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
A 52-year-old man arrives for a new-patient visit and appears
anxious; he avoids eye contact and speaks in clipped sentences.
He has limited English and brings a nephew who offers to
interpret. You need to begin the encounter. Which initial
,approach best follows Bates’ recommendations to ensure
accurate history and respectful patient-centered
communication?
Options
A. Accept the nephew as interpreter and begin the history to
build rapport quickly.
B. Ask the nephew to translate but confirm with the patient
directly using short yes/no questions.
C. Request a professional medical interpreter and begin with an
open-ended question directly addressed to the patient.
D. Proceed with the nephew as translator but avoid sensitive
topics.
Correct Answer
C
Rationales
Correct Option
Bates emphasizes initiating the encounter with patient-centered
communication and using professional interpreters when
language barriers exist to ensure accuracy and confidentiality. A
professional interpreter allows the clinician to address the
patient directly with open-ended questions, building rapport
and eliciting a richer history.
Incorrect Options
A. Using a family member risks inaccurate translation and
breaches confidentiality; Bates advises against this for clinical
complexity.
,B. Short yes/no questions directed through a family member
limit depth and can miss key information; Bates promotes open-
ended questions through a professional interpreter.
D. Avoiding sensitive topics with a family translator perpetuates
incomplete assessment and may miss red flags.
Teaching Point
Use professional interpreters; address the patient directly with
open-ended prompts.
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 — Foundational
Skills Essential to the Clinical Encounter
APRN-Level Question Stem
A 34-year-old woman with chronic abdominal pain repeatedly
interrupts you and insists on specific imaging. You’ve completed
general history but need to gather a focused pain history and
perform the exam. Which communication technique best aligns
with Bates’ foundational skills to manage interruptions while
obtaining clinically useful information?
, Options
A. Allow her to continue uninterrupted to avoid damaging
rapport.
B. Politely acknowledge her concern, set an agenda, then
redirect to an open-ended pain history.
C. Tell her firmly to wait until you finish asking questions.
D. Ignore interruptions and continue your scripted questions.
Correct Answer
B
Rationales
Correct Option
Bates recommends setting the visit agenda and negotiating
time for patient concerns while maintaining a structured
history. Acknowledging concerns preserves rapport and
redirecting to open-ended questions yields richer diagnostic
data.
Incorrect Options
A. Unstructured monologue may miss focused clinical data
necessary for differential diagnosis.
C. A firm rebuke may damage rapport; Bates favors
collaborative agenda setting.
D. Rigid scripts ignore patient priorities and reduce diagnostic
yield.
Teaching Point
Set the agenda: acknowledge concerns then redirect to
focused, open-ended history.
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
A 52-year-old man arrives for a new-patient visit and appears
anxious; he avoids eye contact and speaks in clipped sentences.
He has limited English and brings a nephew who offers to
interpret. You need to begin the encounter. Which initial
,approach best follows Bates’ recommendations to ensure
accurate history and respectful patient-centered
communication?
Options
A. Accept the nephew as interpreter and begin the history to
build rapport quickly.
B. Ask the nephew to translate but confirm with the patient
directly using short yes/no questions.
C. Request a professional medical interpreter and begin with an
open-ended question directly addressed to the patient.
D. Proceed with the nephew as translator but avoid sensitive
topics.
Correct Answer
C
Rationales
Correct Option
Bates emphasizes initiating the encounter with patient-centered
communication and using professional interpreters when
language barriers exist to ensure accuracy and confidentiality. A
professional interpreter allows the clinician to address the
patient directly with open-ended questions, building rapport
and eliciting a richer history.
Incorrect Options
A. Using a family member risks inaccurate translation and
breaches confidentiality; Bates advises against this for clinical
complexity.
,B. Short yes/no questions directed through a family member
limit depth and can miss key information; Bates promotes open-
ended questions through a professional interpreter.
D. Avoiding sensitive topics with a family translator perpetuates
incomplete assessment and may miss red flags.
Teaching Point
Use professional interpreters; address the patient directly with
open-ended prompts.
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 — Foundational
Skills Essential to the Clinical Encounter
APRN-Level Question Stem
A 34-year-old woman with chronic abdominal pain repeatedly
interrupts you and insists on specific imaging. You’ve completed
general history but need to gather a focused pain history and
perform the exam. Which communication technique best aligns
with Bates’ foundational skills to manage interruptions while
obtaining clinically useful information?
, Options
A. Allow her to continue uninterrupted to avoid damaging
rapport.
B. Politely acknowledge her concern, set an agenda, then
redirect to an open-ended pain history.
C. Tell her firmly to wait until you finish asking questions.
D. Ignore interruptions and continue your scripted questions.
Correct Answer
B
Rationales
Correct Option
Bates recommends setting the visit agenda and negotiating
time for patient concerns while maintaining a structured
history. Acknowledging concerns preserves rapport and
redirecting to open-ended questions yields richer diagnostic
data.
Incorrect Options
A. Unstructured monologue may miss focused clinical data
necessary for differential diagnosis.
C. A firm rebuke may damage rapport; Bates favors
collaborative agenda setting.
D. Rigid scripts ignore patient priorities and reduce diagnostic
yield.
Teaching Point
Set the agenda: acknowledge concerns then redirect to
focused, open-ended history.
