Test Bank For Canadian Family Practice Guidelines
– Comprehensive Test Bank (Ch. 1–23)
, TABLE OF CONTENTS
1. Health Maintenance Guidelines
2. Cultural Considerations in Primary Care
3. Evidence-Based Practice & Clinical Decision-Making
4. Preventive Care & Screening Guidelines
5. Cardiovascular Disease Management (Hypertension, CAD, CHF)
6. Respiratory Disorders (Asthma, COPD, Pneumonia)
7. Gastrointestinal Disorders (GERD, PUD, Hepatic & Biliary)
8. Renal & Urinary Disorders
9. Male Reproductive & Genitourinary Disorders
10. Female Reproductive Health (Menstrual, Pregnancy, Contraception)
11. Dyslipidemia & Atherosclerotic Risk
12. Endocrine Disorders (Diabetes, Thyroid, Adrenal, Pituitary)
13. Neurologic Disorders (Headache, Stroke, Seizures, Dementia, Neuropathy)
14. Psychiatric & Behavioral Disorders (Depression, Anxiety, Psychosis, Substance Use)
15. Infectious Disease Guidelines (HIV, Hepatitis, STIs, Immunizations)
16. Hematologic Disorders (Anemia, Coagulopathies, Malignancies)
17. Musculoskeletal Disorders (Arthritis, Osteoporosis, Low Back Pain, Gout)
18. Dermatologic Disorders (Rashes, Infections, Skin Cancer)
19. Eye and ENT Disorders (Ophthalmology & Otolaryngology)
20. Geriatric Health & Polypharmacy
21. Emergency & Trauma Care in Primary Practice
22. Pediatric & Adolescent Health
23. Clinical Synthesis Exam – Board-Style Integrated Review
,Canadian Family Practice Guidelines – Comprehensive Test Bank (Ch. 1–23)
Chapter 1 – Health Maintenance Guidelines
1. A 45-year-old man presents for an annual physical. According to CFPG recommendations,
which preventive screening should be prioritized?
A. PSA annually
B. Colonoscopy every 10 years starting at 50
C. Fasting lipid panel every 5 years
D. Low-dose CT chest scan annually
Answer: C
Rationale: The CFPG advises lipid screening every 5 years beginning at age 40 in men and age
50 in women unless risk factors warrant earlier testing.
2. A 55-year-old woman with no significant history asks about cancer screening. What should be
recommended?
A. Mammogram every 5 years
B. Mammogram every 2 years until 74
C. Annual breast MRI
D. Mammogram only if symptomatic
Answer: B
Rationale: Biennial mammography for women 50–74 is supported by national and CFPG
guidance for early breast-cancer detection.
3. A 21-year-old sexually active woman presents for a well-woman exam. Which Pap-test
interval is appropriate?
A. Annually
B. Every 3 years
C. Every 5 years
D. Only with HPV positivity
Answer: B
Rationale: Cervical-cancer screening starts at 25 and continues every 3 years with cytology
alone per CFPG preventive-care guidance.
4. A 68-year-old woman with no smoking history asks about lung-cancer screening.
A. Annual chest X-ray
B. Low-dose CT scan annually if 30-pack-year history
C. No screening needed
D. Sputum cytology yearly
Answer: C
Rationale: Screening is recommended only for adults 55–74 with a ≥30 pack-year history who
currently smoke or quit within 15 years.
,5. An overweight 50-year-old male with hypertension should be screened for diabetes:
A. Only if symptomatic
B. Every 3 years with fasting glucose or HbA1c
C. Annually with fasting glucose
D. Not needed
Answer: B
Rationale: CFPG recommends screening adults ≥40 or those with risk factors (e.g.,
hypertension, obesity) every 3 years with HbA1c or fasting plasma glucose.
6. A 67-year-old woman asks about DEXA scanning.
A. Start at age 50
B. Begin at 65 for all women
C. Begin at 70 for all adults
D. Not indicated
Answer: B
Rationale: Bone-density screening is indicated for women ≥65 and men ≥70 or earlier with risk
factors for osteoporosis.
7. A 28-year-old male is unsure of his vaccination history. According to CFPG, he should
receive:
A. Td booster every 5 years
B. Td/Tdap booster every 10 years
C. Tdap only once in lifetime
D. No vaccination needed
Answer: B
Rationale: Adults require a Td/Tdap booster every 10 years to maintain tetanus and pertussis
protection.
8. A 35-year-old woman with type 1 diabetes asks about influenza vaccination.
A. Not required under 50 years old
B. Every 2 years
C. Annual influenza vaccination
D. Only if hospitalized
Answer: C
Rationale: Annual flu vaccination is recommended for all adults with chronic diseases
regardless of age.
