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 chronic COPD and newly diagnosed
Stage II colon cancer asks the clinician whether to proceed with
adjuvant chemotherapy. Using the principles of shared decision-
making, which action best demonstrates applying Harrison’s
recommended approach to clinical decision-making?
,A. Recommend the single treatment with the greatest survival
benefit and schedule it.
B. Present both options neutrally, explore the patient’s values
and preferences, and elicit goals of care.
C. Defer the decision to the oncology team and inform the
patient you'll follow their recommendation.
D. Advise against chemotherapy because comorbid COPD
predicts poor tolerance.
Correct Answer
B
Rationales
Correct: Harrison emphasizes shared decision-making —
clinicians should present options, clarify risks/benefits, and
elicit patient values and goals to make a joint plan.
A: Making a unilateral recommendation disregards patient
values and informed consent.
C: Deferring without engaging the patient fails to support
informed, patient-centered decisions.
D: While comorbidity matters, a blanket refusal ignores
individualized risk–benefit discussion.
Teaching Point
Shared decision-making pairs clinical evidence with patient
goals and preferences.
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 an electronic alert to document counseling
on smoking cessation for all current smokers. After 6 months,
counseling documentation increased, but smoking rates did not
decline. Which next step aligns with Harrison’s prevention
framework to improve population health outcomes?
A. Remove the alert because documentation isn't lowering
smoking prevalence.
B. Add brief nicotine-dependence treatment (pharmacotherapy
+ follow-up) into the workflow and measure cessation
outcomes.
C. Replace counseling prompts with printed brochures only.
D. Penalize clinicians for patients who continue to smoke.
Correct Answer
B
Rationales
Correct: Harrison stresses that effective prevention requires
evidence-based interventions (behavioral counseling +
pharmacotherapy) and outcome measurement, not just
documentation.
A: Removing the alert discards a process improvement;
, documentation can be useful if linked to effective interventions.
C: Brochures alone are less effective than structured
interventions; passive education rarely changes behavior.
D: Penalizing clinicians is unethical and unlikely to improve
patient outcomes.
Teaching Point
Prevention requires evidence-based interventions and outcome
tracking, not documentation alone.
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 pediatric nurse encounters parents hesitant about the MMR
vaccine because of misinformation on social media. Which
communication strategy best reflects Harrison’s
recommendations to address vaccine hesitancy?
A. Dismiss the parents’ concerns and insist vaccination is
mandatory.
B. Use presumptive language (“Today we’ll give MMR”) without
exploring concerns.
C. Ask open questions to understand concerns, validate feelings,
(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 chronic COPD and newly diagnosed
Stage II colon cancer asks the clinician whether to proceed with
adjuvant chemotherapy. Using the principles of shared decision-
making, which action best demonstrates applying Harrison’s
recommended approach to clinical decision-making?
,A. Recommend the single treatment with the greatest survival
benefit and schedule it.
B. Present both options neutrally, explore the patient’s values
and preferences, and elicit goals of care.
C. Defer the decision to the oncology team and inform the
patient you'll follow their recommendation.
D. Advise against chemotherapy because comorbid COPD
predicts poor tolerance.
Correct Answer
B
Rationales
Correct: Harrison emphasizes shared decision-making —
clinicians should present options, clarify risks/benefits, and
elicit patient values and goals to make a joint plan.
A: Making a unilateral recommendation disregards patient
values and informed consent.
C: Deferring without engaging the patient fails to support
informed, patient-centered decisions.
D: While comorbidity matters, a blanket refusal ignores
individualized risk–benefit discussion.
Teaching Point
Shared decision-making pairs clinical evidence with patient
goals and preferences.
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 an electronic alert to document counseling
on smoking cessation for all current smokers. After 6 months,
counseling documentation increased, but smoking rates did not
decline. Which next step aligns with Harrison’s prevention
framework to improve population health outcomes?
A. Remove the alert because documentation isn't lowering
smoking prevalence.
B. Add brief nicotine-dependence treatment (pharmacotherapy
+ follow-up) into the workflow and measure cessation
outcomes.
C. Replace counseling prompts with printed brochures only.
D. Penalize clinicians for patients who continue to smoke.
Correct Answer
B
Rationales
Correct: Harrison stresses that effective prevention requires
evidence-based interventions (behavioral counseling +
pharmacotherapy) and outcome measurement, not just
documentation.
A: Removing the alert discards a process improvement;
, documentation can be useful if linked to effective interventions.
C: Brochures alone are less effective than structured
interventions; passive education rarely changes behavior.
D: Penalizing clinicians is unethical and unlikely to improve
patient outcomes.
Teaching Point
Prevention requires evidence-based interventions and outcome
tracking, not documentation alone.
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 pediatric nurse encounters parents hesitant about the MMR
vaccine because of misinformation on social media. Which
communication strategy best reflects Harrison’s
recommendations to address vaccine hesitancy?
A. Dismiss the parents’ concerns and insist vaccination is
mandatory.
B. Use presumptive language (“Today we’ll give MMR”) without
exploring concerns.
C. Ask open questions to understand concerns, validate feelings,
