Harrison's Principles of Internal Medicine
(Vol.1 & Vol.2)
22nd Edition
• Author(s)Joseph Loscalzo; Anthony S.
Fauci; Dennis L. Kasper; Stephen Hauser;
Dan Longo; J. Larry Jameson
Test Bank
Test Bank: Foundations of Clinical Practice
1. When adopting a patient-centered approach to care, the
nurse integrates the biopsychosocial model. Which nursing
action best exemplifies this model for a patient newly
diagnosed with hypertension?
A.) Administering the prescribed antihypertensive medication
and documenting the blood pressure.
B.) Providing a pamphlet on low-sodium diets and scheduling a
follow-up appointment.
C.) Assessing the patient's understanding of the diagnosis, their
dietary habits, stress levels at work, and support system at
home.
,D.) Instructing the patient to purchase a home blood pressure
monitor and to log readings twice daily.
Answer: C.) Assessing the patient's understanding of the
diagnosis, their dietary habits, stress levels at work, and support
system at home.
Rationale: The biopsychosocial model requires an integrated
understanding of the biologic (diagnosis, diet), psychological
(stress, understanding), and social (work, support system)
dimensions of illness. This comprehensive assessment forms
the basis for personalized, patient-centered care, moving
beyond mere task completion.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 1: The Practice of Medicine.
2. A nurse is providing health promotion teaching. Which
modifiable risk factor represents the single leading cause of
preventable death in the United States?
A.) Hypertension
B.) Tobacco use
C.) Sedentary lifestyle
D.) Hyperlipidemia
Answer: B.) Tobacco use
Rationale: Harrison's identifies tobacco use as the foremost
preventable cause of mortality, responsible for a vast burden of
cardiovascular, pulmonary, and oncologic disease. Nursing
health promotion must prioritize smoking cessation
interventions.
,Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 2: Promoting Good Health.
3. A parent in a pediatric clinic expresses hesitation about the
measles, mumps, and rubella (MMR) vaccine, stating, "I read it
can cause autism." What is the most evidence-based and
effective initial nursing response?
A.) Dismiss the concern and state that vaccines are required for
school entry.
B.) Provide empathetic listening, acknowledge the concern, and
then share clear data on the vaccine's safety and the lack of
scientific link to autism.
C.) Report the parent to child protective services for medical
neglect.
D.) Defer all vaccination decisions to the physician.
Answer: B.) Provide empathetic listening, acknowledge the
concern, and then share clear data on the vaccine's safety and
the lack of scientific link to autism.
Rationale: Effective addressing of vaccine hesitancy begins with
establishing trust through empathetic communication.
Dismissing concerns is counterproductive. The nurse should
then provide clear, factual information to correct
misinformation, as the alleged link between MMR and autism
has been thoroughly debunked by extensive research.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 3: Vaccine Opposition and Hesitancy.
, 4. The primary goal of "herd immunity" is to:
A.) Eradicate a pathogen completely from the global
population.
B.) Protect individuals who cannot be vaccinated due to medical
contraindications.
C.) Reduce the cost of vaccination programs for the community.
D.) Allow natural infection to boost immunity in the population.
Answer: B.) Protect individuals who cannot be vaccinated due
to medical contraindications.
Rationale: Herd immunity occurs when a high percentage of the
community is immune, thereby breaking chains of transmission.
This indirectly protects vulnerable individuals (e.g.,
immunocompromised, infants) who cannot receive live vaccines
or may not mount an adequate immune response.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 3: Vaccine Opposition and Hesitancy.
5. In shared decision-making, the nurse's primary role is to:
A.) Make a recommendation for the treatment option with the
best statistical outcome.
B.) Ensure the patient signs the informed consent form for the
physician's chosen plan.
C.) Act as a facilitator, ensuring the patient understands the
options, benefits, and risks to make a values-aligned choice.
D.) Defer all medical decision-making explanations to the
attending physician.