9. Which statement about colorectal-cancer screening is correct?
A. Start at age 45 for average risk
B. Start at age 50 with colonoscopy every 10 years
C. Fecal immunochemical test (FIT) annually starting at 50
D. No screening until symptoms
Answer: C
Rationale: CFPG and Canadian Task Force recommend annual or biennial FIT from 50 to 74 for
average-risk adults.
,10. A 60-year-old woman with a 30-pack-year history quit 10 years ago.
A. Not eligible for lung-cancer screening
B. Eligible for low-dose CT annually
C. Chest X-ray every 2 years
D. CT only if symptomatic
Answer: B
Rationale: Low-dose CT screening is indicated for those 55–74 with ≥30 pack-year history who
currently smoke or quit within 15 years.
11. When should an average-risk adult begin colorectal-cancer screening per CFPG?
A. 40
B. 45
C. 50
D. 55
Answer: C
Rationale: Colorectal screening begins at 50 for average-risk adults.
12. Which immunization is appropriate for all adults ≥65?
A. Annual zoster vaccine
B. Pneumococcal conjugate + polysaccharide vaccine
C. Only influenza
D. Hepatitis B series
Answer: B
Rationale: Older adults should receive PCV13 followed by PPSV23 at least 1 year later for
pneumococcal disease prevention.
13. A 45-year-old female with a new sexual partner should be screened for:
A. Chlamydia and gonorrhea
B. HIV only
C. Syphilis only
D. No screening if asymptomatic
Answer: A
Rationale: CFPG recommends STI screening for sexually active individuals with new or
multiple partners.
14. Which of the following best describes the CFPG recommendation for hypertension
screening?
A. Only if symptomatic
B. Every 2 years for adults ≥18
C. Annually for adults ≥40
D. Once after age 50
Answer: C
Rationale: Annual blood-pressure screening is recommended for adults ≥40 and those at
increased risk; every 3–5 years for low-risk 18–39 year-olds.
,15. Which vaccine is recommended for adults ≥50 regardless of prior infection?
A. Hepatitis A
B. Herpes zoster (Shingrix)
C. MMR
D. HPV
Answer: B
Rationale: Two doses of recombinant zoster vaccine are recommended for all adults ≥50 to
reduce shingles and post-herpetic neuralgia risk.
16. A 25-year-old female with no risk factors asks about cervical-cancer screening.
A. Begin at 21 annually
B. Begin at 25 every 3 years
C. Begin at 30 every 5 years
D. Begin at 35 if sexually active
Answer: B
Rationale: Screening begins at 25 with cytology every 3 years per Canadian guidelines.
17. According to CFPG, depression screening should be considered:
A. For everyone at every visit
B. When integrated care and supports are available
C. Only in high-risk populations
D. Not recommended
Answer: B
Rationale: Depression screening is recommended only if adequate systems for diagnosis and
follow-up are in place.
18. An 18-year-old preparing for university residence should receive which vaccine?
A. HPV only
B. Meningococcal conjugate ACWY
C. Influenza only
D. Td booster
Answer: B
Rationale: Students in congregate housing should receive meningococcal ACWY vaccination
before entry.
19. A 40-year-old woman with strong family history of breast cancer asks about BRCA testing.
A. Not indicated
B. Recommended if ≥2 first-degree relatives affected
C. Only if symptomatic
D. Only after age 50
Answer: B
Rationale: Genetic counseling and testing are indicated for individuals with significant family
histories of early-onset breast/ovarian cancer.
20. The CFPG recommends HIV screening:
A. For everyone at least once in adulthood
,B. Only if symptomatic
C. Only high-risk groups
D. Annually for all adults
Answer: A
Rationale: At least one lifetime HIV screen for all adults, with repeat testing for those at
ongoing risk, is advised for early identification and linkage to care.
Chapter 2 – Cultural Considerations in Primary Care
1. A 36-year-old Indigenous woman presents for a prenatal visit. Which approach best reflects
culturally safe care?
A. Focus on biomedical facts only to avoid stereotyping
B. Explore her cultural beliefs about pregnancy and integrate them into the plan
C. Ask her to defer cultural practices until after delivery
D. Provide the same advice given to all patients
Answer: B
Rationale: CFPG emphasizes cultural safety through respectful inclusion of a patient’s beliefs,
values, and traditions in care decisions, especially for Indigenous populations.
