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
Stem
A 62-year-old man arrives for a new-patient visit. He appears
anxious and speaks quickly. You have 5 minutes before the
schedule behind you becomes critical. Which opening approach
,best aligns with Bates’ recommended initiating techniques to
build rapport while gathering essential context for a safe visit?
Options
A. Begin with a rapid biomedical checklist focused on
cardiopulmonary symptoms to save time.
B. Use a brief open-ended opener (“What brings you in
today?”), then acknowledge emotion and set an agenda.
C. Start with immediate physical exam because anxiety may
prevent accurate history.
D. Delegate initial history to nursing and proceed with focused
problem-based questions only.
Correct answer
B
Rationales
Correct (B): Bates emphasizes a patient-centered opening: an
open-ended question, acknowledgement of emotion, and
collaborative agenda-setting. This balances rapport and efficient
information gathering even under time pressure.
A: A rapid biomedical checklist misses the patient’s concerns
and emotional cues; Bates warns this harms rapport and
diagnostic context.
C: Jumping straight to exam neglects history and may overlook
psychosocial cues Bates highlights as essential.
D: Delegation can be appropriate but relying solely on
delegated info without initial clinician rapport violates Bates’
initiating encounter recommendations.
,Teaching point
Open with an open-ended question, acknowledge emotion, and
set the visit agenda.
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
Stem
A 28-year-old woman presents for fatigue and intermittent
palpitations. She mentions high workplace stress and
inconsistent sleep. Which history strategy most effectively
integrates biomedical and psychosocial domains per Bates’
recommendations?
Options
A. Focus only on cardiopulmonary ROS and labs because fatigue
is nonspecific.
B. Use a focused history that explores symptom characteristics,
contributing psychosocial factors, and functional impact.
C. Perform a full psychiatric assessment before any medical
questioning.
, D. Ask only closed yes/no questions to expedite differential
narrowing.
Correct answer
B
Rationales
Correct (B): Bates advocates integrating symptom analysis with
psychosocial context and functional status to refine differential
diagnosis and prioritize testing.
A: Ignoring psychosocial contributors misses common reversible
causes of fatigue (sleep, stress), contrary to Bates’ holistic
approach.
C: A full psychiatric assessment is excessive first step; Bates
recommends targeted psychosocial inquiry integrated with
medical history.
D: Closed questions limit diagnostic richness and miss nuance
that directs efficient, evidence-based testing.
Teaching point
Integrate symptom characteristics with psychosocial and
functional assessment for focused differential.
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.
3
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
Stem
A 62-year-old man arrives for a new-patient visit. He appears
anxious and speaks quickly. You have 5 minutes before the
schedule behind you becomes critical. Which opening approach
,best aligns with Bates’ recommended initiating techniques to
build rapport while gathering essential context for a safe visit?
Options
A. Begin with a rapid biomedical checklist focused on
cardiopulmonary symptoms to save time.
B. Use a brief open-ended opener (“What brings you in
today?”), then acknowledge emotion and set an agenda.
C. Start with immediate physical exam because anxiety may
prevent accurate history.
D. Delegate initial history to nursing and proceed with focused
problem-based questions only.
Correct answer
B
Rationales
Correct (B): Bates emphasizes a patient-centered opening: an
open-ended question, acknowledgement of emotion, and
collaborative agenda-setting. This balances rapport and efficient
information gathering even under time pressure.
A: A rapid biomedical checklist misses the patient’s concerns
and emotional cues; Bates warns this harms rapport and
diagnostic context.
C: Jumping straight to exam neglects history and may overlook
psychosocial cues Bates highlights as essential.
D: Delegation can be appropriate but relying solely on
delegated info without initial clinician rapport violates Bates’
initiating encounter recommendations.
,Teaching point
Open with an open-ended question, acknowledge emotion, and
set the visit agenda.
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
Stem
A 28-year-old woman presents for fatigue and intermittent
palpitations. She mentions high workplace stress and
inconsistent sleep. Which history strategy most effectively
integrates biomedical and psychosocial domains per Bates’
recommendations?
Options
A. Focus only on cardiopulmonary ROS and labs because fatigue
is nonspecific.
B. Use a focused history that explores symptom characteristics,
contributing psychosocial factors, and functional impact.
C. Perform a full psychiatric assessment before any medical
questioning.
, D. Ask only closed yes/no questions to expedite differential
narrowing.
Correct answer
B
Rationales
Correct (B): Bates advocates integrating symptom analysis with
psychosocial context and functional status to refine differential
diagnosis and prioritize testing.
A: Ignoring psychosocial contributors misses common reversible
causes of fatigue (sleep, stress), contrary to Bates’ holistic
approach.
C: A full psychiatric assessment is excessive first step; Bates
recommends targeted psychosocial inquiry integrated with
medical history.
D: Closed questions limit diagnostic richness and miss nuance
that directs efficient, evidence-based testing.
Teaching point
Integrate symptom characteristics with psychosocial and
functional assessment for focused differential.
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.
3
