FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity & Sensitivity. Springer Publishing Website+1
Stem: A 42-year-old Somali woman presents for a routine visit
and declines colorectal cancer screening because of cultural
beliefs and family obligations. She has a first-degree relative
with colon cancer at age 62. How should the APRN proceed to
maximize adherence while respecting cultural sensitivity?
A. Accept refusal and document cultural objection.
B. Provide a brief culturally tailored explanation of screening
benefits and offer a home fecal immunochemical test (FIT).
C. Insist on referral for colonoscopy per guidelines and schedule
it.
D. Advise delaying screening until family approves.
Page | 1
,Correct: B
Rationale — Correct: Offering a culturally tailored explanation
and a less-invasive, home-based FIT balances guideline-based
prevention with respect for cultural beliefs; it increases uptake
and is acceptable when colonoscopy is declined. Family Practice
Guidelines emphasize culturally sensitive education and feasible
alternatives for adherence.
Rationale — A: Passive acceptance misses an evidence-based
opportunity to reduce cancer risk and does not align with
patient-centered shared decision-making.
Rationale — C: Insisting risks alienation and may reduce
adherence; colonoscopy is preferred for high-risk but must
follow shared decision-making.
Rationale — D: Delaying without offering options fails
guideline-driven preventive care.
Teaching point: Offer culturally tailored education and
acceptable screening alternatives like FIT.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Reference: Ch. 1 — Health Maintenance Guidelines — Adult
Risk Assessment Form (Exhibit 1.1). Dokumen+1
Stem: A 58-year-old man with treated hypertension completes
the Adult Risk Assessment form; he reports smoking 1/2 ppd,
sedentary lifestyle, occasional binge alcohol use, BMI 31, and
Page | 2
,no advance directives. Which next step best aligns with the
form’s prioritization?
A. Immediate referral to cardiology for risk reduction.
B. Initiate brief motivational interviewing, offer smoking
cessation and weight management program, and document
advance care planning discussion.
C. Order full cardiac CT calcium scoring now.
D. Defer lifestyle counseling to next visit.
Correct: B
Rationale — Correct: The Adult Risk Assessment is designed to
identify modifiable risks and prioritize behavior-change
interventions in primary care. Brief MI, smoking cessation,
weight management referral, and initiating advance care
planning address multiple high-yield risks.
Rationale — A: Cardiology referral is premature without
evidence of ischemia or uncontrolled cardiovascular disease.
Rationale — C: CT calcium is not first-line for elevated risk
management compared to addressing modifiable behaviors.
Rationale — D: Delaying counseling forfeits an opportunity for
immediate risk-reduction and contradicts preventive care
principles.
Teaching point: Use the Adult Risk Assessment to prioritize
immediate, modifiable interventions.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
Page | 3
, 3
Reference: Ch. 1 — Health Maintenance Guidelines — Adult
Preventive Healthcare (immunizations). Springer Publishing
Website
Stem: A 67-year-old woman with well-controlled diabetes
presents for annual exam. She received influenza vaccine last
year; her pneumococcal vaccination status is uncertain. Which
prevention step best matches current Family Practice
Guidelines priorities for adults over 65 with chronic disease?
A. No further vaccines required if unsure—document and move
on.
B. Administer pneumococcal vaccination per age-based
recommendation and update influenza if seasonally indicated.
C. Give HPV vaccine because chronic disease increases risk.
D. Only administer tetanus booster if more than 5 years since
last dose.
Correct: B
Rationale — Correct: Guidelines recommend age-based
pneumococcal immunization for adults ≥65 and annual
influenza vaccination; ensuring these are current in a diabetic
patient is prioritized.
Rationale — A: Leaving immunizations unchecked misses
guideline-directed preventive care.
Rationale — C: HPV vaccine is not routinely indicated at age 67.
Rationale — D: Tetanus boosters follow a 10-year schedule for
routine adult care; 5-year intervals are for specific wound
exposures.
