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 hospitalist is managing a 68-year-old patient with multiple
comorbidities and unclear prognosis. Family requests
“everything possible.” Using professional responsibilities and
patient-centered care principles, which action best aligns with
high-quality practice?
,Options
A. Comply with the family request and initiate all available life-
sustaining interventions.
B. Convene a goals-of-care discussion with patient (if able) and
family to align treatments with patient values.
C. Defer decision-making to the most senior attending to avoid
conflict.
D. Limit interventions to those with the highest chance of cure
without further discussion.
Correct Answer
B
Rationales
Correct: Harrison emphasizes physician responsibility to engage
patients/families in goals-of-care discussions and align
treatment with patient values and prognosis. This supports
shared decision-making and ethically appropriate care.
A: Automatically initiating all interventions may conflict with
patient preferences and can cause nonbeneficial care.
C: Deferring to hierarchy avoids patient-centered discussion and
undermines professional responsibility.
D: Unilaterally limiting care without patient/family input risks
paternalism and ethical conflict.
Teaching Point
Elicit goals of care; align interventions with patient values and
prognosis.
,Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A resident must communicate a serious diagnostic error to a
patient. According to professional standards in clinical practice,
what approach best balances honesty, safety, and systems
improvement?
Options
A. Avoid disclosure until legal counsel reviews the case.
B. Provide a timely, honest explanation, apologize if
appropriate, and report the event for system review.
C. Blame the error on workload and reassure the patient it
won’t happen again.
D. Offer a vague statement about “unanticipated outcomes”
without details.
Correct Answer
B
Rationales
Correct: Harrison supports transparent disclosure of errors with
apology when indicated and simultaneous reporting to improve
, system safety. This approach respects patients and promotes
quality improvement.
A: Waiting for legal counsel delays needed ethical obligations
and patient-centered communication.
C: Blaming external factors without transparency is dishonest
and undermines trust.
D: Vague statements fail to meet ethical standards for informed
communication and do not facilitate learning.
Teaching Point
Disclose errors promptly, apologize when appropriate, and
report for system-level improvement.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3
Reference
Ch. 2 — Promoting Good Health
Question Stem
A primary care nurse counsels a 52-year-old smoker with
borderline hypertension on lifestyle change. Which counseling
approach most likely increases sustained behavior change?
Options
A. Prescribe antihypertensives immediately and revisit smoking
cessation later.
(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 hospitalist is managing a 68-year-old patient with multiple
comorbidities and unclear prognosis. Family requests
“everything possible.” Using professional responsibilities and
patient-centered care principles, which action best aligns with
high-quality practice?
,Options
A. Comply with the family request and initiate all available life-
sustaining interventions.
B. Convene a goals-of-care discussion with patient (if able) and
family to align treatments with patient values.
C. Defer decision-making to the most senior attending to avoid
conflict.
D. Limit interventions to those with the highest chance of cure
without further discussion.
Correct Answer
B
Rationales
Correct: Harrison emphasizes physician responsibility to engage
patients/families in goals-of-care discussions and align
treatment with patient values and prognosis. This supports
shared decision-making and ethically appropriate care.
A: Automatically initiating all interventions may conflict with
patient preferences and can cause nonbeneficial care.
C: Deferring to hierarchy avoids patient-centered discussion and
undermines professional responsibility.
D: Unilaterally limiting care without patient/family input risks
paternalism and ethical conflict.
Teaching Point
Elicit goals of care; align interventions with patient values and
prognosis.
,Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A resident must communicate a serious diagnostic error to a
patient. According to professional standards in clinical practice,
what approach best balances honesty, safety, and systems
improvement?
Options
A. Avoid disclosure until legal counsel reviews the case.
B. Provide a timely, honest explanation, apologize if
appropriate, and report the event for system review.
C. Blame the error on workload and reassure the patient it
won’t happen again.
D. Offer a vague statement about “unanticipated outcomes”
without details.
Correct Answer
B
Rationales
Correct: Harrison supports transparent disclosure of errors with
apology when indicated and simultaneous reporting to improve
, system safety. This approach respects patients and promotes
quality improvement.
A: Waiting for legal counsel delays needed ethical obligations
and patient-centered communication.
C: Blaming external factors without transparency is dishonest
and undermines trust.
D: Vague statements fail to meet ethical standards for informed
communication and do not facilitate learning.
Teaching Point
Disclose errors promptly, apologize when appropriate, and
report for system-level improvement.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3
Reference
Ch. 2 — Promoting Good Health
Question Stem
A primary care nurse counsels a 52-year-old smoker with
borderline hypertension on lifestyle change. Which counseling
approach most likely increases sustained behavior change?
Options
A. Prescribe antihypertensives immediately and revisit smoking
cessation later.
