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
Q1
Reference
Ch. 1 — Approach to the Clinical Encounter — Stage 1: Initiating
the Encounter
APRN-Level Question Stem (2–4 sentences)
A 58-year-old man with complex diabetes arrives for a new-
patient visit and appears anxious, speaks rapidly, and begins
recounting several complaints before you introduce yourself.
You have 15 minutes scheduled. Using Bates' recommended
approach to initiating the encounter, what is the best
immediate strategy to establish rapport while ensuring a
complete, patient-centered agenda?
,Options (A–D)
A. Interrupt briefly to set the visit agenda, then allow the
patient to continue uninterrupted for 3–5 minutes.
B. Let the patient tell the entire story without interruption to
build rapport.
C. Ask closed yes/no questions to quickly categorize complaints
and save time.
D. Defer introductions and proceed directly to focused physical
exam to maximize efficiency.
Correct Answer
A
Rationales
Correct Option (A)
Bates advises clinicians to introduce themselves, clarify roles,
and negotiate an agenda early: briefly set time and
expectations, then permit the patient to give an uninterrupted
initial narrative for a short period (3–5 minutes) to reveal
priorities and salient history. This balances rapport-building
with time management and reduces missed concerns.
Incorrect Options
B. Allowing an unbounded narrative may lead to time overruns
and missed priorities; Bates recommends a brief uninterrupted
initial narrative, not an unlimited one.
C. Closed questions limit the patient’s story and risk missing
important context; Bates promotes open-ended openings
followed by focused questioning.
,D. Skipping introductions undermines rapport and informed
consent; Bates emphasizes initiating the encounter with clear
introductions and agenda setting.
Teaching Point
Start with introductions and a brief uninterrupted narrative,
then negotiate the visit agenda.
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.
Q2
Reference
Ch. 1 — Approach to the Clinical Encounter — Stage 1: Initiating
the Encounter
APRN-Level Question Stem
During a preoperative assessment, a 72-year-old woman speaks
limited English and is accompanied by a family member offering
translation. As an APRN aware of Bates’ communication
principles, what is the best next step to ensure accurate history
and informed consent?
Options
A. Use the family member to translate because they know the
patient best.
B. Request a professional medical interpreter and continue only
, when the interpreter is available.
C. Proceed with simplified English, confirm understanding with
nods, and document consent.
D. Ask the family member to summarize main points and
document the summary.
Correct Answer
B
Rationales
Correct Option (B)
Bates stresses the importance of accurate communication and
recommends use of qualified medical interpreters rather than
family members to avoid misinterpretation, preserve
confidentiality, and ensure true informed consent. Waiting for a
professional interpreter is appropriate for high-stakes
discussions like consent.
Incorrect Options
A. Family interpretation risks omissions, inaccuracies, and
breaches of confidentiality; Bates advises against it for critical
information.
C. Simplified English without a trained interpreter may produce
misunderstandings; Bates recommends professional
interpretation for informed consent.
D. A family summary is unreliable and does not meet Bates’
standard for accurate history-taking or consent documentation.
EXAMINATION AND HISTORY TAKING
13TH EDITION
• AUTHOR(S)LYNN S. BICKLEY; PETER
G. SZILAGYI; RICHARD M. HOFFMAN;
RAINIER P. SORIANO
TEST BANK
Q1
Reference
Ch. 1 — Approach to the Clinical Encounter — Stage 1: Initiating
the Encounter
APRN-Level Question Stem (2–4 sentences)
A 58-year-old man with complex diabetes arrives for a new-
patient visit and appears anxious, speaks rapidly, and begins
recounting several complaints before you introduce yourself.
You have 15 minutes scheduled. Using Bates' recommended
approach to initiating the encounter, what is the best
immediate strategy to establish rapport while ensuring a
complete, patient-centered agenda?
,Options (A–D)
A. Interrupt briefly to set the visit agenda, then allow the
patient to continue uninterrupted for 3–5 minutes.
B. Let the patient tell the entire story without interruption to
build rapport.
C. Ask closed yes/no questions to quickly categorize complaints
and save time.
D. Defer introductions and proceed directly to focused physical
exam to maximize efficiency.
Correct Answer
A
Rationales
Correct Option (A)
Bates advises clinicians to introduce themselves, clarify roles,
and negotiate an agenda early: briefly set time and
expectations, then permit the patient to give an uninterrupted
initial narrative for a short period (3–5 minutes) to reveal
priorities and salient history. This balances rapport-building
with time management and reduces missed concerns.
Incorrect Options
B. Allowing an unbounded narrative may lead to time overruns
and missed priorities; Bates recommends a brief uninterrupted
initial narrative, not an unlimited one.
C. Closed questions limit the patient’s story and risk missing
important context; Bates promotes open-ended openings
followed by focused questioning.
,D. Skipping introductions undermines rapport and informed
consent; Bates emphasizes initiating the encounter with clear
introductions and agenda setting.
Teaching Point
Start with introductions and a brief uninterrupted narrative,
then negotiate the visit agenda.
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.
Q2
Reference
Ch. 1 — Approach to the Clinical Encounter — Stage 1: Initiating
the Encounter
APRN-Level Question Stem
During a preoperative assessment, a 72-year-old woman speaks
limited English and is accompanied by a family member offering
translation. As an APRN aware of Bates’ communication
principles, what is the best next step to ensure accurate history
and informed consent?
Options
A. Use the family member to translate because they know the
patient best.
B. Request a professional medical interpreter and continue only
, when the interpreter is available.
C. Proceed with simplified English, confirm understanding with
nods, and document consent.
D. Ask the family member to summarize main points and
document the summary.
Correct Answer
B
Rationales
Correct Option (B)
Bates stresses the importance of accurate communication and
recommends use of qualified medical interpreters rather than
family members to avoid misinterpretation, preserve
confidentiality, and ensure true informed consent. Waiting for a
professional interpreter is appropriate for high-stakes
discussions like consent.
Incorrect Options
A. Family interpretation risks omissions, inaccuracies, and
breaches of confidentiality; Bates advises against it for critical
information.
C. Simplified English without a trained interpreter may produce
misunderstandings; Bates recommends professional
interpretation for informed consent.
D. A family summary is unreliable and does not meet Bates’
standard for accurate history-taking or consent documentation.
