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
Reference — Ch. 1 — The Practice of Medicine
Question Stem
A 68-year-old man with multiple chronic conditions is admitted
after a fall. As the admitting nurse, you must decide whether to
escalate to palliative consult or continue aggressive workup.
,Which approach best applies shared decision-making while
respecting clinical goals?
Options
A. Proceed with full diagnostic testing without family input to
expedite care.
B. Convene the patient (if able), family, and interdisciplinary
team to align care plan with patient values.
C. Defer decisions until the attending physician dictates the care
plan.
D. Automatically enroll the patient in hospice because of age
and comorbidities.
Correct Answer
B
Rationales
Correct: Convening patient, family, and interdisciplinary team
embodies shared decision-making—aligning interventions with
patient goals and medical evidence. This approach balances
autonomy and clinical judgment.
A Incorrect: Acting without family/patient input ignores patient
values and risks nonbeneficial interventions.
C Incorrect: Waiting for sole physician dictation neglects team-
based communication and delays patient-centered decisions.
D Incorrect: Age and comorbidity alone do not justify hospice;
prognosis and patient preferences must guide that decision.
,Teaching Point
Shared decision-making pairs patient values with clinical
evidence via interdisciplinary dialogue.
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 nurse is designing a preventive-care visit for a
45-year-old woman with BMI 31 and family history of Type 2
diabetes. Which evidence-based intervention should the nurse
prioritize to reduce long-term cardiometabolic risk?
Options
A. Recommend immediate pharmacologic weight-loss therapy
for all patients with BMI >30.
B. Focus on individualized lifestyle counseling (diet, exercise)
and arrange follow-up support.
C. Advise the patient that genetics determine weight and no
intervention is effective.
D. Schedule annual imaging studies to monitor fat distribution.
Correct Answer
B
, Rationales
Correct: Individualized lifestyle counseling with follow-up is the
cornerstone of preventive care for overweight patients and
mitigates cardiometabolic risk. It’s pragmatic and evidence-
based.
A Incorrect: Pharmacologic therapy can help select patients but
is not the universal first-line step without individualized
assessment.
C Incorrect: Dismissing modifiable risk factors neglects effective
prevention strategies.
D Incorrect: Routine imaging for fat distribution is not a
standard preventive measure and adds cost without proven
benefit.
Teaching Point
Individualized lifestyle interventions with follow-up are first-line
for cardiometabolic prevention.
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
During a routine clinic visit, a parent refuses routine childhood
immunizations citing safety concerns found online. Which
& 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
Reference — Ch. 1 — The Practice of Medicine
Question Stem
A 68-year-old man with multiple chronic conditions is admitted
after a fall. As the admitting nurse, you must decide whether to
escalate to palliative consult or continue aggressive workup.
,Which approach best applies shared decision-making while
respecting clinical goals?
Options
A. Proceed with full diagnostic testing without family input to
expedite care.
B. Convene the patient (if able), family, and interdisciplinary
team to align care plan with patient values.
C. Defer decisions until the attending physician dictates the care
plan.
D. Automatically enroll the patient in hospice because of age
and comorbidities.
Correct Answer
B
Rationales
Correct: Convening patient, family, and interdisciplinary team
embodies shared decision-making—aligning interventions with
patient goals and medical evidence. This approach balances
autonomy and clinical judgment.
A Incorrect: Acting without family/patient input ignores patient
values and risks nonbeneficial interventions.
C Incorrect: Waiting for sole physician dictation neglects team-
based communication and delays patient-centered decisions.
D Incorrect: Age and comorbidity alone do not justify hospice;
prognosis and patient preferences must guide that decision.
,Teaching Point
Shared decision-making pairs patient values with clinical
evidence via interdisciplinary dialogue.
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 nurse is designing a preventive-care visit for a
45-year-old woman with BMI 31 and family history of Type 2
diabetes. Which evidence-based intervention should the nurse
prioritize to reduce long-term cardiometabolic risk?
Options
A. Recommend immediate pharmacologic weight-loss therapy
for all patients with BMI >30.
B. Focus on individualized lifestyle counseling (diet, exercise)
and arrange follow-up support.
C. Advise the patient that genetics determine weight and no
intervention is effective.
D. Schedule annual imaging studies to monitor fat distribution.
Correct Answer
B
, Rationales
Correct: Individualized lifestyle counseling with follow-up is the
cornerstone of preventive care for overweight patients and
mitigates cardiometabolic risk. It’s pragmatic and evidence-
based.
A Incorrect: Pharmacologic therapy can help select patients but
is not the universal first-line step without individualized
assessment.
C Incorrect: Dismissing modifiable risk factors neglects effective
prevention strategies.
D Incorrect: Routine imaging for fat distribution is not a
standard preventive measure and adds cost without proven
benefit.
Teaching Point
Individualized lifestyle interventions with follow-up are first-line
for cardiometabolic prevention.
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
During a routine clinic visit, a parent refuses routine childhood
immunizations citing safety concerns found online. Which
