Harrison's Principles of Internal Medicine
(Vol.1 & Vol.2)
22nd Edition
• Author(s)Joseph Loscalzo; Anthony S.
Fauci; Dennis L. Kasper; Stephen Hauser;
Dan Longo; J. Larry Jameson
Test Bank
exam-relevant multiple-choice questions derived exclusively
from the specified chapters of Harrison's Principles of Internal
Medicine, 22nd Edition. The questions are designed for medical-
surgical nursing student review, focusing on application,
judgment, and high-yield concepts.
1. A nurse is providing health education in a community setting.
When discussing primary prevention strategies for chronic
disease, the nurse's teaching should be based on the
understanding that the most significant modifiable factor
influencing population health in the United States is:
A. Access to genetic counseling.
,B. Socioeconomic status.
C. Personal behavioral choices (e.g., smoking, diet, exercise).
D. Availability of tertiary care medical centers.
Answer: C. Personal behavioral choices (e.g., smoking, diet,
exercise).
Rationale: Harrison's identifies personal behaviors, such as
tobacco use, physical inactivity, and poor diet, as the leading
contributors to premature mortality and morbidity in the U.S.,
representing a core focus for primary prevention efforts.
Citation: Loscalzo et al. Harrison's Principles of Internal
Medicine, 22nd ed. Chapter 2: Promoting Good Health.
2. A patient expresses strong hesitation about receiving the
influenza vaccine, stating, "I got the flu from the shot last year."
Which response by the nurse best reflects an evidence-based
approach to vaccine hesitancy as discussed in Harrison's?
A. "That is a scientifically impossible reaction; you must be
mistaken."
B. "The vaccine is mandatory for public safety, so you should
comply."
C. "I understand your concern. The injectable vaccine is made
from inactivated virus, so it cannot give you the flu. What you
experienced was likely a coincidental illness or your immune
system responding."
D. "You are entitled to your opinion, but your decision puts
others at risk."
Answer: C. "I understand your concern. The injectable vaccine
is made from inactivated virus, so it cannot give you the flu.
,What you experienced was likely a coincidental illness or your
immune system responding."
Rationale: Effective communication involves empathetic
engagement and providing clear, accurate information to
correct misconceptions. Acknowledging the concern and then
educating on the nature of inactivated vaccines addresses a
common false belief.
Citation: Loscalzo et al. Harrison's Principles of Internal
Medicine, 22nd ed. Chapter 3: Vaccine Opposition and
Hesitancy.
3. When applying the concept of "value" in clinical care, a nurse
understands that it is best defined as:
A. The total cost of a medical intervention.
B. The relationship between patient outcomes achieved and the
cost of achieving them.
C. The use of the most advanced technology available.
D. The patient's subjective satisfaction with their care.
Answer: B. The relationship between patient outcomes
achieved and the cost of achieving them.
Rationale: Harrison's defines value in health care as the
measured improvement in patient outcomes relative to the cost
of delivering the care. This framework is central to improving
healthcare systems.
Citation: Loscalzo et al. Harrison's Principles of Internal
Medicine, 22nd ed. Chapter 7: The Safety and Quality of Health
Care.
, 4. A nurse is preparing a patient for discharge after a
hospitalization for heart failure. The nurse recognizes that
which action is the most critical component of an effective
transition of care to prevent readmission?
A. Providing a typed list of medications.
B. Scheduling a follow-up appointment with the primary care
provider within 7 days.
C. Conducting a comprehensive bedside physical assessment.
D. Ensuring direct, person-to-person communication between
the hospital nurse and the next care provider.
Answer: D. Ensuring direct, person-to-person communication
between the hospital nurse and the next care provider.
Rationale: Harrison's emphasizes that the single most
important factor in reducing readmissions is direct, verbal
communication (a "warm handoff") between hospital and next-
provider clinicians to convey critical information and ensure
accountability.
Citation: Loscalzo et al. Harrison's Principles of Internal
Medicine, 22nd ed. Chapter 7: The Safety and Quality of Health
Care.
5. During a shift assessment, a nurse detects a new, subtle
diastolic murmur in a patient with a history of fever. This finding
directly illustrates the principle that:
A. Laboratory diagnostics have rendered the physical exam
obsolete.
