FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1–5. Cultural Diversity and Sensitivity
1
Reference: Ch. Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 56-year-old Somali woman presents for an annual visit.
She declines colorectal cancer screening despite being due by
guidelines. She cites modesty concerns and a preference for
community-based healers. Vitals and exam are normal. As the
APRN you must decide the next best step to improve care
adherence.
Options:
A. Explore her cultural beliefs and offer culturally concordant
screening options (e.g., fecal immunochemical test) with shared
decision-making.
Page | 1
,B. Inform her bluntly that refusing screening increases mortality
and schedule a colonoscopy anyway.
C. Discharge her from practice for nonadherence and refer to
community health center.
D. Offer only watchful waiting and revisit screening at next
annual visit.
Correct Answer: A
Rationale — Correct: Exploring beliefs and offering acceptable
alternatives (FIT) respects cultural sensitivity and increases
uptake. Shared decision-making aligns with FPG
recommendations to use patient preferences to guide
preventive care.
Rationale — Incorrect:
B. Coercive language undermines trust and reduces future
engagement.
C. Discharging is punitive and contraindicated; collaboration
with community resources is preferred.
D. Passive delay misses an opportunity for immediate
negotiated prevention.
Teaching point: Use culturally sensitive alternatives (e.g., FIT)
and shared decision-making.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance Guidelines — Cultural Diversity and
Sensitivity.
2
Page | 2
,Reference: Ch. Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 17-year-old male immigrant from Central America
requests contraception counseling but insists his parents be
present. He wants confidentiality but fears cultural
repercussions. You must balance legal confidentiality and
cultural family expectations.
Options:
A. Provide confidential counseling and contraception consistent
with minor consent laws.
B. Refuse to counsel without parental presence to respect
family culture.
C. Insist on parental presence and deny services if parents
refuse.
D. Postpone counseling until he brings a translator and family
meeting.
Correct Answer: A
Rationale — Correct: Minors often have legal rights to
confidential reproductive care; APRN should provide services
while offering culturally sensitive family engagement if patient
consents. This follows FPG principles on confidentiality and
culturally informed care.
Rationale — Incorrect:
B/C. Requiring parental presence risks harm and violates minor
consent provisions.
D. Delaying care may result in missed prevention; offer
translator immediately if needed.
Page | 3
, Teaching point: Prioritize legally protected minor confidentiality
while offering culturally sensitive family options.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance Guidelines — Cultural Diversity and
Sensitivity.
3
Reference: Ch. Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: During a well visit, a Black patient describes using a
traditional herbal remedy that may interact with warfarin. INR
last month was 2.5. Which approach best addresses safety
while respecting cultural practices?
Options:
A. Ask specifics about the remedy, assess interaction risk, and
adjust monitoring/management collaboratively.
B. Dismiss herbal use as ineffective and order immediate
warfarin cessation.
C. Substitute warfarin with aspirin without discussing the herb.
D. Refer the patient to herbalist without further clinical action.
Correct Answer: A
Rationale — Correct: Gathering details, assessing interaction
risk, and adjusting monitoring matches FPG guidance—safety
plus respect for cultural practices. Collaborative plans improve
adherence.
Rationale — Incorrect:
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1–5. Cultural Diversity and Sensitivity
1
Reference: Ch. Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 56-year-old Somali woman presents for an annual visit.
She declines colorectal cancer screening despite being due by
guidelines. She cites modesty concerns and a preference for
community-based healers. Vitals and exam are normal. As the
APRN you must decide the next best step to improve care
adherence.
Options:
A. Explore her cultural beliefs and offer culturally concordant
screening options (e.g., fecal immunochemical test) with shared
decision-making.
Page | 1
,B. Inform her bluntly that refusing screening increases mortality
and schedule a colonoscopy anyway.
C. Discharge her from practice for nonadherence and refer to
community health center.
D. Offer only watchful waiting and revisit screening at next
annual visit.
Correct Answer: A
Rationale — Correct: Exploring beliefs and offering acceptable
alternatives (FIT) respects cultural sensitivity and increases
uptake. Shared decision-making aligns with FPG
recommendations to use patient preferences to guide
preventive care.
Rationale — Incorrect:
B. Coercive language undermines trust and reduces future
engagement.
C. Discharging is punitive and contraindicated; collaboration
with community resources is preferred.
D. Passive delay misses an opportunity for immediate
negotiated prevention.
Teaching point: Use culturally sensitive alternatives (e.g., FIT)
and shared decision-making.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance Guidelines — Cultural Diversity and
Sensitivity.
2
Page | 2
,Reference: Ch. Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 17-year-old male immigrant from Central America
requests contraception counseling but insists his parents be
present. He wants confidentiality but fears cultural
repercussions. You must balance legal confidentiality and
cultural family expectations.
Options:
A. Provide confidential counseling and contraception consistent
with minor consent laws.
B. Refuse to counsel without parental presence to respect
family culture.
C. Insist on parental presence and deny services if parents
refuse.
D. Postpone counseling until he brings a translator and family
meeting.
Correct Answer: A
Rationale — Correct: Minors often have legal rights to
confidential reproductive care; APRN should provide services
while offering culturally sensitive family engagement if patient
consents. This follows FPG principles on confidentiality and
culturally informed care.
Rationale — Incorrect:
B/C. Requiring parental presence risks harm and violates minor
consent provisions.
D. Delaying care may result in missed prevention; offer
translator immediately if needed.
Page | 3
, Teaching point: Prioritize legally protected minor confidentiality
while offering culturally sensitive family options.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance Guidelines — Cultural Diversity and
Sensitivity.
3
Reference: Ch. Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: During a well visit, a Black patient describes using a
traditional herbal remedy that may interact with warfarin. INR
last month was 2.5. Which approach best addresses safety
while respecting cultural practices?
Options:
A. Ask specifics about the remedy, assess interaction risk, and
adjust monitoring/management collaboratively.
B. Dismiss herbal use as ineffective and order immediate
warfarin cessation.
C. Substitute warfarin with aspirin without discussing the herb.
D. Refer the patient to herbalist without further clinical action.
Correct Answer: A
Rationale — Correct: Gathering details, assessing interaction
risk, and adjusting monitoring matches FPG guidance—safety
plus respect for cultural practices. Collaborative plans improve
adherence.
Rationale — Incorrect:
Page | 4
