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
Question 1
Reference
Ch. 1 — Approach to the Clinical Encounter — FOUNDATIONAL
SKILLS ESSENTIAL TO THE CLINICAL ENCOUNTER
APRN-Level Question Stem
A 62-year-old man with diabetes arrives for a new-patient visit
escorted by his adult daughter who answers most questions. He
provides limited eye contact and brief answers. As an APRN,
you must determine whether observed behavior reflects
,patient preference, cognitive impairment, or family dominance
affecting accuracy of history. Which initial step best aligns with
Bates’ foundational skills to optimize accurate information
gathering?
Options
A. Continue the interview with the daughter answering to
expedite data collection.
B. Privately invite the patient to speak alone and obtain his
perspective first.
C. Rely on the daughter’s account as likely more accurate for
functional history.
D. Use closed yes/no questions directed to the daughter to
avoid patient embarrassment.
Correct Answer
B
Rationales
Correct Option — B: Bates emphasizes patient-centered
communication and observing behavior while prioritizing the
patient’s own history when possible. Privately inviting the
patient reduces family influence, allows assessment of
cognition and capacity, and adheres to ethical autonomy. This
step improves validity of history and aligns with foundational
interview skills.
Incorrect Option — A: Allowing the daughter to dominate risks
inaccurate or biased data and undermines the patient’s
autonomy and Bates’ recommended approach.
,Incorrect Option — C: While informants can be useful, relying
on a family member as primary source fails Bates’ guidance to
obtain patient’s own narrative when possible.
Incorrect Option — D: Closed questions to the daughter avoid
assessing the patient directly and limit diagnostic information
about cognition or mood.
Teaching Point
Start with the patient alone to assess capacity, cognition, and
personal history first.
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.
Question 2
Reference
Ch. 1 — Approach to the Clinical Encounter — STRUCTURE AND
SEQUENCE OF THE CLINICAL ENCOUNTER — Stage 1: Initiating
the Encounter
APRN-Level Question Stem
You are about to see a 28-year-old transgender man who
appears nervous and asks if you have experience with trans
healthcare. He requests pronouns be used correctly and for you
to explain each exam step before touching. According to Bates’
guidance for initiating the encounter, which approach most
, reduces bias and supports rapport while maintaining exam
efficiency?
Options
A. Begin the physical exam immediately to avoid prolonging an
anxious visit.
B. Ask the patient’s preferred name and pronouns, explain the
exam sequence, and invite questions.
C. Defer pronoun use and use chart name to avoid potential
mistakes.
D. Delegate the exam explanation to a nurse to save time.
Correct Answer
B
Rationales
Correct Option — B: Bates recommends respectful
introductions, clarifying identity and preferences, and
explaining exam steps to build trust and reduce anxiety. Using
correct pronouns and explaining the sequence demonstrates
cultural humility and improves communication and safety. This
approach aligns with initiating the encounter while minimizing
bias.
Incorrect Option — A: Rushing the exam disregards patient
comfort and misses opportunities for informed consent and
rapport.
Incorrect Option — C: Ignoring patient-stated identity can cause
harm, reduce disclosure, and contradicts Bates’ patient-
centered approach.
EXAMINATION AND HISTORY TAKING
13TH EDITION
• AUTHOR(S)LYNN S. BICKLEY; PETER
G. SZILAGYI; RICHARD M. HOFFMAN;
RAINIER P. SORIANO
TEST BANK
Question 1
Reference
Ch. 1 — Approach to the Clinical Encounter — FOUNDATIONAL
SKILLS ESSENTIAL TO THE CLINICAL ENCOUNTER
APRN-Level Question Stem
A 62-year-old man with diabetes arrives for a new-patient visit
escorted by his adult daughter who answers most questions. He
provides limited eye contact and brief answers. As an APRN,
you must determine whether observed behavior reflects
,patient preference, cognitive impairment, or family dominance
affecting accuracy of history. Which initial step best aligns with
Bates’ foundational skills to optimize accurate information
gathering?
Options
A. Continue the interview with the daughter answering to
expedite data collection.
B. Privately invite the patient to speak alone and obtain his
perspective first.
C. Rely on the daughter’s account as likely more accurate for
functional history.
D. Use closed yes/no questions directed to the daughter to
avoid patient embarrassment.
Correct Answer
B
Rationales
Correct Option — B: Bates emphasizes patient-centered
communication and observing behavior while prioritizing the
patient’s own history when possible. Privately inviting the
patient reduces family influence, allows assessment of
cognition and capacity, and adheres to ethical autonomy. This
step improves validity of history and aligns with foundational
interview skills.
Incorrect Option — A: Allowing the daughter to dominate risks
inaccurate or biased data and undermines the patient’s
autonomy and Bates’ recommended approach.
,Incorrect Option — C: While informants can be useful, relying
on a family member as primary source fails Bates’ guidance to
obtain patient’s own narrative when possible.
Incorrect Option — D: Closed questions to the daughter avoid
assessing the patient directly and limit diagnostic information
about cognition or mood.
Teaching Point
Start with the patient alone to assess capacity, cognition, and
personal history first.
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.
Question 2
Reference
Ch. 1 — Approach to the Clinical Encounter — STRUCTURE AND
SEQUENCE OF THE CLINICAL ENCOUNTER — Stage 1: Initiating
the Encounter
APRN-Level Question Stem
You are about to see a 28-year-old transgender man who
appears nervous and asks if you have experience with trans
healthcare. He requests pronouns be used correctly and for you
to explain each exam step before touching. According to Bates’
guidance for initiating the encounter, which approach most
, reduces bias and supports rapport while maintaining exam
efficiency?
Options
A. Begin the physical exam immediately to avoid prolonging an
anxious visit.
B. Ask the patient’s preferred name and pronouns, explain the
exam sequence, and invite questions.
C. Defer pronoun use and use chart name to avoid potential
mistakes.
D. Delegate the exam explanation to a nurse to save time.
Correct Answer
B
Rationales
Correct Option — B: Bates recommends respectful
introductions, clarifying identity and preferences, and
explaining exam steps to build trust and reduce anxiety. Using
correct pronouns and explaining the sequence demonstrates
cultural humility and improves communication and safety. This
approach aligns with initiating the encounter while minimizing
bias.
Incorrect Option — A: Rushing the exam disregards patient
comfort and misses opportunities for informed consent and
rapport.
Incorrect Option — C: Ignoring patient-stated identity can cause
harm, reduce disclosure, and contradicts Bates’ patient-
centered approach.
