FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1.
Reference: Ch. Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 42-year-old Somali woman attends for annual care and
asks for advice about diet and exercise. She speaks limited
English and brings her adult daughter as a translator. You note
traditional dietary staples and fasting during religious
observances. Which approach best respects cultural context
while promoting evidence-based preventive care?
A. Provide a generic low-fat, low-calorie written handout in
English and ask the daughter to translate.
B. Explore dietary patterns and fasting practices, use a trained
interpreter, and tailor recommendations to align with cultural
foods and fasting schedules.
Page | 1
,C. Advise strict avoidance of traditional staples and recommend
an American-style Mediterranean diet without further
discussion.
D. Defer preventive counseling until the daughter can fully
explain cultural details at a follow-up visit.
Correct Answer: B
Rationale — Correct: Exploring dietary patterns and using a
trained interpreter enables shared decision-making and
culturally tailored counseling. This preserves trust,
acknowledges fasting practices, and integrates guideline-based
prevention strategies into the patient's lived context. Tailoring
increases adherence and reduces miscommunication.
Rationale — Incorrect A: A generic English handout with an
informal family translator risks miscommunication and may
miss cultural specifics.
Rationale — Incorrect C: Imposing a strict, culturally
incongruent diet risks refusal and poor adherence; not
guideline-concordant.
Rationale — Incorrect D: Deferring counseling ignores an
immediate preventive opportunity and may signal disrespect
for the patient's priorities.
Teaching Point: Always use trained interpreters and tailor
preventive advice to cultural practices.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance Guidelines.
Page | 2
, 2.
Reference: Ch. Health Maintenance Guidelines — Health
Maintenance During the Life Span
Stem: A 68-year-old man with well-controlled type 2 diabetes
and hypertension asks which preventive services he still needs.
He is active, independent, and has no cognitive impairment.
Which health maintenance priority aligns best with lifespan-
focused preventive care?
A. Discontinue all age-related screening since comorbidities
limit benefit.
B. Continue individualized cancer screenings and immunizations
based on life expectancy and patient preferences.
C. Prioritize only cardiovascular risk reduction and omit cancer
screening.
D. Recommend intensive screening for all cancers regardless of
comorbidities.
Correct Answer: B
Rationale — Correct: Lifespan health maintenance emphasizes
individualized screening and immunizations based on life
expectancy, comorbidity, and patient values. For a functional
68-year-old, many preventive services (e.g., colorectal, lung if
indicated, immunizations) remain beneficial. Shared decision-
making is essential.
Rationale — Incorrect A: Blanket discontinuation ignores the
patient’s functional status and potential benefit from
preventive services.
Page | 3
, Rationale — Incorrect C: Focusing solely on cardiovascular risk
neglects other significant morbidity that screening could
prevent.
Rationale — Incorrect D: Universal intensive screening risks
harms from overdiagnosis without considering individual
benefit.
Teaching Point: Individualize screening by function, life
expectancy, and patient goals.
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 29-year-old woman with BMI 38 kg/m² requests a
weight-loss plan. Your clinic offers limited behavioral
counseling. Which collaborative referral best matches guideline-
recommended, evidence-based management for obesity in
primary care?
A. Refer to a community gym for general exercise classes only.
B. Coordinate referral to a multidisciplinary weight
management program including dietitian, behavioral therapist,
and primary care follow-up.
C. Immediate referral for bariatric surgery without trial of
lifestyle interventions.
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1.
Reference: Ch. Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 42-year-old Somali woman attends for annual care and
asks for advice about diet and exercise. She speaks limited
English and brings her adult daughter as a translator. You note
traditional dietary staples and fasting during religious
observances. Which approach best respects cultural context
while promoting evidence-based preventive care?
A. Provide a generic low-fat, low-calorie written handout in
English and ask the daughter to translate.
B. Explore dietary patterns and fasting practices, use a trained
interpreter, and tailor recommendations to align with cultural
foods and fasting schedules.
Page | 1
,C. Advise strict avoidance of traditional staples and recommend
an American-style Mediterranean diet without further
discussion.
D. Defer preventive counseling until the daughter can fully
explain cultural details at a follow-up visit.
Correct Answer: B
Rationale — Correct: Exploring dietary patterns and using a
trained interpreter enables shared decision-making and
culturally tailored counseling. This preserves trust,
acknowledges fasting practices, and integrates guideline-based
prevention strategies into the patient's lived context. Tailoring
increases adherence and reduces miscommunication.
Rationale — Incorrect A: A generic English handout with an
informal family translator risks miscommunication and may
miss cultural specifics.
Rationale — Incorrect C: Imposing a strict, culturally
incongruent diet risks refusal and poor adherence; not
guideline-concordant.
Rationale — Incorrect D: Deferring counseling ignores an
immediate preventive opportunity and may signal disrespect
for the patient's priorities.
Teaching Point: Always use trained interpreters and tailor
preventive advice to cultural practices.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance Guidelines.
Page | 2
, 2.
Reference: Ch. Health Maintenance Guidelines — Health
Maintenance During the Life Span
Stem: A 68-year-old man with well-controlled type 2 diabetes
and hypertension asks which preventive services he still needs.
He is active, independent, and has no cognitive impairment.
Which health maintenance priority aligns best with lifespan-
focused preventive care?
A. Discontinue all age-related screening since comorbidities
limit benefit.
B. Continue individualized cancer screenings and immunizations
based on life expectancy and patient preferences.
C. Prioritize only cardiovascular risk reduction and omit cancer
screening.
D. Recommend intensive screening for all cancers regardless of
comorbidities.
Correct Answer: B
Rationale — Correct: Lifespan health maintenance emphasizes
individualized screening and immunizations based on life
expectancy, comorbidity, and patient values. For a functional
68-year-old, many preventive services (e.g., colorectal, lung if
indicated, immunizations) remain beneficial. Shared decision-
making is essential.
Rationale — Incorrect A: Blanket discontinuation ignores the
patient’s functional status and potential benefit from
preventive services.
Page | 3
, Rationale — Incorrect C: Focusing solely on cardiovascular risk
neglects other significant morbidity that screening could
prevent.
Rationale — Incorrect D: Universal intensive screening risks
harms from overdiagnosis without considering individual
benefit.
Teaching Point: Individualize screening by function, life
expectancy, and patient goals.
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 29-year-old woman with BMI 38 kg/m² requests a
weight-loss plan. Your clinic offers limited behavioral
counseling. Which collaborative referral best matches guideline-
recommended, evidence-based management for obesity in
primary care?
A. Refer to a community gym for general exercise classes only.
B. Coordinate referral to a multidisciplinary weight
management program including dietitian, behavioral therapist,
and primary care follow-up.
C. Immediate referral for bariatric surgery without trial of
lifestyle interventions.
Page | 4
