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 62-year-old male with multiple chronic conditions arrives
visibly anxious and avoids eye contact while a family member
answers most questions. You note the patient’s chart lists
hearing impairment. Using Bates’ recommended initial
approach, what is the best immediate strategy to build rapport
and obtain accurate history?
,Options
A. Continue to direct questions to the family member to
expedite the visit.
B. Pause, reintroduce yourself to the patient, and arrange
seating and communication aids before proceeding.
C. Tell the family member to step out and conduct the interview
without them present.
D. Begin the physical exam and defer history to the end to
reduce patient stress.
Correct Answer
B
Rationales
Correct Option
Bates emphasizes initiating the encounter by reintroducing
yourself, establishing patient-centered rapport, and addressing
environmental/communication needs (e.g., seating, hearing
aids) to facilitate accurate information. Pausing and arranging
accommodations respects autonomy and improves data quality.
This approach reduces reliance on third-party reporting and
aligns with patient-centered communication.
Incorrect Options
A. Directing questions to family undermines patient autonomy
and may produce second-hand history inconsistent with Bates’
patient-centered initiation.
C. Forcibly excluding family may violate patient preference and
cultural norms; Bates recommends negotiation rather than
,assumption.
D. Beginning the exam before addressing communication needs
risks missing key history and ignores Bates’ structured sequence
of the encounter.
Teaching Point
Address communication needs and reintroduce yourself to
center the patient.
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
APRN-Level Question Stem
A 28-year-old pregnant woman presents for a prenatal visit and
mentions intermittent abdominal cramping. Her verbal history
is limited by time constraints and EMR templates. According to
Bates’ guidance on gathering information, which approach best
balances open-ended data collection with efficient
documentation?
Options
A. Rely solely on the structured EMR template to ensure billing
, completeness.
B. Start with a focused open-ended question, then use targeted
directed questions and document succinctly.
C. Skip history and proceed straight to ordering labs based on
standard prenatal protocols.
D. Ask only “yes/no” questions to save time and then complete
the physical exam.
Correct Answer
B
Rationales
Correct Option
Bates recommends beginning with open-ended questions to
elicit the patient’s narrative, followed by targeted questioning
to clarify items and direct exam focus. This preserves clinical
reasoning while allowing efficient documentation. The
combined approach reduces missed cues and supports
diagnostic synthesis.
Incorrect Options
A. Overreliance on templates can miss the patient’s story and
subtle red flags that Bates warns against.
C. Skipping history undermines patient safety and contradicts
Bates’ sequence of care.
D. Yes/no questioning limits diagnostic information and may
miss relevant context.
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 62-year-old male with multiple chronic conditions arrives
visibly anxious and avoids eye contact while a family member
answers most questions. You note the patient’s chart lists
hearing impairment. Using Bates’ recommended initial
approach, what is the best immediate strategy to build rapport
and obtain accurate history?
,Options
A. Continue to direct questions to the family member to
expedite the visit.
B. Pause, reintroduce yourself to the patient, and arrange
seating and communication aids before proceeding.
C. Tell the family member to step out and conduct the interview
without them present.
D. Begin the physical exam and defer history to the end to
reduce patient stress.
Correct Answer
B
Rationales
Correct Option
Bates emphasizes initiating the encounter by reintroducing
yourself, establishing patient-centered rapport, and addressing
environmental/communication needs (e.g., seating, hearing
aids) to facilitate accurate information. Pausing and arranging
accommodations respects autonomy and improves data quality.
This approach reduces reliance on third-party reporting and
aligns with patient-centered communication.
Incorrect Options
A. Directing questions to family undermines patient autonomy
and may produce second-hand history inconsistent with Bates’
patient-centered initiation.
C. Forcibly excluding family may violate patient preference and
cultural norms; Bates recommends negotiation rather than
,assumption.
D. Beginning the exam before addressing communication needs
risks missing key history and ignores Bates’ structured sequence
of the encounter.
Teaching Point
Address communication needs and reintroduce yourself to
center the patient.
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
APRN-Level Question Stem
A 28-year-old pregnant woman presents for a prenatal visit and
mentions intermittent abdominal cramping. Her verbal history
is limited by time constraints and EMR templates. According to
Bates’ guidance on gathering information, which approach best
balances open-ended data collection with efficient
documentation?
Options
A. Rely solely on the structured EMR template to ensure billing
, completeness.
B. Start with a focused open-ended question, then use targeted
directed questions and document succinctly.
C. Skip history and proceed straight to ordering labs based on
standard prenatal protocols.
D. Ask only “yes/no” questions to save time and then complete
the physical exam.
Correct Answer
B
Rationales
Correct Option
Bates recommends beginning with open-ended questions to
elicit the patient’s narrative, followed by targeted questioning
to clarify items and direct exam focus. This preserves clinical
reasoning while allowing efficient documentation. The
combined approach reduces missed cues and supports
diagnostic synthesis.
Incorrect Options
A. Overreliance on templates can miss the patient’s story and
subtle red flags that Bates warns against.
C. Skipping history undermines patient safety and contradicts
Bates’ sequence of care.
D. Yes/no questioning limits diagnostic information and may
miss relevant context.
