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
Covered
PART 1: Foundations of Clinical Medicine
PART 2: Cardinal Symptoms & Clinical Presentations
PART 3: Clinical Pharmacology
PART 4: Oncology & Hematology
PART 5: Infectious Diseases
PART 6: Cardiovascular Disorders
PART 7: Respiratory Disorders
PART 8: Critical Care Medicine
PART 9: Kidney & Urinary Tract Disorders
PART 10: Gastrointestinal & Hepatobiliary Disorders
,PART 11: Immune-Mediated & Rheumatologic Disorders
PART 12: Endocrinology & Metabolism
PART 13: Neurologic & Psychiatric Disorders
PART 14: Toxicology & Environmental Injury
PART 15: Environmental & Occupational Medicine
PART 16: Genetics, Precision & Systems Medicine
PART 17–20: Special & Emerging Topics
1. A 68-year-old patient is admitted for multiple
comorbidities and asks the nurse how clinicians weigh a
patient’s values when choosing between equally
reasonable treatments. Which principle of "the practice of
medicine" best guides shared decision-making?
A. Paternalism — clinician decides what’s best
B. Evidence alone — follow guideline without patient input
C. Patient-centered care — integrate patient values with
clinical evidence
D. Resource maximization — choose the least costly option
Correct: C. Patient-centered care — integrate patient values
with clinical evidence.
Rationale: Modern practice emphasizes integrating best
evidence with patient preferences and values; nurses facilitate
eliciting values and supporting informed choices.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 1: The Practice of Medicine.
, 2. A nurse implementing a preventive health visit prioritizes
counseling on a major modifiable risk factor that reduces
cardiovascular mortality. Which topic should be
emphasized first?
A. Genetic testing for rare variants
B. Tobacco cessation
C. Routine vitamin supplementation
D. Annual brain MRI screening
Correct: B. Tobacco cessation.
Rationale: Smoking is a leading modifiable risk factor for
cardiovascular disease; health promotion interventions focus on
cessation counseling, assessment, and referral.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 2: Promoting Good Health.
3. A parent expresses concern about vaccinating their infant
because of online misinformation. Which initial nursing
response most aligns with best practice for addressing
vaccine hesitancy?
A. Ignore concerns and insist on vaccination immediately
B. Acknowledge concerns, elicit specific reasons, and
provide clear, evidence-based information
C. Provide a printed scientific paper only and leave
D. Advise delaying all vaccines until school age
Correct: B. Acknowledge concerns, elicit specific reasons, and
provide clear, evidence-based information.
, Rationale: Effective counseling for vaccine hesitancy involves
respectful engagement, identifying specific beliefs, correcting
misinformation, and recommending vaccination.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 3: Vaccine Opposition and Hesitancy.
4. In a complex diagnostic case with multiple reasonable
options, which decision-making approach reduces
cognitive bias and supports safer choices?
A. Fast intuitive decisions without documentation
B. Use of structured clinical decision tools and explicit
consideration of alternatives
C. Rely exclusively on memory of past similar cases
D. Defer all decisions to the most senior clinician without
discussion
Correct: B. Use of structured clinical decision tools and explicit
consideration of alternatives.
Rationale: Structured decision processes (algorithms,
checklists, differential-diagnosis frameworks) reduce bias and
improve diagnostic accuracy; nurses support documentation
and implementation.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 4: Decision-Making in Clinical 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
Covered
PART 1: Foundations of Clinical Medicine
PART 2: Cardinal Symptoms & Clinical Presentations
PART 3: Clinical Pharmacology
PART 4: Oncology & Hematology
PART 5: Infectious Diseases
PART 6: Cardiovascular Disorders
PART 7: Respiratory Disorders
PART 8: Critical Care Medicine
PART 9: Kidney & Urinary Tract Disorders
PART 10: Gastrointestinal & Hepatobiliary Disorders
,PART 11: Immune-Mediated & Rheumatologic Disorders
PART 12: Endocrinology & Metabolism
PART 13: Neurologic & Psychiatric Disorders
PART 14: Toxicology & Environmental Injury
PART 15: Environmental & Occupational Medicine
PART 16: Genetics, Precision & Systems Medicine
PART 17–20: Special & Emerging Topics
1. A 68-year-old patient is admitted for multiple
comorbidities and asks the nurse how clinicians weigh a
patient’s values when choosing between equally
reasonable treatments. Which principle of "the practice of
medicine" best guides shared decision-making?
A. Paternalism — clinician decides what’s best
B. Evidence alone — follow guideline without patient input
C. Patient-centered care — integrate patient values with
clinical evidence
D. Resource maximization — choose the least costly option
Correct: C. Patient-centered care — integrate patient values
with clinical evidence.
Rationale: Modern practice emphasizes integrating best
evidence with patient preferences and values; nurses facilitate
eliciting values and supporting informed choices.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 1: The Practice of Medicine.
, 2. A nurse implementing a preventive health visit prioritizes
counseling on a major modifiable risk factor that reduces
cardiovascular mortality. Which topic should be
emphasized first?
A. Genetic testing for rare variants
B. Tobacco cessation
C. Routine vitamin supplementation
D. Annual brain MRI screening
Correct: B. Tobacco cessation.
Rationale: Smoking is a leading modifiable risk factor for
cardiovascular disease; health promotion interventions focus on
cessation counseling, assessment, and referral.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 2: Promoting Good Health.
3. A parent expresses concern about vaccinating their infant
because of online misinformation. Which initial nursing
response most aligns with best practice for addressing
vaccine hesitancy?
A. Ignore concerns and insist on vaccination immediately
B. Acknowledge concerns, elicit specific reasons, and
provide clear, evidence-based information
C. Provide a printed scientific paper only and leave
D. Advise delaying all vaccines until school age
Correct: B. Acknowledge concerns, elicit specific reasons, and
provide clear, evidence-based information.
, Rationale: Effective counseling for vaccine hesitancy involves
respectful engagement, identifying specific beliefs, correcting
misinformation, and recommending vaccination.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 3: Vaccine Opposition and Hesitancy.
4. In a complex diagnostic case with multiple reasonable
options, which decision-making approach reduces
cognitive bias and supports safer choices?
A. Fast intuitive decisions without documentation
B. Use of structured clinical decision tools and explicit
consideration of alternatives
C. Rely exclusively on memory of past similar cases
D. Defer all decisions to the most senior clinician without
discussion
Correct: B. Use of structured clinical decision tools and explicit
consideration of alternatives.
Rationale: Structured decision processes (algorithms,
checklists, differential-diagnosis frameworks) reduce bias and
improve diagnostic accuracy; nurses support documentation
and implementation.
Citation: Harrison’s Principles of Internal Medicine, 22nd ed.,
Chapter 4: Decision-Making in Clinical Medicine.
