TEST BANK FOR BATES’ GUIDE TO PHYSICAL
EXAMINATION AND HISTORY TAKING 13TH EDITION
BY LYNN S. BICKLEY,
The following information is recorded in the health history: "Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea." Which category does it
belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - D) Review of systems
Review of systems documents the presence or absence of common symptoms related
to each major body system.
The following information is best placed in which category?
"The patient has had three cesarean sections."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - B) Surgeries
,A cesarean section is a surgical procedure. Approximate dates or the age of the patient
at the time of the surgery should also be recorded.
The following information is best placed in which category?
"The patient had a stent placed in the left anterior descending artery (LAD) in 1999."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - A) Adult illnesses
The adult illnesses category is reserved for chronic illnesses, significant
hospitalizations, significant injuries, and significant procedures. A stent is a major
procedure but does not involve a surgery.
The following information is best placed in which category?
"The patient was treated for an asthma exacerbation in the hospital last year; the patient
has
never been intubated."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - A) Adult illnesses
This is information about a significant hospitalization and should be placed in the adult
illnesses section. If the patient is being seen for an asthma exacerbation, you may
consider placing this info in the present illness section, because it relates to the chief
complaint at that visit.
You are running late after your quarterly quality improvement meeting at the hospital
and
have just gotten paged from the nurses' station because a family member of one of your
patients wants to talk with you about that patient's care. You have clinic this afternoon
and are double-booked for the first appointment time; three other patients also have
arrived and are
sitting in the waiting room. Which of the following demeanors is a behavior consistent
with
skilled interviewing when you walk into the examination room to speak with your first
clinic patient?
A) Irritability
B) Impatience
,C) Boredom
D) Calm - D) Calm
The appearance of calmness and patience, even when time is limited, is the hallmark of
a skilled interviewer.
Suzanne, a 25 year old, comes to your clinic to establish care. You are the student
preparing
to go into the examination room to interview her. Which of the following is the most
logical sequence for the patient-provider interview?
A) Establish the agenda, negotiate a plan, establish rapport, and invite the patient's
story.
B) Invite the patient's story, negotiate a plan, establish the agenda, and establish
rapport.
C) Greet the patient, establish rapport, invite the patient's story, establish the
agenda, expand and clarify the patient's story, and negotiate a plan.
D) Negotiate a plan, establish an agenda, invite the patient's story, and establish
rapport. - C) Greet the patient, establish rapport, invite the patient's story, establish the
agenda, expand and clarify the patient's story, and negotiate a plan.
This is the most productive sequence for the interview. Greeting patients and
establishing rapport allows them to feel more comfortable before "inviting" them to
relate their
story. After hearing the patient's story, together you establish the agenda regarding the
most
important items to expand upon. At the end, together you negotiate the plan of
diagnosis and treatment.
Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The
pain is
a dull ache, located in the right upper quadrant, that she rates as a 3 at the least and an
8 at the
worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a time, it comes and
goes, and
it seems to be worse a couple of hours after eating. She has noticed that it starts after
eating
greasy foods, so she has cut down on these as much as she can. Initially it occurred
once a week, but now it is occurring every other day. Nothing makes it better. From
this description, which of the seven attributes of a symptom has been omitted?
A) Setting in which the symptom occurs
B) Associated manifestations
C) Quality
, D) Timing - B) Associated manifestations
The interviewer has not recorded whether or not the pain has been accompanied by
nausea, vomiting, fever, chills, weight loss, and so on. Associated manifestations are
additional
symptoms that may accompany the initial chief complaint and that help the examiner to
start refining his or her differential diagnosis.
A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine - A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall. Pleuritic
chest pain is also a sharp chest pain which increases with a deep breath. This type of
pain can
occur with inflammation of the pleura from pneumonia or other conditions and
pulmonary embolus.
A patient comes to the emergency room for evaluation of shortness of breath. To which
anatomic region would you assign the symptom?
A) Reproductive
B) Urinary
C) Cardiac
D) Hematologic - C) Cardiac
Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may
also result
in shortness of breath, such as anemia in the hematologic category, pregnancy in the
reproductive category, or sepsis with UTI in the urinary category.
