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 requests an
off-label medication recommended by an online forum. As the
,admitting nurse, which action best exemplifies professional
practice in shared decision-making?
Options
A. Tell the patient the medication is unsafe and refuse to
administer it.
B. Explain the lack of evidence, discuss risks/benefits, and
document a plan aligned with patient goals.
C. Defer all discussion to the attending physician without
engaging the patient.
D. Encourage the patient to follow online advice because it
respects autonomy.
Correct Answer
B
Rationales
• Correct: Engaging the patient with evidence-informed
discussion, aligning choices with goals, and documenting
the plan exemplifies professional shared decision-making.
• A: Refusing without discussion overrides autonomy and
undermines trust.
• C: Abandoning the patient to another clinician neglects
duty to inform and support immediate decisions.
• D: Encouraging unverified online advice risks harm and is
not evidence-based.
,Teaching Point
Shared decision-making: discuss evidence, risks, benefits, and
patient goals; document plan.
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 primary care clinic implements a nurse-led program to
increase tobacco cessation. Which metric best measures the
program’s effectiveness at the population level?
Options
A. Number of nicotine patches distributed.
B. Clinic clinician satisfaction scores.
C. Reduction in smoking prevalence among the clinic’s adult
patients over 12 months.
D. Number of educational pamphlets on smoking given out.
Correct Answer
C
Rationales
• Correct: Prevalence reduction measures actual health
behavior change at the population level.
, • A: Distribution is a process measure, not an outcome of
health promotion.
• B: Clinician satisfaction is an implementation metric, not
population health impact.
• D: Pamphlets are inputs; they don’t directly indicate
behavior change.
Teaching Point
Use outcome measures (prevalence, morbidity) to evaluate
health-promotion success.
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 clinic nurse encounters a parent hesitant about routine
childhood vaccines due to safety fears. Which nursing
response most effectively addresses hesitancy?
Options
A. Insist vaccines are mandatory and proceed without
discussion.
B. Provide empathetic listening, correct misconceptions with
evidence, and offer time to decide.
& 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 requests an
off-label medication recommended by an online forum. As the
,admitting nurse, which action best exemplifies professional
practice in shared decision-making?
Options
A. Tell the patient the medication is unsafe and refuse to
administer it.
B. Explain the lack of evidence, discuss risks/benefits, and
document a plan aligned with patient goals.
C. Defer all discussion to the attending physician without
engaging the patient.
D. Encourage the patient to follow online advice because it
respects autonomy.
Correct Answer
B
Rationales
• Correct: Engaging the patient with evidence-informed
discussion, aligning choices with goals, and documenting
the plan exemplifies professional shared decision-making.
• A: Refusing without discussion overrides autonomy and
undermines trust.
• C: Abandoning the patient to another clinician neglects
duty to inform and support immediate decisions.
• D: Encouraging unverified online advice risks harm and is
not evidence-based.
,Teaching Point
Shared decision-making: discuss evidence, risks, benefits, and
patient goals; document plan.
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 primary care clinic implements a nurse-led program to
increase tobacco cessation. Which metric best measures the
program’s effectiveness at the population level?
Options
A. Number of nicotine patches distributed.
B. Clinic clinician satisfaction scores.
C. Reduction in smoking prevalence among the clinic’s adult
patients over 12 months.
D. Number of educational pamphlets on smoking given out.
Correct Answer
C
Rationales
• Correct: Prevalence reduction measures actual health
behavior change at the population level.
, • A: Distribution is a process measure, not an outcome of
health promotion.
• B: Clinician satisfaction is an implementation metric, not
population health impact.
• D: Pamphlets are inputs; they don’t directly indicate
behavior change.
Teaching Point
Use outcome measures (prevalence, morbidity) to evaluate
health-promotion success.
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 clinic nurse encounters a parent hesitant about routine
childhood vaccines due to safety fears. Which nursing
response most effectively addresses hesitancy?
Options
A. Insist vaccines are mandatory and proceed without
discussion.
B. Provide empathetic listening, correct misconceptions with
evidence, and offer time to decide.
