FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: 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
Page | 1
,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.
Correct Answer: B
Rationales — Correct: 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 principles. It
balances urgent evaluation of symptoms with respect for beliefs
and improves diagnostic uptake.
Incorrect Options:
• A. Overly coercive; may damage trust and reduce
adherence. Immediate testing without discussion is not
culturally sensitive and may be unnecessary given stable
vitals.
• C. Deferring evidence-based assessment risks missing
coronary disease; endorsing unproven therapy first is not
guideline-based.
• D. Passive approach ignores current symptoms and misses
opportunity for risk reduction and culturally tailored care.
Teaching Point: Use shared decision-making plus cultural
liaisons to align preventive care with patient beliefs.
Page | 2
, Citation: Cash, J. C. (2025). Family Practice Guidelines (6th
Ed.). Ch. Health Maintenance Guidelines.
2
Reference: Ch. — Health Maintenance Guidelines — Health
Maintenance During the Life Span
Stem: A 28-year-old G1P0 woman presents for a routine health
maintenance visit. She asks what screenings she needs now and
in future. She is healthy, non-smoker, with no family history of
early cancer. Which screening and prevention plan is most
consistent with life-span–oriented family practice guidelines?
A. Begin Pap smear now and repeat annually; no need for HPV
vaccination.
B. Offer HPV vaccination if not previously vaccinated, provide
age-appropriate STI screening, counsel on contraception and
preconception planning.
C. No preventive measures needed until age 40.
D. Start colonoscopy screening immediately due to age.
Correct Answer: B
Rationales — Correct: Option B aligns with life-span health
maintenance: offering HPV vaccine up to recommended ages,
addressing STI screening, contraception, and future
reproductive planning. It uses preventive framework
appropriate for reproductive-age adults.
Incorrect Options:
Page | 3
, • A. Annual Pap smears are outdated for low-risk women;
HPV vaccination remains indicated for eligible age groups.
• C. Incorrect—many preventive measures are appropriate
in 20s/30s (vaccinations, counseling, STI screening).
• D. Colon cancer screening is not recommended until
typical age thresholds (usually ≥45 unless family risk).
Teaching Point: Life-span care includes vaccines, STI
screening, contraception and preconception counseling for
reproductive-age adults.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th
Ed.). Ch. Health Maintenance Guidelines.
3
Reference: Ch. — Health Maintenance Guidelines — Other
Collaborating Providers
Stem: A 68-year-old man with poorly controlled type 2 diabetes
and limited health literacy misses nephrology follow-up
referrals. He develops microalbuminuria. As the APRN
managing his primary care, which collaborative strategy best
supports evidence-based prevention of progression?
A. Continue to manage alone in primary care and reissue the
nephrology referral without changes.
B. Coordinate a multidisciplinary care plan: involve a diabetes
educator, community health worker, pharmacist for med
reconciliation, and schedule joint telehealth with nephrology.
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: 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
Page | 1
,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.
Correct Answer: B
Rationales — Correct: 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 principles. It
balances urgent evaluation of symptoms with respect for beliefs
and improves diagnostic uptake.
Incorrect Options:
• A. Overly coercive; may damage trust and reduce
adherence. Immediate testing without discussion is not
culturally sensitive and may be unnecessary given stable
vitals.
• C. Deferring evidence-based assessment risks missing
coronary disease; endorsing unproven therapy first is not
guideline-based.
• D. Passive approach ignores current symptoms and misses
opportunity for risk reduction and culturally tailored care.
Teaching Point: Use shared decision-making plus cultural
liaisons to align preventive care with patient beliefs.
Page | 2
, Citation: Cash, J. C. (2025). Family Practice Guidelines (6th
Ed.). Ch. Health Maintenance Guidelines.
2
Reference: Ch. — Health Maintenance Guidelines — Health
Maintenance During the Life Span
Stem: A 28-year-old G1P0 woman presents for a routine health
maintenance visit. She asks what screenings she needs now and
in future. She is healthy, non-smoker, with no family history of
early cancer. Which screening and prevention plan is most
consistent with life-span–oriented family practice guidelines?
A. Begin Pap smear now and repeat annually; no need for HPV
vaccination.
B. Offer HPV vaccination if not previously vaccinated, provide
age-appropriate STI screening, counsel on contraception and
preconception planning.
C. No preventive measures needed until age 40.
D. Start colonoscopy screening immediately due to age.
Correct Answer: B
Rationales — Correct: Option B aligns with life-span health
maintenance: offering HPV vaccine up to recommended ages,
addressing STI screening, contraception, and future
reproductive planning. It uses preventive framework
appropriate for reproductive-age adults.
Incorrect Options:
Page | 3
, • A. Annual Pap smears are outdated for low-risk women;
HPV vaccination remains indicated for eligible age groups.
• C. Incorrect—many preventive measures are appropriate
in 20s/30s (vaccinations, counseling, STI screening).
• D. Colon cancer screening is not recommended until
typical age thresholds (usually ≥45 unless family risk).
Teaching Point: Life-span care includes vaccines, STI
screening, contraception and preconception counseling for
reproductive-age adults.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th
Ed.). Ch. Health Maintenance Guidelines.
3
Reference: Ch. — Health Maintenance Guidelines — Other
Collaborating Providers
Stem: A 68-year-old man with poorly controlled type 2 diabetes
and limited health literacy misses nephrology follow-up
referrals. He develops microalbuminuria. As the APRN
managing his primary care, which collaborative strategy best
supports evidence-based prevention of progression?
A. Continue to manage alone in primary care and reissue the
nephrology referral without changes.
B. Coordinate a multidisciplinary care plan: involve a diabetes
educator, community health worker, pharmacist for med
reconciliation, and schedule joint telehealth with nephrology.
Page | 4
