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 68-year-old man with newly diagnosed congestive heart
failure asks whether shared decision-making means the
physician will choose his treatment. Which response best
,exemplifies shared decision-making consistent with Harrison’s
recommendations?
Options
A. “I will make the decision — you should trust my expertise.”
B. “I’ll present options, their risks/benefits, and we’ll decide
together based on your values.”
C. “You must choose; I will only implement what you request.”
D. “We’ll use the newest technology regardless of cost or your
preference.”
Correct Answer
B
Rationales
Correct: Harrison emphasizes shared decision-making as
presenting evidence, benefits/harms, and integrating patient
values to reach a joint plan.
A: Paternalistic and not aligned with shared decision principles.
C: Leaving patient unsupported without clinical guidance
violates the collaborative model.
D: Prioritizing technology without considering patient
values/cost is inconsistent with shared decisions.
Teaching Point
Shared decision-making = evidence + clinician expertise +
patient values.
,Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2)
Reference
Ch. 1 — The Practice of Medicine
Question Stem
During admission, a nurse notes the patient cannot pay for an
expensive medication. According to Harrison’s approach to
professionalism and systems thinking, what is the nurse’s best
immediate action?
Options
A. Withhold the medication until payment is arranged.
B. Alert the treating team and social work to identify affordable
alternatives and access programs.
C. Tell the patient to obtain the drug later as an outpatient.
D. Substitute a cheaper, unproven therapy without informing
the team.
Correct Answer
B
Rationales
Correct: Harrison advocates addressing social determinants and
coordinating resources (team, social work) to ensure care
access.
, A: Withholding care conflicts with professional duty and safety.
C: Delaying therapy may harm the patient without arranging
alternatives.
D: Unapproved substitution without team/patient consent
breaches ethics and safety.
Teaching Point
Address social determinants early; coordinate multi-disciplinary
resources.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3)
Reference
Ch. 2 — Promoting Good Health
Question Stem
A clinic is designing a smoking-cessation program targeting
high-risk local patients. Which intervention best follows
Harrison’s evidence-based prevention strategies?
Options
A. One-time distribution of a pamphlet about quitting.
B. Repeated brief clinician counseling combined with nicotine
replacement and follow-up.
C. Posting a “quit or else” message on the clinic wall.
& 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 68-year-old man with newly diagnosed congestive heart
failure asks whether shared decision-making means the
physician will choose his treatment. Which response best
,exemplifies shared decision-making consistent with Harrison’s
recommendations?
Options
A. “I will make the decision — you should trust my expertise.”
B. “I’ll present options, their risks/benefits, and we’ll decide
together based on your values.”
C. “You must choose; I will only implement what you request.”
D. “We’ll use the newest technology regardless of cost or your
preference.”
Correct Answer
B
Rationales
Correct: Harrison emphasizes shared decision-making as
presenting evidence, benefits/harms, and integrating patient
values to reach a joint plan.
A: Paternalistic and not aligned with shared decision principles.
C: Leaving patient unsupported without clinical guidance
violates the collaborative model.
D: Prioritizing technology without considering patient
values/cost is inconsistent with shared decisions.
Teaching Point
Shared decision-making = evidence + clinician expertise +
patient values.
,Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
2)
Reference
Ch. 1 — The Practice of Medicine
Question Stem
During admission, a nurse notes the patient cannot pay for an
expensive medication. According to Harrison’s approach to
professionalism and systems thinking, what is the nurse’s best
immediate action?
Options
A. Withhold the medication until payment is arranged.
B. Alert the treating team and social work to identify affordable
alternatives and access programs.
C. Tell the patient to obtain the drug later as an outpatient.
D. Substitute a cheaper, unproven therapy without informing
the team.
Correct Answer
B
Rationales
Correct: Harrison advocates addressing social determinants and
coordinating resources (team, social work) to ensure care
access.
, A: Withholding care conflicts with professional duty and safety.
C: Delaying therapy may harm the patient without arranging
alternatives.
D: Unapproved substitution without team/patient consent
breaches ethics and safety.
Teaching Point
Address social determinants early; coordinate multi-disciplinary
resources.
Citation
Loscalzo et al. (2022). Harrison’s Principles of Internal Medicine
(21st Ed.). Ch. 1.
3)
Reference
Ch. 2 — Promoting Good Health
Question Stem
A clinic is designing a smoking-cessation program targeting
high-risk local patients. Which intervention best follows
Harrison’s evidence-based prevention strategies?
Options
A. One-time distribution of a pamphlet about quitting.
B. Repeated brief clinician counseling combined with nicotine
replacement and follow-up.
C. Posting a “quit or else” message on the clinic wall.
