FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
Ch. Health Maintenance — Cultural Diversity and Sensitivity
Q1
Reference: Ch. Health Maintenance — Cultural Diversity and
Sensitivity
Stem: A 52-year-old Somali woman presents for annual care.
She is reluctant to discuss intimate partner violence and
declines certain screening tests, citing cultural modesty and a
male translator in the room. As her APRN, how should you
proceed to ensure appropriate preventive care while respecting
cultural sensitivity?
Options:
A. Accept refusal and document that patient declined all
screening.
B. Offer a female interpreter/private interview and explain
Page | 1
,screening benefits, then proceed if patient consents.
C. Insist on testing to follow standardized preventive guidelines
regardless of expressed discomfort.
D. Refer immediately to social services without further
discussion.
Correct Answer: B
Rationale (correct): Offer a same-sex interpreter and a private
interview to reduce cultural barriers; informed consent after
culturally sensitive explanation aligns with patient-centered
preventive care. This balances respect for cultural values with
guideline-based screening. Family Practice Guidelines
emphasize negotiated care and use of culturally appropriate
communication.
Rationale (incorrect):
A. Passive acceptance neglects advocacy and may miss needed
prevention.
C. Forcing tests breaches autonomy and may harm trust.
D. Immediate referral is premature without assessment and
consent.
Teaching Point: Offer same-sex interpreters and private
discussion to improve screening uptake.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance — Cultural Diversity and Sensitivity.
Q2
Reference: Ch. Health Maintenance — Cultural Diversity and
Page | 2
,Sensitivity
Stem: A 28-year-old transgender man requests routine health
maintenance. He uses testosterone and is due for cervical
cancer screening. He reports prior negative experiences in
clinics. Which approach best aligns with culturally sensitive,
guideline-based care?
Options:
A. Defer cervical screening because testosterone lowers risk.
B. Provide trauma-informed, gender-affirming care and offer
Pap/HPV per screening guidelines if cervix present.
C. Only provide self-swab HPV testing and avoid pelvic exam
entirely.
D. Refer to specialty gender clinic and postpone preventive
care.
Correct Answer: B
Rationale (correct): Provide gender-affirming, trauma-informed
communication and offer guideline-based screening considering
anatomy; testosterone does not negate the need for cervical
cancer screening when a cervix is present. This respects identity
while ensuring evidence-based prevention per Family Practice
Guidelines.
Rationale (incorrect):
A. Testosterone does not eliminate cervical cancer risk.
C. Self-swab may be an option but should be offered, not
mandated; pelvic exam may still be necessary.
D. Referral without care delays prevention and fragments care.
Teaching Point: Deliver gender-affirming, anatomy-based
Page | 3
, screening with trauma-informed communication.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance — Cultural Diversity and Sensitivity.
Q3
Reference: Ch. Health Maintenance — Cultural Diversity and
Sensitivity
Stem: You’re seeing a 67-year-old man from a rural Appalachian
background who strongly prefers traditional remedies and is
skeptical of vaccines. He’s due for influenza and pneumococcal
vaccines. How should you integrate cultural sensitivity while
applying preventive recommendations?
Options:
A. Avoid discussing vaccines to respect his beliefs.
B. Provide culturally congruent education linking vaccines to
protection of family and community, then offer vaccines.
C. Insist he receives vaccines immediately or document refusal.
D. Delegate vaccine counseling to a pamphlet in standard
language.
Correct Answer: B
Rationale (correct): Framing preventive benefits around family
and community protection often resonates across cultures;
culturally tailored education followed by an offer respects
autonomy and aligns with Family Practice Guidelines for shared
decision-making.
Rationale (incorrect):
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
Ch. Health Maintenance — Cultural Diversity and Sensitivity
Q1
Reference: Ch. Health Maintenance — Cultural Diversity and
Sensitivity
Stem: A 52-year-old Somali woman presents for annual care.
She is reluctant to discuss intimate partner violence and
declines certain screening tests, citing cultural modesty and a
male translator in the room. As her APRN, how should you
proceed to ensure appropriate preventive care while respecting
cultural sensitivity?
Options:
A. Accept refusal and document that patient declined all
screening.
B. Offer a female interpreter/private interview and explain
Page | 1
,screening benefits, then proceed if patient consents.
C. Insist on testing to follow standardized preventive guidelines
regardless of expressed discomfort.
D. Refer immediately to social services without further
discussion.
Correct Answer: B
Rationale (correct): Offer a same-sex interpreter and a private
interview to reduce cultural barriers; informed consent after
culturally sensitive explanation aligns with patient-centered
preventive care. This balances respect for cultural values with
guideline-based screening. Family Practice Guidelines
emphasize negotiated care and use of culturally appropriate
communication.
Rationale (incorrect):
A. Passive acceptance neglects advocacy and may miss needed
prevention.
C. Forcing tests breaches autonomy and may harm trust.
D. Immediate referral is premature without assessment and
consent.
Teaching Point: Offer same-sex interpreters and private
discussion to improve screening uptake.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance — Cultural Diversity and Sensitivity.
Q2
Reference: Ch. Health Maintenance — Cultural Diversity and
Page | 2
,Sensitivity
Stem: A 28-year-old transgender man requests routine health
maintenance. He uses testosterone and is due for cervical
cancer screening. He reports prior negative experiences in
clinics. Which approach best aligns with culturally sensitive,
guideline-based care?
Options:
A. Defer cervical screening because testosterone lowers risk.
B. Provide trauma-informed, gender-affirming care and offer
Pap/HPV per screening guidelines if cervix present.
C. Only provide self-swab HPV testing and avoid pelvic exam
entirely.
D. Refer to specialty gender clinic and postpone preventive
care.
Correct Answer: B
Rationale (correct): Provide gender-affirming, trauma-informed
communication and offer guideline-based screening considering
anatomy; testosterone does not negate the need for cervical
cancer screening when a cervix is present. This respects identity
while ensuring evidence-based prevention per Family Practice
Guidelines.
Rationale (incorrect):
A. Testosterone does not eliminate cervical cancer risk.
C. Self-swab may be an option but should be offered, not
mandated; pelvic exam may still be necessary.
D. Referral without care delays prevention and fragments care.
Teaching Point: Deliver gender-affirming, anatomy-based
Page | 3
, screening with trauma-informed communication.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. Health Maintenance — Cultural Diversity and Sensitivity.
Q3
Reference: Ch. Health Maintenance — Cultural Diversity and
Sensitivity
Stem: You’re seeing a 67-year-old man from a rural Appalachian
background who strongly prefers traditional remedies and is
skeptical of vaccines. He’s due for influenza and pneumococcal
vaccines. How should you integrate cultural sensitivity while
applying preventive recommendations?
Options:
A. Avoid discussing vaccines to respect his beliefs.
B. Provide culturally congruent education linking vaccines to
protection of family and community, then offer vaccines.
C. Insist he receives vaccines immediately or document refusal.
D. Delegate vaccine counseling to a pamphlet in standard
language.
Correct Answer: B
Rationale (correct): Framing preventive benefits around family
and community protection often resonates across cultures;
culturally tailored education followed by an offer respects
autonomy and aligns with Family Practice Guidelines for shared
decision-making.
Rationale (incorrect):
Page | 4
