Page 1 of 67
TEST BANK FOR FAMILY PRACTICE GUIDELINES DETAILED
RATIONALES GRADED A+
Test Bank for Family Practice Guidelines — 250
Questions and Answers
SECTION 1: HEALTH MAINTENANCE GUIDELINES (25
Questions)
1. A 62-year-old woman from a rural community with limited English proficiency
presents for an annual exam. She has poorly controlled hypertension and
mentions using a traditional herbal tea recommended by family. The patient
seems hesitant to discuss medication changes. As the APRN, what is the best next
step to ensure culturally sensitive, evidence-based care while addressing blood
pressure control?
A. Insist on immediate medication titration and provide printed pamphlets in English.
B. Use a professional medical interpreter, explore beliefs about the herbal tea, and
negotiate a shared plan integrating safety monitoring.
C. Ask a family member to interpret, discontinue the herbal tea, and change
medications.
D. Delay treatment changes until the patient brings a family elder to the visit.
Answer: B
Rationale: Using a professional interpreter and exploring the patient's beliefs allows
assessment of potential herb-drug interactions and builds trust; negotiating an agreed
monitoring plan aligns with culturally sensitive, guideline-based preventive care. This
supports adherence and safe BP control.
2. A 28-year-old woman is planning pregnancy in the next year. She has a BMI of
34, uses combined oral contraceptives, and has a history of chlamydia treated two
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years ago. Which preventive counseling/assessment should you prioritize now to
optimize maternal-fetal outcomes?
A. Recommend immediate discontinuation of OCPs and start preconception folic acid
only.
B. Counsel on preconception weight optimization, arrange STI screening, review
immunizations (MMR, varicella), and start folic acid 400–800 mcg daily.
C. Schedule an annual pelvic exam only and advise to stop smoking when she becomes
pregnant.
D. Advise weight loss after conception and defer immunization review until pregnancy is
confirmed.
Answer: B
Rationale: Preconception care includes optimizing BMI, screening/treating STIs,
ensuring immunity (MMR, varicella) before pregnancy, and starting folic acid; these
measures reduce adverse pregnancy outcomes per preventive health principles.
3. A 52-year-old Kenyan woman who recently immigrated reports intermittent
chest pressure after climbing stairs. She is reluctant to undergo diagnostic testing,
citing beliefs that blood tests can "steal" energy and that illness should be
managed with traditional herbs. Physical exam and vitals are unremarkable. As an
APRN, what is the best first approach to address her cardiovascular risk while
respecting cultural beliefs?
A. Insist on immediate ECG and troponin testing to rule out ischemia.
B. Offer shared decision-making: perform a focused cardiovascular risk assessment,
discuss culturally acceptable diagnostic options, and arrange community-trusted
interpreter/cultural liaison.
C. Defer any testing and recommend traditional herbal therapy first to build rapport.
D. Dismiss her concerns and schedule routine follow-up in 6 months.
Answer: B
Rationale: Option B integrates evidence-based risk assessment with cultural sensitivity,
uses shared decision-making, and leverages a cultural liaison to improve adherence and
trust—consistent with health maintenance guidelines.
4. The nurse is preparing to teach a patient of Asian culture to perform
postoperative dressing changes at home after discharge. Which statement made
by the nurse indicates cultural competence?
A. "Asian people are smart, so you should have no trouble learning this."
B. "I will show you how to do this, and then you can teach it back to me in your own
words."
C. "This is the only correct way to change your dressing, so please follow these
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instructions exactly."
D. "Your family should do this for you since that is your cultural tradition."
Answer: B
Rationale: Cultural competence involves avoiding stereotypes, using teach-back to
confirm understanding, and respecting the patient's individual learning needs. Options
A and C contain cultural stereotypes and ethnocentric assumptions.
5. According to the 2018 Astana Declaration on Primary Health Care, which of the
following is NOT one of the three pillars of PHC?
A. Empowering people and communities
B. Multisectoral policies and action
C. Primary care and essential public health functions
D. Tertiary hospital care
Answer: D
Rationale: The 2018 Astana Declaration identifies three pillars: empowering people and
communities, multisectoral policies and action, and primary care/essential public health
functions. Tertiary hospital care is not a pillar of PHC.
6. The Genogram is a tool used in family-centred care. Which of the following
correctly describes its primary clinical use?
A. To document individual patient medication history
B. To map family relationships, health history, and psychosocial patterns across
generations
C. To calculate family income for NHIF eligibility
D. To screen for domestic violence using standardised questions
Answer: B
Rationale: A genogram is a pictorial representation of family structure and medical
history across at least 3 generations. It identifies hereditary diseases, family dynamics,
communication patterns, and psychosocial stressors.
