FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
Q1
Reference: Ch. — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 64-year-old Vietnamese male with poorly controlled
type 2 diabetes presents for routine follow-up. He brings a
family member who speaks for him and prefers traditional
herbal remedies. His HbA1c is 9.2%. You suspect limited English
proficiency and cultural health beliefs affecting adherence.
What is the best next step to improve glycemic management?
Options:
A. Encourage the family member to translate medical
instructions and continue current plan.
B. Use a certified medical interpreter, assess health beliefs
about diabetes, and negotiate a culturally acceptable plan.
Page | 1
,C. Recommend immediate insulin initiation without discussion
to reach target quickly.
D. Refer to endocrinology and postpone diabetes education
until specialist visit.
Correct answer: B
Rationale — Correct (B): Using a certified interpreter and
eliciting the patient’s explanatory model identifies cultural
barriers and allows shared decision-making that improves
adherence; Family Practice Guidelines emphasize culturally
sensitive negotiation rather than unilateral decisions.
Addressing beliefs and providing tailored education supports
realistic glycemic targets and safer transitions to insulin if
needed.
Rationale — Incorrect:
A. Family members commonly introduce bias and errors in
translation; Guidelines recommend professional interpreters to
ensure accuracy and privacy.
C. Immediate insulin without assessing beliefs risks
nonadherence and potential hypoglycemia if instructions
misunderstood.
D. Referring without addressing current education defers
essential primary-care management and misses opportunity for
culturally tailored interventions.
Teaching Point: Use certified interpreters and elicit health
beliefs before changing therapy.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Health Maintenance Guidelines.
Page | 2
,Q2
Reference: Ch. — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 28-year-old Muslim woman declines HPV vaccination
during a well visit, citing modesty concerns and wanting to
consult her family. She is otherwise healthy. How should you
proceed now?
Options:
A. Document refusal and avoid further discussion to respect
autonomy.
B. Provide brief education on HPV risks, ask permission to
discuss her concerns, and offer culturally sensitive options
(female provider, private counseling, decision aids).
C. Insist on immediate vaccination because it is standard
preventive care.
D. Defer all preventive counseling to a later visit.
Correct answer: B
Rationale — Correct (B): The Guidelines recommend culturally
sensitive, patient-centered counseling, offering
accommodations (same-gender provider, privacy) and decision
aids. Asking permission to discuss and providing clear,
nonjudgmental information improves uptake.
Rationale — Incorrect:
A. Passive documentation misses opportunities to address
barriers; FPG encourages informed, culturally respectful
Page | 3
, counseling.
C. Insistence undermines trust and may increase refusal or loss
to follow-up.
D. Deferring misses a window of opportunity for
adolescent/young adult vaccination and may reduce
completion rates.
Teaching Point: Use culturally sensitive counseling and
accommodations to increase vaccine acceptance.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Health Maintenance Guidelines.
Q3
Reference: Ch. — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: An 82-year-old Native American man presents after a fall
but refuses home safety recommendations because he believes
falls are “part of aging.” He has a history of COPD and uses
multiple meds. What is the best APRN approach to reduce
future falls?
Options:
A. Provide pamphlets and insist on immediate removal of rugs
and stairs.
B. Use motivational interviewing to explore beliefs, involve
family or community supports, and tailor a gradual, culturally
acceptable home-safety plan.
C. Tell him that falls are preventable and force compliance with
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
Q1
Reference: Ch. — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 64-year-old Vietnamese male with poorly controlled
type 2 diabetes presents for routine follow-up. He brings a
family member who speaks for him and prefers traditional
herbal remedies. His HbA1c is 9.2%. You suspect limited English
proficiency and cultural health beliefs affecting adherence.
What is the best next step to improve glycemic management?
Options:
A. Encourage the family member to translate medical
instructions and continue current plan.
B. Use a certified medical interpreter, assess health beliefs
about diabetes, and negotiate a culturally acceptable plan.
Page | 1
,C. Recommend immediate insulin initiation without discussion
to reach target quickly.
D. Refer to endocrinology and postpone diabetes education
until specialist visit.
Correct answer: B
Rationale — Correct (B): Using a certified interpreter and
eliciting the patient’s explanatory model identifies cultural
barriers and allows shared decision-making that improves
adherence; Family Practice Guidelines emphasize culturally
sensitive negotiation rather than unilateral decisions.
Addressing beliefs and providing tailored education supports
realistic glycemic targets and safer transitions to insulin if
needed.
Rationale — Incorrect:
A. Family members commonly introduce bias and errors in
translation; Guidelines recommend professional interpreters to
ensure accuracy and privacy.
C. Immediate insulin without assessing beliefs risks
nonadherence and potential hypoglycemia if instructions
misunderstood.
D. Referring without addressing current education defers
essential primary-care management and misses opportunity for
culturally tailored interventions.
Teaching Point: Use certified interpreters and elicit health
beliefs before changing therapy.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Health Maintenance Guidelines.
Page | 2
,Q2
Reference: Ch. — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 28-year-old Muslim woman declines HPV vaccination
during a well visit, citing modesty concerns and wanting to
consult her family. She is otherwise healthy. How should you
proceed now?
Options:
A. Document refusal and avoid further discussion to respect
autonomy.
B. Provide brief education on HPV risks, ask permission to
discuss her concerns, and offer culturally sensitive options
(female provider, private counseling, decision aids).
C. Insist on immediate vaccination because it is standard
preventive care.
D. Defer all preventive counseling to a later visit.
Correct answer: B
Rationale — Correct (B): The Guidelines recommend culturally
sensitive, patient-centered counseling, offering
accommodations (same-gender provider, privacy) and decision
aids. Asking permission to discuss and providing clear,
nonjudgmental information improves uptake.
Rationale — Incorrect:
A. Passive documentation misses opportunities to address
barriers; FPG encourages informed, culturally respectful
Page | 3
, counseling.
C. Insistence undermines trust and may increase refusal or loss
to follow-up.
D. Deferring misses a window of opportunity for
adolescent/young adult vaccination and may reduce
completion rates.
Teaching Point: Use culturally sensitive counseling and
accommodations to increase vaccine acceptance.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Health Maintenance Guidelines.
Q3
Reference: Ch. — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: An 82-year-old Native American man presents after a fall
but refuses home safety recommendations because he believes
falls are “part of aging.” He has a history of COPD and uses
multiple meds. What is the best APRN approach to reduce
future falls?
Options:
A. Provide pamphlets and insist on immediate removal of rugs
and stairs.
B. Use motivational interviewing to explore beliefs, involve
family or community supports, and tailor a gradual, culturally
acceptable home-safety plan.
C. Tell him that falls are preventable and force compliance with
Page | 4
