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: A 68-year-old man presents with progressive dyspnea
and fatigue. As the admitting nurse, which initial action most
directly applies the practice-of-medicine principle of diagnostic
stewardship to avoid unnecessary harm?
A. Order a full-body CT scan to search for occult disease.
B. Obtain a focused history and targeted physical exam before
ordering tests.
C. Start broad-spectrum antibiotics immediately “to be safe.”
D. Request all available laboratory panels to establish a
,baseline.
Correct Answer: B
Rationale (correct): Targeted history and focused physical
examination guide appropriate test selection and minimize
unnecessary testing and harms. This reflects diagnostic
stewardship and efficient clinical reasoning.
Rationale (A): Full-body CT is high-cost and high-radiation
without focused indication; not consistent with stewardship.
Rationale (C): Empiric broad antibiotics without evidence risks
resistance and adverse effects.
Rationale (D): Ordering indiscriminate labs increases false
positives and downstream harm.
Teaching Point: Start with targeted history and exam to guide
appropriate testing.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 1.
2
Reference: Ch. 2 — Promoting Good Health
Question: A nurse counseling a 52-year-old with obesity wants
to apply behavior-change theory to increase physical activity.
Which strategy best translates evidence-based health
promotion into practice?
A. Provide a generic exercise pamphlet and ask the patient to
read it.
B. Set a specific, achievable walking goal with agreed follow-up
,assessment.
C. Warn the patient that inactivity will cause immediate organ
failure.
D. Refer to an unspecified community program and discharge
the responsibility.
Correct Answer: B
Rationale (correct): Specific, achievable goals with follow-up
use behavior-change techniques (goal-setting, monitoring)
shown to improve adherence and outcomes.
Rationale (A): Generic materials without tailoring have limited
effectiveness.
Rationale (C): Fear-based hyperbole undermines trust and is
not effective counseling.
Rationale (D): Referral without coordination fails to support
patient activation and continuity.
Teaching Point: Set specific, measurable goals and plan follow-
up to promote lasting behavior change.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 2.
3
Reference: Ch. 3 — Vaccine Opposition and Hesitancy
Question: A parent expresses doubt about vaccinating an infant
due to safety fears. Which nurse response best applies
evidence-based communication to reduce hesitancy?
A. Insist the parent vaccinate immediately or refuse care.
, B. Provide empathetic listening, correct misconceptions, and
offer credible safety data.
C. Tell the parent that vaccines are mandatory and there is no
debate.
D. Avoid discussing vaccines to prevent upsetting the parent.
Correct Answer: B
Rationale (correct): Empathic dialogue, addressing concerns
with clear, credible data, and preserving trust increases vaccine
acceptance.
Rationale (A): Coercive approaches damage rapport and may
increase resistance.
Rationale (C): Dismissive statements ignore legitimate concerns
and reduce engagement.
Rationale (D): Avoidance fails to correct misinformation and
misses an opportunity for education.
Teaching Point: Use empathy and evidence to address vaccine
concerns and build trust.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 3.
4
Reference: Ch. 4 — Decision-Making in Clinical Medicine
Question: A 75-year-old with advanced COPD must choose
between continued invasive ventilation and palliative-focused
care. Which approach best exemplifies shared decision-making?
A. The physician chooses based on clinical judgment without
(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: A 68-year-old man presents with progressive dyspnea
and fatigue. As the admitting nurse, which initial action most
directly applies the practice-of-medicine principle of diagnostic
stewardship to avoid unnecessary harm?
A. Order a full-body CT scan to search for occult disease.
B. Obtain a focused history and targeted physical exam before
ordering tests.
C. Start broad-spectrum antibiotics immediately “to be safe.”
D. Request all available laboratory panels to establish a
,baseline.
Correct Answer: B
Rationale (correct): Targeted history and focused physical
examination guide appropriate test selection and minimize
unnecessary testing and harms. This reflects diagnostic
stewardship and efficient clinical reasoning.
Rationale (A): Full-body CT is high-cost and high-radiation
without focused indication; not consistent with stewardship.
Rationale (C): Empiric broad antibiotics without evidence risks
resistance and adverse effects.
Rationale (D): Ordering indiscriminate labs increases false
positives and downstream harm.
Teaching Point: Start with targeted history and exam to guide
appropriate testing.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 1.
2
Reference: Ch. 2 — Promoting Good Health
Question: A nurse counseling a 52-year-old with obesity wants
to apply behavior-change theory to increase physical activity.
Which strategy best translates evidence-based health
promotion into practice?
A. Provide a generic exercise pamphlet and ask the patient to
read it.
B. Set a specific, achievable walking goal with agreed follow-up
,assessment.
C. Warn the patient that inactivity will cause immediate organ
failure.
D. Refer to an unspecified community program and discharge
the responsibility.
Correct Answer: B
Rationale (correct): Specific, achievable goals with follow-up
use behavior-change techniques (goal-setting, monitoring)
shown to improve adherence and outcomes.
Rationale (A): Generic materials without tailoring have limited
effectiveness.
Rationale (C): Fear-based hyperbole undermines trust and is
not effective counseling.
Rationale (D): Referral without coordination fails to support
patient activation and continuity.
Teaching Point: Set specific, measurable goals and plan follow-
up to promote lasting behavior change.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 2.
3
Reference: Ch. 3 — Vaccine Opposition and Hesitancy
Question: A parent expresses doubt about vaccinating an infant
due to safety fears. Which nurse response best applies
evidence-based communication to reduce hesitancy?
A. Insist the parent vaccinate immediately or refuse care.
, B. Provide empathetic listening, correct misconceptions, and
offer credible safety data.
C. Tell the parent that vaccines are mandatory and there is no
debate.
D. Avoid discussing vaccines to prevent upsetting the parent.
Correct Answer: B
Rationale (correct): Empathic dialogue, addressing concerns
with clear, credible data, and preserving trust increases vaccine
acceptance.
Rationale (A): Coercive approaches damage rapport and may
increase resistance.
Rationale (C): Dismissive statements ignore legitimate concerns
and reduce engagement.
Rationale (D): Avoidance fails to correct misinformation and
misses an opportunity for education.
Teaching Point: Use empathy and evidence to address vaccine
concerns and build trust.
Citation: Loscalzo et al. (2022). Harrison’s Principles of Internal
Medicine (21st Ed.). Ch. 3.
4
Reference: Ch. 4 — Decision-Making in Clinical Medicine
Question: A 75-year-old with advanced COPD must choose
between continued invasive ventilation and palliative-focused
care. Which approach best exemplifies shared decision-making?
A. The physician chooses based on clinical judgment without