7. The Family APGAR score assesses family function. What does the acronym
'APGAR' stand for in this context?
A. Affection, Participation, Growth, Attention, Relationships
B. Adaptability, Partnership, Growth, Affection, Resolve
C. Assessment, Planning, Goals, Action, Review
D. Autonomy, Participation, Gratitude, Attachment, Resilience
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Answer: B
Rationale: Family APGAR (Smilkstein 1978): Adaptability, Partnership, Growth, Affection,
Resolve. Scores 0-10; 0-3 = severe dysfunction, 4-6 = moderate, 7-10 = functional.
8. A 28-year-old woman presents anxious and tearful. She describes her husband
as 'controlling all money, isolating me from friends, and occasionally pushing me.'
Using the RADAR model, what is the FIRST step?
A. Refer immediately to police
B. Routinely ask all female patients about intimate partner violence using a validated
tool
C. Ask the husband to join the consultation for clarification
D. Prescribe anxiolytics and discharge
Answer: B
Rationale: RADAR: Routinely ask, Ask directly, Document findings, Assess safety, Review
options and refer. The family physician should NEVER conduct couples counselling when
IPV is suspected (increases risk).
9. The 'Calgary-Cambridge Consultation Model' is widely used in family medicine
training. Which of the following is NOT one of its 5 core tasks?
A. Initiating the session
B. Gathering information
C. Prescribing the evidence-based medication
D. Building the relationship
Answer: C
Rationale: Calgary-Cambridge 5 tasks: Initiation, Information gathering, Physical
examination, Explanation & planning, Closing the session. Running throughout: building
the relationship and providing structure. Prescribing is a clinical action, not a core
consultation task.
10. A 62-year-old Somali man with controlled type 2 diabetes presents for a
routine visit. He reports fasting during Ramadan and asks whether he should
adjust his medications. What is the most appropriate nursing action?
A. Tell him fasting is prohibited for patients with diabetes.
B. Assess his current medication regimen, provide education on risk of hypoglycemia,
and coordinate with his provider for dose adjustments.
C. Advise him to stop all medications during Ramadan.
D. Refer him to the emergency department for evaluation.
Answer: B
Rationale: Patients with diabetes who fast during Ramadan require individualized
TEST BANK FOR FAMILY PRACTICE GUIDELINES DETAILED
RATIONALES GRADED A+
Test Bank for Family Practice Guidelines — 250
Questions and Answers
SECTION 1: HEALTH MAINTENANCE GUIDELINES (25
Questions)
1. A 62-year-old woman from a rural community with limited English proficiency
presents for an annual exam. She has poorly controlled hypertension and
mentions using a traditional herbal tea recommended by family. The patient
seems hesitant to discuss medication changes. As the APRN, what is the best next
step to ensure culturally sensitive, evidence-based care while addressing blood
pressure control?
A. Insist on immediate medication titration and provide printed pamphlets in English.
B. Use a professional medical interpreter, explore beliefs about the herbal tea, and
negotiate a shared plan integrating safety monitoring.
C. Ask a family member to interpret, discontinue the herbal tea, and change
medications.
D. Delay treatment changes until the patient brings a family elder to the visit.
Answer: B
Rationale: Using a professional interpreter and exploring the patient's beliefs allows
assessment of potential herb-drug interactions and builds trust; negotiating an agreed
monitoring plan aligns with culturally sensitive, guideline-based preventive care. This
supports adherence and safe BP control.
2. A 28-year-old woman is planning pregnancy in the next year. She has a BMI of
34, uses combined oral contraceptives, and has a history of chlamydia treated two
,Page 2 of 67
years ago. Which preventive counseling/assessment should you prioritize now to
optimize maternal-fetal outcomes?
A. Recommend immediate discontinuation of OCPs and start preconception folic acid
only.
B. Counsel on preconception weight optimization, arrange STI screening, review
immunizations (MMR, varicella), and start folic acid 400–800 mcg daily.
C. Schedule an annual pelvic exam only and advise to stop smoking when she becomes
pregnant.
D. Advise weight loss after conception and defer immunization review until pregnancy is
confirmed.
Answer: B
Rationale: Preconception care includes optimizing BMI, screening/treating STIs,
ensuring immunity (MMR, varicella) before pregnancy, and starting folic acid; these
measures reduce adverse pregnancy outcomes per preventive health principles.
3. A 52-year-old Kenyan woman who recently immigrated reports intermittent
chest pressure after climbing stairs. She is reluctant to undergo diagnostic testing,
citing beliefs that blood tests can "steal" energy and that illness should be
managed with traditional herbs. Physical exam and vitals are unremarkable. As an
APRN, what is the best first approach to address her cardiovascular risk while
respecting cultural beliefs?
