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 72-year-old man with multiple chronic conditions asks
whether to accept a new invasive diagnostic procedure with
,modest expected benefit and significant morbidity risk. Which
approach best aligns with high-quality, patient-centered
medical practice?
Options
A. Recommend the procedure because the clinician believes it
is in the patient’s best interest.
B. Provide balanced information about risks/benefits and elicit
the patient’s values to make a shared decision.
C. Decline the procedure to avoid exposing the patient to
potential harm.
D. Ask the family to decide since the patient may defer to them.
Correct Answer
B
Rationales
Correct (B): Shared decision-making—presenting clear risks and
benefits and eliciting patient values—maximizes patient
autonomy and aligns care with the patient’s goals.
A: Clinician-driven paternalism ignores the patient’s preferences
and may lead to nonaligned care.
C: Unilaterally declining may withhold beneficial options
without understanding patient values.
D: Family decision-making without eliciting the patient’s own
goals can undermine autonomy unless the patient explicitly
delegates decisions.
Teaching Point
Shared decision-making: inform, elicit values, decide jointly.
,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 clinic wants to reduce tobacco use prevalence in
its panel. Which multi-component strategy most likely produces
durable population-level declines?
Options
A. Brief clinician advice alone at a single visit.
B. Clinic-based counseling plus pharmacotherapy and proactive
follow-up.
C. Posting cessation pamphlets in the waiting room.
D. Encouraging patients to quit on their own using willpower.
Correct Answer
B
Rationales
Correct (B): Combining counseling, evidence-based
pharmacotherapy, and proactive follow-up addresses behavior
change, withdrawal, and relapse—highest effectiveness.
A: Brief advice helps but is insufficient alone for durable
cessation.
, C: Passive materials have low impact without active
interventions.
D: Reliance on willpower alone underestimates addiction
physiology and produces low success rates.
Teaching Point
Multi-component cessation (counseling + meds + follow-up)
yields the best outcomes.
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 mother firmly states she will not vaccinate her infant because
of safety fears after reading online reports. Which clinician
response most effectively reduces hesitancy while maintaining
trust?
Options
A. Deliver a long technical lecture detailing immune
mechanisms and vaccine trials.
B. Use a presumptive recommendation, then ask about specific
concerns and respond empathetically.
C. Refuse to continue care unless the child is vaccinated.
& 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 72-year-old man with multiple chronic conditions asks
whether to accept a new invasive diagnostic procedure with
,modest expected benefit and significant morbidity risk. Which
approach best aligns with high-quality, patient-centered
medical practice?
Options
A. Recommend the procedure because the clinician believes it
is in the patient’s best interest.
B. Provide balanced information about risks/benefits and elicit
the patient’s values to make a shared decision.
C. Decline the procedure to avoid exposing the patient to
potential harm.
D. Ask the family to decide since the patient may defer to them.
Correct Answer
B
Rationales
Correct (B): Shared decision-making—presenting clear risks and
benefits and eliciting patient values—maximizes patient
autonomy and aligns care with the patient’s goals.
A: Clinician-driven paternalism ignores the patient’s preferences
and may lead to nonaligned care.
C: Unilaterally declining may withhold beneficial options
without understanding patient values.
D: Family decision-making without eliciting the patient’s own
goals can undermine autonomy unless the patient explicitly
delegates decisions.
Teaching Point
Shared decision-making: inform, elicit values, decide jointly.
,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 clinic wants to reduce tobacco use prevalence in
its panel. Which multi-component strategy most likely produces
durable population-level declines?
Options
A. Brief clinician advice alone at a single visit.
B. Clinic-based counseling plus pharmacotherapy and proactive
follow-up.
C. Posting cessation pamphlets in the waiting room.
D. Encouraging patients to quit on their own using willpower.
Correct Answer
B
Rationales
Correct (B): Combining counseling, evidence-based
pharmacotherapy, and proactive follow-up addresses behavior
change, withdrawal, and relapse—highest effectiveness.
A: Brief advice helps but is insufficient alone for durable
cessation.
, C: Passive materials have low impact without active
interventions.
D: Reliance on willpower alone underestimates addiction
physiology and produces low success rates.
Teaching Point
Multi-component cessation (counseling + meds + follow-up)
yields the best outcomes.
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 mother firmly states she will not vaccinate her infant because
of safety fears after reading online reports. Which clinician
response most effectively reduces hesitancy while maintaining
trust?
Options
A. Deliver a long technical lecture detailing immune
mechanisms and vaccine trials.
B. Use a presumptive recommendation, then ask about specific
concerns and respond empathetically.
C. Refuse to continue care unless the child is vaccinated.
