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
Reference: Ch. 1 — The Practice of Medicine
Question Stem: A 68-year-old man with multiple chronic
illnesses wants a physician who will coordinate care and avoid
unnecessary tests. Which physician behavior best aligns with
Harrison’s principles of high-quality primary care?
,A. Ordering comprehensive screening panels annually
regardless of life expectancy
B. Prioritizing continuity, shared decision-making, and
individualized preventive care
C. Referring all specialty issues immediately to subspecialists to
avoid risk
D. Focusing visits exclusively on acute complaints to maximize
throughput
Correct Answer: B
Rationales:
• Correct (B): Continuity, shared decision-making, and
tailoring preventive interventions to patient goals and
prognosis maximize value and patient-centered care.
• A: Routine blanket screening without considering life
expectancy can cause harm and low-value care.
• C: Over-referral fragments care; coordination by the
primary physician improves outcomes.
• D: Ignoring chronic disease management undermines long-
term outcomes and continuity.
Teaching Point: Continuity and patient-centered decision-
making improve quality and reduce low-value care.
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 community clinic with limited resources must
choose one public-health intervention to reduce cardiovascular
disease burden. Which intervention offers the greatest
population-level impact per Harrison’s prevention framework?
A. Mass cholesterol screening of all adults under 40
B. Implementing a community-wide tobacco cessation program
C. Free individual genetic testing for familial
hypercholesterolemia
D. Annual stress-testing for people with no symptoms
Correct Answer: B
Rationales:
• Correct (B): Tobacco cessation programs yield large,
population-level reductions in cardiovascular morbidity
and mortality and are high-impact preventive measures.
• A: Screening younger adults broadly is low yield and not
cost-effective.
• C: Targeted genetic testing is valuable but affects a small
population subset.
• D: Routine stress testing in asymptomatic individuals leads
to overdiagnosis and low benefit.
Teaching Point: Population-level tobacco cessation
achieves large cardiovascular health gains.
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 pediatric nurse encounters a parent who
refuses routine immunizations due to misinformation online.
According to Harrison’s guidance, which approach best reduces
vaccine hesitancy?
A. Dismissing the parent's concerns and insisting on vaccination
immediately
B. Providing empathetic listening, correcting misconceptions,
and discussing benefits and risks
C. Offering to document refusal without further discussion to
avoid confrontation
D. Referring the family to anti-vaccine online communities for
reassurance
Correct Answer: B
Rationales:
• Correct (B): Empathy, addressing specific concerns, and
clear risk–benefit communication are evidence-based
strategies to reduce hesitancy.
• A: Dismissal damages trust and reduces the chance of
future acceptance.
• C: Passive documentation misses an opportunity for
education and harm reduction.
& 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
Reference: Ch. 1 — The Practice of Medicine
Question Stem: A 68-year-old man with multiple chronic
illnesses wants a physician who will coordinate care and avoid
unnecessary tests. Which physician behavior best aligns with
Harrison’s principles of high-quality primary care?
,A. Ordering comprehensive screening panels annually
regardless of life expectancy
B. Prioritizing continuity, shared decision-making, and
individualized preventive care
C. Referring all specialty issues immediately to subspecialists to
avoid risk
D. Focusing visits exclusively on acute complaints to maximize
throughput
Correct Answer: B
Rationales:
• Correct (B): Continuity, shared decision-making, and
tailoring preventive interventions to patient goals and
prognosis maximize value and patient-centered care.
• A: Routine blanket screening without considering life
expectancy can cause harm and low-value care.
• C: Over-referral fragments care; coordination by the
primary physician improves outcomes.
• D: Ignoring chronic disease management undermines long-
term outcomes and continuity.
Teaching Point: Continuity and patient-centered decision-
making improve quality and reduce low-value care.
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 community clinic with limited resources must
choose one public-health intervention to reduce cardiovascular
disease burden. Which intervention offers the greatest
population-level impact per Harrison’s prevention framework?
A. Mass cholesterol screening of all adults under 40
B. Implementing a community-wide tobacco cessation program
C. Free individual genetic testing for familial
hypercholesterolemia
D. Annual stress-testing for people with no symptoms
Correct Answer: B
Rationales:
• Correct (B): Tobacco cessation programs yield large,
population-level reductions in cardiovascular morbidity
and mortality and are high-impact preventive measures.
• A: Screening younger adults broadly is low yield and not
cost-effective.
• C: Targeted genetic testing is valuable but affects a small
population subset.
• D: Routine stress testing in asymptomatic individuals leads
to overdiagnosis and low benefit.
Teaching Point: Population-level tobacco cessation
achieves large cardiovascular health gains.
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 pediatric nurse encounters a parent who
refuses routine immunizations due to misinformation online.
According to Harrison’s guidance, which approach best reduces
vaccine hesitancy?
A. Dismissing the parent's concerns and insisting on vaccination
immediately
B. Providing empathetic listening, correcting misconceptions,
and discussing benefits and risks
C. Offering to document refusal without further discussion to
avoid confrontation
D. Referring the family to anti-vaccine online communities for
reassurance
Correct Answer: B
Rationales:
• Correct (B): Empathy, addressing specific concerns, and
clear risk–benefit communication are evidence-based
strategies to reduce hesitancy.
• A: Dismissal damages trust and reduces the chance of
future acceptance.
• C: Passive documentation misses an opportunity for
education and harm reduction.
