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
Stem
A 56-year-old man arrives for a new-patient visit and appears
anxious, avoiding eye contact and giving one-word answers. He
says, “I don’t have much time.” You need to establish rapport
and gather a focused history. What is the best initial clinician
response?
,Options
A. Begin a rapid, targeted review of systems to save time.
B. Acknowledge his anxiety and open with an invitation: “I know
visits are stressful—what concerns you most today?”
C. State the clinic time constraints and ask him to summarize his
problem in one sentence.
D. Proceed directly to physical exam since he seems short on
words.
Correct Answer
B
Rationales
Correct Option: A Bates-based initiating encounter strategy
emphasizes empathy and an open invitation to elicit concerns;
acknowledging anxiety reduces barriers and elicits priorities,
improving information gathering.
A: Rapid ROS violates Bates’ first stage—may miss patient
priorities and undermine rapport.
C: Emphasizing constraints shifts focus away from patient,
hindering trust and full disclosure.
D: Skipping the history neglects Bates’ recommended sequence;
exam without context reduces diagnostic yield.
Teaching Point
Acknowledge emotion and invite concerns to prioritize the visit.
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
Stem
A bilingual 32-year-old woman with limited English arrives with
abdominal pain. Her adult son offers to translate. You must
obtain a reliable history. According to Bates’ approach, what is
the best step?
Options
A. Use the son as interpreter to speed care since he seems
fluent.
B. Ask the son to translate only basic details and rely on
nonverbal cues yourself.
C. Arrange a professional interpreter and ask the son to step
back during the interview.
D. Decline an interpreter and use simplified English with
gestures.
Correct Answer
C
Rationales
Correct Option: Bates emphasizes using professional
, interpreters to avoid errors, preserve confidentiality, and ensure
accurate history and informed consent; family members can
bias or omit details.
A: Family interpreters risk omissions, inaccuracies, and breach
of privacy—contrary to best practice.
B: Partial use still permits bias and may miss sensitive
information; Bates recommends professional interpretation.
D: Simplified speech risks misunderstanding and incomplete
history.
Teaching Point
Use trained interpreters to ensure accuracy, confidentiality, and
complete histories.
Citation
Bickley et al. (2021). Ch. 1.
3
Reference
Ch. 1 — Structure and Sequence of the Clinical Encounter —
Stage 3: Performing the Physical Examination
Stem
A 40-year-old patient with chest discomfort requests that only a
same-gender provider examine him. He is assigned to you
(different gender). You must respect preferences while
completing a focused cardiac exam. What is the best action?
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
Stem
A 56-year-old man arrives for a new-patient visit and appears
anxious, avoiding eye contact and giving one-word answers. He
says, “I don’t have much time.” You need to establish rapport
and gather a focused history. What is the best initial clinician
response?
,Options
A. Begin a rapid, targeted review of systems to save time.
B. Acknowledge his anxiety and open with an invitation: “I know
visits are stressful—what concerns you most today?”
C. State the clinic time constraints and ask him to summarize his
problem in one sentence.
D. Proceed directly to physical exam since he seems short on
words.
Correct Answer
B
Rationales
Correct Option: A Bates-based initiating encounter strategy
emphasizes empathy and an open invitation to elicit concerns;
acknowledging anxiety reduces barriers and elicits priorities,
improving information gathering.
A: Rapid ROS violates Bates’ first stage—may miss patient
priorities and undermine rapport.
C: Emphasizing constraints shifts focus away from patient,
hindering trust and full disclosure.
D: Skipping the history neglects Bates’ recommended sequence;
exam without context reduces diagnostic yield.
Teaching Point
Acknowledge emotion and invite concerns to prioritize the visit.
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
Stem
A bilingual 32-year-old woman with limited English arrives with
abdominal pain. Her adult son offers to translate. You must
obtain a reliable history. According to Bates’ approach, what is
the best step?
Options
A. Use the son as interpreter to speed care since he seems
fluent.
B. Ask the son to translate only basic details and rely on
nonverbal cues yourself.
C. Arrange a professional interpreter and ask the son to step
back during the interview.
D. Decline an interpreter and use simplified English with
gestures.
Correct Answer
C
Rationales
Correct Option: Bates emphasizes using professional
, interpreters to avoid errors, preserve confidentiality, and ensure
accurate history and informed consent; family members can
bias or omit details.
A: Family interpreters risk omissions, inaccuracies, and breach
of privacy—contrary to best practice.
B: Partial use still permits bias and may miss sensitive
information; Bates recommends professional interpretation.
D: Simplified speech risks misunderstanding and incomplete
history.
Teaching Point
Use trained interpreters to ensure accuracy, confidentiality, and
complete histories.
Citation
Bickley et al. (2021). Ch. 1.
3
Reference
Ch. 1 — Structure and Sequence of the Clinical Encounter —
Stage 3: Performing the Physical Examination
Stem
A 40-year-old patient with chest discomfort requests that only a
same-gender provider examine him. He is assigned to you
(different gender). You must respect preferences while
completing a focused cardiac exam. What is the best action?
