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
Q1
Reference: Ch. 1 — The Practice of Medicine
Question Stem: A 68-year-old man with multiple chronic
conditions is admitted for heart failure exacerbation. The
primary team must communicate prognosis and plan with him
and his daughter, who insists on “doing everything.” Which
,approach best reflects professional practice balancing
beneficence, autonomy, and realistic goals of care?
A. Agree to all possible life-sustaining interventions regardless
of prognosis to respect the daughter's wishes.
B. Explain the prognosis, elicit the patient's values/goals, and
align interventions with those goals.
C. Defer all decisions to the daughter because she is the most
involved family member.
D. Immediately place a do-not-resuscitate order without
discussion to avoid conflict.
Correct Answer: B
Rationales:
• Correct (B): Professional practice requires clear prognosis
communication, eliciting the patient’s values, and choosing
interventions consistent with those goals—balancing
autonomy and beneficence.
• A: Accepting all interventions solely to satisfy a surrogate
disregards likely harm and the patient’s own values.
• C: Automatically deferring to a family member overrides
patient autonomy unless a lawful surrogate has explicit
decision-making authority.
• D: Unilateral DNR placement without discussion is ethically
and legally inappropriate except in rare emergent
circumstances.
,Teaching Point: Elicit patient goals, then match care to those
goals through shared decision-making.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 1.
Q2
Reference: Ch. 2 — Promoting Good Health
Question Stem: A primary care nurse develops a community
program to reduce Type 2 diabetes incidence. Which
intervention is most likely to produce sustained population-level
risk reduction?
A. Monthly mass media ads promoting healthy eating.
B. Screening blood sugars once per year at churches.
C. Implementing community-based structured lifestyle
programs with built environment changes.
D. Distributing pamphlets on exercise at clinics.
Correct Answer: C
Rationales:
• Correct (C): Sustainable population health improvements
arise from structured lifestyle interventions combined with
environmental changes that enable healthy choices.
• A: Mass media alone raises awareness but rarely produces
sustained behavior change.
, • B: Screening identifies disease but does not by itself
reduce incidence without linked interventions.
• D: Pamphlets alone have limited impact on long-term
behavior without supportive programs.
Teaching Point: Combine structured interventions with
environment change for sustained public-health impact.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 2.
Q3
Reference: Ch. 3 — Vaccine Opposition and Hesitancy
Question Stem: A clinic nurse encounters a parent expressing
fear that the MMR vaccine causes developmental disorders.
What evidence-based communication strategy should the nurse
use to reduce hesitancy and increase vaccine uptake?
A. Dismiss the parent's concerns and insist on vaccination to
avoid delay.
B. Present empathetic listening, correct misinformation with
clear facts, and recommend vaccination strongly.
C. Provide only scientific studies and leave decision exclusively
to the parent.
D. Delay discussion and let the parent consult the internet for
more information.
Correct Answer: B
& 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
Q1
Reference: Ch. 1 — The Practice of Medicine
Question Stem: A 68-year-old man with multiple chronic
conditions is admitted for heart failure exacerbation. The
primary team must communicate prognosis and plan with him
and his daughter, who insists on “doing everything.” Which
,approach best reflects professional practice balancing
beneficence, autonomy, and realistic goals of care?
A. Agree to all possible life-sustaining interventions regardless
of prognosis to respect the daughter's wishes.
B. Explain the prognosis, elicit the patient's values/goals, and
align interventions with those goals.
C. Defer all decisions to the daughter because she is the most
involved family member.
D. Immediately place a do-not-resuscitate order without
discussion to avoid conflict.
Correct Answer: B
Rationales:
• Correct (B): Professional practice requires clear prognosis
communication, eliciting the patient’s values, and choosing
interventions consistent with those goals—balancing
autonomy and beneficence.
• A: Accepting all interventions solely to satisfy a surrogate
disregards likely harm and the patient’s own values.
• C: Automatically deferring to a family member overrides
patient autonomy unless a lawful surrogate has explicit
decision-making authority.
• D: Unilateral DNR placement without discussion is ethically
and legally inappropriate except in rare emergent
circumstances.
,Teaching Point: Elicit patient goals, then match care to those
goals through shared decision-making.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 1.
Q2
Reference: Ch. 2 — Promoting Good Health
Question Stem: A primary care nurse develops a community
program to reduce Type 2 diabetes incidence. Which
intervention is most likely to produce sustained population-level
risk reduction?
A. Monthly mass media ads promoting healthy eating.
B. Screening blood sugars once per year at churches.
C. Implementing community-based structured lifestyle
programs with built environment changes.
D. Distributing pamphlets on exercise at clinics.
Correct Answer: C
Rationales:
• Correct (C): Sustainable population health improvements
arise from structured lifestyle interventions combined with
environmental changes that enable healthy choices.
• A: Mass media alone raises awareness but rarely produces
sustained behavior change.
, • B: Screening identifies disease but does not by itself
reduce incidence without linked interventions.
• D: Pamphlets alone have limited impact on long-term
behavior without supportive programs.
Teaching Point: Combine structured interventions with
environment change for sustained public-health impact.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 2.
Q3
Reference: Ch. 3 — Vaccine Opposition and Hesitancy
Question Stem: A clinic nurse encounters a parent expressing
fear that the MMR vaccine causes developmental disorders.
What evidence-based communication strategy should the nurse
use to reduce hesitancy and increase vaccine uptake?
A. Dismiss the parent's concerns and insist on vaccination to
avoid delay.
B. Present empathetic listening, correct misinformation with
clear facts, and recommend vaccination strongly.
C. Provide only scientific studies and leave decision exclusively
to the parent.
D. Delay discussion and let the parent consult the internet for
more information.
Correct Answer: B
