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 hospitalized patient with multiple comorbidities
requests an experimental medication that has shown
preliminary benefit in a small trial but is not standard of care.
The nurse’s best first step in the decision-making process is to:
Options
A. Agree immediately because the patient requested it.
,B. Seek informed consent and explain risks, benefits, and
evidence.
C. Refuse because experimental therapies are always
inappropriate in older adults.
D. Tell the patient the team will decide without further
discussion.
Correct Answer
B
Rationales
• Correct (B): Informed consent and clear explanation of
risks, benefits, and the quality of evidence are central to
ethical, patient-centered decision-making in clinical
practice.
• A: Immediate agreement bypasses necessary evaluation of
evidence, safety, and appropriateness.
• C: Age alone is not a contraindication; treatment
appropriateness depends on goals of care and evidence.
• D: Excluding the patient undermines autonomy and shared
decision-making principles.
Teaching Point
Obtain informed consent — explain risks, benefits, and
evidence before acting.
,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 wants to reduce cardiovascular risk in a low-
income neighborhood. Which population-level intervention is
most likely to produce sustained improvements in population
cardiovascular health?
Options
A. One-time free lipid panels for residents.
B. Implementing a sustained community program improving
access to healthy food and physical activity.
C. Distributing pamphlets about diet once per year.
D. Providing a short lecture on exercise at a single community
meeting.
Correct Answer
B
Rationales
• Correct (B): Structural, sustained changes that increase
access to healthy foods and opportunities for physical
, activity address social determinants and yield sustainable
population health improvements.
• A: One-time screenings identify risk but don’t change
underlying determinants or long-term behavior.
• C: Pamphlets alone have minimal impact without broader
support and access.
• D: Single lectures rarely change long-term behavior or
environmental barriers.
Teaching Point
Sustained structural interventions addressing social
determinants yield durable population health gains.
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 concern about vaccine safety and refuses
the child’s routine immunizations. Which counseling approach is
most consistent with evidence-based strategies to reduce
hesitancy?
(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 hospitalized patient with multiple comorbidities
requests an experimental medication that has shown
preliminary benefit in a small trial but is not standard of care.
The nurse’s best first step in the decision-making process is to:
Options
A. Agree immediately because the patient requested it.
,B. Seek informed consent and explain risks, benefits, and
evidence.
C. Refuse because experimental therapies are always
inappropriate in older adults.
D. Tell the patient the team will decide without further
discussion.
Correct Answer
B
Rationales
• Correct (B): Informed consent and clear explanation of
risks, benefits, and the quality of evidence are central to
ethical, patient-centered decision-making in clinical
practice.
• A: Immediate agreement bypasses necessary evaluation of
evidence, safety, and appropriateness.
• C: Age alone is not a contraindication; treatment
appropriateness depends on goals of care and evidence.
• D: Excluding the patient undermines autonomy and shared
decision-making principles.
Teaching Point
Obtain informed consent — explain risks, benefits, and
evidence before acting.
,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 wants to reduce cardiovascular risk in a low-
income neighborhood. Which population-level intervention is
most likely to produce sustained improvements in population
cardiovascular health?
Options
A. One-time free lipid panels for residents.
B. Implementing a sustained community program improving
access to healthy food and physical activity.
C. Distributing pamphlets about diet once per year.
D. Providing a short lecture on exercise at a single community
meeting.
Correct Answer
B
Rationales
• Correct (B): Structural, sustained changes that increase
access to healthy foods and opportunities for physical
, activity address social determinants and yield sustainable
population health improvements.
• A: One-time screenings identify risk but don’t change
underlying determinants or long-term behavior.
• C: Pamphlets alone have minimal impact without broader
support and access.
• D: Single lectures rarely change long-term behavior or
environmental barriers.
Teaching Point
Sustained structural interventions addressing social
determinants yield durable population health gains.
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 concern about vaccine safety and refuses
the child’s routine immunizations. Which counseling approach is
most consistent with evidence-based strategies to reduce
hesitancy?
