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 asks whether a
proposed invasive diagnostic test will change management.
Which clinician behavior best demonstrates the practice-of-
medicine principle of clinical prudence?
A. Proceed with the test because it provides maximal diagnostic
certainty.
,B. Elicit the patient’s goals, explain likely impact on treatment,
and recommend for or against the test.
C. Defer the discussion and ask the patient to sign a blanket
consent form.
D. Offer the test only if it is covered by the patient’s insurer.
Correct Answer
B
Rationales
• Correct (B): Clinical prudence centers on aligning
diagnostic choices with patient goals and the likely impact
on management; informed, recommendation-based
discussion optimizes patient-centered care.
• A: Maximal diagnostic certainty alone may expose the
patient to harm and may not alter treatment—contrary to
prudent practice.
• C: Deferring individualized discussion undermines
informed decision-making and patient autonomy.
• D: Basing decisions solely on insurance coverage neglects
clinical judgment and patient values.
Teaching Point
Align diagnostic decisions with patient goals and expected
impact on management.
,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 counsels a 45-year-old patient about
cardiovascular risk reduction. Which advice most directly
applies the preventive health principle of “high-risk strategy”
rather than population strategy?
A. Encourage all patients to adopt a Mediterranean diet.
B. Start statin therapy after calculating the patient’s individual
10-year ASCVD risk.
C. Run community fitness programs to reduce obesity
prevalence.
D. Implement a clinic-wide smoking cessation poster campaign.
Correct Answer
B
Rationales
• Correct (B): High-risk strategy targets interventions (like
statins) to individuals identified through risk assessment to
reduce their personal disease risk.
, • A: Universal dietary advice is a population-level
intervention.
• C: Community fitness programs are population strategies
addressing broad determinants.
• D: Posters are population-level health promotion, not
individualized high-risk care.
Teaching Point
High-risk prevention targets individual risk assessment and
tailored interventions.
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 nurse encounters a parent hesitant about childhood vaccines
due to safety concerns. Which evidence-based communication
strategy most effectively reduces vaccine hesitancy?
A. Refute the parent’s concerns with long lists of safety data.
B. Use presumptive language (“Today your child will receive…”)
and address specific concerns empathetically.
(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 asks whether a
proposed invasive diagnostic test will change management.
Which clinician behavior best demonstrates the practice-of-
medicine principle of clinical prudence?
A. Proceed with the test because it provides maximal diagnostic
certainty.
,B. Elicit the patient’s goals, explain likely impact on treatment,
and recommend for or against the test.
C. Defer the discussion and ask the patient to sign a blanket
consent form.
D. Offer the test only if it is covered by the patient’s insurer.
Correct Answer
B
Rationales
• Correct (B): Clinical prudence centers on aligning
diagnostic choices with patient goals and the likely impact
on management; informed, recommendation-based
discussion optimizes patient-centered care.
• A: Maximal diagnostic certainty alone may expose the
patient to harm and may not alter treatment—contrary to
prudent practice.
• C: Deferring individualized discussion undermines
informed decision-making and patient autonomy.
• D: Basing decisions solely on insurance coverage neglects
clinical judgment and patient values.
Teaching Point
Align diagnostic decisions with patient goals and expected
impact on management.
,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 counsels a 45-year-old patient about
cardiovascular risk reduction. Which advice most directly
applies the preventive health principle of “high-risk strategy”
rather than population strategy?
A. Encourage all patients to adopt a Mediterranean diet.
B. Start statin therapy after calculating the patient’s individual
10-year ASCVD risk.
C. Run community fitness programs to reduce obesity
prevalence.
D. Implement a clinic-wide smoking cessation poster campaign.
Correct Answer
B
Rationales
• Correct (B): High-risk strategy targets interventions (like
statins) to individuals identified through risk assessment to
reduce their personal disease risk.
, • A: Universal dietary advice is a population-level
intervention.
• C: Community fitness programs are population strategies
addressing broad determinants.
• D: Posters are population-level health promotion, not
individualized high-risk care.
Teaching Point
High-risk prevention targets individual risk assessment and
tailored interventions.
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 nurse encounters a parent hesitant about childhood vaccines
due to safety concerns. Which evidence-based communication
strategy most effectively reduces vaccine hesitancy?
A. Refute the parent’s concerns with long lists of safety data.
B. Use presumptive language (“Today your child will receive…”)
and address specific concerns empathetically.
