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
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A 72-year-old man with multiple chronic illnesses requests that
you manage all his specialty care. As his primary physician you
recognize fragmented care and repeated testing. What is the
,single best action to improve quality and reduce harm for this
patient?
A. Continue usual referrals and ask specialists to communicate
results by fax.
B. Serve as care coordinator—consolidate medication list,
schedule consolidated visits, and communicate a single plan.
C. Refer the patient to a different health system for a second
opinion on each condition.
D. Stop all specialty referrals to limit procedures and testing.
Correct Answer
B
Rationales
• Correct (B): Coordinated primary-care leadership reduces
duplication, improves medication reconciliation, and
centralizes decision making—key components of safer,
higher-quality care.
• Incorrect (A): Passive requests for faxed results do not
ensure reconciliation or an integrated management plan.
• Incorrect (C): Repeated referrals to other systems often
increases fragmentation and uncertainty rather than
improving continuity.
• Incorrect (D): Blanket cessation of specialty care risks
undertreatment and ignores conditions requiring specialist
input.
,Teaching Point
Primary care coordination reduces errors, duplication, and
adverse events.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1. accessmedicine.mhmedical.com
2
Reference
Ch. 2 — Promoting Good Health
Question Stem
A 45-year-old woman who smokes expresses interest in quitting
but reports prior failed attempts. Which counseling approach
most aligns with evidence-based behavior change to maximize
cessation success?
A. Provide an emphatic long lecture about smoking harms.
B. Use brief motivational interviewing to elicit readiness and set
achievable steps.
C. Advise "cold turkey" cessation without pharmacologic
support.
D. Inform her cessation is unlikely given previous failures.
Correct Answer
B
Rationales
, • Correct (B): Motivational interviewing assesses readiness,
enhances self-efficacy, and tailors steps—strategies shown
to increase uptake of evidence-based cessation
treatments.
• Incorrect (A): Lecturing increases resistance and does not
address readiness or barriers.
• Incorrect (C): Cold-turkey may work for some, but
combined behavioral and pharmacologic support yields
higher quit rates.
• Incorrect (D): Discouraging statements reduce motivation
and undermine evidence-based engagement.
Teaching Point
Motivational interviewing + evidence-based support improves
behavior change outcomes.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2. accessmedicine.mhmedical.com
3
Reference
Ch. 3 — Vaccine Opposition and Hesitancy
Question Stem
A mother is hesitant about routine childhood vaccinations after
& 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
Reference
Ch. 1 — The Practice of Medicine
Question Stem
A 72-year-old man with multiple chronic illnesses requests that
you manage all his specialty care. As his primary physician you
recognize fragmented care and repeated testing. What is the
,single best action to improve quality and reduce harm for this
patient?
A. Continue usual referrals and ask specialists to communicate
results by fax.
B. Serve as care coordinator—consolidate medication list,
schedule consolidated visits, and communicate a single plan.
C. Refer the patient to a different health system for a second
opinion on each condition.
D. Stop all specialty referrals to limit procedures and testing.
Correct Answer
B
Rationales
• Correct (B): Coordinated primary-care leadership reduces
duplication, improves medication reconciliation, and
centralizes decision making—key components of safer,
higher-quality care.
• Incorrect (A): Passive requests for faxed results do not
ensure reconciliation or an integrated management plan.
• Incorrect (C): Repeated referrals to other systems often
increases fragmentation and uncertainty rather than
improving continuity.
• Incorrect (D): Blanket cessation of specialty care risks
undertreatment and ignores conditions requiring specialist
input.
,Teaching Point
Primary care coordination reduces errors, duplication, and
adverse events.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1. accessmedicine.mhmedical.com
2
Reference
Ch. 2 — Promoting Good Health
Question Stem
A 45-year-old woman who smokes expresses interest in quitting
but reports prior failed attempts. Which counseling approach
most aligns with evidence-based behavior change to maximize
cessation success?
A. Provide an emphatic long lecture about smoking harms.
B. Use brief motivational interviewing to elicit readiness and set
achievable steps.
C. Advise "cold turkey" cessation without pharmacologic
support.
D. Inform her cessation is unlikely given previous failures.
Correct Answer
B
Rationales
, • Correct (B): Motivational interviewing assesses readiness,
enhances self-efficacy, and tailors steps—strategies shown
to increase uptake of evidence-based cessation
treatments.
• Incorrect (A): Lecturing increases resistance and does not
address readiness or barriers.
• Incorrect (C): Cold-turkey may work for some, but
combined behavioral and pharmacologic support yields
higher quit rates.
• Incorrect (D): Discouraging statements reduce motivation
and undermine evidence-based engagement.
Teaching Point
Motivational interviewing + evidence-based support improves
behavior change outcomes.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 2. accessmedicine.mhmedical.com
3
Reference
Ch. 3 — Vaccine Opposition and Hesitancy
Question Stem
A mother is hesitant about routine childhood vaccinations after
