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 — FOUNDATIONAL
SKILLS ESSENTIAL TO THE CLINICAL ENCOUNTER
APRN-Level Question Stem (2–4 sentences)
A 56-year-old man with poorly controlled diabetes presents for
a routine visit and appears withdrawn, answers questions
tersely, and avoids eye contact. You note partial missing follow-
up labs in the chart and he declines to discuss social supports.
Using Bates’ foundational communication skills, which initial
,clinician action best addresses the likely barrier to accurate
history-taking and builds therapeutic rapport?
Options
A. Continue the planned focused review of systems to save
time.
B. Use open-ended, nonjudgmental prompts and reflective
statements to explore concerns.
C. Offer immediate pharmacologic treatment for depression
without exploring context.
D. Refer directly to psychiatry and postpone further assessment
today.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes foundational communication
skills—open-ended questions, reflective listening, and
nonjudgmental prompts—to elicit patient concerns and social
barriers. These techniques address withdrawal and facilitate
disclosure of contextual factors (e.g., depression, stigma, social
determinants) affecting follow-up. They also preserve rapport
and guide further targeted assessment.
Incorrect (A): Rushing into a ROS risks missing psychosocial
drivers; Bates warns that structured checklists without rapport
reduce accuracy.
Incorrect (C): Starting pharmacotherapy without assessment
ignores differential diagnoses and contextual factors
,recommended by Bates.
Incorrect (D): Immediate referral abandons the therapeutic
relationship and delays essential primary assessment steps that
Bates recommends the clinician perform first.
Teaching Point
Open-ended, reflective prompts uncover psychosocial barriers
and build rapport.
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 visit, a 68-year-old woman seems anxious
and repeatedly asks clarifying questions about consent. You
have 8 minutes before the OR schedule. According to Bates’
recommended structure for initiating the encounter, what is the
best immediate clinician strategy?
Options
A. Give brief reassurances and proceed quickly to signing the
consent.
, B. Pause to introduce yourself, explain your role, invite the
patient’s primary concerns, then focus the encounter.
C. Delegate consent discussion to nursing to save time.
D. Document minimal interaction and proceed—time pressures
justify efficiency.
Correct Answer
B
Rationales
Correct (B): Bates stresses that initiating the encounter includes
clear introductions, defining the clinician role, and eliciting the
patient's chief concerns—essential for informed consent and
reducing preoperative anxiety. This preserves autonomy and
clarifies priorities even when time-limited.
Incorrect (A): Reassurance without eliciting concerns risks
superficial consent and missed fears; Bates warns against
skipping introductions.
Incorrect (C): Delegation may be appropriate for some tasks but
not for addressing informed-consent questions requiring clinical
judgment.
Incorrect (D): Documentation alone can’t replace the ethical
and practical need to ensure understanding; Bates emphasizes
patient-centered initiation despite time constraints.
Teaching Point
Start with introductions, role clarity, and the patient's main
concerns even when time is limited.
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 — FOUNDATIONAL
SKILLS ESSENTIAL TO THE CLINICAL ENCOUNTER
APRN-Level Question Stem (2–4 sentences)
A 56-year-old man with poorly controlled diabetes presents for
a routine visit and appears withdrawn, answers questions
tersely, and avoids eye contact. You note partial missing follow-
up labs in the chart and he declines to discuss social supports.
Using Bates’ foundational communication skills, which initial
,clinician action best addresses the likely barrier to accurate
history-taking and builds therapeutic rapport?
Options
A. Continue the planned focused review of systems to save
time.
B. Use open-ended, nonjudgmental prompts and reflective
statements to explore concerns.
C. Offer immediate pharmacologic treatment for depression
without exploring context.
D. Refer directly to psychiatry and postpone further assessment
today.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes foundational communication
skills—open-ended questions, reflective listening, and
nonjudgmental prompts—to elicit patient concerns and social
barriers. These techniques address withdrawal and facilitate
disclosure of contextual factors (e.g., depression, stigma, social
determinants) affecting follow-up. They also preserve rapport
and guide further targeted assessment.
Incorrect (A): Rushing into a ROS risks missing psychosocial
drivers; Bates warns that structured checklists without rapport
reduce accuracy.
Incorrect (C): Starting pharmacotherapy without assessment
ignores differential diagnoses and contextual factors
,recommended by Bates.
Incorrect (D): Immediate referral abandons the therapeutic
relationship and delays essential primary assessment steps that
Bates recommends the clinician perform first.
Teaching Point
Open-ended, reflective prompts uncover psychosocial barriers
and build rapport.
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 visit, a 68-year-old woman seems anxious
and repeatedly asks clarifying questions about consent. You
have 8 minutes before the OR schedule. According to Bates’
recommended structure for initiating the encounter, what is the
best immediate clinician strategy?
Options
A. Give brief reassurances and proceed quickly to signing the
consent.
, B. Pause to introduce yourself, explain your role, invite the
patient’s primary concerns, then focus the encounter.
C. Delegate consent discussion to nursing to save time.
D. Document minimal interaction and proceed—time pressures
justify efficiency.
Correct Answer
B
Rationales
Correct (B): Bates stresses that initiating the encounter includes
clear introductions, defining the clinician role, and eliciting the
patient's chief concerns—essential for informed consent and
reducing preoperative anxiety. This preserves autonomy and
clarifies priorities even when time-limited.
Incorrect (A): Reassurance without eliciting concerns risks
superficial consent and missed fears; Bates warns against
skipping introductions.
Incorrect (C): Delegation may be appropriate for some tasks but
not for addressing informed-consent questions requiring clinical
judgment.
Incorrect (D): Documentation alone can’t replace the ethical
and practical need to ensure understanding; Bates emphasizes
patient-centered initiation despite time constraints.
Teaching Point
Start with introductions, role clarity, and the patient's main
concerns even when time is limited.
