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 COPD and chronic kidney disease asks
whether his recent diagnostic test results justify stopping his
inhaled corticosteroid. As the clinician, which action best
demonstrates professional standards in shared decision-making
while ensuring patient safety?
Options
A. Agree to stop the medication because the patient prefers
fewer drugs.
,B. Explain risks/benefits, verify understanding, and jointly
develop a monitoring plan.
C. Refuse on principle because current guidelines recommend
continuing inhaled corticosteroids for all COPD patients.
D. Provide printed guidelines and discharge the patient to
review them alone.
Correct Answer
B
Rationales
Correct: B — Shared decision-making combines evidence,
patient values, and safety: explain risks/benefits, confirm
comprehension, and set a monitoring plan to detect clinical
change.
A — Patient preference matters but stopping without informed
discussion risks harm.
C — Guidelines inform but do not eliminate individualized
discussion; absolute refusal ignores patient autonomy.
D — Giving materials alone does not ensure understanding or a
plan; it risks miscommunication and unsafe discontinuation.
Teaching Point
Shared decision-making = evidence + patient values + explicit
monitoring/contingency 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 nurse is designing a community program to
reduce tobacco use. Which intervention most aligns with
evidence-based population strategies to achieve sustained
behavior change?
Options
A. Distribute nicotine replacement patches at a one-time clinic
fair.
B. Offer a multi-session counseling program combined with
pharmacotherapy and follow-up.
C. Post anti-smoking flyers in public places without direct
services.
D. Provide a single 5-minute advice session during routine visits
without follow-up.
Correct Answer
B
Rationales
Correct: B — Sustained cessation is most likely when behavioral
counseling is combined with pharmacotherapy and ongoing
follow-up and support.
A — One-time distribution without counseling and follow-up
has limited sustained effectiveness.
, C — Passive education alone often fails to change entrenched
behaviors.
D — Brief advice has some effect but is less effective than
structured counseling plus medication and follow-up.
Teaching Point
Behavioral counseling + pharmacotherapy + follow-up yields
highest sustained tobacco cessation rates.
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 expresses concerns that a routine childhood vaccine
causes developmental problems and requests to defer
vaccination. Which response best addresses hesitancy while
prioritizing pediatric safety?
Options
A. Ignore concerns and administer the vaccine without
discussion.
B. Validate concern, correct misinformation with evidence, and
agree on a timely vaccination plan.
C. Defer vaccination indefinitely to respect parental autonomy.
(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 COPD and chronic kidney disease asks
whether his recent diagnostic test results justify stopping his
inhaled corticosteroid. As the clinician, which action best
demonstrates professional standards in shared decision-making
while ensuring patient safety?
Options
A. Agree to stop the medication because the patient prefers
fewer drugs.
,B. Explain risks/benefits, verify understanding, and jointly
develop a monitoring plan.
C. Refuse on principle because current guidelines recommend
continuing inhaled corticosteroids for all COPD patients.
D. Provide printed guidelines and discharge the patient to
review them alone.
Correct Answer
B
Rationales
Correct: B — Shared decision-making combines evidence,
patient values, and safety: explain risks/benefits, confirm
comprehension, and set a monitoring plan to detect clinical
change.
A — Patient preference matters but stopping without informed
discussion risks harm.
C — Guidelines inform but do not eliminate individualized
discussion; absolute refusal ignores patient autonomy.
D — Giving materials alone does not ensure understanding or a
plan; it risks miscommunication and unsafe discontinuation.
Teaching Point
Shared decision-making = evidence + patient values + explicit
monitoring/contingency 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 nurse is designing a community program to
reduce tobacco use. Which intervention most aligns with
evidence-based population strategies to achieve sustained
behavior change?
Options
A. Distribute nicotine replacement patches at a one-time clinic
fair.
B. Offer a multi-session counseling program combined with
pharmacotherapy and follow-up.
C. Post anti-smoking flyers in public places without direct
services.
D. Provide a single 5-minute advice session during routine visits
without follow-up.
Correct Answer
B
Rationales
Correct: B — Sustained cessation is most likely when behavioral
counseling is combined with pharmacotherapy and ongoing
follow-up and support.
A — One-time distribution without counseling and follow-up
has limited sustained effectiveness.
, C — Passive education alone often fails to change entrenched
behaviors.
D — Brief advice has some effect but is less effective than
structured counseling plus medication and follow-up.
Teaching Point
Behavioral counseling + pharmacotherapy + follow-up yields
highest sustained tobacco cessation rates.
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 expresses concerns that a routine childhood vaccine
causes developmental problems and requests to defer
vaccination. Which response best addresses hesitancy while
prioritizing pediatric safety?
Options
A. Ignore concerns and administer the vaccine without
discussion.
B. Validate concern, correct misinformation with evidence, and
agree on a timely vaccination plan.
C. Defer vaccination indefinitely to respect parental autonomy.
