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 is admitted with
dyspnea. As the senior nurse, you must communicate the plan
with the primary team while ensuring patient-centered care.
,Which action best demonstrates application of the “patient-as-
partner” principle in clinical practice?
Options
A. Explain the diagnostic and treatment plan only to the
patient's adult son because he is the primary contact.
B. Present the plan to the patient, elicit his goals and
preferences, and document shared decisions.
C. Implement the team's recommended treatment immediately
to avoid delays, then inform the patient.
D. Ask the patient to defer decision-making to the physician to
reduce anxiety.
Correct Answer
B
Rationales
Correct: B — Engaging the patient, eliciting goals/preferences,
and documenting shared decisions integrates patient
partnership with clinical planning and supports informed
consent.
A — Excluding the patient ignores autonomy unless the patient
lacks capacity; involving surrogate only when appropriate is
required.
C — Acting before discussion sacrifices shared decision-making
and may conflict with patient values.
D — Defaulting decisions to physicians disregards patient
autonomy and shared decision models.
,Teaching Point
Shared decision-making centers on patient goals, preferences,
and documented consensus.
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
A junior clinician wants to improve diagnostic accuracy on the
ward. Which deliberate practice strategy most directly reduces
cognitive biases and improves clinical reasoning?
Options
A. Relying on pattern recognition from prior similar cases
exclusively.
B. Using reflective debriefing that compares initial hypotheses
with outcome data.
C. Avoiding second opinions to build independent clinical
confidence.
D. Increasing the number of patients seen per hour to gain
exposure.
Correct Answer
B
, Rationales
Correct: B — Reflective debriefing that compares hypotheses to
outcomes fosters metacognition and reduces anchoring and
availability biases.
A — Pattern recognition is efficient but increases error risk
when used without analytic reflection.
C — Avoiding second opinions removes a vital safeguard against
error, especially in complex cases.
D — Volume alone may increase exposure but doesn't target
bias reduction or improve diagnostic accuracy.
Teaching Point
Reflective comparison of hypotheses and outcomes reduces
bias and strengthens reasoning.
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 serving low-income patients plans
interventions to lower type 2 diabetes incidence. Which
population-level intervention aligns best with primary
prevention principles and expected greatest population impact?
& 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 is admitted with
dyspnea. As the senior nurse, you must communicate the plan
with the primary team while ensuring patient-centered care.
,Which action best demonstrates application of the “patient-as-
partner” principle in clinical practice?
Options
A. Explain the diagnostic and treatment plan only to the
patient's adult son because he is the primary contact.
B. Present the plan to the patient, elicit his goals and
preferences, and document shared decisions.
C. Implement the team's recommended treatment immediately
to avoid delays, then inform the patient.
D. Ask the patient to defer decision-making to the physician to
reduce anxiety.
Correct Answer
B
Rationales
Correct: B — Engaging the patient, eliciting goals/preferences,
and documenting shared decisions integrates patient
partnership with clinical planning and supports informed
consent.
A — Excluding the patient ignores autonomy unless the patient
lacks capacity; involving surrogate only when appropriate is
required.
C — Acting before discussion sacrifices shared decision-making
and may conflict with patient values.
D — Defaulting decisions to physicians disregards patient
autonomy and shared decision models.
,Teaching Point
Shared decision-making centers on patient goals, preferences,
and documented consensus.
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
A junior clinician wants to improve diagnostic accuracy on the
ward. Which deliberate practice strategy most directly reduces
cognitive biases and improves clinical reasoning?
Options
A. Relying on pattern recognition from prior similar cases
exclusively.
B. Using reflective debriefing that compares initial hypotheses
with outcome data.
C. Avoiding second opinions to build independent clinical
confidence.
D. Increasing the number of patients seen per hour to gain
exposure.
Correct Answer
B
, Rationales
Correct: B — Reflective debriefing that compares hypotheses to
outcomes fosters metacognition and reduces anchoring and
availability biases.
A — Pattern recognition is efficient but increases error risk
when used without analytic reflection.
C — Avoiding second opinions removes a vital safeguard against
error, especially in complex cases.
D — Volume alone may increase exposure but doesn't target
bias reduction or improve diagnostic accuracy.
Teaching Point
Reflective comparison of hypotheses and outcomes reduces
bias and strengthens reasoning.
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 serving low-income patients plans
interventions to lower type 2 diabetes incidence. Which
population-level intervention aligns best with primary
prevention principles and expected greatest population impact?
