Behavioral Science & Ethics USMLE Step 1 Practice Question
A 45-year-old man presents to his physician's office for a 3-month follow-up visit after being diagnosed with hypertension. The patient was counseled to reduce sodium intake to <2,300 mg daily and exercise for 30 minutes at least 5 days per week. His home blood pressure log shows readings consistently between 145-155 mmHg systolic. When asked about his adherence, the patient reports that he has "mostly followed the diet" and "exercises most days." His wife mentions that she frequently prepares high-sodium meals, and the patient admits he has not joined a gym or established a regular exercise routine. Despite these details, the patient states he expected his blood pressure to normalize by now and is surprised by the persistent elevation. Which cognitive bias best explains the discrepancy between the patient's self-reported adherence and his actual behavior?
Answer choices
- ADunning-Kruger effect, leading him to overestimate his knowledge about hypertension management
- BAnchoring bias, causing him to fixate on his initial blood pressure reading from diagnosis
- CAvailability heuristic, making him recall exceptional days of good adherence more readily
- DFundamental attribution error, causing him to blame external factors rather than his own choices
- ESocial desirability bias, leading him to overstate his adherence to meet perceived physician expectationsCorrect answer
- FIllusory truth effect, believing dietary advice he repeated to himself multiple times must be effective
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