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 chronic conditions tells you he
wants aggressive interventions despite poor prognosis. As his
primary clinician, which approach best aligns with professional
practice standards to respect autonomy while ensuring
informed consent?
,Options
A. Honor his request immediately because patient autonomy is
absolute.
B. Explain prognosis, discuss likely outcomes of aggressive care,
and confirm informed choice.
C. Decline his request and recommend comfort-focused care
because of age and comorbidities.
D. Request family consent to override the patient’s preference
for less clinical risk.
Correct Answer
B
Rationales
• B (Correct): Professional practice emphasizes respecting
autonomy while ensuring decisions are informed; clinicians
should explain prognosis, risks, benefits, and alternatives
so the patient can make an informed choice.
• A: Autonomy is critical but not absolute; it requires that
choices be informed and voluntary.
• C: Clinician recommendation is appropriate, but
unilaterally declining requested treatment disregards the
patient’s rights without due process.
• D: Family cannot override a capacitated patient's choices;
surrogate decision-making is only appropriate when the
patient lacks capacity.
,Teaching Point
Respect autonomy by ensuring decisions are informed and
capacity is assessed.
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
During morning rounds, a resident isolates one lab test as
definitive for diagnosis despite conflicting clinical findings.
Which step best demonstrates high-quality clinical reasoning
and reduces diagnostic error?
Options
A. Accept the test result because lab values are always
definitive.
B. Reconcile test results with clinical context and consider
alternative explanations.
C. Order every available diagnostic test to reconcile the conflict.
D. Defer to the resident’s assertion to avoid undermining team
dynamics.
Correct Answer
B
, Rationales
• B (Correct): High-quality reasoning integrates test results
with history and exam; reconciling discordance limits error
and prompts reconsideration of differential diagnoses.
• A: Tests are valuable but can be misleading without clinical
correlation.
• C: Blanket testing increases harm, cost, and false positives
rather than improving accuracy.
• D: Team dynamics matter, but patient safety and sound
reasoning take priority over deference.
Teaching Point
Always interpret diagnostic tests within the full clinical context.
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 community clinic with limited resources must decide whether
to implement a smoking cessation program or a community
exercise program. Using population health principles, which
(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 chronic conditions tells you he
wants aggressive interventions despite poor prognosis. As his
primary clinician, which approach best aligns with professional
practice standards to respect autonomy while ensuring
informed consent?
,Options
A. Honor his request immediately because patient autonomy is
absolute.
B. Explain prognosis, discuss likely outcomes of aggressive care,
and confirm informed choice.
C. Decline his request and recommend comfort-focused care
because of age and comorbidities.
D. Request family consent to override the patient’s preference
for less clinical risk.
Correct Answer
B
Rationales
• B (Correct): Professional practice emphasizes respecting
autonomy while ensuring decisions are informed; clinicians
should explain prognosis, risks, benefits, and alternatives
so the patient can make an informed choice.
• A: Autonomy is critical but not absolute; it requires that
choices be informed and voluntary.
• C: Clinician recommendation is appropriate, but
unilaterally declining requested treatment disregards the
patient’s rights without due process.
• D: Family cannot override a capacitated patient's choices;
surrogate decision-making is only appropriate when the
patient lacks capacity.
,Teaching Point
Respect autonomy by ensuring decisions are informed and
capacity is assessed.
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
During morning rounds, a resident isolates one lab test as
definitive for diagnosis despite conflicting clinical findings.
Which step best demonstrates high-quality clinical reasoning
and reduces diagnostic error?
Options
A. Accept the test result because lab values are always
definitive.
B. Reconcile test results with clinical context and consider
alternative explanations.
C. Order every available diagnostic test to reconcile the conflict.
D. Defer to the resident’s assertion to avoid undermining team
dynamics.
Correct Answer
B
, Rationales
• B (Correct): High-quality reasoning integrates test results
with history and exam; reconciling discordance limits error
and prompts reconsideration of differential diagnoses.
• A: Tests are valuable but can be misleading without clinical
correlation.
• C: Blanket testing increases harm, cost, and false positives
rather than improving accuracy.
• D: Team dynamics matter, but patient safety and sound
reasoning take priority over deference.
Teaching Point
Always interpret diagnostic tests within the full clinical context.
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 community clinic with limited resources must decide whether
to implement a smoking cessation program or a community
exercise program. Using population health principles, which
