FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference
Ch. 1 — Cultural Diversity and Sensitivity
Stem
A 62-year-old Somali woman presents for a routine visit. She
speaks limited English, wears traditional dress, and appears
reluctant when you discuss colorectal cancer screening. Her
daughter (interpreter) says the patient fears being examined
and prefers female clinicians. You must decide how to proceed
with screening recommendations and the encounter.
Options
A. Strongly insist on immediate colonoscopy because age-based
screening is mandatory at 62.
B. Offer fecal immunochemical testing (FIT) with culturally
Page | 1
,sensitive explanation and arrange same-day female clinician or
chaperone if possible.
C. Defer all screening until the patient provides written consent
in English.
D. Recommend CT colonography only because it avoids digital
rectal exam concerns.
Correct answer
B
Rationales
Correct (B): Offer an evidence-based, less-invasive screening
(FIT) and adapt the encounter to cultural preferences (female
clinician/chaperone). This respects autonomy, reduces barriers,
and aligns with family practice guidance emphasizing culturally
sensitive shared decision-making.
A: Insisting on colonoscopy ignores patient preferences and
may reduce adherence. Guidelines prioritize shared decision-
making.
C: Requiring English consent is discriminatory and impractical;
use a qualified interpreter and translated materials.
D: CT colonography avoids sedation/biopsy options and still
may be unacceptable; FIT is lower-burden and evidence-based
for screening adherence.
Teaching point
Use culturally sensitive options (FIT, female clinician,
interpreter) to improve screening uptake.
Page | 2
,Citation (Simplified APA)
Cash, J. C. (2025). Family Practice Guidelines (6th Ed.). Ch. 1.
Dokumen
2
Reference
Ch. 1 — Cultural Diversity and Sensitivity
Stem
A 28-year-old transgender man requests routine STI screening
and asks for birth control counseling. He previously took
testosterone but stopped 3 months ago. He expresses mistrust
of prior clinicians who misgendered him. You must design an
initial preventive visit.
Options
A. Use the chart sex designation only for screening decisions;
avoid discussing gender identity to prevent discomfort.
B. Ask which name/pronouns to use, obtain sexual history
sensitively, and offer screening and contraception based on
anatomy and exposures.
C. Defer all sexual health screening until referral to an LGBTQ
clinic.
D. Assume testosterone exposure eliminates need for
contraception counseling.
Correct answer
B
Page | 3
, Rationales
Correct (B): Ask about name/pronouns and sexual practices;
preventive care should be based on anatomy and exposures.
This follows family practice principles of culturally competent
care and individualized screening.
A: Ignoring gender identity undermines trust and can miss
relevant risk factors.
C: Deferral creates barriers; primary care should provide basic
preventive services.
D: Testosterone is not a reliable contraceptive; contraception
counseling remains necessary if ovaries/uterus present.
Teaching point
Base screening and contraception on anatomy/exposures; use
respectful language to improve care.
Citation (Simplified APA)
Cash, J. C. (2025). Family Practice Guidelines (6th Ed.). Ch. 1.
Dokumen
3
Reference
Ch. 1 — Health Maintenance During the Life Span
Stem
An 82-year-old man with mild cognitive impairment and limited
mobility presents for annual exam. His daughter is concerned
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference
Ch. 1 — Cultural Diversity and Sensitivity
Stem
A 62-year-old Somali woman presents for a routine visit. She
speaks limited English, wears traditional dress, and appears
reluctant when you discuss colorectal cancer screening. Her
daughter (interpreter) says the patient fears being examined
and prefers female clinicians. You must decide how to proceed
with screening recommendations and the encounter.
Options
A. Strongly insist on immediate colonoscopy because age-based
screening is mandatory at 62.
B. Offer fecal immunochemical testing (FIT) with culturally
Page | 1
,sensitive explanation and arrange same-day female clinician or
chaperone if possible.
C. Defer all screening until the patient provides written consent
in English.
D. Recommend CT colonography only because it avoids digital
rectal exam concerns.
Correct answer
B
Rationales
Correct (B): Offer an evidence-based, less-invasive screening
(FIT) and adapt the encounter to cultural preferences (female
clinician/chaperone). This respects autonomy, reduces barriers,
and aligns with family practice guidance emphasizing culturally
sensitive shared decision-making.
A: Insisting on colonoscopy ignores patient preferences and
may reduce adherence. Guidelines prioritize shared decision-
making.
C: Requiring English consent is discriminatory and impractical;
use a qualified interpreter and translated materials.
D: CT colonography avoids sedation/biopsy options and still
may be unacceptable; FIT is lower-burden and evidence-based
for screening adherence.
Teaching point
Use culturally sensitive options (FIT, female clinician,
interpreter) to improve screening uptake.
Page | 2
,Citation (Simplified APA)
Cash, J. C. (2025). Family Practice Guidelines (6th Ed.). Ch. 1.
Dokumen
2
Reference
Ch. 1 — Cultural Diversity and Sensitivity
Stem
A 28-year-old transgender man requests routine STI screening
and asks for birth control counseling. He previously took
testosterone but stopped 3 months ago. He expresses mistrust
of prior clinicians who misgendered him. You must design an
initial preventive visit.
Options
A. Use the chart sex designation only for screening decisions;
avoid discussing gender identity to prevent discomfort.
B. Ask which name/pronouns to use, obtain sexual history
sensitively, and offer screening and contraception based on
anatomy and exposures.
C. Defer all sexual health screening until referral to an LGBTQ
clinic.
D. Assume testosterone exposure eliminates need for
contraception counseling.
Correct answer
B
Page | 3
, Rationales
Correct (B): Ask about name/pronouns and sexual practices;
preventive care should be based on anatomy and exposures.
This follows family practice principles of culturally competent
care and individualized screening.
A: Ignoring gender identity undermines trust and can miss
relevant risk factors.
C: Deferral creates barriers; primary care should provide basic
preventive services.
D: Testosterone is not a reliable contraceptive; contraception
counseling remains necessary if ovaries/uterus present.
Teaching point
Base screening and contraception on anatomy/exposures; use
respectful language to improve care.
Citation (Simplified APA)
Cash, J. C. (2025). Family Practice Guidelines (6th Ed.). Ch. 1.
Dokumen
3
Reference
Ch. 1 — Health Maintenance During the Life Span
Stem
An 82-year-old man with mild cognitive impairment and limited
mobility presents for annual exam. His daughter is concerned
Page | 4