A patient presents for evaluation of a cough. Which of the following anatomic regions
can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
EXAMINATION AND HISTORY TAKING 13TH EDITION
BY LYNN S. BICKLEY,
The following information is recorded in the health history: "Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea." Which category does it
belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - D) Review of systems
Review of systems documents the presence or absence of common symptoms related
to each major body system.
The following information is best placed in which category?
"The patient has had three cesarean sections."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - B) Surgeries
,A cesarean section is a surgical procedure. Approximate dates or the age of the patient
at the time of the surgery should also be recorded.
The following information is best placed in which category?
"The patient had a stent placed in the left anterior descending artery (LAD) in 1999."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - A) Adult illnesses
The adult illnesses category is reserved for chronic illnesses, significant
hospitalizations, significant injuries, and significant procedures. A stent is a major
procedure but does not involve a surgery.
The following information is best placed in which category?
"The patient was treated for an asthma exacerbation in the hospital last year; the patient
has
never been intubated."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - A) Adult illnesses
This is information about a significant hospitalization and should be placed in the adult
illnesses section. If the patient is being seen for an asthma exacerbation, you may
consider placing this info in the present illness section, because it relates to the chief
complaint at that visit.
You are running late after your quarterly quality improvement meeting at the hospital
and
have just gotten paged from the nurses' station because a family member of one of your
patients wants to talk with you about that patient's care. You have clinic this afternoon
and are double-booked for the first appointment time; three other patients also have
arrived and are
sitting in the waiting room. Which of the following demeanors is a behavior consistent
with
skilled interviewing when you walk into the examination room to speak with your first
clinic patient?
A) Irritability
B) Impatience
,C) Boredom
D) Calm - D) Calm
The appearance of calmness and patience, even when time is limited, is the hallmark of
a skilled interviewer.
Suzanne, a 25 year old, comes to your clinic to establish care. You are the student
preparing
to go into the examination room to interview her. Which of the following is the most
logical sequence for the patient-provider interview?
A) Establish the agenda, negotiate a plan, establish rapport, and invite the patient's
story.
B) Invite the patient's story, negotiate a plan, establish the agenda, and establish
rapport.
C) Greet the patient, establish rapport, invite the patient's story, establish the
agenda, expand and clarify the patient's story, and negotiate a plan.
D) Negotiate a plan, establish an agenda, invite the patient's story, and establish
rapport. - C) Greet the patient, establish rapport, invite the patient's story, establish the
agenda, expand and clarify the patient's story, and negotiate a plan.
This is the most productive sequence for the interview. Greeting patients and
establishing rapport allows them to feel more comfortable before "inviting" them to
relate their
story. After hearing the patient's story, together you establish the agenda regarding the
most
important items to expand upon. At the end, together you negotiate the plan of
diagnosis and treatment.
Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The
pain is
a dull ache, located in the right upper quadrant, that she rates as a 3 at the least and an
8 at the
worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a time, it comes and
goes, and
it seems to be worse a couple of hours after eating. She has noticed that it starts after
eating
greasy foods, so she has cut down on these as much as she can. Initially it occurred
once a week, but now it is occurring every other day. Nothing makes it better. From
this description, which of the seven attributes of a symptom has been omitted?
A) Setting in which the symptom occurs
B) Associated manifestations
C) Quality
, D) Timing - B) Associated manifestations
The interviewer has not recorded whether or not the pain has been accompanied by
nausea, vomiting, fever, chills, weight loss, and so on. Associated manifestations are
additional
symptoms that may accompany the initial chief complaint and that help the examiner to
start refining his or her differential diagnosis.
A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine - A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall. Pleuritic
chest pain is also a sharp chest pain which increases with a deep breath. This type of
pain can
occur with inflammation of the pleura from pneumonia or other conditions and
pulmonary embolus.
A patient comes to the emergency room for evaluation of shortness of breath. To which
anatomic region would you assign the symptom?
A) Reproductive
B) Urinary
C) Cardiac
D) Hematologic - C) Cardiac
Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may
also result
in shortness of breath, such as anemia in the hematologic category, pregnancy in the
reproductive category, or sepsis with UTI in the urinary category.
A patient presents for evaluation of a cough. Which of the following anatomic regions
can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