A. Insist on immediate ECG and troponin testing to rule out ischemia.
B. Offer shared decision-making: perform a focused cardiovascular risk assessment,
discuss culturally acceptable diagnostic options, and arrange community-trusted
interpreter/cultural liaison.
C. Defer any testing and recommend traditional herbal therapy first to build rapport.
D. Dismiss her concerns and schedule routine follow-up in 6 months.
Answer: B
Rationale: Option B integrates evidence-based risk assessment with cultural sensitivity,
uses shared decision-making, and leverages a cultural liaison to improve adherence and
trust—consistent with health maintenance guidelines.
4. The nurse is preparing to teach a patient of Asian culture to perform
postoperative dressing changes at home after discharge. Which statement made
by the nurse indicates cultural competence?
A. "Asian people are smart, so you should have no trouble learning this."
B. "I will show you how to do this, and then you can teach it back to me in your own
words."
C. "This is the only correct way to change your dressing, so please follow these
,Page 3 of 67
instructions exactly."
D. "Your family should do this for you since that is your cultural tradition."
Answer: B
Rationale: Cultural competence involves avoiding stereotypes, using teach-back to
confirm understanding, and respecting the patient's individual learning needs. Options
A and C contain cultural stereotypes and ethnocentric assumptions.
5. According to the 2018 Astana Declaration on Primary Health Care, which of the
following is NOT one of the three pillars of PHC?
A. Empowering people and communities
B. Multisectoral policies and action
C. Primary care and essential public health functions
D. Tertiary hospital care
Answer: D
Rationale: The 2018 Astana Declaration identifies three pillars: empowering people and
communities, multisectoral policies and action, and primary care/essential public health
functions. Tertiary hospital care is not a pillar of PHC.
6. The Genogram is a tool used in family-centred care. Which of the following
correctly describes its primary clinical use?
A. To document individual patient medication history
B. To map family relationships, health history, and psychosocial patterns across
generations
C. To calculate family income for NHIF eligibility
D. To screen for domestic violence using standardised questions
Answer: B
Rationale: A genogram is a pictorial representation of family structure and medical
history across at least 3 generations. It identifies hereditary diseases, family dynamics,
communication patterns, and psychosocial stressors.
7. The Family APGAR score assesses family function. What does the acronym
'APGAR' stand for in this context?
A. Affection, Participation, Growth, Attention, Relationships
B. Adaptability, Partnership, Growth, Affection, Resolve
C. Assessment, Planning, Goals, Action, Review
D. Autonomy, Participation, Gratitude, Attachment, Resilience
, Page 4 of 67
Answer: B
Rationale: Family APGAR (Smilkstein 1978): Adaptability, Partnership, Growth, Affection,
Resolve. Scores 0-10; 0-3 = severe dysfunction, 4-6 = moderate, 7-10 = functional.
8. A 28-year-old woman presents anxious and tearful. She describes her husband
as 'controlling all money, isolating me from friends, and occasionally pushing me.'
Using the RADAR model, what is the FIRST step?
A. Refer immediately to police
B. Routinely ask all female patients about intimate partner violence using a validated
tool
C. Ask the husband to join the consultation for clarification
D. Prescribe anxiolytics and discharge
Answer: B
Rationale: RADAR: Routinely ask, Ask directly, Document findings, Assess safety, Review
options and refer. The family physician should NEVER conduct couples counselling when
IPV is suspected (increases risk).
9. The 'Calgary-Cambridge Consultation Model' is widely used in family medicine
training. Which of the following is NOT one of its 5 core tasks?
A. Initiating the session
B. Gathering information
C. Prescribing the evidence-based medication
D. Building the relationship
Answer: C
Rationale: Calgary-Cambridge 5 tasks: Initiation, Information gathering, Physical
examination, Explanation & planning, Closing the session. Running throughout: building
the relationship and providing structure. Prescribing is a clinical action, not a core
consultation task.
10. A 62-year-old Somali man with controlled type 2 diabetes presents for a
routine visit. He reports fasting during Ramadan and asks whether he should
adjust his medications. What is the most appropriate nursing action?
A. Tell him fasting is prohibited for patients with diabetes.
B. Assess his current medication regimen, provide education on risk of hypoglycemia,
and coordinate with his provider for dose adjustments.
C. Advise him to stop all medications during Ramadan.
D. Refer him to the emergency department for evaluation.
Answer: B
Rationale: Patients with diabetes who fast during Ramadan require individualized
