Harrison's Principles of Internal Medicine
(Vol.1 & Vol.2)
22nd Edition
• Author(s)Joseph Loscalzo; Anthony S.
Fauci; Dennis L. Kasper; Stephen Hauser;
Dan Longo; J. Larry Jameson
Test Bank
Covered
PART 1: Foundations of Clinical Medicine
PART 2: Cardinal Symptoms & Clinical Presentations
PART 3: Clinical Pharmacology
PART 4: Oncology & Hematology
PART 5: Infectious Diseases
PART 6: Cardiovascular Disorders
PART 7: Respiratory Disorders
PART 8: Critical Care Medicine
PART 9: Kidney & Urinary Tract Disorders
PART 10: Gastrointestinal & Hepatobiliary Disorders
,PART 11: Immune-Mediated & Rheumatologic Disorders
PART 12: Endocrinology & Metabolism
PART 13: Neurologic & Psychiatric Disorders
PART 14: Toxicology & Environmental Injury
PART 15: Environmental & Occupational Medicine
PART 16: Genetics, Precision & Systems Medicine
PART 17–20: Special & Emerging Topics
In a patient presenting with new-onset fatigue and weight
loss, which initial action most increases diagnostic yield during
the first encounter?
A. Immediate CT imaging
B. Comprehensive history including symptom chronology and
risk factors
C. Empiric broad-spectrum antibiotics
D. Routine laboratory panel only
Answer: B
Rationale: A focused, systematic history oriented to symptom
onset, duration, and risk factors directs subsequent targeted
exam and testing and often yields the highest early diagnostic
value.
Which nursing intervention is highest-priority when
implementing primary prevention at a clinic visit for
cardiovascular risk reduction?
A. Prescribing statin therapy immediately
B. Counseling on tobacco cessation and facilitating referral to
cessation resources
,C. Ordering advanced lipid genetic testing
D. Scheduling a follow-up in one year without intervention
Answer: B
Rationale: Lifestyle modification counseling—especially tobacco
cessation—provides high-impact primary prevention and is a
nurse-led, actionable intervention at point of care.
A parent expresses strong concerns about vaccinating their
child. According to Harrison’s guidance on vaccine hesitancy,
the most effective initial nursing approach is to:
A. Refuse to vaccinate and discharge from practice
B. Provide a long list of scientific references immediately
C. Elicit the parent’s specific concerns, listen empathically, and
use a presumptive recommendation with tailored education
D. Promise a vaccine if they sign a consent waiver
Answer: C
Rationale: Addressing hesitancy begins with eliciting concerns,
listening, and offering a clear, presumptive recommendation
plus brief, targeted information—an evidence-based
communication strategy.
When clinical benefits and harms of an intervention are
closely balanced and patient values vary, the clinician should:
A. Make the decision without patient input
B. Use shared decision-making that explains benefits, risks, and
alternatives
C. Default to the most expensive option
D. Avoid discussing risks to reduce patient anxiety
, Answer: B
Rationale: Shared decision-making is indicated when tradeoffs
exist; it integrates patient values into the medical decision.
Nurses play a key role facilitating this process.
A patient is offered pharmacogenomic testing to guide
medication choice. The nurse’s most important pre-test
counseling point is:
A. The test guarantees the medication will be effective
B. Results may have implications for family members and
require informed consent and discussion of potential risks and
benefits
C. Results will be available immediately in the clinic
D. Test results are universally actionable for all drugs
Answer: B
Rationale: Precision medicine testing can affect family risk
information and treatment decisions; informed consent should
cover implications, limitations, and privacy.
For a screening program intended to identify early disease in
an asymptomatic population, which test characteristic is most
desirable?
A. High specificity only
B. High sensitivity to minimize missed cases
C. High cost so only high-risk patients are screened
D. Low negative predictive value
Answer: B
Rationale: Screening prioritizes sensitivity to detect most cases;
(Vol.1 & Vol.2)
22nd Edition
• Author(s)Joseph Loscalzo; Anthony S.
Fauci; Dennis L. Kasper; Stephen Hauser;
Dan Longo; J. Larry Jameson
Test Bank
Covered
PART 1: Foundations of Clinical Medicine
PART 2: Cardinal Symptoms & Clinical Presentations
PART 3: Clinical Pharmacology
PART 4: Oncology & Hematology
PART 5: Infectious Diseases
PART 6: Cardiovascular Disorders
PART 7: Respiratory Disorders
PART 8: Critical Care Medicine
PART 9: Kidney & Urinary Tract Disorders
PART 10: Gastrointestinal & Hepatobiliary Disorders
,PART 11: Immune-Mediated & Rheumatologic Disorders
PART 12: Endocrinology & Metabolism
PART 13: Neurologic & Psychiatric Disorders
PART 14: Toxicology & Environmental Injury
PART 15: Environmental & Occupational Medicine
PART 16: Genetics, Precision & Systems Medicine
PART 17–20: Special & Emerging Topics
In a patient presenting with new-onset fatigue and weight
loss, which initial action most increases diagnostic yield during
the first encounter?
A. Immediate CT imaging
B. Comprehensive history including symptom chronology and
risk factors
C. Empiric broad-spectrum antibiotics
D. Routine laboratory panel only
Answer: B
Rationale: A focused, systematic history oriented to symptom
onset, duration, and risk factors directs subsequent targeted
exam and testing and often yields the highest early diagnostic
value.
Which nursing intervention is highest-priority when
implementing primary prevention at a clinic visit for
cardiovascular risk reduction?
A. Prescribing statin therapy immediately
B. Counseling on tobacco cessation and facilitating referral to
cessation resources
,C. Ordering advanced lipid genetic testing
D. Scheduling a follow-up in one year without intervention
Answer: B
Rationale: Lifestyle modification counseling—especially tobacco
cessation—provides high-impact primary prevention and is a
nurse-led, actionable intervention at point of care.
A parent expresses strong concerns about vaccinating their
child. According to Harrison’s guidance on vaccine hesitancy,
the most effective initial nursing approach is to:
A. Refuse to vaccinate and discharge from practice
B. Provide a long list of scientific references immediately
C. Elicit the parent’s specific concerns, listen empathically, and
use a presumptive recommendation with tailored education
D. Promise a vaccine if they sign a consent waiver
Answer: C
Rationale: Addressing hesitancy begins with eliciting concerns,
listening, and offering a clear, presumptive recommendation
plus brief, targeted information—an evidence-based
communication strategy.
When clinical benefits and harms of an intervention are
closely balanced and patient values vary, the clinician should:
A. Make the decision without patient input
B. Use shared decision-making that explains benefits, risks, and
alternatives
C. Default to the most expensive option
D. Avoid discussing risks to reduce patient anxiety
, Answer: B
Rationale: Shared decision-making is indicated when tradeoffs
exist; it integrates patient values into the medical decision.
Nurses play a key role facilitating this process.
A patient is offered pharmacogenomic testing to guide
medication choice. The nurse’s most important pre-test
counseling point is:
A. The test guarantees the medication will be effective
B. Results may have implications for family members and
require informed consent and discussion of potential risks and
benefits
C. Results will be available immediately in the clinic
D. Test results are universally actionable for all drugs
Answer: B
Rationale: Precision medicine testing can affect family risk
information and treatment decisions; informed consent should
cover implications, limitations, and privacy.
For a screening program intended to identify early disease in
an asymptomatic population, which test characteristic is most
desirable?
A. High specificity only
B. High sensitivity to minimize missed cases
C. High cost so only high-risk patients are screened
D. Low negative predictive value
Answer: B
Rationale: Screening prioritizes sensitivity to detect most cases;