2. A 45-year-old recent immigrant has difficulty understanding his medication instructions. The
most appropriate first step is to:
A. Raise your voice and repeat slowly
B. Use a trained medical interpreter
C. Ask a family member to translate
D. Write instructions in English
Answer: B
Rationale: The CFPG promotes use of trained interpreters to ensure accurate communication
and maintain confidentiality.
3. A Muslim patient with diabetes is fasting during Ramadan. What is the most culturally
appropriate plan?
A. Advise stopping the fast immediately
B. Collaborate to adjust medication timing safely during fasting hours
C. Recommend skipping insulin on fasting days
D. Ignore fasting practices
Answer: B
Rationale: CFPG supports collaborative management respecting religious observances while
minimizing health risks through medication and diet adjustments.
, 4. A 30-year-old First Nations man expresses distrust of healthcare due to past discrimination.
The best response is:
A. Explain that racism no longer exists in healthcare
B. Ask him to see another provider
C. Acknowledge his experience and build trust through transparency
D. Focus only on his symptoms
Answer: C
Rationale: Recognizing systemic racism and validating lived experiences promotes therapeutic
trust and aligns with CFPG principles of reconciliation and cultural humility.
5. When providing care to a refugee patient with PTSD symptoms, the CFPG recommends:
A. Immediate pharmacologic therapy
B. Trauma-informed care and screening for safety
C. Avoid discussing trauma to prevent re-traumatization
D. Referral to psychiatry only if requested
Answer: B
Rationale: Trauma-informed care—prioritizing safety, choice, and empowerment—is a
cornerstone of culturally competent refugee health practice.
6. Which of the following best describes cultural competence?
A. Memorizing customs of diverse groups
B. Continuous self-reflection and awareness of personal bias
C. Using cultural stereotypes to improve communication
D. Avoiding discussions of culture altogether
Answer: B
Rationale: CFPG defines cultural competence as an evolving process of self-awareness,
learning, and adapting care to patients’ cultural contexts.
7. A 50-year-old Chinese man prefers traditional remedies alongside prescribed therapy. What
should the clinician do?
A. Discourage traditional practices
B. Explore remedies used and evaluate for potential interactions
C. Refuse care until he discontinues traditional medicine
D. Substitute all prescribed medications with herbal remedies
Answer: B
Rationale: Culturally competent care involves respecting traditional practices while ensuring
safety and avoiding harmful interactions.
– Comprehensive Test Bank (Ch. 1–23)
, TABLE OF CONTENTS
1. Health Maintenance Guidelines
2. Cultural Considerations in Primary Care
3. Evidence-Based Practice & Clinical Decision-Making
4. Preventive Care & Screening Guidelines
5. Cardiovascular Disease Management (Hypertension, CAD, CHF)
6. Respiratory Disorders (Asthma, COPD, Pneumonia)
7. Gastrointestinal Disorders (GERD, PUD, Hepatic & Biliary)
8. Renal & Urinary Disorders
9. Male Reproductive & Genitourinary Disorders
10. Female Reproductive Health (Menstrual, Pregnancy, Contraception)
11. Dyslipidemia & Atherosclerotic Risk
12. Endocrine Disorders (Diabetes, Thyroid, Adrenal, Pituitary)
13. Neurologic Disorders (Headache, Stroke, Seizures, Dementia, Neuropathy)
14. Psychiatric & Behavioral Disorders (Depression, Anxiety, Psychosis, Substance Use)
15. Infectious Disease Guidelines (HIV, Hepatitis, STIs, Immunizations)
16. Hematologic Disorders (Anemia, Coagulopathies, Malignancies)
17. Musculoskeletal Disorders (Arthritis, Osteoporosis, Low Back Pain, Gout)
18. Dermatologic Disorders (Rashes, Infections, Skin Cancer)
19. Eye and ENT Disorders (Ophthalmology & Otolaryngology)
20. Geriatric Health & Polypharmacy
21. Emergency & Trauma Care in Primary Practice
22. Pediatric & Adolescent Health
23. Clinical Synthesis Exam – Board-Style Integrated Review
,Canadian Family Practice Guidelines – Comprehensive Test Bank (Ch. 1–23)
Chapter 1 – Health Maintenance Guidelines
1. A 45-year-old man presents for an annual physical. According to CFPG recommendations,
which preventive screening should be prioritized?
A. PSA annually
B. Colonoscopy every 10 years starting at 50
C. Fasting lipid panel every 5 years
D. Low-dose CT chest scan annually
Answer: C
Rationale: The CFPG advises lipid screening every 5 years beginning at age 40 in men and age
50 in women unless risk factors warrant earlier testing.