B. The physical exam is primarily for establishing rapport.
C. A carefully performed physical exam can generate diagnostic
(Vol.1 & Vol.2)
22nd Edition
• Author(s)Joseph Loscalzo; Anthony S.
Fauci; Dennis L. Kasper; Stephen Hauser;
Dan Longo; J. Larry Jameson
Test Bank
exam-relevant multiple-choice questions derived exclusively
from the specified chapters of Harrison's Principles of Internal
Medicine, 22nd Edition. The questions are designed for medical-
surgical nursing student review, focusing on application,
judgment, and high-yield concepts.
1. A nurse is providing health education in a community setting.
When discussing primary prevention strategies for chronic
disease, the nurse's teaching should be based on the
understanding that the most significant modifiable factor
influencing population health in the United States is:
A. Access to genetic counseling.
,B. Socioeconomic status.
C. Personal behavioral choices (e.g., smoking, diet, exercise).
D. Availability of tertiary care medical centers.
Answer: C. Personal behavioral choices (e.g., smoking, diet,
exercise).
Rationale: Harrison's identifies personal behaviors, such as
tobacco use, physical inactivity, and poor diet, as the leading
contributors to premature mortality and morbidity in the U.S.,
representing a core focus for primary prevention efforts.
Citation: Loscalzo et al. Harrison's Principles of Internal
Medicine, 22nd ed. Chapter 2: Promoting Good Health.
2. A patient expresses strong hesitation about receiving the
influenza vaccine, stating, "I got the flu from the shot last year."
Which response by the nurse best reflects an evidence-based
approach to vaccine hesitancy as discussed in Harrison's?
A. "That is a scientifically impossible reaction; you must be
mistaken."
B. "The vaccine is mandatory for public safety, so you should
comply."
C. "I understand your concern. The injectable vaccine is made
from inactivated virus, so it cannot give you the flu. What you
experienced was likely a coincidental illness or your immune
system responding."
D. "You are entitled to your opinion, but your decision puts
others at risk."
Answer: C. "I understand your concern. The injectable vaccine
is made from inactivated virus, so it cannot give you the flu.
,What you experienced was likely a coincidental illness or your
immune system responding."
Rationale: Effective communication involves empathetic
engagement and providing clear, accurate information to
correct misconceptions. Acknowledging the concern and then
educating on the nature of inactivated vaccines addresses a
common false belief.
Citation: Loscalzo et al. Harrison's Principles of Internal
Medicine, 22nd ed. Chapter 3: Vaccine Opposition and
Hesitancy.
3. When applying the concept of "value" in clinical care, a nurse
understands that it is best defined as:
A. The total cost of a medical intervention.
B. The relationship between patient outcomes achieved and the
cost of achieving them.
C. The use of the most advanced technology available.
D. The patient's subjective satisfaction with their care.
Answer: B. The relationship between patient outcomes
achieved and the cost of achieving them.
Rationale: Harrison's defines value in health care as the
measured improvement in patient outcomes relative to the cost
of delivering the care. This framework is central to improving
healthcare systems.
Citation: Loscalzo et al. Harrison's Principles of Internal
Medicine, 22nd ed. Chapter 7: The Safety and Quality of Health
Care.
, 4. A nurse is preparing a patient for discharge after a
hospitalization for heart failure. The nurse recognizes that
which action is the most critical component of an effective
transition of care to prevent readmission?
A. Providing a typed list of medications.
B. Scheduling a follow-up appointment with the primary care
provider within 7 days.
C. Conducting a comprehensive bedside physical assessment.
D. Ensuring direct, person-to-person communication between
the hospital nurse and the next care provider.
Answer: D. Ensuring direct, person-to-person communication
between the hospital nurse and the next care provider.
Rationale: Harrison's emphasizes that the single most
important factor in reducing readmissions is direct, verbal
communication (a "warm handoff") between hospital and next-
provider clinicians to convey critical information and ensure
accountability.
Citation: Loscalzo et al. Harrison's Principles of Internal
Medicine, 22nd ed. Chapter 7: The Safety and Quality of Health
Care.
5. During a shift assessment, a nurse detects a new, subtle
diastolic murmur in a patient with a history of fever. This finding
directly illustrates the principle that:
A. Laboratory diagnostics have rendered the physical exam
obsolete.
B. The physical exam is primarily for establishing rapport.
C. A carefully performed physical exam can generate diagnostic
