balances patient safety, rapport, and
ethical duty?
,Options
A. Continue the standard intake with the partner present to
avoid conflict.
B. Politely ask the partner to step out and privately inquire
about safety and bruises.
C. Document the injuries and refer to social work without
asking the patient directly.
D. Ask the partner whether the injuries resulted from an
accident.
Correct Answer
B
Rationales
Correct Option — B (3–4 sentences)
Bates emphasizes initiating the encounter with privacy and
establishing safety. Privately asking the patient allows disclosure
without coercion, supports rapport, and meets duty to assess
for intimate partner violence. This step is both clinically
essential and ethically required before documenting or
referring.
Incorrect Options — A (1–3 sentences)
Keeping the partner present may inhibit disclosure and fails
Bates’ recommendation to ensure a private, patient-centered
history when safety concerns exist.
Incorrect Options — C (1–3 sentences)
Documenting without direct patient inquiry misses an
,opportunity to assess danger, obtain consent for reporting, and
violates Bates’ staged, patient-centered information gathering.
Incorrect Options — D (1–3 sentences)
Asking the partner frames the partner as the source of truth,
reduces patient autonomy, and risks escalating danger; Bates
prioritizes private, direct patient questioning.
Teaching Point
Ensure privacy and directly screen for interpersonal violence
when safety cues present.
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
APRN-Level Question Stem
A 68-year-old man with COPD presents for medication review.
He uses multiple OTC supplements and reports “forgetting”
doses. During your history, his answers conflict with medication
bottles brought by his spouse. Which approach best follows
Bates’ guidance to gather accurate information?
, Options
A. Rely on the spouse’s account—family reports are generally
more reliable.
B. Reconcile by reviewing pill bottles together, asking the
patient to describe his routine.
C. Assume nonadherence and stop one medication to simplify
the regimen.
D. Schedule a medication reconciliation with pharmacy without
asking the patient.
Correct Answer
B
Rationales
Correct Option — B (3–4 sentences)
Bates stresses comprehensive information gathering, including
collateral sources, but prioritizes verifying data at the point of
care. Jointly reviewing bottles engages the patient, clarifies
discrepancies, and enables targeted adherence counseling.
Incorrect Options — A (1–3 sentences)
Relying solely on a caregiver introduces bias and can diminish
patient autonomy; Bates advises triangulation, not substitution,
of information sources.
Incorrect Options — C (1–3 sentences)
Stopping meds without synthesis or discussion risks harm;
clinical decisions should follow accurate reconciliation and
shared decision-making per Bates.
