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 — Structure and
Sequence of the Clinical Encounter: Stage 1: Initiating the
Encounter
Stem
A 56-year-old man arrives for a new-patient visit for poorly
controlled hypertension. He appears withdrawn and avoids eye
contact while filling the intake form. You begin the encounter
and must rapidly build rapport to obtain a reliable history.
Which initial approach best aligns with Bates’ recommendations
,to foster a patient-centered opening while detecting barriers to
communication?
Options
A. Provide a brief scripted introduction, state the agenda, and
immediately ask about his main concern.
B. Give a warm greeting, confirm the patient’s preferred name
and pronouns, and ask an open invitation question about his
health priorities.
C. Start with focused questions about medication adherence
and side effects, deferring psychosocial topics until later.
D. Explain clinic policies and expected visit length before asking
any personal questions to set boundaries.
Correct Answer
B
Rationales — Correct Option
Bates emphasizes a warm, respectful opening that establishes
rapport and an open invitation to the patient’s concerns.
Confirming preferred name/pronouns and asking open
invitation questions promotes patient-centered communication
and reveals potential social/contextual issues affecting
hypertension care. This approach aligns with Stage 1 goals of
initiating the encounter and reducing barriers.
Rationales — Incorrect Options
A. A scripted introduction and immediate agenda-setting may
feel impersonal and can miss patient priorities; Bates favors
personalization first.
,C. Beginning narrowly about meds risks missing psychosocial
contributors to adherence; Bates recommends open invitations
early.
D. Leading with clinic logistics may inhibit trust and reduce
empathy; logistics are appropriate after rapport is established.
Teaching Point
Start with warmth, preferred identifiers, and open invitations to
reveal priorities and barriers.
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 2:
Gathering Information
Stem
A 28-year-old woman presents with intermittent palpitations.
Her history includes anxiety but she downplays psychosocial
stressors. While gathering information you note inconsistent
answers between her verbal report and the intake form
completed online. According to Bates’ approach, what
technique most effectively reconciles conflicting data and
uncovers relevant context?
, Options
A. Confront the patient directly about discrepancies to obtain
truthful answers.
B. Use summarization and a neutral follow-up question about
the differences, inviting clarification.
C. Ignore the discrepancy and proceed to physical examination
to avoid discomfort.
D. Ask closed yes/no questions about each item on the intake
form to force consistency.
Correct Answer
B
Rationales — Correct Option
Bates recommends summarizing and using neutral,
nonjudgmental follow-up to reconcile conflicting information.
This technique reduces defensiveness, invites patient
clarification of context or reasons for discrepancies, and
improves accuracy of the history—essential for correct
diagnostic reasoning.
Rationales — Incorrect Options
A. Confrontation increases defensiveness and reduces
disclosure; Bates discourages accusatory approaches.
C. Ignoring conflicts risks diagnostic error by relying on
inaccurate data.
D. Closed questions may produce superficial agreement without
exploring reasons for the discrepancy.
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 — Structure and
Sequence of the Clinical Encounter: Stage 1: Initiating the
Encounter
Stem
A 56-year-old man arrives for a new-patient visit for poorly
controlled hypertension. He appears withdrawn and avoids eye
contact while filling the intake form. You begin the encounter
and must rapidly build rapport to obtain a reliable history.
Which initial approach best aligns with Bates’ recommendations
,to foster a patient-centered opening while detecting barriers to
communication?
Options
A. Provide a brief scripted introduction, state the agenda, and
immediately ask about his main concern.
B. Give a warm greeting, confirm the patient’s preferred name
and pronouns, and ask an open invitation question about his
health priorities.
C. Start with focused questions about medication adherence
and side effects, deferring psychosocial topics until later.
D. Explain clinic policies and expected visit length before asking
any personal questions to set boundaries.
Correct Answer
B
Rationales — Correct Option
Bates emphasizes a warm, respectful opening that establishes
rapport and an open invitation to the patient’s concerns.
Confirming preferred name/pronouns and asking open
invitation questions promotes patient-centered communication
and reveals potential social/contextual issues affecting
hypertension care. This approach aligns with Stage 1 goals of
initiating the encounter and reducing barriers.
Rationales — Incorrect Options
A. A scripted introduction and immediate agenda-setting may
feel impersonal and can miss patient priorities; Bates favors
personalization first.
,C. Beginning narrowly about meds risks missing psychosocial
contributors to adherence; Bates recommends open invitations
early.
D. Leading with clinic logistics may inhibit trust and reduce
empathy; logistics are appropriate after rapport is established.
Teaching Point
Start with warmth, preferred identifiers, and open invitations to
reveal priorities and barriers.
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 2:
Gathering Information
Stem
A 28-year-old woman presents with intermittent palpitations.
Her history includes anxiety but she downplays psychosocial
stressors. While gathering information you note inconsistent
answers between her verbal report and the intake form
completed online. According to Bates’ approach, what
technique most effectively reconciles conflicting data and
uncovers relevant context?
, Options
A. Confront the patient directly about discrepancies to obtain
truthful answers.
B. Use summarization and a neutral follow-up question about
the differences, inviting clarification.
C. Ignore the discrepancy and proceed to physical examination
to avoid discomfort.
D. Ask closed yes/no questions about each item on the intake
form to force consistency.
Correct Answer
B
Rationales — Correct Option
Bates recommends summarizing and using neutral,
nonjudgmental follow-up to reconcile conflicting information.
This technique reduces defensiveness, invites patient
clarification of context or reasons for discrepancies, and
improves accuracy of the history—essential for correct
diagnostic reasoning.
Rationales — Incorrect Options
A. Confrontation increases defensiveness and reduces
disclosure; Bates discourages accusatory approaches.
C. Ignoring conflicts risks diagnostic error by relying on
inaccurate data.
D. Closed questions may produce superficial agreement without
exploring reasons for the discrepancy.
