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 comorbidities is admitted; you
must decide whether to pursue an invasive diagnostic test that
,carries risk but may change management. Which decision
approach best balances patient values, benefit, and harm?
Options
A. Paternalistic decision-making where clinician decides to
minimize risk.
B. Shared decision-making that presents options, risks, benefits,
and elicits values.
C. Random selection to avoid bias and expedite care.
D. Deferring decision to family without exploring patient
preferences.
Correct Answer
B
Rationales
• Correct (B): Shared decision-making integrates clinical
evidence, potential benefits/harms, and the patient’s
values—optimal when interventions carry tradeoffs.
• A: Paternalism ignores patient autonomy and may conflict
with informed consent standards.
• C: Random selection is ethically inappropriate and fails to
consider patient-specific risks/benefits.
• D: Deferring to family without discussing the patient’s
preferences violates autonomy unless the patient lacks
decisional capacity.
,Teaching Point
Shared decision-making aligns treatment with evidence and
patient values.
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 plans an intervention to increase physical activity among
sedentary adults. Which design element will best improve long-
term behavior change?
Options
A. Single educational lecture on exercise benefits.
B. Brief advice during a visit with no follow-up.
C. Multi-component program with goal-setting, follow-up, and
social support.
D. Distribution of pamphlets only.
Correct Answer
C
Rationales
, • Correct (C): Multi-component interventions that include
goal-setting, reinforcement, and social support produce
more sustained behavior change.
• A: A single lecture yields short-term knowledge but poor
sustained behavior change.
• B: Brief unreinforced advice has limited durability for
lifestyle change.
• D: Pamphlets alone are passive and rarely change long-
term behavior.
Teaching Point
Sustained health behavior change needs multicomponent
interventions with follow-up.
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 expresses vaccine hesitancy due to safety fears. Which
clinician strategy most effectively increases vaccine acceptance?
Options
A. Dismissing concerns and insisting on vaccination
& 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 comorbidities is admitted; you
must decide whether to pursue an invasive diagnostic test that
,carries risk but may change management. Which decision
approach best balances patient values, benefit, and harm?
Options
A. Paternalistic decision-making where clinician decides to
minimize risk.
B. Shared decision-making that presents options, risks, benefits,
and elicits values.
C. Random selection to avoid bias and expedite care.
D. Deferring decision to family without exploring patient
preferences.
Correct Answer
B
Rationales
• Correct (B): Shared decision-making integrates clinical
evidence, potential benefits/harms, and the patient’s
values—optimal when interventions carry tradeoffs.
• A: Paternalism ignores patient autonomy and may conflict
with informed consent standards.
• C: Random selection is ethically inappropriate and fails to
consider patient-specific risks/benefits.
• D: Deferring to family without discussing the patient’s
preferences violates autonomy unless the patient lacks
decisional capacity.
,Teaching Point
Shared decision-making aligns treatment with evidence and
patient values.
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 plans an intervention to increase physical activity among
sedentary adults. Which design element will best improve long-
term behavior change?
Options
A. Single educational lecture on exercise benefits.
B. Brief advice during a visit with no follow-up.
C. Multi-component program with goal-setting, follow-up, and
social support.
D. Distribution of pamphlets only.
Correct Answer
C
Rationales
, • Correct (C): Multi-component interventions that include
goal-setting, reinforcement, and social support produce
more sustained behavior change.
• A: A single lecture yields short-term knowledge but poor
sustained behavior change.
• B: Brief unreinforced advice has limited durability for
lifestyle change.
• D: Pamphlets alone are passive and rarely change long-
term behavior.
Teaching Point
Sustained health behavior change needs multicomponent
interventions with follow-up.
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 expresses vaccine hesitancy due to safety fears. Which
clinician strategy most effectively increases vaccine acceptance?
Options
A. Dismissing concerns and insisting on vaccination