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity & Sensitivity. Springer Publishing Website+1
Stem: A 42-year-old Somali woman presents for a routine visit
and declines colorectal cancer screening because of cultural
beliefs and family obligations. She has a first-degree relative
with colon cancer at age 62. How should the APRN proceed to
maximize adherence while respecting cultural sensitivity?
A. Accept refusal and document cultural objection.
B. Provide a brief culturally tailored explanation of screening
benefits and offer a home fecal immunochemical test (FIT).
C. Insist on referral for colonoscopy per guidelines and schedule
it.
D. Advise delaying screening until family approves.
Page | 1
,Correct: B
Rationale — Correct: Offering a culturally tailored explanation
and a less-invasive, home-based FIT balances guideline-based
prevention with respect for cultural beliefs; it increases uptake
and is acceptable when colonoscopy is declined. Family Practice
Guidelines emphasize culturally sensitive education and feasible
alternatives for adherence.
Rationale — A: Passive acceptance misses an evidence-based
opportunity to reduce cancer risk and does not align with
patient-centered shared decision-making.
Rationale — C: Insisting risks alienation and may reduce
adherence; colonoscopy is preferred for high-risk but must
follow shared decision-making.
Rationale — D: Delaying without offering options fails
guideline-driven preventive care.
Teaching point: Offer culturally tailored education and
acceptable screening alternatives like FIT.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Reference: Ch. 1 — Health Maintenance Guidelines — Adult
Risk Assessment Form (Exhibit 1.1). Dokumen+1
Stem: A 58-year-old man with treated hypertension completes
the Adult Risk Assessment form; he reports smoking 1/2 ppd,
sedentary lifestyle, occasional binge alcohol use, BMI 31, and
Page | 2
,no advance directives. Which next step best aligns with the
form’s prioritization?
A. Immediate referral to cardiology for risk reduction.
B. Initiate brief motivational interviewing, offer smoking
cessation and weight management program, and document
advance care planning discussion.
C. Order full cardiac CT calcium scoring now.
D. Defer lifestyle counseling to next visit.
Correct: B
Rationale — Correct: The Adult Risk Assessment is designed to
identify modifiable risks and prioritize behavior-change
interventions in primary care. Brief MI, smoking cessation,
weight management referral, and initiating advance care
planning address multiple high-yield risks.
Rationale — A: Cardiology referral is premature without
evidence of ischemia or uncontrolled cardiovascular disease.
Rationale — C: CT calcium is not first-line for elevated risk
management compared to addressing modifiable behaviors.
Rationale — D: Delaying counseling forfeits an opportunity for
immediate risk-reduction and contradicts preventive care
principles.
Teaching point: Use the Adult Risk Assessment to prioritize
immediate, modifiable interventions.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
Page | 3
, 3
Reference: Ch. 1 — Health Maintenance Guidelines — Adult
Preventive Healthcare (immunizations). Springer Publishing
Website
Stem: A 67-year-old woman with well-controlled diabetes
presents for annual exam. She received influenza vaccine last
year; her pneumococcal vaccination status is uncertain. Which
prevention step best matches current Family Practice
Guidelines priorities for adults over 65 with chronic disease?
A. No further vaccines required if unsure—document and move
on.
B. Administer pneumococcal vaccination per age-based
recommendation and update influenza if seasonally indicated.
C. Give HPV vaccine because chronic disease increases risk.
D. Only administer tetanus booster if more than 5 years since
last dose.
Correct: B
Rationale — Correct: Guidelines recommend age-based
pneumococcal immunization for adults ≥65 and annual
influenza vaccination; ensuring these are current in a diabetic
patient is prioritized.
Rationale — A: Leaving immunizations unchecked misses
guideline-directed preventive care.
Rationale — C: HPV vaccine is not routinely indicated at age 67.
Rationale — D: Tetanus boosters follow a 10-year schedule for
routine adult care; 5-year intervals are for specific wound
exposures.
Page | 4
