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
Stem
A 58-year-old man arrives for a new-patient visit and appears
reluctant to answer questions, avoiding eye contact and offering
brief answers. You have 10 minutes before the next
appointment. Integrate a trauma-informed approach and Bates’
,recommendations to prioritize patient rapport while gathering
essential information. What is the best initial strategy?
Options
A. Launch straight into the biomedical history to maximize time.
B. Use a brief open-ended invitation, validate feelings, and ask
permission to proceed.
C. Ask family members present to provide history while you
observe the patient silently.
D. Schedule a longer visit and reschedule now, stating you
cannot proceed.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes initiating the encounter with
rapport-building, open invitations, and asking permission; this
supports patient comfort and disclosure while allowing
essential data collection. A brief empathetic opening addresses
reluctance and reduces re-traumatization.
Incorrect (A): Jumping into biomedical questions ignores
rapport-building, risks incomplete history, and may worsen
disclosure.
Incorrect (C): Relying on family bypasses patient autonomy and
privacy; Bates recommends private patient-centered inquiry
first.
Incorrect (D): Rescheduling wastes an opportunity for brief,
,effective engagement and may reduce follow-through; Bates
encourages flexibility within the encounter.
Teaching Point
Begin with brief open invitations and permission to build trust
before focused questioning.
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
Stem
A 35-year-old woman with poorly controlled asthma reports
“worsening symptoms” but cannot quantify them. You note
multiple missed appointments in the chart and sporadic inhaler
refills. Using Bates’ recommended history-taking approach,
which next-step question best elicits meaningful, actionable
information about adherence and social determinants?
Options
A. “Why don’t you use your inhaler regularly?”
B. “Tell me about a typical day—how do you manage your
asthma and medications?”
, C. “Have you been following medical advice?” (yes/no)
D. “You must be noncompliant; will you try harder?”
Correct Answer
B
Rationales
Correct (B): Bates advocates contextual, open-ended questions
that elicit routines and SDOH impacting adherence; “typical
day” uncovers barriers like work, cost, or health literacy. This
yields actionable data.
Incorrect (A): “Why” questions can feel accusatory and provoke
defensiveness, reducing reliable information.
Incorrect (C): Closed yes/no questions lack context and fail to
identify barriers.
Incorrect (D): Judgmental language alienates patients and
impedes disclosure; Bates emphasizes nonjudgmental inquiry.
Teaching Point
Use contextual, open-ended prompts to uncover barriers and
routines affecting adherence.
Citation
Bickley et al. (2021). Ch. 1.
3
Reference
Ch. 1 — Approach to the Clinical Encounter — Structure and
Sequence of the Clinical Encounter
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
Stem
A 58-year-old man arrives for a new-patient visit and appears
reluctant to answer questions, avoiding eye contact and offering
brief answers. You have 10 minutes before the next
appointment. Integrate a trauma-informed approach and Bates’
,recommendations to prioritize patient rapport while gathering
essential information. What is the best initial strategy?
Options
A. Launch straight into the biomedical history to maximize time.
B. Use a brief open-ended invitation, validate feelings, and ask
permission to proceed.
C. Ask family members present to provide history while you
observe the patient silently.
D. Schedule a longer visit and reschedule now, stating you
cannot proceed.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes initiating the encounter with
rapport-building, open invitations, and asking permission; this
supports patient comfort and disclosure while allowing
essential data collection. A brief empathetic opening addresses
reluctance and reduces re-traumatization.
Incorrect (A): Jumping into biomedical questions ignores
rapport-building, risks incomplete history, and may worsen
disclosure.
Incorrect (C): Relying on family bypasses patient autonomy and
privacy; Bates recommends private patient-centered inquiry
first.
Incorrect (D): Rescheduling wastes an opportunity for brief,
,effective engagement and may reduce follow-through; Bates
encourages flexibility within the encounter.
Teaching Point
Begin with brief open invitations and permission to build trust
before focused questioning.
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
Stem
A 35-year-old woman with poorly controlled asthma reports
“worsening symptoms” but cannot quantify them. You note
multiple missed appointments in the chart and sporadic inhaler
refills. Using Bates’ recommended history-taking approach,
which next-step question best elicits meaningful, actionable
information about adherence and social determinants?
Options
A. “Why don’t you use your inhaler regularly?”
B. “Tell me about a typical day—how do you manage your
asthma and medications?”
, C. “Have you been following medical advice?” (yes/no)
D. “You must be noncompliant; will you try harder?”
Correct Answer
B
Rationales
Correct (B): Bates advocates contextual, open-ended questions
that elicit routines and SDOH impacting adherence; “typical
day” uncovers barriers like work, cost, or health literacy. This
yields actionable data.
Incorrect (A): “Why” questions can feel accusatory and provoke
defensiveness, reducing reliable information.
Incorrect (C): Closed yes/no questions lack context and fail to
identify barriers.
Incorrect (D): Judgmental language alienates patients and
impedes disclosure; Bates emphasizes nonjudgmental inquiry.
Teaching Point
Use contextual, open-ended prompts to uncover barriers and
routines affecting adherence.
Citation
Bickley et al. (2021). Ch. 1.
3
Reference
Ch. 1 — Approach to the Clinical Encounter — Structure and
Sequence of the Clinical Encounter