Answer: C.) Act as a facilitator, ensuring the patient
understands the options, benefits, and risks to make a values-
(Vol.1 & Vol.2)
22nd Edition
• Author(s)Joseph Loscalzo; Anthony S.
Fauci; Dennis L. Kasper; Stephen Hauser;
Dan Longo; J. Larry Jameson
Test Bank
Test Bank: Foundations of Clinical Practice
1. When adopting a patient-centered approach to care, the
nurse integrates the biopsychosocial model. Which nursing
action best exemplifies this model for a patient newly
diagnosed with hypertension?
A.) Administering the prescribed antihypertensive medication
and documenting the blood pressure.
B.) Providing a pamphlet on low-sodium diets and scheduling a
follow-up appointment.
C.) Assessing the patient's understanding of the diagnosis, their
dietary habits, stress levels at work, and support system at
home.
,D.) Instructing the patient to purchase a home blood pressure
monitor and to log readings twice daily.
Answer: C.) Assessing the patient's understanding of the
diagnosis, their dietary habits, stress levels at work, and support
system at home.
Rationale: The biopsychosocial model requires an integrated
understanding of the biologic (diagnosis, diet), psychological
(stress, understanding), and social (work, support system)
dimensions of illness. This comprehensive assessment forms
the basis for personalized, patient-centered care, moving
beyond mere task completion.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 1: The Practice of Medicine.
2. A nurse is providing health promotion teaching. Which
modifiable risk factor represents the single leading cause of
preventable death in the United States?
A.) Hypertension
B.) Tobacco use
C.) Sedentary lifestyle
D.) Hyperlipidemia
Answer: B.) Tobacco use
Rationale: Harrison's identifies tobacco use as the foremost
preventable cause of mortality, responsible for a vast burden of
cardiovascular, pulmonary, and oncologic disease. Nursing
health promotion must prioritize smoking cessation
interventions.
,Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 2: Promoting Good Health.
3. A parent in a pediatric clinic expresses hesitation about the
measles, mumps, and rubella (MMR) vaccine, stating, "I read it
can cause autism." What is the most evidence-based and
effective initial nursing response?
A.) Dismiss the concern and state that vaccines are required for
school entry.
B.) Provide empathetic listening, acknowledge the concern, and
then share clear data on the vaccine's safety and the lack of
scientific link to autism.
C.) Report the parent to child protective services for medical
neglect.
D.) Defer all vaccination decisions to the physician.
Answer: B.) Provide empathetic listening, acknowledge the
concern, and then share clear data on the vaccine's safety and
the lack of scientific link to autism.
Rationale: Effective addressing of vaccine hesitancy begins with
establishing trust through empathetic communication.
Dismissing concerns is counterproductive. The nurse should
then provide clear, factual information to correct
misinformation, as the alleged link between MMR and autism
has been thoroughly debunked by extensive research.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 3: Vaccine Opposition and Hesitancy.
, 4. The primary goal of "herd immunity" is to:
A.) Eradicate a pathogen completely from the global
population.
B.) Protect individuals who cannot be vaccinated due to medical
contraindications.
C.) Reduce the cost of vaccination programs for the community.
D.) Allow natural infection to boost immunity in the population.
Answer: B.) Protect individuals who cannot be vaccinated due
to medical contraindications.
Rationale: Herd immunity occurs when a high percentage of the
community is immune, thereby breaking chains of transmission.
This indirectly protects vulnerable individuals (e.g.,
immunocompromised, infants) who cannot receive live vaccines
or may not mount an adequate immune response.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 3: Vaccine Opposition and Hesitancy.
5. In shared decision-making, the nurse's primary role is to:
A.) Make a recommendation for the treatment option with the
best statistical outcome.
B.) Ensure the patient signs the informed consent form for the
physician's chosen plan.
C.) Act as a facilitator, ensuring the patient understands the
options, benefits, and risks to make a values-aligned choice.
D.) Defer all medical decision-making explanations to the
attending physician.
Answer: C.) Act as a facilitator, ensuring the patient
understands the options, benefits, and risks to make a values-
