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 — FOUNDATIONAL
SKILLS ESSENTIAL TO THE CLINICAL ENCOUNTER
APRN-Level Question Stem
A 62-year-old man with poorly controlled diabetes arrives for a
routine visit. He appears anxious, keeps glancing at his phone,
and initially answers yes/no to questions without elaboration.
The patient is on time; his vitals are stable. Which clinician
action best applies Bates’ foundational skills to optimize
information gathering and trust at this encounter’s start?
,Options
A. Quickly confirm medications, then proceed directly to
focused exam to respect his time.
B. Use an open-ended lead and allow a brief silence before
asking targeted questions.
C. Ask only closed questions to avoid increasing anxiety and
speed the visit.
D. Tell him to put away his phone and continue with the history.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes initiating the encounter with
open-ended prompts and allowing silence to let patients
organize their narrative; this fosters rapport, elicits richer
history, and reduces anxiety.
A: Skipping relational opening risks missing context and
psychosocial clues Bates recommends.
C: Closed questions limit diagnostic information and impair
pattern recognition.
D: Demanding behavior without rapport can increase
resistance; Bates suggests collaborative rules.
Teaching Point
Open prompts + silence encourage patient narratives and richer
diagnostic clues.
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 — STRUCTURE AND
SEQUENCE OF THE CLINICAL ENCOUNTER — Stage 1: Initiating
the Encounter
APRN-Level Question Stem
A 28-year-old woman presents for contraceptive counseling.
She seems reserved and avoids eye contact. You note cultural
differences in communication. According to Bates’
recommended Stage 1 practices, what initial approach best
balances efficiency and cultural humility?
Options
A. Begin with direct questions about contraception to be
efficient.
B. Use a brief culturally neutral statement of purpose, invite
questions, and ask how she prefers to be addressed.
C. Assume silence indicates lack of interest and end the
encounter early.
D. Refer immediately to another clinician from her cultural
group.
Correct Answer
B
, Rationales
Correct (B): Bates recommends clarifying visit purpose, using
respectful introductions, and inquiring about preferences —
core to initiating encounters and cultural humility.
A: Jumping into topic may bypass rapport and culturally
influenced concerns.
C: Misreading silence can miss important barriers; Bates advises
exploration.
D: Immediate referral may fragment care; first ask patient
preference.
Teaching Point
State visit purpose; invite preferences to respect culture and
build rapport.
Citation
Bickley et al. (2021). Ch. 1.
3
Reference
Ch. 1 — Approach to the Clinical Encounter — Stage 2:
Gathering Information
APRN-Level Question Stem
During a complex multi-system complaint, a 47-year-old man
gives an 8-minute chronological story, including psychosocial
stressors. Based on Bates’ guidance for gathering information,
what is the best next step to refine differential diagnosis?
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 — FOUNDATIONAL
SKILLS ESSENTIAL TO THE CLINICAL ENCOUNTER
APRN-Level Question Stem
A 62-year-old man with poorly controlled diabetes arrives for a
routine visit. He appears anxious, keeps glancing at his phone,
and initially answers yes/no to questions without elaboration.
The patient is on time; his vitals are stable. Which clinician
action best applies Bates’ foundational skills to optimize
information gathering and trust at this encounter’s start?
,Options
A. Quickly confirm medications, then proceed directly to
focused exam to respect his time.
B. Use an open-ended lead and allow a brief silence before
asking targeted questions.
C. Ask only closed questions to avoid increasing anxiety and
speed the visit.
D. Tell him to put away his phone and continue with the history.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes initiating the encounter with
open-ended prompts and allowing silence to let patients
organize their narrative; this fosters rapport, elicits richer
history, and reduces anxiety.
A: Skipping relational opening risks missing context and
psychosocial clues Bates recommends.
C: Closed questions limit diagnostic information and impair
pattern recognition.
D: Demanding behavior without rapport can increase
resistance; Bates suggests collaborative rules.
Teaching Point
Open prompts + silence encourage patient narratives and richer
diagnostic clues.
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 — STRUCTURE AND
SEQUENCE OF THE CLINICAL ENCOUNTER — Stage 1: Initiating
the Encounter
APRN-Level Question Stem
A 28-year-old woman presents for contraceptive counseling.
She seems reserved and avoids eye contact. You note cultural
differences in communication. According to Bates’
recommended Stage 1 practices, what initial approach best
balances efficiency and cultural humility?
Options
A. Begin with direct questions about contraception to be
efficient.
B. Use a brief culturally neutral statement of purpose, invite
questions, and ask how she prefers to be addressed.
C. Assume silence indicates lack of interest and end the
encounter early.
D. Refer immediately to another clinician from her cultural
group.
Correct Answer
B
, Rationales
Correct (B): Bates recommends clarifying visit purpose, using
respectful introductions, and inquiring about preferences —
core to initiating encounters and cultural humility.
A: Jumping into topic may bypass rapport and culturally
influenced concerns.
C: Misreading silence can miss important barriers; Bates advises
exploration.
D: Immediate referral may fragment care; first ask patient
preference.
Teaching Point
State visit purpose; invite preferences to respect culture and
build rapport.
Citation
Bickley et al. (2021). Ch. 1.
3
Reference
Ch. 1 — Approach to the Clinical Encounter — Stage 2:
Gathering Information
APRN-Level Question Stem
During a complex multi-system complaint, a 47-year-old man
gives an 8-minute chronological story, including psychosocial
stressors. Based on Bates’ guidance for gathering information,
what is the best next step to refine differential diagnosis?
