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 man with multimorbidity (heart
failure, COPD, and chronic kidney disease) is admitted for
decompensated heart failure. The team must decide whether to
pursue aggressive diagnostic testing. Which approach best
demonstrates patient-centered practice consistent with
Harrison’s guidance on the practice of medicine?
A. Proceed with all recommended tests to avoid missing
reversible pathology.
,B. Prioritize tests that will change management in alignment
with the patient’s goals.
C. Defer diagnostics until inpatient consultants agree on a plan.
D. Limit testing to those covered by the patient’s insurer to
reduce cost.
Correct Answer: B
Rationales:
• Correct (B): Patient-centered practice emphasizes selecting
diagnostic actions that meaningfully affect care and align
with the patient’s goals and prognosis. Choosing tests likely
to change management respects patient values and avoids
unnecessary burdens.
• A: Doing all tests may increase harm (procedural risk,
burden) without improving outcomes if results won’t alter
management.
• C: Waiting for consultant consensus may delay timely,
patient-aligned decisions; shared decision-making with the
patient is primary.
• D: Cost considerations are important but should not
replace individualized clinical judgment and patient goals.
Teaching Point: Match diagnostics to management impact and
patient goals.
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 increase
influenza vaccination rates among patients with chronic
disease. Which strategy best applies population-health
principles to achieve sustained improvement?
A. Provide single educational handouts at the clinic entrance.
B. Implement standing orders plus reminders and audit-
feedback for staff.
C. Offer vaccination only during physician visits to ensure
counseling.
D. Rely on patients to request vaccines during acute visits.
Correct Answer: B
Rationales:
• Correct (B): Population-health approaches combine
system-level interventions (standing orders, reminders,
audit-feedback) to reliably increase preventive care uptake.
• A: Handouts alone rarely change behavior or address
system barriers.
• C: Restricting to physician visits reduces access and misses
opportunities from other team members.
• D: Passive approaches depend on patient initiative and are
ineffective for reaching high-risk groups.
, Teaching Point: Use system-level interventions (standing orders
+ feedback) to improve preventive care.
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 expresses strong hesitancy about
routine childhood vaccines due to safety fears. As a clinician,
which communication technique best reflects evidence-based
strategies to reduce vaccine hesitancy?
A. Use authoritative statements to insist the parent vaccinate
immediately.
B. Provide empathetic listening, elicit concerns, and offer clear,
tailored information.
C. Avoid discussing risks; only present benefits and dismissal of
safety claims.
D. Tell the parent that refusal will result in discharge from the
clinic.
Correct Answer: B
Rationales:
• Correct (B): Empathic engagement, eliciting specific
concerns, and delivering tailored, factual information is
most effective at addressing hesitancy and building trust.
(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 man with multimorbidity (heart
failure, COPD, and chronic kidney disease) is admitted for
decompensated heart failure. The team must decide whether to
pursue aggressive diagnostic testing. Which approach best
demonstrates patient-centered practice consistent with
Harrison’s guidance on the practice of medicine?
A. Proceed with all recommended tests to avoid missing
reversible pathology.
,B. Prioritize tests that will change management in alignment
with the patient’s goals.
C. Defer diagnostics until inpatient consultants agree on a plan.
D. Limit testing to those covered by the patient’s insurer to
reduce cost.
Correct Answer: B
Rationales:
• Correct (B): Patient-centered practice emphasizes selecting
diagnostic actions that meaningfully affect care and align
with the patient’s goals and prognosis. Choosing tests likely
to change management respects patient values and avoids
unnecessary burdens.
• A: Doing all tests may increase harm (procedural risk,
burden) without improving outcomes if results won’t alter
management.
• C: Waiting for consultant consensus may delay timely,
patient-aligned decisions; shared decision-making with the
patient is primary.
• D: Cost considerations are important but should not
replace individualized clinical judgment and patient goals.
Teaching Point: Match diagnostics to management impact and
patient goals.
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 increase
influenza vaccination rates among patients with chronic
disease. Which strategy best applies population-health
principles to achieve sustained improvement?
A. Provide single educational handouts at the clinic entrance.
B. Implement standing orders plus reminders and audit-
feedback for staff.
C. Offer vaccination only during physician visits to ensure
counseling.
D. Rely on patients to request vaccines during acute visits.
Correct Answer: B
Rationales:
• Correct (B): Population-health approaches combine
system-level interventions (standing orders, reminders,
audit-feedback) to reliably increase preventive care uptake.
• A: Handouts alone rarely change behavior or address
system barriers.
• C: Restricting to physician visits reduces access and misses
opportunities from other team members.
• D: Passive approaches depend on patient initiative and are
ineffective for reaching high-risk groups.
, Teaching Point: Use system-level interventions (standing orders
+ feedback) to improve preventive care.
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 expresses strong hesitancy about
routine childhood vaccines due to safety fears. As a clinician,
which communication technique best reflects evidence-based
strategies to reduce vaccine hesitancy?
A. Use authoritative statements to insist the parent vaccinate
immediately.
B. Provide empathetic listening, elicit concerns, and offer clear,
tailored information.
C. Avoid discussing risks; only present benefits and dismissal of
safety claims.
D. Tell the parent that refusal will result in discharge from the
clinic.
Correct Answer: B
Rationales:
• Correct (B): Empathic engagement, eliciting specific
concerns, and delivering tailored, factual information is
most effective at addressing hesitancy and building trust.
