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. Ch. 1 — Structure and Sequence of the Clinical Encounter
— Stage 1: Initiating the Encounter
APRN-Level Question Stem
A 62-year-old man arrives late to clinic, visibly anxious,
clutching a hospital discharge summary. He says, “They said
everything’s okay,” but avoids eye contact and gives one-word
answers. Which initial clinician behavior best aligns with Bates’
recommended initiating approach to build rapport and elicit the
patient’s primary concerns?
Options
A. Begin the focused review of systems immediately to save
,time.
B. Use an open-ended empathic statement and allow the
patient to tell his story.
C. Ask direct yes/no questions about each symptom in the
discharge summary.
D. Refer immediately to the hospital record and summarize
findings for him.
Correct Answer
B
Rationales
Correct Option
B: Bates emphasizes establishing rapport, using open-ended
questions, and empathic statements at initiation to encourage
patient narrative and uncover concerns. An empathic opening
respects the patient’s affect and invites disclosure.
Incorrect Options
A: Jumping to ROS neglects rapport and can shut down
narrative; Bates discourages premature checklist behavior.
C: Direct yes/no questioning early limits narrative and misses
contextual psychosocial cues.
D: Summarizing records before hearing the patient’s view may
undermine trust and miss discrepancies between patient
experience and documentation.
Teaching Point
Open-ended empathy early elicits patient priorities and
uncovers hidden concerns.
,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 — Structure and Sequence of the Clinical Encounter
— Stage 2: Gathering Information
APRN-Level Question Stem
A 28-year-old woman presents with intermittent palpitations
and fatigue. During history taking, she spontaneously mentions
job loss and housing instability. According to Bates’ approach,
what is the most appropriate way to integrate these social
determinants into the clinical assessment?
Options
A. Record them in social history but avoid affecting medical
decision-making.
B. Explore these issues briefly, then defer detailed social work
screening to later.
C. Elicit specifics about housing, employment, and their impact
on health, integrating them into diagnosis and plan.
D. Focus solely on cardiopulmonary review because social
issues are outside scope.
Correct Answer
C
, Rationales
Correct Option
C: Bates stresses that social determinants are integral to
diagnosis and management; clinicians should assess specifics
and connect them to health risks and care planning. Integration
guides realistic treatment choices and referrals.
Incorrect Options
A: Treating SDOH as peripheral misses their causal impact on
symptoms and adherence.
B: Deferring may lose opportunity for immediate risk mitigation
and shared decision-making.
D: Ignoring social context violates Bates’ holistic assessment
framework.
Teaching Point
Assess SDOH concretely and incorporate them into diagnosis,
risk assessment, and care planning.
Citation
Bickley et al. (2021). Bates’ Guide... Ch. 1.
3. Reference
Ch. 1 — Foundational Skills Essential to the Clinical
Encounter — Communication & Listening Skills
APRN-Level Question Stem
A 45-year-old patient with chronic pain presents with guarded
speech and repeated interruptions by an anxious spouse who
EXAMINATION AND HISTORY TAKING
13TH EDITION
• AUTHOR(S)LYNN S. BICKLEY; PETER
G. SZILAGYI; RICHARD M. HOFFMAN;
RAINIER P. SORIANO
TEST BANK
1. Ch. 1 — Structure and Sequence of the Clinical Encounter
— Stage 1: Initiating the Encounter
APRN-Level Question Stem
A 62-year-old man arrives late to clinic, visibly anxious,
clutching a hospital discharge summary. He says, “They said
everything’s okay,” but avoids eye contact and gives one-word
answers. Which initial clinician behavior best aligns with Bates’
recommended initiating approach to build rapport and elicit the
patient’s primary concerns?
Options
A. Begin the focused review of systems immediately to save
,time.
B. Use an open-ended empathic statement and allow the
patient to tell his story.
C. Ask direct yes/no questions about each symptom in the
discharge summary.
D. Refer immediately to the hospital record and summarize
findings for him.
Correct Answer
B
Rationales
Correct Option
B: Bates emphasizes establishing rapport, using open-ended
questions, and empathic statements at initiation to encourage
patient narrative and uncover concerns. An empathic opening
respects the patient’s affect and invites disclosure.
Incorrect Options
A: Jumping to ROS neglects rapport and can shut down
narrative; Bates discourages premature checklist behavior.
C: Direct yes/no questioning early limits narrative and misses
contextual psychosocial cues.
D: Summarizing records before hearing the patient’s view may
undermine trust and miss discrepancies between patient
experience and documentation.
Teaching Point
Open-ended empathy early elicits patient priorities and
uncovers hidden concerns.
,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 — Structure and Sequence of the Clinical Encounter
— Stage 2: Gathering Information
APRN-Level Question Stem
A 28-year-old woman presents with intermittent palpitations
and fatigue. During history taking, she spontaneously mentions
job loss and housing instability. According to Bates’ approach,
what is the most appropriate way to integrate these social
determinants into the clinical assessment?
Options
A. Record them in social history but avoid affecting medical
decision-making.
B. Explore these issues briefly, then defer detailed social work
screening to later.
C. Elicit specifics about housing, employment, and their impact
on health, integrating them into diagnosis and plan.
D. Focus solely on cardiopulmonary review because social
issues are outside scope.
Correct Answer
C
, Rationales
Correct Option
C: Bates stresses that social determinants are integral to
diagnosis and management; clinicians should assess specifics
and connect them to health risks and care planning. Integration
guides realistic treatment choices and referrals.
Incorrect Options
A: Treating SDOH as peripheral misses their causal impact on
symptoms and adherence.
B: Deferring may lose opportunity for immediate risk mitigation
and shared decision-making.
D: Ignoring social context violates Bates’ holistic assessment
framework.
Teaching Point
Assess SDOH concretely and incorporate them into diagnosis,
risk assessment, and care planning.
Citation
Bickley et al. (2021). Bates’ Guide... Ch. 1.
3. Reference
Ch. 1 — Foundational Skills Essential to the Clinical
Encounter — Communication & Listening Skills
APRN-Level Question Stem
A 45-year-old patient with chronic pain presents with guarded
speech and repeated interruptions by an anxious spouse who