2. A 55-year-old woman with no significant history asks about cancer screening. What should be
recommended?
A. Mammogram every 5 years
B. Mammogram every 2 years until 74
C. Annual breast MRI
D. Mammogram only if symptomatic
Answer: B
Rationale: Biennial mammography for women 50–74 is supported by national and CFPG
guidance for early breast-cancer detection.
3. A 21-year-old sexually active woman presents for a well-woman exam. Which Pap-test
interval is appropriate?
A. Annually
B. Every 3 years
C. Every 5 years
D. Only with HPV positivity
Answer: B
Rationale: Cervical-cancer screening starts at 25 and continues every 3 years with cytology
alone per CFPG preventive-care guidance.
4. A 68-year-old woman with no smoking history asks about lung-cancer screening.
A. Annual chest X-ray
B. Low-dose CT scan annually if 30-pack-year history
C. No screening needed
D. Sputum cytology yearly
Answer: C
Rationale: Screening is recommended only for adults 55–74 with a ≥30 pack-year history who
currently smoke or quit within 15 years.
,5. An overweight 50-year-old male with hypertension should be screened for diabetes:
A. Only if symptomatic
B. Every 3 years with fasting glucose or HbA1c
C. Annually with fasting glucose
D. Not needed
Answer: B
Rationale: CFPG recommends screening adults ≥40 or those with risk factors (e.g.,
hypertension, obesity) every 3 years with HbA1c or fasting plasma glucose.
6. A 67-year-old woman asks about DEXA scanning.
A. Start at age 50
B. Begin at 65 for all women
C. Begin at 70 for all adults
D. Not indicated
Answer: B
Rationale: Bone-density screening is indicated for women ≥65 and men ≥70 or earlier with risk
factors for osteoporosis.
7. A 28-year-old male is unsure of his vaccination history. According to CFPG, he should
receive:
A. Td booster every 5 years
B. Td/Tdap booster every 10 years
C. Tdap only once in lifetime
D. No vaccination needed
Answer: B
Rationale: Adults require a Td/Tdap booster every 10 years to maintain tetanus and pertussis
protection.
8. A 35-year-old woman with type 1 diabetes asks about influenza vaccination.
A. Not required under 50 years old
B. Every 2 years
C. Annual influenza vaccination
D. Only if hospitalized
Answer: C
Rationale: Annual flu vaccination is recommended for all adults with chronic diseases
regardless of age.
9. Which statement about colorectal-cancer screening is correct?
A. Start at age 45 for average risk
B. Start at age 50 with colonoscopy every 10 years
C. Fecal immunochemical test (FIT) annually starting at 50
D. No screening until symptoms
Answer: C
Rationale: CFPG and Canadian Task Force recommend annual or biennial FIT from 50 to 74 for
average-risk adults.
,10. A 60-year-old woman with a 30-pack-year history quit 10 years ago.
A. Not eligible for lung-cancer screening
B. Eligible for low-dose CT annually
C. Chest X-ray every 2 years
D. CT only if symptomatic
Answer: B
Rationale: Low-dose CT screening is indicated for those 55–74 with ≥30 pack-year history who
currently smoke or quit within 15 years.
11. When should an average-risk adult begin colorectal-cancer screening per CFPG?
A. 40
B. 45
C. 50
D. 55
Answer: C
Rationale: Colorectal screening begins at 50 for average-risk adults.
12. Which immunization is appropriate for all adults ≥65?
A. Annual zoster vaccine
B. Pneumococcal conjugate + polysaccharide vaccine
C. Only influenza
D. Hepatitis B series
Answer: B
Rationale: Older adults should receive PCV13 followed by PPSV23 at least 1 year later for
pneumococcal disease prevention.
13. A 45-year-old female with a new sexual partner should be screened for:
A. Chlamydia and gonorrhea
B. HIV only
C. Syphilis only
D. No screening if asymptomatic
Answer: A
Rationale: CFPG recommends STI screening for sexually active individuals with new or
multiple partners.
14. Which of the following best describes the CFPG recommendation for hypertension
screening?
A. Only if symptomatic
B. Every 2 years for adults ≥18
C. Annually for adults ≥40
D. Once after age 50
Answer: C
Rationale: Annual blood-pressure screening is recommended for adults ≥40 and those at
increased risk; every 3–5 years for low-risk 18–39 year-olds.
,15. Which vaccine is recommended for adults ≥50 regardless of prior infection?
A. Hepatitis A
B. Herpes zoster (Shingrix)
C. MMR
D. HPV
Answer: B
Rationale: Two doses of recombinant zoster vaccine are recommended for all adults ≥50 to
reduce shingles and post-herpetic neuralgia risk.
