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 62-year-old man arrives for a new primary care visit. He
seems guarded, avoids eye contact, and answers the intake
question about smoking with “I used to.” You need to establish
trust quickly to obtain an accurate history and prioritize issues.
,Which opening approach best follows Bates’ recommendations
for initiating the encounter to maximize accurate disclosure and
rapport?
Options
A. Begin with a direct tobacco-use checklist and move quickly to
physical exam.
B. Use an open-ended question about what brought him in
today, followed by empathy and affirming statements.
C. Offer immediate unsolicited advice about quitting smoking to
demonstrate concern.
D. Ask family members for corroboration about his smoking
status before continuing.
Correct Answer
B
Rationales
Correct Option: B — Bates emphasizes starting with open-
ended prompts, active listening, and empathy to build rapport
and elicit an accurate account; this approach reduces patient
guardedness and encourages disclosure.
A: Checklist-first is efficient but risks shutting down the patient
and missing context; Bates advises rapport before structured
checklists.
C: Immediate advice may feel judgmental and impair trust;
Bates recommends exploring the patient’s perspective first.
D: Involving family without permission breaches privacy and
,may inhibit the patient’s willingness to disclose sensitive
information.
Teaching Point
Open questions + empathy first; build rapport before checklist
or advice.
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 — Approach to the Clinical Encounter — Stage 2:
Gathering Information
APRN-Level Question Stem
A 28-year-old pregnant patient reports intermittent headaches.
You obtain a focused history but physical and labs are pending.
According to Bates’ guidance on gathering information, what
sequence and focus should you prioritize during history taking
to distinguish benign and worrisome causes?
Options
A. Perform a broad review of systems last, after the physical
exam.
B. Focus history on timing, triggers, associated neurologic
symptoms, hypertensive risk factors, and pregnancy-specific
, concerns.
C. Limit questions to current headache severity to reduce
patient anxiety.
D. Defer questions about social determinants of health until a
later visit.
Correct Answer
B
Rationales
Correct Option: B — Bates recommends targeted questioning
for current concerns, assessing timing, red-flag neurologic signs,
and context (pregnancy, HTN risk) to identify urgent causes.
A: ROS should be used to corroborate but not always
postponed; key red flags belong in initial history.
C: Solely asking severity misses context and red flags per Bates’
framework.
D: SDoH may affect care and should be incorporated
appropriately rather than indefinitely deferred.
Teaching Point
Prioritize timing, red flags, and context (pregnancy, HTN risk)
during focused 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.
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 62-year-old man arrives for a new primary care visit. He
seems guarded, avoids eye contact, and answers the intake
question about smoking with “I used to.” You need to establish
trust quickly to obtain an accurate history and prioritize issues.
,Which opening approach best follows Bates’ recommendations
for initiating the encounter to maximize accurate disclosure and
rapport?
Options
A. Begin with a direct tobacco-use checklist and move quickly to
physical exam.
B. Use an open-ended question about what brought him in
today, followed by empathy and affirming statements.
C. Offer immediate unsolicited advice about quitting smoking to
demonstrate concern.
D. Ask family members for corroboration about his smoking
status before continuing.
Correct Answer
B
Rationales
Correct Option: B — Bates emphasizes starting with open-
ended prompts, active listening, and empathy to build rapport
and elicit an accurate account; this approach reduces patient
guardedness and encourages disclosure.
A: Checklist-first is efficient but risks shutting down the patient
and missing context; Bates advises rapport before structured
checklists.
C: Immediate advice may feel judgmental and impair trust;
Bates recommends exploring the patient’s perspective first.
D: Involving family without permission breaches privacy and
,may inhibit the patient’s willingness to disclose sensitive
information.
Teaching Point
Open questions + empathy first; build rapport before checklist
or advice.
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 — Approach to the Clinical Encounter — Stage 2:
Gathering Information
APRN-Level Question Stem
A 28-year-old pregnant patient reports intermittent headaches.
You obtain a focused history but physical and labs are pending.
According to Bates’ guidance on gathering information, what
sequence and focus should you prioritize during history taking
to distinguish benign and worrisome causes?
Options
A. Perform a broad review of systems last, after the physical
exam.
B. Focus history on timing, triggers, associated neurologic
symptoms, hypertensive risk factors, and pregnancy-specific
, concerns.
C. Limit questions to current headache severity to reduce
patient anxiety.
D. Defer questions about social determinants of health until a
later visit.
Correct Answer
B
Rationales
Correct Option: B — Bates recommends targeted questioning
for current concerns, assessing timing, red-flag neurologic signs,
and context (pregnancy, HTN risk) to identify urgent causes.
A: ROS should be used to corroborate but not always
postponed; key red flags belong in initial history.
C: Solely asking severity misses context and red flags per Bates’
framework.
D: SDoH may affect care and should be incorporated
appropriately rather than indefinitely deferred.
Teaching Point
Prioritize timing, red flags, and context (pregnancy, HTN risk)
during focused 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.
