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
1️⃣ Question 1
Reference
Ch. 1️ — Approach to the Clinical Encounter — Stage 1️: Initiating
the Encounter
APRN-Level Question Stem
A 62-year-old male with poorly controlled diabetes presents to
clinic for a new cough. You enter the room, note he is sitting
upright and avoiding eye contact. During introductions he gives
short answers and appears anxious. Which initial approach best
aligns with Bates’ recommendations to build rapport and elicit
the patient’s agenda?
,Options
A. Begin immediately with a focused respiratory history to save
time.
B. Use open-ended questions about his chief concern and
reflect his emotions.
C. Ask closed yes/no screening questions about smoking and
immunizations.
D. Explain practice policies about visit length and proceed to
exam.
Correct Answer
B
Rationales
Correct Option
Using open-ended questions and reflective statements
establishes rapport, uncovers the patient’s agenda, and
addresses emotional cues—consistent with Bates’ initiation
stage. This encourages disclosure of concerns and aligns with
person-centered interviewing.
Incorrect Options
A. Starting with focused history ignores rapport and may miss
the patient’s primary concerns; inconsistent with Bates’
emphasis on eliciting the agenda.
C. Closed screening questions are useful later but inappropriate
for initiating the encounter and building trust.
D. Leading with administrative explanations risks shutting down
communication and neglects early empathic connection.
,Teaching Point
Begin with open-ended questions and emotional reflection to
surface the patient’s agenda.
Citation
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P.
(2021️). Bates’ Guide to Physical Examination & History Taking
(1️3th Ed.). Ch. 1️.
2⃣ Question 2
Reference
Ch. 1️ — Structure and Sequence of the Clinical Encounter —
Stage 2: Gathering Information
APRN-Level Question Stem
A 28-year-old woman presents with intermittent palpitations.
After an open-ended opening, you collect a targeted history and
vitals that are normal. The patient mentions stress at work only
when prompted. According to Bates’ framework, which
interviewing move most likely improves diagnostic accuracy
here?
Options
A. Proceed to physical exam since vitals are normal.
B. Use focused, symptom-specific probes and explore context
and timing.
C. Reassure the patient that stress causes palpitations and stop
, further questioning.
D. Immediately order an ECG without further history.
Correct Answer
B
Rationales
Correct Option
Bates emphasizes thorough history with targeted probes
(OLDCARTS, context) because psychosocial factors and timing
refine differential diagnosis and testing decisions. Exploring
stressors clarifies triggers and guides appropriate testing.
Incorrect Options
A. Skipping further history risks missing triggers or red flags
despite normal vitals.
C. Premature reassurance prevents full exploration of causes
and may miss cardiac red flags.
D. ECG may be needed, but history first directs appropriate
testing and avoids unnecessary investigations.
Teaching Point
Use focused probes to clarify symptom context and guide
testing.
Citation
Bickley et al. (2021️). Ch. 1️.
3⃣ Question 3
EXAMINATION AND HISTORY TAKING
13TH EDITION
• AUTHOR(S)LYNN S. BICKLEY; PETER
G. SZILAGYI; RICHARD M. HOFFMAN;
RAINIER P. SORIANO
TEST BANK
1️⃣ Question 1
Reference
Ch. 1️ — Approach to the Clinical Encounter — Stage 1️: Initiating
the Encounter
APRN-Level Question Stem
A 62-year-old male with poorly controlled diabetes presents to
clinic for a new cough. You enter the room, note he is sitting
upright and avoiding eye contact. During introductions he gives
short answers and appears anxious. Which initial approach best
aligns with Bates’ recommendations to build rapport and elicit
the patient’s agenda?
,Options
A. Begin immediately with a focused respiratory history to save
time.
B. Use open-ended questions about his chief concern and
reflect his emotions.
C. Ask closed yes/no screening questions about smoking and
immunizations.
D. Explain practice policies about visit length and proceed to
exam.
Correct Answer
B
Rationales
Correct Option
Using open-ended questions and reflective statements
establishes rapport, uncovers the patient’s agenda, and
addresses emotional cues—consistent with Bates’ initiation
stage. This encourages disclosure of concerns and aligns with
person-centered interviewing.
Incorrect Options
A. Starting with focused history ignores rapport and may miss
the patient’s primary concerns; inconsistent with Bates’
emphasis on eliciting the agenda.
C. Closed screening questions are useful later but inappropriate
for initiating the encounter and building trust.
D. Leading with administrative explanations risks shutting down
communication and neglects early empathic connection.
,Teaching Point
Begin with open-ended questions and emotional reflection to
surface the patient’s agenda.
Citation
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P.
(2021️). Bates’ Guide to Physical Examination & History Taking
(1️3th Ed.). Ch. 1️.
2⃣ Question 2
Reference
Ch. 1️ — Structure and Sequence of the Clinical Encounter —
Stage 2: Gathering Information
APRN-Level Question Stem
A 28-year-old woman presents with intermittent palpitations.
After an open-ended opening, you collect a targeted history and
vitals that are normal. The patient mentions stress at work only
when prompted. According to Bates’ framework, which
interviewing move most likely improves diagnostic accuracy
here?
Options
A. Proceed to physical exam since vitals are normal.
B. Use focused, symptom-specific probes and explore context
and timing.
C. Reassure the patient that stress causes palpitations and stop
, further questioning.
D. Immediately order an ECG without further history.
Correct Answer
B
Rationales
Correct Option
Bates emphasizes thorough history with targeted probes
(OLDCARTS, context) because psychosocial factors and timing
refine differential diagnosis and testing decisions. Exploring
stressors clarifies triggers and guides appropriate testing.
Incorrect Options
A. Skipping further history risks missing triggers or red flags
despite normal vitals.
C. Premature reassurance prevents full exploration of causes
and may miss cardiac red flags.
D. ECG may be needed, but history first directs appropriate
testing and avoids unnecessary investigations.
Teaching Point
Use focused probes to clarify symptom context and guide
testing.
Citation
Bickley et al. (2021️). Ch. 1️.
3⃣ Question 3
