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 progressive dyspnea is admitted; the
team must decide whether to start empiric treatment before
diagnostic confirmation. Which principle best justifies beginning
empiric therapy in a high-probability, potentially reversible
condition?
,A. Always await confirmatory testing to avoid unnecessary
treatment.
B. Treat when the probability of disease and potential benefit
outweigh immediate harms.
C. Use population-level guidelines only; avoid individual clinical
judgment.
D. Defer treatment until multidisciplinary consensus is obtained.
Correct Answer
B
Rationales
Correct: Harrison emphasizes balancing pretest probability,
time-sensitivity, and risk–benefit; when disease is likely and
delay harms prognosis, empiric therapy is justified.
A: In time-sensitive or high-risk cases, awaiting confirmation can
cause harm; this is not always appropriate.
C: Guidelines inform care but must be integrated with individual
assessment and context.
D: Multidisciplinary input is valuable but delaying needed
therapy for consensus can be harmful.
Teaching Point
Start empiric therapy when likely disease and benefit exceed
immediate risk of treatment.
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 nurse designs a smoking-cessation intervention for
hospitalized patients. Which approach most likely increases
sustained behavior change?
A. Provide a single educational pamphlet on risks.
B. Combine motivational interviewing, nicotine replacement,
and structured follow-up.
C. Rely solely on physician advice at discharge.
D. Offer financial incentives only during hospitalization.
Correct Answer
B
Rationales
Correct: Harrison highlights multi-component interventions
(behavioral counseling + pharmacotherapy + follow-up) as
highest yield for sustained change.
A: Pamphlets alone rarely produce durable cessation.
C: Brief advice helps but is less effective without counseling and
pharmacotherapy.
D: Short-term incentives may prompt temporary change but
lack sustained support strategies.
, Teaching Point
Combine counseling, medication, and follow-up for effective
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 Stem
A clinic sees many vaccine-hesitant parents. Which clinician
action best addresses hesitancy and increases immunization
uptake?
A. Present long lists of adverse-event statistics to convince
them.
B. Use presumptive vaccine recommendations and explore
parental concerns empathetically.
C. Dismiss their concerns and refuse to see them if they decline
vaccines.
D. Offer vaccines only if parents request them explicitly.
Correct Answer
B
(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 progressive dyspnea is admitted; the
team must decide whether to start empiric treatment before
diagnostic confirmation. Which principle best justifies beginning
empiric therapy in a high-probability, potentially reversible
condition?
,A. Always await confirmatory testing to avoid unnecessary
treatment.
B. Treat when the probability of disease and potential benefit
outweigh immediate harms.
C. Use population-level guidelines only; avoid individual clinical
judgment.
D. Defer treatment until multidisciplinary consensus is obtained.
Correct Answer
B
Rationales
Correct: Harrison emphasizes balancing pretest probability,
time-sensitivity, and risk–benefit; when disease is likely and
delay harms prognosis, empiric therapy is justified.
A: In time-sensitive or high-risk cases, awaiting confirmation can
cause harm; this is not always appropriate.
C: Guidelines inform care but must be integrated with individual
assessment and context.
D: Multidisciplinary input is valuable but delaying needed
therapy for consensus can be harmful.
Teaching Point
Start empiric therapy when likely disease and benefit exceed
immediate risk of treatment.
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 nurse designs a smoking-cessation intervention for
hospitalized patients. Which approach most likely increases
sustained behavior change?
A. Provide a single educational pamphlet on risks.
B. Combine motivational interviewing, nicotine replacement,
and structured follow-up.
C. Rely solely on physician advice at discharge.
D. Offer financial incentives only during hospitalization.
Correct Answer
B
Rationales
Correct: Harrison highlights multi-component interventions
(behavioral counseling + pharmacotherapy + follow-up) as
highest yield for sustained change.
A: Pamphlets alone rarely produce durable cessation.
C: Brief advice helps but is less effective without counseling and
pharmacotherapy.
D: Short-term incentives may prompt temporary change but
lack sustained support strategies.
, Teaching Point
Combine counseling, medication, and follow-up for effective
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 Stem
A clinic sees many vaccine-hesitant parents. Which clinician
action best addresses hesitancy and increases immunization
uptake?
A. Present long lists of adverse-event statistics to convince
them.
B. Use presumptive vaccine recommendations and explore
parental concerns empathetically.
C. Dismiss their concerns and refuse to see them if they decline
vaccines.
D. Offer vaccines only if parents request them explicitly.
Correct Answer
B
