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 58-year-old man arrives for a new primary care visit and
appears anxious and hurried. You introduce yourself, and he
says, “I don’t have time — just tell me what’s wrong.” Which
initial communication approach best aligns with Bates’
recommended initiating techniques to build rapport while
eliciting urgent concerns?
,Options
A. Interrupt with direct medical questions to expedite history
taking.
B. Acknowledge his time pressure, ask one focused open
question about the urgent concern, and offer brief agenda
setting.
C. Ignore his statement and proceed with a scripted social
history to establish rapport.
D. Ask him to return when he has more time so you can
perform a complete evaluation.
Correct Answer
B
Rationales
Correct Option
Bates emphasizes respectful opening, agenda setting, and
validating patient cues. Acknowledge time pressure, elicit the
chief urgent concern with a focused open question, and
negotiate the visit agenda to balance rapport and efficiency.
This approach reduces patient defensiveness and promptly
identifies red flags.
Incorrect Options
A. Interrupting increases anxiety, misses context, and violates
Bates’ patient-centered opening.
C. Skipping acknowledgement with scripted social history may
alienate a hurried patient and miss the urgent issue.
,D. Asking the patient to return risks missing time-sensitive
problems and conflicts with patient-centered care.
Teaching Point
Acknowledge concerns, set a brief agenda, and prioritize urgent
issues immediately.
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 1: Initiating
the Encounter
APRN-Level Question Stem
During a preop visit, a 34-year-old woman avoids eye contact
and answers questions in one-word replies. According to Bates,
which nonverbal technique should you use first to facilitate
disclosure and what is the clinical rationale?
Options
A. Increase proximity immediately to create intimacy and force
disclosure.
B. Use open body language, reflective silence, and a neutral
tone to invite elaboration.
, C. Criticize her guarded behavior to prompt honesty.
D. Switch to a written questionnaire to avoid verbal interaction.
Correct Answer
B
Rationales
Correct Option
Bates highlights nonverbal skills — open posture, reflective
silence, and a calm tone — to encourage patients who are
guarded. These techniques reduce threat, allow patient to
organize thoughts, and often elicit clinically relevant concerns.
They also align with trauma-informed, patient-centered care.
Incorrect Options
A. Rapidly closing distance can be perceived as intrusive and
escalate withdrawal.
C. Criticism damages rapport and may suppress critical history.
D. Written questionnaires can miss emotional content and
reduce opportunity for therapeutic rapport.
Teaching Point
Use neutral posture and reflective silence to elicit guarded
patients’ concerns.
Citation
Bickley et al. (2021). Ch. 1.
3.
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 58-year-old man arrives for a new primary care visit and
appears anxious and hurried. You introduce yourself, and he
says, “I don’t have time — just tell me what’s wrong.” Which
initial communication approach best aligns with Bates’
recommended initiating techniques to build rapport while
eliciting urgent concerns?
,Options
A. Interrupt with direct medical questions to expedite history
taking.
B. Acknowledge his time pressure, ask one focused open
question about the urgent concern, and offer brief agenda
setting.
C. Ignore his statement and proceed with a scripted social
history to establish rapport.
D. Ask him to return when he has more time so you can
perform a complete evaluation.
Correct Answer
B
Rationales
Correct Option
Bates emphasizes respectful opening, agenda setting, and
validating patient cues. Acknowledge time pressure, elicit the
chief urgent concern with a focused open question, and
negotiate the visit agenda to balance rapport and efficiency.
This approach reduces patient defensiveness and promptly
identifies red flags.
Incorrect Options
A. Interrupting increases anxiety, misses context, and violates
Bates’ patient-centered opening.
C. Skipping acknowledgement with scripted social history may
alienate a hurried patient and miss the urgent issue.
,D. Asking the patient to return risks missing time-sensitive
problems and conflicts with patient-centered care.
Teaching Point
Acknowledge concerns, set a brief agenda, and prioritize urgent
issues immediately.
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 1: Initiating
the Encounter
APRN-Level Question Stem
During a preop visit, a 34-year-old woman avoids eye contact
and answers questions in one-word replies. According to Bates,
which nonverbal technique should you use first to facilitate
disclosure and what is the clinical rationale?
Options
A. Increase proximity immediately to create intimacy and force
disclosure.
B. Use open body language, reflective silence, and a neutral
tone to invite elaboration.
, C. Criticize her guarded behavior to prompt honesty.
D. Switch to a written questionnaire to avoid verbal interaction.
Correct Answer
B
Rationales
Correct Option
Bates highlights nonverbal skills — open posture, reflective
silence, and a calm tone — to encourage patients who are
guarded. These techniques reduce threat, allow patient to
organize thoughts, and often elicit clinically relevant concerns.
They also align with trauma-informed, patient-centered care.
Incorrect Options
A. Rapidly closing distance can be perceived as intrusive and
escalate withdrawal.
C. Criticism damages rapport and may suppress critical history.
D. Written questionnaires can miss emotional content and
reduce opportunity for therapeutic rapport.
Teaching Point
Use neutral posture and reflective silence to elicit guarded
patients’ concerns.
Citation
Bickley et al. (2021). Ch. 1.
3.
