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 congestive heart failure asks whether
an invasive diagnostic test is “worth it” given his age and frailty.
Which approach best aligns with professional ethical practice
when discussing options?
,Options
A. Recommend the test if it’s standard of care, regardless of his
values.
B. Provide balanced information about risks, benefits, and
alternatives and elicit his goals.
C. Defer the decision to the family to avoid distressing the
patient.
D. Decide against the test because frailty predicts poor
outcomes.
Correct Answer
B
Rationales
• Correct (B): Ethical practice requires shared decision-
making: present risks, benefits, alternatives, and actively
elicit patient goals and values to align care.
• A: Incorrect — offering only standard-of-care without
eliciting patient values fails to respect autonomy.
• C: Incorrect — deferring to family without involving the
competent patient undermines autonomy.
• D: Incorrect — frailty informs prognosis but does not
automatically preclude discussing or offering testing;
decisions should be individualized.
Teaching Point
Shared decision-making integrates evidence with patient goals.
,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 52-year-old patient with BMI 32 asks which single lifestyle
change will most rapidly reduce cardiovascular risk. Which
counseling focus is most supported for greatest near-term risk
reduction?
Options
A. Increase daily multivitamin use.
B. Start moderate-intensity aerobic exercise and reduce caloric
intake.
C. Replace all dietary fat with carbohydrates.
D. Focus primarily on resistance training without changing diet.
Correct Answer
B
Rationales
• Correct (B): Combined caloric reduction and moderate
aerobic exercise produce early improvements in blood
, pressure, lipids, and insulin sensitivity—reducing
cardiovascular risk.
• A: Incorrect — multivitamins have not demonstrated rapid
CV risk reduction.
• C: Incorrect — replacing fats with refined carbohydrates
can worsen metabolic risk.
• D: Incorrect — resistance training helps but is less effective
alone than combined aerobic exercise plus diet change for
near-term cardiometabolic risk.
Teaching Point
Dietary caloric reduction + aerobic exercise yields rapid
cardiometabolic benefit.
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 parent cites misinformation on social media and declines
routine childhood vaccines. Which strategy best reduces
hesitancy while maintaining trust?
(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 congestive heart failure asks whether
an invasive diagnostic test is “worth it” given his age and frailty.
Which approach best aligns with professional ethical practice
when discussing options?
,Options
A. Recommend the test if it’s standard of care, regardless of his
values.
B. Provide balanced information about risks, benefits, and
alternatives and elicit his goals.
C. Defer the decision to the family to avoid distressing the
patient.
D. Decide against the test because frailty predicts poor
outcomes.
Correct Answer
B
Rationales
• Correct (B): Ethical practice requires shared decision-
making: present risks, benefits, alternatives, and actively
elicit patient goals and values to align care.
• A: Incorrect — offering only standard-of-care without
eliciting patient values fails to respect autonomy.
• C: Incorrect — deferring to family without involving the
competent patient undermines autonomy.
• D: Incorrect — frailty informs prognosis but does not
automatically preclude discussing or offering testing;
decisions should be individualized.
Teaching Point
Shared decision-making integrates evidence with patient goals.
,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 52-year-old patient with BMI 32 asks which single lifestyle
change will most rapidly reduce cardiovascular risk. Which
counseling focus is most supported for greatest near-term risk
reduction?
Options
A. Increase daily multivitamin use.
B. Start moderate-intensity aerobic exercise and reduce caloric
intake.
C. Replace all dietary fat with carbohydrates.
D. Focus primarily on resistance training without changing diet.
Correct Answer
B
Rationales
• Correct (B): Combined caloric reduction and moderate
aerobic exercise produce early improvements in blood
, pressure, lipids, and insulin sensitivity—reducing
cardiovascular risk.
• A: Incorrect — multivitamins have not demonstrated rapid
CV risk reduction.
• C: Incorrect — replacing fats with refined carbohydrates
can worsen metabolic risk.
• D: Incorrect — resistance training helps but is less effective
alone than combined aerobic exercise plus diet change for
near-term cardiometabolic risk.
Teaching Point
Dietary caloric reduction + aerobic exercise yields rapid
cardiometabolic benefit.
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 parent cites misinformation on social media and declines
routine childhood vaccines. Which strategy best reduces
hesitancy while maintaining trust?
