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
Stem
A 62-year-old man with poorly controlled diabetes presents for
a routine follow-up. He appears withdrawn and speaks
minimally. You note reduced eye contact and a flat affect; vitals
are stable. Considering Bates’ approach to foundational
,communication skills, what is the most appropriate next-step to
gather a thorough history?
Options
A. Proceed directly to medication reconciliation and focused
diabetes questions to save time.
B. Use an open-ended empathy-focused prompt exploring the
patient’s feelings about diabetes and daily challenges.
C. Refer to psychiatry for formal mental health evaluation
before continuing medical history.
D. Ask only closed yes/no questions to ensure objective data
collection.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes building rapport and using open-
ended, empathetic prompts to elicit patient concerns and
contextual factors that affect health behavior. Exploring feelings
and daily challenges uncovers barriers to self-care and social
determinants relevant to diabetes control. This integrates
foundation skills to improve diagnostic accuracy and plan.
Incorrect (A): Jumping to biomedical questions neglects rapport
and may miss psychosocial data Bates deems essential. It risks
incomplete contextual understanding.
Incorrect (C): Immediate psychiatric referral is premature; Bates
recommends gathering illness experience and screening first.
Psychiatry may be appropriate later.
,Incorrect (D): Closed questions limit narrative information and
can miss important SDOH or emotional cues per Bates’
communication framework.
Teaching Point
Open-ended, empathic prompts reveal context and barriers to
care.
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 — Structure and Sequence of the Clinical Encounter —
Stage 1: Initiating the Encounter
Stem
A 28-year-old woman arrives for a pre-employment exam and
seems anxious. You have limited time and multiple tasks to
complete. According to Bates’ recommended Stage 1 behaviors,
which approach best balances efficiency with patient-centered
care?
Options
A. Introduce yourself, confirm the purpose of visit, then ask a
single focused screening question.
B. Skip the introduction to save time and begin the physical
, exam immediately.
C. Introduce yourself, ask the patient what she hopes to
accomplish in the visit, and clarify expectations before
proceeding.
D. Hand the patient paperwork and ask her to complete it while
you gather equipment.
Correct Answer
C
Rationales
Correct (C): Bates recommends initiating the encounter with
introductions, clarifying the patient’s perspective and
expectations, and setting an agenda — enhancing efficiency and
aligning care. This approach reduces anxiety and frames the
visit.
Incorrect (A): While an introduction is necessary, a single
focused screening question ignores agenda-setting; Bates favors
asking what the patient hopes to accomplish.
Incorrect (B): Skipping introductions harms rapport and violates
Bates’ structured approach to initiating encounters.
Incorrect (D): Paperwork may be necessary, but passive
handing-off undermines early patient engagement and shared
agenda setting.
Teaching Point
Always introduce, elicit patient goals, and set an agenda before
assessments.
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
Stem
A 62-year-old man with poorly controlled diabetes presents for
a routine follow-up. He appears withdrawn and speaks
minimally. You note reduced eye contact and a flat affect; vitals
are stable. Considering Bates’ approach to foundational
,communication skills, what is the most appropriate next-step to
gather a thorough history?
Options
A. Proceed directly to medication reconciliation and focused
diabetes questions to save time.
B. Use an open-ended empathy-focused prompt exploring the
patient’s feelings about diabetes and daily challenges.
C. Refer to psychiatry for formal mental health evaluation
before continuing medical history.
D. Ask only closed yes/no questions to ensure objective data
collection.
Correct Answer
B
Rationales
Correct (B): Bates emphasizes building rapport and using open-
ended, empathetic prompts to elicit patient concerns and
contextual factors that affect health behavior. Exploring feelings
and daily challenges uncovers barriers to self-care and social
determinants relevant to diabetes control. This integrates
foundation skills to improve diagnostic accuracy and plan.
Incorrect (A): Jumping to biomedical questions neglects rapport
and may miss psychosocial data Bates deems essential. It risks
incomplete contextual understanding.
Incorrect (C): Immediate psychiatric referral is premature; Bates
recommends gathering illness experience and screening first.
Psychiatry may be appropriate later.
,Incorrect (D): Closed questions limit narrative information and
can miss important SDOH or emotional cues per Bates’
communication framework.
Teaching Point
Open-ended, empathic prompts reveal context and barriers to
care.
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 — Structure and Sequence of the Clinical Encounter —
Stage 1: Initiating the Encounter
Stem
A 28-year-old woman arrives for a pre-employment exam and
seems anxious. You have limited time and multiple tasks to
complete. According to Bates’ recommended Stage 1 behaviors,
which approach best balances efficiency with patient-centered
care?
Options
A. Introduce yourself, confirm the purpose of visit, then ask a
single focused screening question.
B. Skip the introduction to save time and begin the physical
, exam immediately.
C. Introduce yourself, ask the patient what she hopes to
accomplish in the visit, and clarify expectations before
proceeding.
D. Hand the patient paperwork and ask her to complete it while
you gather equipment.
Correct Answer
C
Rationales
Correct (C): Bates recommends initiating the encounter with
introductions, clarifying the patient’s perspective and
expectations, and setting an agenda — enhancing efficiency and
aligning care. This approach reduces anxiety and frames the
visit.
Incorrect (A): While an introduction is necessary, a single
focused screening question ignores agenda-setting; Bates favors
asking what the patient hopes to accomplish.
Incorrect (B): Skipping introductions harms rapport and violates
Bates’ structured approach to initiating encounters.
Incorrect (D): Paperwork may be necessary, but passive
handing-off undermines early patient engagement and shared
agenda setting.
Teaching Point
Always introduce, elicit patient goals, and set an agenda before
assessments.
