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 — Clinical Reasoning and
Diagnostic Strategy
Question Stem
A 58-year-old man with well-controlled hypertension presents
with mild, non-exertional chest discomfort. Pretest probability
for acute coronary syndrome (ACS) is low. Which is the best
next step to minimize diagnostic error and harm?
,Options
A. Order coronary angiography immediately.
B. Obtain an exercise stress test now.
C. Reassure, observe, and use focused history / serial ECGs if
symptoms change.
D. Start empiric anticoagulation and admit.
Correct Answer
C
Rationales
Correct: Observation with targeted history and serial ECGs
prevents unnecessary invasive testing when pretest probability
is low and reduces false positives.
accessmedicine.mhmedical.com
A: Angiography is invasive and inappropriate for low pretest
probability; it increases harm.
B: Stress testing when baseline probability is low can produce
more false positives and downstream harm.
D: Empiric anticoagulation risks bleeding and is not indicated
without stronger evidence of ACS.
Teaching Point
Match diagnostic intensity to pretest probability to reduce
harm.
Citation (APA)
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
,2)
Reference
Ch. 2 — Promoting Good Health — Preventive Interventions
and Behavior Change
Question Stem
A clinic implements a nurse-led brief motivational interviewing
(MI) program for smokers. After 6 months the quit rate
improves modestly. Which aspect of MI most likely explains
improved quit rates?
Options
A. Directive advice telling patients to quit immediately.
B. Eliciting patient's own motivations and supporting autonomy.
C. Providing nicotine gum without counseling.
D. Repeating epidemiologic statistics about smoking harms.
Correct Answer
B
Rationales
Correct: Motivational interviewing increases internal motivation
by eliciting patients’ own reasons and supporting autonomy,
improving adherence to behavior change.
accessmedicine.mhmedical.com
A: Directive advice alone often fails to change behavior; it may
provoke resistance.
C: Pharmacotherapy alone has benefit but is less effective
, without behavioral support.
D: Facts alone rarely change entrenched behavior without
addressing motivation and readiness.
Teaching Point
Behavior change succeeds when patients articulate their own
reasons for change.
Citation (APA)
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2.
3)
Reference
Ch. 3 — Vaccine Opposition and Hesitancy — Communication
and Risk Perception
Question Stem
A nurse encounters a parent worried vaccines cause long-term
developmental harm. Which communication approach best
reduces vaccine hesitancy and supports vaccination uptake?
Options
A. Provide long scientific monologue disproving the myth.
B. Use a presumptive recommendation and address concerns
empathically.
C. Avoid the topic to prevent conflict.
D. Provide a list of studies without context and send it home.
(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 — Clinical Reasoning and
Diagnostic Strategy
Question Stem
A 58-year-old man with well-controlled hypertension presents
with mild, non-exertional chest discomfort. Pretest probability
for acute coronary syndrome (ACS) is low. Which is the best
next step to minimize diagnostic error and harm?
,Options
A. Order coronary angiography immediately.
B. Obtain an exercise stress test now.
C. Reassure, observe, and use focused history / serial ECGs if
symptoms change.
D. Start empiric anticoagulation and admit.
Correct Answer
C
Rationales
Correct: Observation with targeted history and serial ECGs
prevents unnecessary invasive testing when pretest probability
is low and reduces false positives.
accessmedicine.mhmedical.com
A: Angiography is invasive and inappropriate for low pretest
probability; it increases harm.
B: Stress testing when baseline probability is low can produce
more false positives and downstream harm.
D: Empiric anticoagulation risks bleeding and is not indicated
without stronger evidence of ACS.
Teaching Point
Match diagnostic intensity to pretest probability to reduce
harm.
Citation (APA)
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
,2)
Reference
Ch. 2 — Promoting Good Health — Preventive Interventions
and Behavior Change
Question Stem
A clinic implements a nurse-led brief motivational interviewing
(MI) program for smokers. After 6 months the quit rate
improves modestly. Which aspect of MI most likely explains
improved quit rates?
Options
A. Directive advice telling patients to quit immediately.
B. Eliciting patient's own motivations and supporting autonomy.
C. Providing nicotine gum without counseling.
D. Repeating epidemiologic statistics about smoking harms.
Correct Answer
B
Rationales
Correct: Motivational interviewing increases internal motivation
by eliciting patients’ own reasons and supporting autonomy,
improving adherence to behavior change.
accessmedicine.mhmedical.com
A: Directive advice alone often fails to change behavior; it may
provoke resistance.
C: Pharmacotherapy alone has benefit but is less effective
, without behavioral support.
D: Facts alone rarely change entrenched behavior without
addressing motivation and readiness.
Teaching Point
Behavior change succeeds when patients articulate their own
reasons for change.
Citation (APA)
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2.
3)
Reference
Ch. 3 — Vaccine Opposition and Hesitancy — Communication
and Risk Perception
Question Stem
A nurse encounters a parent worried vaccines cause long-term
developmental harm. Which communication approach best
reduces vaccine hesitancy and supports vaccination uptake?
Options
A. Provide long scientific monologue disproving the myth.
B. Use a presumptive recommendation and address concerns
empathically.
C. Avoid the topic to prevent conflict.
D. Provide a list of studies without context and send it home.
