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 68-year-old man with multiple comorbidities is transferred
from a nursing home after a fall. The inpatient team must
decide whether to pursue a full diagnostic workup or palliative-
,focused care. Which approach best applies shared decision-
making principles to determine next steps?
Options
A. Proceed with full diagnostic testing because clinicians know
best for older patients.
B. Explain options, elicit the patient's values/goals, and align the
plan with those preferences.
C. Defer decisions to family without assessing patient capacity
to avoid conflict.
D. Use an algorithm that mandates full diagnostic evaluation for
all falls in nursing-home residents.
Correct Answer
B
Rationales
Correct: Shared decision-making requires clinicians to explain
options, actively elicit the patient's values and goals, and
choose care concordant with those preferences and medical
judgment.
A: Paternalistic action ignores the patient’s values and can lead
to unwanted interventions.
C: Deferring to family without assessing capacity risks overriding
the patient’s autonomy.
D: Rigid algorithms may ignore individual goals, comorbidities,
and likely benefit.
,Teaching Point
Shared decision-making = inform, elicit values, and align plan
with patient goals.
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 primary care clinic in a low-income area wants to increase
statin adherence for high-risk patients. Which intervention most
directly addresses social determinants of health to improve
medication adherence?
Options
A. Educate patients on cholesterol biology during each visit.
B. Provide subsidized transportation vouchers and low-cost
medication access.
C. Increase prescription refill duration to 3 months without
outreach.
D. Require monthly in-person lipid panels before refilling
medications.
Correct Answer
B
, Rationales
Correct: Addressing social determinants—transportation and
affordability—removes practical barriers and increases the
likelihood of adherence.
A: Education alone often fails if structural barriers remain.
C: Longer fills can help but do not address cost or access
directly.
D: Monthly in-person requirements create access barriers and
may worsen adherence.
Teaching Point
Tackle structural barriers (cost, transport) to improve adherence
and health equity.
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 pregnant patient expresses concern about receiving influenza
vaccine due to safety rumors she read online. Which clinician
response best reduces hesitancy and supports vaccination?
Options
A. Insist she must receive the vaccine now to protect herself
and the fetus.
& 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 68-year-old man with multiple comorbidities is transferred
from a nursing home after a fall. The inpatient team must
decide whether to pursue a full diagnostic workup or palliative-
,focused care. Which approach best applies shared decision-
making principles to determine next steps?
Options
A. Proceed with full diagnostic testing because clinicians know
best for older patients.
B. Explain options, elicit the patient's values/goals, and align the
plan with those preferences.
C. Defer decisions to family without assessing patient capacity
to avoid conflict.
D. Use an algorithm that mandates full diagnostic evaluation for
all falls in nursing-home residents.
Correct Answer
B
Rationales
Correct: Shared decision-making requires clinicians to explain
options, actively elicit the patient's values and goals, and
choose care concordant with those preferences and medical
judgment.
A: Paternalistic action ignores the patient’s values and can lead
to unwanted interventions.
C: Deferring to family without assessing capacity risks overriding
the patient’s autonomy.
D: Rigid algorithms may ignore individual goals, comorbidities,
and likely benefit.
,Teaching Point
Shared decision-making = inform, elicit values, and align plan
with patient goals.
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 primary care clinic in a low-income area wants to increase
statin adherence for high-risk patients. Which intervention most
directly addresses social determinants of health to improve
medication adherence?
Options
A. Educate patients on cholesterol biology during each visit.
B. Provide subsidized transportation vouchers and low-cost
medication access.
C. Increase prescription refill duration to 3 months without
outreach.
D. Require monthly in-person lipid panels before refilling
medications.
Correct Answer
B
, Rationales
Correct: Addressing social determinants—transportation and
affordability—removes practical barriers and increases the
likelihood of adherence.
A: Education alone often fails if structural barriers remain.
C: Longer fills can help but do not address cost or access
directly.
D: Monthly in-person requirements create access barriers and
may worsen adherence.
Teaching Point
Tackle structural barriers (cost, transport) to improve adherence
and health equity.
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 pregnant patient expresses concern about receiving influenza
vaccine due to safety rumors she read online. Which clinician
response best reduces hesitancy and supports vaccination?
Options
A. Insist she must receive the vaccine now to protect herself
and the fetus.
