FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
Items 1–5 — Cultural Diversity and Sensitivity (Ch. 1)
1
Reference: Ch. 1 — Cultural Diversity and Sensitivity
Stem: A 42-year-old Somali woman presents for a routine exam.
She prefers a same-sex clinician, speaks limited English, and
uses traditional herbal remedies regularly. You must create a
prevention plan that respects cultural practices while
addressing elevated BMI (31) and uncontrolled prediabetes
(A1c 6.1%). What is the best next step?
A. Insist on discontinuation of all herbal remedies before
lifestyle counseling.
B. Arrange for a female clinician and a trained medical
interpreter, elicit beliefs about remedies, then co-create a
Page | 1
,culturally adapted lifestyle plan.
C. Provide standard diet and exercise materials in English and
repeat in simpler terms.
D. Refer immediately to endocrinology for medication initiation.
Correct answer: B
Rationale (correct): Co-creating plans with culturally
concordant provider access and an interpreter builds trust,
identifies potential herb–drug interactions, and increases
adherence—consistent with culturally sensitive preventive care.
Rationale (A): Demanding cessation alienates the patient and
may reduce engagement.
Rationale (C): Language and cultural adaptation are required
beyond simply simplifying English.
Rationale (D): Her A1c and BMI support primary prevention
and lifestyle intervention first; endocrinology referral is
premature.
Teaching point: Use interpreters and co-create culturally
tailored prevention plans.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Reference: Ch. 1 — Cultural Diversity and Sensitivity
Stem: A 16-year-old Hispanic male with limited parental
engagement presents for acne counseling; parents request only
traditional topical remedies. He reports low mood and social
Page | 2
,withdrawal. How should the APRN prioritize care?
A. Honor parents’ wishes exclusively and withhold medical
therapy.
B. Evaluate suicidal risk, assess for clinical depression, offer
evidence-based acne therapy, and involve family respectfully.
C. Prescribe isotretinoin immediately without psychosocial
assessment.
D. Delay any assessment until parents consent for mental health
screening.
Correct answer: B
Rationale (correct): Safety first—screen for
depression/suicidality; provide evidence-based treatment while
engaging family culturally; adolescent autonomy when safety
concerns exist.
Rationale (A): Blindly deferring to family may miss urgent
mental health issues.
Rationale (C): Isotretinoin requires strict mental-health
screening and informed consent—unsafe without assessment.
Rationale (D): Delaying safety assessment risks harm; parental
consent does not supersede urgent safety needs.
Teaching point: Prioritize safety; screen mood and co-manage
medically and culturally.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
3
Page | 3
, Reference: Ch. 1 — Cultural Diversity and Sensitivity
Stem: An elderly Asian man with limited English and low health
literacy declines colorectal screening, citing fatalistic beliefs. He
has controlled HTN but strong family history of colon cancer.
What is the best APRN approach to increase screening uptake?
A. Document refusal and stop the screening discussion.
B. Provide a culturally framed, plain-language explanation of
benefits and offer options (FIT vs colonoscopy) with interpreter.
C. Insist on colonoscopy scheduling without further discussion.
D. Refer to gastroenterology regardless of patient preference.
Correct answer: B
Rationale (correct): Presenting options and culturally adapted
education with an interpreter respects beliefs while enabling
informed choice—consistent with culturally sensitive preventive
care.
Rationale (A): Accepting refusal without education misses
opportunity to change decision.
Rationale (C): Coercion undermines trust; informed choice is
preferred.
Rationale (D): Referral may be premature without informed
discussion of options and barriers.
Teaching point: Use culturally tailored, option-based screening
discussions with interpreters.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
Items 1–5 — Cultural Diversity and Sensitivity (Ch. 1)
1
Reference: Ch. 1 — Cultural Diversity and Sensitivity
Stem: A 42-year-old Somali woman presents for a routine exam.
She prefers a same-sex clinician, speaks limited English, and
uses traditional herbal remedies regularly. You must create a
prevention plan that respects cultural practices while
addressing elevated BMI (31) and uncontrolled prediabetes
(A1c 6.1%). What is the best next step?
A. Insist on discontinuation of all herbal remedies before
lifestyle counseling.
B. Arrange for a female clinician and a trained medical
interpreter, elicit beliefs about remedies, then co-create a
Page | 1
,culturally adapted lifestyle plan.
C. Provide standard diet and exercise materials in English and
repeat in simpler terms.
D. Refer immediately to endocrinology for medication initiation.
Correct answer: B
Rationale (correct): Co-creating plans with culturally
concordant provider access and an interpreter builds trust,
identifies potential herb–drug interactions, and increases
adherence—consistent with culturally sensitive preventive care.
Rationale (A): Demanding cessation alienates the patient and
may reduce engagement.
Rationale (C): Language and cultural adaptation are required
beyond simply simplifying English.
Rationale (D): Her A1c and BMI support primary prevention
and lifestyle intervention first; endocrinology referral is
premature.
Teaching point: Use interpreters and co-create culturally
tailored prevention plans.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Reference: Ch. 1 — Cultural Diversity and Sensitivity
Stem: A 16-year-old Hispanic male with limited parental
engagement presents for acne counseling; parents request only
traditional topical remedies. He reports low mood and social
Page | 2
,withdrawal. How should the APRN prioritize care?
A. Honor parents’ wishes exclusively and withhold medical
therapy.
B. Evaluate suicidal risk, assess for clinical depression, offer
evidence-based acne therapy, and involve family respectfully.
C. Prescribe isotretinoin immediately without psychosocial
assessment.
D. Delay any assessment until parents consent for mental health
screening.
Correct answer: B
Rationale (correct): Safety first—screen for
depression/suicidality; provide evidence-based treatment while
engaging family culturally; adolescent autonomy when safety
concerns exist.
Rationale (A): Blindly deferring to family may miss urgent
mental health issues.
Rationale (C): Isotretinoin requires strict mental-health
screening and informed consent—unsafe without assessment.
Rationale (D): Delaying safety assessment risks harm; parental
consent does not supersede urgent safety needs.
Teaching point: Prioritize safety; screen mood and co-manage
medically and culturally.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
3
Page | 3
, Reference: Ch. 1 — Cultural Diversity and Sensitivity
Stem: An elderly Asian man with limited English and low health
literacy declines colorectal screening, citing fatalistic beliefs. He
has controlled HTN but strong family history of colon cancer.
What is the best APRN approach to increase screening uptake?
A. Document refusal and stop the screening discussion.
B. Provide a culturally framed, plain-language explanation of
benefits and offer options (FIT vs colonoscopy) with interpreter.
C. Insist on colonoscopy scheduling without further discussion.
D. Refer to gastroenterology regardless of patient preference.
Correct answer: B
Rationale (correct): Presenting options and culturally adapted
education with an interpreter respects beliefs while enabling
informed choice—consistent with culturally sensitive preventive
care.
Rationale (A): Accepting refusal without education misses
opportunity to change decision.
Rationale (C): Coercion undermines trust; informed choice is
preferred.
Rationale (D): Referral may be premature without informed
discussion of options and barriers.
Teaching point: Use culturally tailored, option-based screening
discussions with interpreters.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
Page | 4