16. A 25-year-old female with no risk factors asks about cervical-cancer screening.
A. Begin at 21 annually
B. Begin at 25 every 3 years
C. Begin at 30 every 5 years
D. Begin at 35 if sexually active
Answer: B
Rationale: Screening begins at 25 with cytology every 3 years per Canadian guidelines.
17. According to CFPG, depression screening should be considered:
A. For everyone at every visit
B. When integrated care and supports are available
C. Only in high-risk populations
D. Not recommended
Answer: B
Rationale: Depression screening is recommended only if adequate systems for diagnosis and
follow-up are in place.
18. An 18-year-old preparing for university residence should receive which vaccine?
A. HPV only
B. Meningococcal conjugate ACWY
C. Influenza only
D. Td booster
Answer: B
Rationale: Students in congregate housing should receive meningococcal ACWY vaccination
before entry.
19. A 40-year-old woman with strong family history of breast cancer asks about BRCA testing.
A. Not indicated
B. Recommended if ≥2 first-degree relatives affected
C. Only if symptomatic
D. Only after age 50
Answer: B
Rationale: Genetic counseling and testing are indicated for individuals with significant family
histories of early-onset breast/ovarian cancer.
20. The CFPG recommends HIV screening:
A. For everyone at least once in adulthood
,B. Only if symptomatic
C. Only high-risk groups
D. Annually for all adults
Answer: A
Rationale: At least one lifetime HIV screen for all adults, with repeat testing for those at
ongoing risk, is advised for early identification and linkage to care.
Chapter 2 – Cultural Considerations in Primary Care
1. A 36-year-old Indigenous woman presents for a prenatal visit. Which approach best reflects
culturally safe care?
A. Focus on biomedical facts only to avoid stereotyping
B. Explore her cultural beliefs about pregnancy and integrate them into the plan
C. Ask her to defer cultural practices until after delivery
D. Provide the same advice given to all patients
Answer: B
Rationale: CFPG emphasizes cultural safety through respectful inclusion of a patient’s beliefs,
values, and traditions in care decisions, especially for Indigenous populations.
2. A 45-year-old recent immigrant has difficulty understanding his medication instructions. The
most appropriate first step is to:
A. Raise your voice and repeat slowly
B. Use a trained medical interpreter
C. Ask a family member to translate
D. Write instructions in English
Answer: B
Rationale: The CFPG promotes use of trained interpreters to ensure accurate communication
and maintain confidentiality.
3. A Muslim patient with diabetes is fasting during Ramadan. What is the most culturally
appropriate plan?
A. Advise stopping the fast immediately
B. Collaborate to adjust medication timing safely during fasting hours
C. Recommend skipping insulin on fasting days
D. Ignore fasting practices
Answer: B
Rationale: CFPG supports collaborative management respecting religious observances while
minimizing health risks through medication and diet adjustments.
, 4. A 30-year-old First Nations man expresses distrust of healthcare due to past discrimination.
The best response is:
A. Explain that racism no longer exists in healthcare
B. Ask him to see another provider
C. Acknowledge his experience and build trust through transparency
D. Focus only on his symptoms
Answer: C
Rationale: Recognizing systemic racism and validating lived experiences promotes therapeutic
trust and aligns with CFPG principles of reconciliation and cultural humility.
5. When providing care to a refugee patient with PTSD symptoms, the CFPG recommends:
A. Immediate pharmacologic therapy
B. Trauma-informed care and screening for safety
C. Avoid discussing trauma to prevent re-traumatization
D. Referral to psychiatry only if requested
Answer: B
Rationale: Trauma-informed care—prioritizing safety, choice, and empowerment—is a
cornerstone of culturally competent refugee health practice.
6. Which of the following best describes cultural competence?
A. Memorizing customs of diverse groups
B. Continuous self-reflection and awareness of personal bias
C. Using cultural stereotypes to improve communication
D. Avoiding discussions of culture altogether
Answer: B
Rationale: CFPG defines cultural competence as an evolving process of self-awareness,
learning, and adapting care to patients’ cultural contexts.
7. A 50-year-old Chinese man prefers traditional remedies alongside prescribed therapy. What
should the clinician do?
A. Discourage traditional practices
B. Explore remedies used and evaluate for potential interactions
C. Refuse care until he discontinues traditional medicine
D. Substitute all prescribed medications with herbal remedies
Answer: B
Rationale: Culturally competent care involves respecting traditional practices while ensuring
safety and avoiding harmful interactions.
