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 — Structure and Sequence of the Clinical Encounter —
Stage 1: Initiating the Encounter
APRN-Level Stem
A 54-year-old man arrives for a new-patient visit. He appears
anxious, sits hunched, and answers questions tersely. You must
quickly establish rapport and identify chief concerns while
ensuring informed consent for the physical exam. What is the
best next step?
,Options
A. Begin the head-to-toe physical exam to save time.
B. Ask an open-ended question about his main concern and
offer a brief agenda-setting statement.
C. Explain all clinic policies before asking clinical questions.
D. Immediately request his full medical record before
interacting further.
Correct Answer
B
Rationales
Correct Option — B: Bates emphasizes initiating with rapport,
open-ended questions, and agenda-setting to identify patient
priorities and build trust; this addresses anxiety and guides
focused exam planning.
A: Beginning the exam without eliciting concerns undermines
rapport and may miss key history.
C: Explaining policies first can appear impersonal and delay
clinical engagement.
D: Requesting records before any interaction ignores the
patient's immediate emotional state and misses agenda-setting.
Teaching Point
Start with open-ended questions and a brief agenda to build
rapport and focus the encounter.
Citation
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P.
(2021). Bates’ Guide… Ch. 1.
,2
Reference
Ch. 1 — Structure and Sequence of the Clinical Encounter —
Stage 2: Gathering Information
APRN-Level Stem
A 28-year-old woman with poorly documented asthma presents
with intermittent dyspnea. During history, she volunteers use of
traditional herbal powders at home. How should an APRN
integrate this information into diagnostic reasoning and plan?
Options
A. Dismiss herbal use as irrelevant to asthma management.
B. Document the use, ask about ingredients and administration,
and assess for interactions/allergen exposure.
C. Insist she immediately discontinue all herbal products before
treatment.
D. Substitute herbal therapy with a different over-the-counter
remedy.
Correct Answer
B
Rationales
Correct Option — B: Bates stresses thorough history including
complementary therapies; APRNs must probe ingredients,
routes, timing, and possible interactions or allergenic exposures
influencing respiratory symptoms.
, A: Dismissing misses potential causes and harms.
C: Demanding cessation without understanding risks may
damage rapport and adherence.
D: Recommending an alternative OTC without evidence or
assessment is inappropriate.
Teaching Point
Always ask specifics about complementary therapies — route,
dose, frequency, and timing.
Citation
Bickley et al. (2021). Bates’ Guide… Ch. 1.
3
Reference
Ch. 1 — Structure and Sequence of the Clinical Encounter —
Stage 3: Performing the Physical Examination
APRN-Level Stem
A 66-year-old diabetic patient reports numbness in feet. On
exam you must choose exam sequence to efficiently detect
neuropathy while maintaining dignity and safety. Which
approach aligns with Bates’ recommended exam sequence and
rationale?
Options
A. Begin with invasive lower-extremity testing (vibration) before
general inspection.
B. Start with general inspection, then sensory testing
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 — Structure and Sequence of the Clinical Encounter —
Stage 1: Initiating the Encounter
APRN-Level Stem
A 54-year-old man arrives for a new-patient visit. He appears
anxious, sits hunched, and answers questions tersely. You must
quickly establish rapport and identify chief concerns while
ensuring informed consent for the physical exam. What is the
best next step?
,Options
A. Begin the head-to-toe physical exam to save time.
B. Ask an open-ended question about his main concern and
offer a brief agenda-setting statement.
C. Explain all clinic policies before asking clinical questions.
D. Immediately request his full medical record before
interacting further.
Correct Answer
B
Rationales
Correct Option — B: Bates emphasizes initiating with rapport,
open-ended questions, and agenda-setting to identify patient
priorities and build trust; this addresses anxiety and guides
focused exam planning.
A: Beginning the exam without eliciting concerns undermines
rapport and may miss key history.
C: Explaining policies first can appear impersonal and delay
clinical engagement.
D: Requesting records before any interaction ignores the
patient's immediate emotional state and misses agenda-setting.
Teaching Point
Start with open-ended questions and a brief agenda to build
rapport and focus the encounter.
Citation
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P.
(2021). Bates’ Guide… Ch. 1.
,2
Reference
Ch. 1 — Structure and Sequence of the Clinical Encounter —
Stage 2: Gathering Information
APRN-Level Stem
A 28-year-old woman with poorly documented asthma presents
with intermittent dyspnea. During history, she volunteers use of
traditional herbal powders at home. How should an APRN
integrate this information into diagnostic reasoning and plan?
Options
A. Dismiss herbal use as irrelevant to asthma management.
B. Document the use, ask about ingredients and administration,
and assess for interactions/allergen exposure.
C. Insist she immediately discontinue all herbal products before
treatment.
D. Substitute herbal therapy with a different over-the-counter
remedy.
Correct Answer
B
Rationales
Correct Option — B: Bates stresses thorough history including
complementary therapies; APRNs must probe ingredients,
routes, timing, and possible interactions or allergenic exposures
influencing respiratory symptoms.
, A: Dismissing misses potential causes and harms.
C: Demanding cessation without understanding risks may
damage rapport and adherence.
D: Recommending an alternative OTC without evidence or
assessment is inappropriate.
Teaching Point
Always ask specifics about complementary therapies — route,
dose, frequency, and timing.
Citation
Bickley et al. (2021). Bates’ Guide… Ch. 1.
3
Reference
Ch. 1 — Structure and Sequence of the Clinical Encounter —
Stage 3: Performing the Physical Examination
APRN-Level Stem
A 66-year-old diabetic patient reports numbness in feet. On
exam you must choose exam sequence to efficiently detect
neuropathy while maintaining dignity and safety. Which
approach aligns with Bates’ recommended exam sequence and
rationale?
Options
A. Begin with invasive lower-extremity testing (vibration) before
general inspection.
B. Start with general inspection, then sensory testing
