Harrison's Principles of Internal Medicine (Vol.1
& Vol.2)
21st Edition Newer Edition
Author(s)Joseph Loscalzo; Anthony S. Fauci;
Dennis L. Kasper; Stephen Hauser; Dan Longo; J.
Larry Jameson
TEST BANK
1
Reference: Ch. 1 — The Practice of Medicine
Question Stem: A 72-year-old man with multiple chronic
illnesses asks whether to continue an aggressive medication
that reduces a surrogate marker but increases fall risk. Which
clinician action best demonstrates shared decision-making
,aligned with patient-centered practice?
Options:
A. Explain the guideline recommendation and insist on
continuing the medication.
B. Present the risks and benefits, elicit the patient’s values, and
decide together.
C. Defer decision entirely to the family to avoid upsetting the
patient.
D. Stop the medication immediately to eliminate fall risk
without discussion.
Correct Answer: B
Rationales:
• Correct (B): Shared decision-making requires presenting
evidence, assessing the patient’s values and preferences,
and arriving at a mutual plan—core to patient-centered
practice.
• Incorrect (A): Insisting on a guideline without discussing
patient goals neglects individualization and autonomy.
• Incorrect (C): Deferring to family without engaging the
competent patient undermines autonomy and professional
duty.
• Incorrect (D): Stopping therapy unilaterally risks harm and
ignores informed consent and discussion of tradeoffs.
Teaching Point: Shared decision-making = evidence + patient
values → joint plan.
,Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 1.
2
Reference: Ch. 2 — Promoting Good Health
Question Stem: A clinic implements brief counseling to help
smokers quit. Which counseling approach most increases the
probability of behavioral change according to health-promotion
principles?
Options:
A. Providing a single pamphlet about harms of smoking.
B. Using motivational interviewing to explore ambivalence and
build commitment.
C. Scolding the patient to increase fear of consequences.
D. Scheduling a follow-up only if the patient requests it.
Correct Answer: B
Rationales:
• Correct (B): Motivational interviewing addresses
ambivalence, enhances intrinsic motivation, and is
evidence-aligned for behavior change promotion.
• Incorrect (A): Passive information alone has limited impact
on sustained behavior change.
• Incorrect (C): Scolding increases resistance and is
counterproductive for long-term change.
, • Incorrect (D): Passive follow-up reduces opportunities for
reinforcement and relapse prevention.
Teaching Point: Motivational interviewing enhances readiness
and sustained behavior change.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 2.
3
Reference: Ch. 3 — Vaccine Opposition and Hesitancy
Question Stem: A parent refuses routine childhood vaccines
citing safety concerns from social media. Which clinician
response best follows evidence-based guidance to address
vaccine hesitancy?
Options:
A. Provide long lists of scientific studies in one visit to
overwhelm objections.
B. Validate concerns, ask what they’ve heard, and provide clear,
empathetic corrective information.
C. Threaten to report them to public health authorities unless
they consent.
D. Accept refusal and avoid further vaccine discussion to
preserve rapport.
Correct Answer: B
Rationales:
& Vol.2)
21st Edition Newer Edition
Author(s)Joseph Loscalzo; Anthony S. Fauci;
Dennis L. Kasper; Stephen Hauser; Dan Longo; J.
Larry Jameson
TEST BANK
1
Reference: Ch. 1 — The Practice of Medicine
Question Stem: A 72-year-old man with multiple chronic
illnesses asks whether to continue an aggressive medication
that reduces a surrogate marker but increases fall risk. Which
clinician action best demonstrates shared decision-making
,aligned with patient-centered practice?
Options:
A. Explain the guideline recommendation and insist on
continuing the medication.
B. Present the risks and benefits, elicit the patient’s values, and
decide together.
C. Defer decision entirely to the family to avoid upsetting the
patient.
D. Stop the medication immediately to eliminate fall risk
without discussion.
Correct Answer: B
Rationales:
• Correct (B): Shared decision-making requires presenting
evidence, assessing the patient’s values and preferences,
and arriving at a mutual plan—core to patient-centered
practice.
• Incorrect (A): Insisting on a guideline without discussing
patient goals neglects individualization and autonomy.
• Incorrect (C): Deferring to family without engaging the
competent patient undermines autonomy and professional
duty.
• Incorrect (D): Stopping therapy unilaterally risks harm and
ignores informed consent and discussion of tradeoffs.
Teaching Point: Shared decision-making = evidence + patient
values → joint plan.
,Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 1.
2
Reference: Ch. 2 — Promoting Good Health
Question Stem: A clinic implements brief counseling to help
smokers quit. Which counseling approach most increases the
probability of behavioral change according to health-promotion
principles?
Options:
A. Providing a single pamphlet about harms of smoking.
B. Using motivational interviewing to explore ambivalence and
build commitment.
C. Scolding the patient to increase fear of consequences.
D. Scheduling a follow-up only if the patient requests it.
Correct Answer: B
Rationales:
• Correct (B): Motivational interviewing addresses
ambivalence, enhances intrinsic motivation, and is
evidence-aligned for behavior change promotion.
• Incorrect (A): Passive information alone has limited impact
on sustained behavior change.
• Incorrect (C): Scolding increases resistance and is
counterproductive for long-term change.
, • Incorrect (D): Passive follow-up reduces opportunities for
reinforcement and relapse prevention.
Teaching Point: Motivational interviewing enhances readiness
and sustained behavior change.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 2.
3
Reference: Ch. 3 — Vaccine Opposition and Hesitancy
Question Stem: A parent refuses routine childhood vaccines
citing safety concerns from social media. Which clinician
response best follows evidence-based guidance to address
vaccine hesitancy?
Options:
A. Provide long lists of scientific studies in one visit to
overwhelm objections.
B. Validate concerns, ask what they’ve heard, and provide clear,
empathetic corrective information.
C. Threaten to report them to public health authorities unless
they consent.
D. Accept refusal and avoid further vaccine discussion to
preserve rapport.
Correct Answer: B
Rationales:
