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: An outpatient adult presents for a
new visit with poorly controlled diabetes. You observe the
patient avoiding eye contact, gives one-word answers, and their
companion frequently answers for them. Which initial clinician
strategy best aligns with Bates’ recommended approach to
initiating the encounter to improve information gathering and
rapport?
,Options:
A. Continue the current interview style and direct questions to
the companion for efficiency.
B. Pause, reintroduce yourself to the patient, explain
confidentiality, and invite the patient to speak for themselves.
C. Tell the companion to step out immediately and proceed with
a focused history without explanation.
D. Begin a physical exam first to reduce reliance on verbal
history.
Correct Answer: B
Rationale — Correct Option: Bates emphasizes a respectful,
patient-centered opening that establishes rapport and clarifies
roles. Reintroducing yourself and explaining confidentiality
empowers the patient, reduces companion domination, and
facilitates direct history-taking. This approach aligns with Stage
1 goals: build rapport and elicit patient concerns.
Rationale — Incorrect Options:
A. Delegating to the companion undermines patient autonomy
and may miss the patient's own priorities.
C. Dismissing the companion without explanation risks hostility
and violates Bates’ recommended respectful engagement.
D. Starting the exam bypasses the recommended sequence and
may miss context that guides focused exam maneuvers.
Teaching Point: Start by orienting and empowering the patient;
clarify confidentiality and invite their voice.
,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
2: Gathering Information
APRN-Level Question Stem: A 72-year-old with mild cognitive
impairment attends with a family member. The patient provides
inconsistent timelines about medication adherence. According
to Bates, which combination best preserves accuracy while
respecting patient autonomy when gathering history?
Options:
A. Rely solely on the family member’s history as they are more
reliable.
B. Ask brief, specific questions to the patient first, then use the
family member to fill gaps and confirm medication details.
C. Delay history-taking until a cognitive consultant is available.
D. Document only the family’s account, noting the patient’s
incompetence.
Correct Answer: B
Rationale — Correct Option: Bates recommends obtaining the
patient’s own account first to respect autonomy and then
corroborating with reliable informants when necessary. This
, dual approach yields more complete, ethically appropriate
information and supports shared decision-making.
Rationale — Incorrect Options:
A. Exclusively using the family member removes the patient’s
voice and risks bias.
C. Immediate delay is impractical and may compromise care;
Bates supports clinician adaptability.
D. Labeling a patient incompetent without assessment violates
ethical standards and Bates’ guidance.
Teaching Point: Ask the patient first; use corroboration to
confirm details and preserve autonomy.
Citation: Bickley et al., (2021). Ch. 1.
3)
Reference: Ch. 1 — Structure and Sequence — Stage 3:
Performing the Physical Examination
APRN-Level Question Stem: During a focused cardiovascular
exam for chest pain, you note bounding pulses and a wide pulse
pressure. According to Bates’ recommended sequence and
inspection-palpation-percussion-auscultation principles, which
immediate next step most effectively refines your assessment?
Options:
A. Proceed to full abdominal palpation unrelated to
cardiovascular complaint.
B. Auscultate the carotid arteries for bruits and listen for a
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: An outpatient adult presents for a
new visit with poorly controlled diabetes. You observe the
patient avoiding eye contact, gives one-word answers, and their
companion frequently answers for them. Which initial clinician
strategy best aligns with Bates’ recommended approach to
initiating the encounter to improve information gathering and
rapport?
,Options:
A. Continue the current interview style and direct questions to
the companion for efficiency.
B. Pause, reintroduce yourself to the patient, explain
confidentiality, and invite the patient to speak for themselves.
C. Tell the companion to step out immediately and proceed with
a focused history without explanation.
D. Begin a physical exam first to reduce reliance on verbal
history.
Correct Answer: B
Rationale — Correct Option: Bates emphasizes a respectful,
patient-centered opening that establishes rapport and clarifies
roles. Reintroducing yourself and explaining confidentiality
empowers the patient, reduces companion domination, and
facilitates direct history-taking. This approach aligns with Stage
1 goals: build rapport and elicit patient concerns.
Rationale — Incorrect Options:
A. Delegating to the companion undermines patient autonomy
and may miss the patient's own priorities.
C. Dismissing the companion without explanation risks hostility
and violates Bates’ recommended respectful engagement.
D. Starting the exam bypasses the recommended sequence and
may miss context that guides focused exam maneuvers.
Teaching Point: Start by orienting and empowering the patient;
clarify confidentiality and invite their voice.
,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
2: Gathering Information
APRN-Level Question Stem: A 72-year-old with mild cognitive
impairment attends with a family member. The patient provides
inconsistent timelines about medication adherence. According
to Bates, which combination best preserves accuracy while
respecting patient autonomy when gathering history?
Options:
A. Rely solely on the family member’s history as they are more
reliable.
B. Ask brief, specific questions to the patient first, then use the
family member to fill gaps and confirm medication details.
C. Delay history-taking until a cognitive consultant is available.
D. Document only the family’s account, noting the patient’s
incompetence.
Correct Answer: B
Rationale — Correct Option: Bates recommends obtaining the
patient’s own account first to respect autonomy and then
corroborating with reliable informants when necessary. This
, dual approach yields more complete, ethically appropriate
information and supports shared decision-making.
Rationale — Incorrect Options:
A. Exclusively using the family member removes the patient’s
voice and risks bias.
C. Immediate delay is impractical and may compromise care;
Bates supports clinician adaptability.
D. Labeling a patient incompetent without assessment violates
ethical standards and Bates’ guidance.
Teaching Point: Ask the patient first; use corroboration to
confirm details and preserve autonomy.
Citation: Bickley et al., (2021). Ch. 1.
3)
Reference: Ch. 1 — Structure and Sequence — Stage 3:
Performing the Physical Examination
APRN-Level Question Stem: During a focused cardiovascular
exam for chest pain, you note bounding pulses and a wide pulse
pressure. According to Bates’ recommended sequence and
inspection-palpation-percussion-auscultation principles, which
immediate next step most effectively refines your assessment?
Options:
A. Proceed to full abdominal palpation unrelated to
cardiovascular complaint.
B. Auscultate the carotid arteries for bruits and listen for a
