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 62-year-old man arrives for an initial visit; he seems guarded
and gives brief answers. You note his chart lists prior missed
appointments. You must begin the encounter to optimize
disclosure and build trust while acknowledging possible barriers
,to care. Which opening strategy best aligns with Bates’
recommended initiating techniques to increase information
yield and patient engagement?
Options
A. Immediately review the reason for visit, then proceed with
focused questions about the chief complaint.
B. Use a brief empathic statement acknowledging missed
appointments and invite the patient to share concerns.
C. Provide a rapid explanation of clinic policy and time
constraints to set boundaries.
D. Ask the patient to complete a detailed history questionnaire
before speaking to save time.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes initiating the encounter with
rapport-building and brief empathic statements that
acknowledge context; this lowers patient defensiveness and
increases disclosure relevant to history-gathering.
A: Jumping straight into chief-complaint questions can miss
psychosocial barriers and may perpetuate patient guardedness;
Bates recommends rapport first.
C: Emphasizing policy and time constraints before rapport can
shut down the encounter and reduce trust.
D: Deferring communication to paperwork may miss immediate
,clues and fails to establish the clinician–patient relationship as
Bates advises.
Teaching Point
Start with brief empathy to build trust and surface barriers to
care.
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
You are seeing a 28-year-old woman who speaks limited
English. A family member offers to translate. Based on Bates’
guidance on professional communication, what is the best next
step to ensure an accurate, ethical history?
Options
A. Accept the family member as an ad-hoc translator to
preserve patient comfort.
B. Use a professional medical interpreter (in-person or remote)
and address the patient directly.
C. Speak slowly in English while gesturing and rely on the family
, member only if clarification is needed.
D. Ask the family member to translate only for non-sensitive
items and interpret sensitive items yourself.
Correct Answer
B
Rationales
Correct (B): Bates and best practice recommend using
professional interpreters and speaking directly to the patient to
respect autonomy, accuracy, and confidentiality.
A: Family members introduce error, bias, and confidentiality
concerns—Bates warns against ad-hoc interpreters.
C: Speaking slowly to the patient without an interpreter risks
inaccuracies; Bates prioritizes professional interpretation.
D: Selective use of family interpreters still risks distortion of
sensitive information and breaches confidentiality.
Teaching Point
Always use a professional medical interpreter; speak to the
patient, not the interpreter.
Citation
Bickley et al. (2021). Bates’ Guide… Ch. 1.
3
Reference
Ch. 1 — Approach to the Clinical Encounter — Stage 2:
Gathering Information
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 62-year-old man arrives for an initial visit; he seems guarded
and gives brief answers. You note his chart lists prior missed
appointments. You must begin the encounter to optimize
disclosure and build trust while acknowledging possible barriers
,to care. Which opening strategy best aligns with Bates’
recommended initiating techniques to increase information
yield and patient engagement?
Options
A. Immediately review the reason for visit, then proceed with
focused questions about the chief complaint.
B. Use a brief empathic statement acknowledging missed
appointments and invite the patient to share concerns.
C. Provide a rapid explanation of clinic policy and time
constraints to set boundaries.
D. Ask the patient to complete a detailed history questionnaire
before speaking to save time.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes initiating the encounter with
rapport-building and brief empathic statements that
acknowledge context; this lowers patient defensiveness and
increases disclosure relevant to history-gathering.
A: Jumping straight into chief-complaint questions can miss
psychosocial barriers and may perpetuate patient guardedness;
Bates recommends rapport first.
C: Emphasizing policy and time constraints before rapport can
shut down the encounter and reduce trust.
D: Deferring communication to paperwork may miss immediate
,clues and fails to establish the clinician–patient relationship as
Bates advises.
Teaching Point
Start with brief empathy to build trust and surface barriers to
care.
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
You are seeing a 28-year-old woman who speaks limited
English. A family member offers to translate. Based on Bates’
guidance on professional communication, what is the best next
step to ensure an accurate, ethical history?
Options
A. Accept the family member as an ad-hoc translator to
preserve patient comfort.
B. Use a professional medical interpreter (in-person or remote)
and address the patient directly.
C. Speak slowly in English while gesturing and rely on the family
, member only if clarification is needed.
D. Ask the family member to translate only for non-sensitive
items and interpret sensitive items yourself.
Correct Answer
B
Rationales
Correct (B): Bates and best practice recommend using
professional interpreters and speaking directly to the patient to
respect autonomy, accuracy, and confidentiality.
A: Family members introduce error, bias, and confidentiality
concerns—Bates warns against ad-hoc interpreters.
C: Speaking slowly to the patient without an interpreter risks
inaccuracies; Bates prioritizes professional interpretation.
D: Selective use of family interpreters still risks distortion of
sensitive information and breaches confidentiality.
Teaching Point
Always use a professional medical interpreter; speak to the
patient, not the interpreter.
Citation
Bickley et al. (2021). Bates’ Guide… Ch. 1.
3
Reference
Ch. 1 — Approach to the Clinical Encounter — Stage 2:
Gathering Information
