FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. 1 — Health Maintenance — Cultural Diversity
and Sensitivity. Springer Publishing Website
Stem: A 42-year-old woman from a recent immigrant
community presents for a routine exam. She is hesitant to
discuss sexual health and asks the clinician to speak with her
husband present. She reports no acute complaints but has
limited English and uses family members to translate. As an
APRN, which immediate action best balances cultural sensitivity
with quality preventive care?
A. Accept family translation, proceed with screening per usual
adult preventive schedule.
B. Request a professional medical interpreter and ask to speak
with the patient alone for part of the visit.
Page | 1
,C. Defer sexual health questions to the husband to respect
cultural norms and proceed with physical exam.
D. Reschedule the visit and provide written patient teaching
materials in English only.
Correct Answer: B
Rationale — Correct (B): Requesting a professional interpreter
and asking to speak with the patient alone demonstrates
culturally sensitive, patient-centered care while protecting
confidentiality and enabling accurate sexual/ preventive
screening. This aligns with health maintenance principles that
prioritize appropriate communication and informed decision-
making.
Rationale — Incorrect:
A — Using family members risks inaccurate translation and
breaches confidentiality for sensitive topics.
C — Deferring to the husband compromises patient autonomy
and may miss private health risks.
D — Rescheduling and providing English materials fails to
address current needs and excludes those with limited English.
Teaching Point: Always use professional interpreters and allow
private time for sensitive screening.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Page | 2
,Reference: Ch. 1 — Health Maintenance — Health Maintenance
During the Life Span. Springer Publishing Website
Stem: A 68-year-old man with controlled hypertension and no
other complaints asks about what preventive tests he still
needs. He is active, independent, and asks specifically whether
cancer screenings remain beneficial. Which APRN response best
reflects life-span health maintenance reasoning?
A. Recommend stopping all cancer screenings because he has
controlled chronic disease and age alone negates benefit.
B. Review individualized risks, life expectancy, and current
screening benefits to decide which tests to continue.
C. Continue all standard adult screenings indefinitely regardless
of comorbidities.
D. Defer all screening decisions to a specialist since cancer
screening is beyond primary care scope.
Correct Answer: B
Rationale — Correct (B): Life-span health maintenance
emphasizes individualized decision-making—balance life
expectancy, comorbid conditions, patient values, and test
harms/benefits. This analytic approach aligns with FPG
guidance to tailor screenings across the lifespan.
Rationale — Incorrect:
A — Age alone is not the sole determinant; blanket cessation
ignores individualized benefit/harm assessment.
C — Continuing all tests without reassessment risks over-
Page | 3
, screening and harm.
D — Primary care is responsible for coordinating preventive
care; deferral is unnecessary.
Teaching Point: Individualize preventive screening by life
expectancy, comorbidity, and patient values.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
3
Reference: Ch. 1 — Health Maintenance — Other Collaborating
Providers. Springer Publishing Website
Stem: A 29-year-old pregnant patient at 10 weeks with mild
anxiety requests counseling about exercise and nutrition. Your
clinic uses a multi-disciplinary model. Which next step best uses
collaborating providers to meet health maintenance goals?
A. Provide a brief plan yourself and refer to a social worker only
if issues escalate.
B. Arrange an immediate referral to obstetrics, a prenatal
nutritionist, and behavioral health for coordinated counseling.
C. Tell the patient to follow standard internet resources and call
if problems arise.
D. Schedule serial home visits by nursing staff only and avoid
external referrals.
Correct Answer: B
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. 1 — Health Maintenance — Cultural Diversity
and Sensitivity. Springer Publishing Website
Stem: A 42-year-old woman from a recent immigrant
community presents for a routine exam. She is hesitant to
discuss sexual health and asks the clinician to speak with her
husband present. She reports no acute complaints but has
limited English and uses family members to translate. As an
APRN, which immediate action best balances cultural sensitivity
with quality preventive care?
A. Accept family translation, proceed with screening per usual
adult preventive schedule.
B. Request a professional medical interpreter and ask to speak
with the patient alone for part of the visit.
Page | 1
,C. Defer sexual health questions to the husband to respect
cultural norms and proceed with physical exam.
D. Reschedule the visit and provide written patient teaching
materials in English only.
Correct Answer: B
Rationale — Correct (B): Requesting a professional interpreter
and asking to speak with the patient alone demonstrates
culturally sensitive, patient-centered care while protecting
confidentiality and enabling accurate sexual/ preventive
screening. This aligns with health maintenance principles that
prioritize appropriate communication and informed decision-
making.
Rationale — Incorrect:
A — Using family members risks inaccurate translation and
breaches confidentiality for sensitive topics.
C — Deferring to the husband compromises patient autonomy
and may miss private health risks.
D — Rescheduling and providing English materials fails to
address current needs and excludes those with limited English.
Teaching Point: Always use professional interpreters and allow
private time for sensitive screening.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Page | 2
,Reference: Ch. 1 — Health Maintenance — Health Maintenance
During the Life Span. Springer Publishing Website
Stem: A 68-year-old man with controlled hypertension and no
other complaints asks about what preventive tests he still
needs. He is active, independent, and asks specifically whether
cancer screenings remain beneficial. Which APRN response best
reflects life-span health maintenance reasoning?
A. Recommend stopping all cancer screenings because he has
controlled chronic disease and age alone negates benefit.
B. Review individualized risks, life expectancy, and current
screening benefits to decide which tests to continue.
C. Continue all standard adult screenings indefinitely regardless
of comorbidities.
D. Defer all screening decisions to a specialist since cancer
screening is beyond primary care scope.
Correct Answer: B
Rationale — Correct (B): Life-span health maintenance
emphasizes individualized decision-making—balance life
expectancy, comorbid conditions, patient values, and test
harms/benefits. This analytic approach aligns with FPG
guidance to tailor screenings across the lifespan.
Rationale — Incorrect:
A — Age alone is not the sole determinant; blanket cessation
ignores individualized benefit/harm assessment.
C — Continuing all tests without reassessment risks over-
Page | 3
, screening and harm.
D — Primary care is responsible for coordinating preventive
care; deferral is unnecessary.
Teaching Point: Individualize preventive screening by life
expectancy, comorbidity, and patient values.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
3
Reference: Ch. 1 — Health Maintenance — Other Collaborating
Providers. Springer Publishing Website
Stem: A 29-year-old pregnant patient at 10 weeks with mild
anxiety requests counseling about exercise and nutrition. Your
clinic uses a multi-disciplinary model. Which next step best uses
collaborating providers to meet health maintenance goals?
A. Provide a brief plan yourself and refer to a social worker only
if issues escalate.
B. Arrange an immediate referral to obstetrics, a prenatal
nutritionist, and behavioral health for coordinated counseling.
C. Tell the patient to follow standard internet resources and call
if problems arise.
D. Schedule serial home visits by nursing staff only and avoid
external referrals.
Correct Answer: B
Page | 4
