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 presents with
new-onset fatigue and weight loss. Laboratory studies show
mild anemia. You must decide whether to pursue an invasive
diagnostic biopsy. Which approach best aligns with high-quality,
patient-centered clinical practice?
,Options
A. Proceed with biopsy immediately because tissue diagnosis is
definitive.
B. Discuss risks, benefits, alternatives, and align testing with the
patient’s goals before deciding.
C. Defer any testing because elderly patients rarely tolerate
invasive procedures.
D. Order additional imaging first and only biopsy if imaging is
abnormal.
Correct Answer
B
Rationales
Correct: Shared decision-making—discussing risks, benefits, and
patient goals—aligns with high-quality, patient-centered
practice and avoids unnecessary or unwanted interventions.
A: Definitive diagnosis is important but proceeding without
discussion neglects patient autonomy and may conflict with
goals.
C: Age alone is not a reason to forgo testing; individualized risk–
benefit assessment is required.
D: Additional imaging may be useful but does not replace the
need to incorporate patient values and informed consent.
Teaching Point
Shared decision-making integrates evidence and patient goals
for appropriate care.
,Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2)
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A hospitalist considers the results of a single poorly controlled
observational study showing benefit for an off-label drug.
Which next step best reflects rigorous evidence-based practice?
Options
A. Adopt the drug for all eligible patients immediately.
B. Perform a systematic appraisal of study quality and seek
corroborating evidence before changing practice.
C. Ignore the study because it is only observational.
D. Survey colleagues and implement the drug if most agree.
Correct Answer
B
Rationales
Correct: Evidence-based practice requires appraisal of study
design, bias, effect size, and corroboration before practice
change.
A: Immediate adoption from a single low-level study risks harm
and premature practice change.
, C: Observational studies can be informative; they should be
critically appraised rather than dismissed.
D: Consensus without critical appraisal risks propagation of low-
quality evidence.
Teaching Point
Critically appraise evidence and weigh strength before altering
clinical practice.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3)
Reference
Ch. 2 — Promoting Good Health
Question Stem
A primary-care nurse counsels a 45-year-old patient with
obesity and prediabetes. Which intervention most effectively
supports long-term health promotion according to population-
health principles?
Options
A. Prescribe metformin immediately to prevent diabetes.
B. Provide individualized weight-loss counseling plus referral to
community resources.
C. Advise the patient to reduce caloric intake without follow-up.
(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 presents with
new-onset fatigue and weight loss. Laboratory studies show
mild anemia. You must decide whether to pursue an invasive
diagnostic biopsy. Which approach best aligns with high-quality,
patient-centered clinical practice?
,Options
A. Proceed with biopsy immediately because tissue diagnosis is
definitive.
B. Discuss risks, benefits, alternatives, and align testing with the
patient’s goals before deciding.
C. Defer any testing because elderly patients rarely tolerate
invasive procedures.
D. Order additional imaging first and only biopsy if imaging is
abnormal.
Correct Answer
B
Rationales
Correct: Shared decision-making—discussing risks, benefits, and
patient goals—aligns with high-quality, patient-centered
practice and avoids unnecessary or unwanted interventions.
A: Definitive diagnosis is important but proceeding without
discussion neglects patient autonomy and may conflict with
goals.
C: Age alone is not a reason to forgo testing; individualized risk–
benefit assessment is required.
D: Additional imaging may be useful but does not replace the
need to incorporate patient values and informed consent.
Teaching Point
Shared decision-making integrates evidence and patient goals
for appropriate care.
,Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2)
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A hospitalist considers the results of a single poorly controlled
observational study showing benefit for an off-label drug.
Which next step best reflects rigorous evidence-based practice?
Options
A. Adopt the drug for all eligible patients immediately.
B. Perform a systematic appraisal of study quality and seek
corroborating evidence before changing practice.
C. Ignore the study because it is only observational.
D. Survey colleagues and implement the drug if most agree.
Correct Answer
B
Rationales
Correct: Evidence-based practice requires appraisal of study
design, bias, effect size, and corroboration before practice
change.
A: Immediate adoption from a single low-level study risks harm
and premature practice change.
, C: Observational studies can be informative; they should be
critically appraised rather than dismissed.
D: Consensus without critical appraisal risks propagation of low-
quality evidence.
Teaching Point
Critically appraise evidence and weigh strength before altering
clinical practice.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3)
Reference
Ch. 2 — Promoting Good Health
Question Stem
A primary-care nurse counsels a 45-year-old patient with
obesity and prediabetes. Which intervention most effectively
supports long-term health promotion according to population-
health principles?
Options
A. Prescribe metformin immediately to prevent diabetes.
B. Provide individualized weight-loss counseling plus referral to
community resources.
C. Advise the patient to reduce caloric intake without follow-up.
