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 patient with multiple chronic conditions asks
whether to accept a proposed invasive diagnostic test that
carries moderate risk and marginal expected benefit. As the
clinician, which approach best embodies shared decision-
making aligned with professional practice?
Options
A. Recommend the test strongly because clinicians know best.
B. Present risks and benefits neutrally, then ask the patient’s
values and preferences before recommending.
C. Defer the decision to the patient without offering
professional opinion.
D. Refuse the test since it has only marginal benefit.
Correct Answer
B
Rationales
Correct: Shared decision-making requires presenting balanced
information and eliciting the patient’s values to make a patient-
centered recommendation. This respects autonomy while
providing clinical guidance.
A: Overly paternalistic and neglects patient values, contrary to
modern practice.
C: Pure deferral places undue burden on the patient and omits
clinician expertise.
D: Clinician refusal without discussion disregards patient
,autonomy and may be inappropriate when preference-
sensitive.
Teaching Point
Shared decision-making = explain options + elicit values +
recommend.
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 has limited resources and must choose
between expanding hypertension screening or creating a
smoking-cessation program. Using population health principles,
which choice is likely to yield the greatest reduction in
preventable morbidity?
Options
A. Prioritize hypertension screening if blood-pressure control is
currently poor in the community.
B. Always choose smoking cessation because smoking causes
more disease generally.
C. Choose the intervention favored by clinic staff regardless of
, local data.
D. Implement the cheaper program regardless of impact.
Correct Answer
A
Rationales
Correct: Population health prioritization depends on local
disease burden and feasibility; if uncontrolled hypertension is
prevalent, screening/treatment yields largest morbidity
reduction.
B: While smoking cessation is high-yield broadly, local data must
drive resource allocation.
C: Staff preference alone is not evidence-based; local
epidemiology should guide choices.
D: Cost matters but ignoring impact can waste resources and
fail to improve health.
Teaching Point
Public-health priorities should follow local burden, feasibility,
and impact.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2.
3)
Reference
Ch. 3 — Vaccine Opposition and Hesitancy
& 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 patient with multiple chronic conditions asks
whether to accept a proposed invasive diagnostic test that
carries moderate risk and marginal expected benefit. As the
clinician, which approach best embodies shared decision-
making aligned with professional practice?
Options
A. Recommend the test strongly because clinicians know best.
B. Present risks and benefits neutrally, then ask the patient’s
values and preferences before recommending.
C. Defer the decision to the patient without offering
professional opinion.
D. Refuse the test since it has only marginal benefit.
Correct Answer
B
Rationales
Correct: Shared decision-making requires presenting balanced
information and eliciting the patient’s values to make a patient-
centered recommendation. This respects autonomy while
providing clinical guidance.
A: Overly paternalistic and neglects patient values, contrary to
modern practice.
C: Pure deferral places undue burden on the patient and omits
clinician expertise.
D: Clinician refusal without discussion disregards patient
,autonomy and may be inappropriate when preference-
sensitive.
Teaching Point
Shared decision-making = explain options + elicit values +
recommend.
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 has limited resources and must choose
between expanding hypertension screening or creating a
smoking-cessation program. Using population health principles,
which choice is likely to yield the greatest reduction in
preventable morbidity?
Options
A. Prioritize hypertension screening if blood-pressure control is
currently poor in the community.
B. Always choose smoking cessation because smoking causes
more disease generally.
C. Choose the intervention favored by clinic staff regardless of
, local data.
D. Implement the cheaper program regardless of impact.
Correct Answer
A
Rationales
Correct: Population health prioritization depends on local
disease burden and feasibility; if uncontrolled hypertension is
prevalent, screening/treatment yields largest morbidity
reduction.
B: While smoking cessation is high-yield broadly, local data must
drive resource allocation.
C: Staff preference alone is not evidence-based; local
epidemiology should guide choices.
D: Cost matters but ignoring impact can waste resources and
fail to improve health.
Teaching Point
Public-health priorities should follow local burden, feasibility,
and impact.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2.
3)
Reference
Ch. 3 — Vaccine Opposition and Hesitancy
