FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity & Sensitivity
Stem: A 34-year-old woman from a recent immigrant
community presents for an annual exam. She speaks limited
English and prefers female clinicians; notes traditional herbal
remedies for fatigue. You need to complete preventive
screening and counseling while respecting cultural beliefs and
ensuring informed consent. Which approach best balances
evidence-based prevention and culturally sensitive care?
A. Insist on standard screening protocols without
accommodation to avoid missed diagnoses.
B. Use a trained medical interpreter, ask about herbal remedies,
Page | 1
,and negotiate a mutually acceptable screening plan.
C. Defer all screening until the patient demonstrates fluency in
English to ensure comprehension.
D. Accept traditional remedies as equivalent and avoid
discussing screening to build trust.
Correct answer: B
Rationales:
Correct: Using a trained interpreter, eliciting use of remedies,
and negotiating screening incorporates cultural humility,
improves adherence, and preserves evidence-based prevention.
This aligns with Family Practice Guidelines’ emphasis on
culturally competent shared decision-making.
Incorrect A: Insisting without cultural negotiation risks
nonadherence and distrust.
Incorrect C: Deferring screening delays care and is
discriminatory; comprehension can be ensured by interpreter
services.
Incorrect D: Overlooking evidence-based screening may put the
patient at risk and fails to balance culture with safety.
Teaching point: Use interpreters and negotiate screening within
cultural context to improve uptake.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Page | 2
,Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity & Sensitivity
Stem: A male adolescent (15) of Indigenous background
declines HPV vaccination because of family beliefs. His mother
fears sexualization. You are the APRN counseling them at a
school clinic. Which strategy best addresses vaccine hesitancy
while respecting cultural values?
A. Refuse to vaccinate unless the parent gives formal consent
under threat of reporting.
B. Provide clear, nonjudgmental information about cancer
prevention, address misconceptions, and explore culturally
acceptable framing.
C. Avoid the topic to preserve rapport and offer vaccination
only when the adolescent turns 18.
D. Tell them the vaccine is mandatory and schedule it without
answering questions.
Correct answer: B
Rationales:
Correct: Providing respectful education, correcting myths, and
framing HPV vaccine as cancer prevention aligns with cultural
sensitivity and evidence-based preventive care. Exploring values
improves informed consent and uptake.
Incorrect A: Threats damage trust and are unethical.
Incorrect C: Avoidance perpetuates harm by missing protection
during recommended window.
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, Incorrect D: Coercion undermines informed consent and may
entrench hesitancy.
Teaching point: Frame vaccines as disease-prevention; use
respectful, culturally relevant education.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
3
Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity & Sensitivity
Stem: An older adult with limited health literacy asks for a
written smoking-cessation handout. You notice the patient
prefers oral traditions over written materials. Which
intervention best matches their communication style while
promoting cessation?
A. Give the handout and assume they will read it at home.
B. Use a brief teach-back conversation and arrange a follow-up
phone call with a culturally familiar community health worker.
C. Refer them to an online smoking-cessation module.
D. Provide only pharmacotherapy and skip behavioral
counseling.
Correct answer: B
Rationales:
Correct: Teach-back plus involvement of a culturally congruent
community health worker aligns with low-literacy strategies and
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity & Sensitivity
Stem: A 34-year-old woman from a recent immigrant
community presents for an annual exam. She speaks limited
English and prefers female clinicians; notes traditional herbal
remedies for fatigue. You need to complete preventive
screening and counseling while respecting cultural beliefs and
ensuring informed consent. Which approach best balances
evidence-based prevention and culturally sensitive care?
A. Insist on standard screening protocols without
accommodation to avoid missed diagnoses.
B. Use a trained medical interpreter, ask about herbal remedies,
Page | 1
,and negotiate a mutually acceptable screening plan.
C. Defer all screening until the patient demonstrates fluency in
English to ensure comprehension.
D. Accept traditional remedies as equivalent and avoid
discussing screening to build trust.
Correct answer: B
Rationales:
Correct: Using a trained interpreter, eliciting use of remedies,
and negotiating screening incorporates cultural humility,
improves adherence, and preserves evidence-based prevention.
This aligns with Family Practice Guidelines’ emphasis on
culturally competent shared decision-making.
Incorrect A: Insisting without cultural negotiation risks
nonadherence and distrust.
Incorrect C: Deferring screening delays care and is
discriminatory; comprehension can be ensured by interpreter
services.
Incorrect D: Overlooking evidence-based screening may put the
patient at risk and fails to balance culture with safety.
Teaching point: Use interpreters and negotiate screening within
cultural context to improve uptake.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Page | 2
,Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity & Sensitivity
Stem: A male adolescent (15) of Indigenous background
declines HPV vaccination because of family beliefs. His mother
fears sexualization. You are the APRN counseling them at a
school clinic. Which strategy best addresses vaccine hesitancy
while respecting cultural values?
A. Refuse to vaccinate unless the parent gives formal consent
under threat of reporting.
B. Provide clear, nonjudgmental information about cancer
prevention, address misconceptions, and explore culturally
acceptable framing.
C. Avoid the topic to preserve rapport and offer vaccination
only when the adolescent turns 18.
D. Tell them the vaccine is mandatory and schedule it without
answering questions.
Correct answer: B
Rationales:
Correct: Providing respectful education, correcting myths, and
framing HPV vaccine as cancer prevention aligns with cultural
sensitivity and evidence-based preventive care. Exploring values
improves informed consent and uptake.
Incorrect A: Threats damage trust and are unethical.
Incorrect C: Avoidance perpetuates harm by missing protection
during recommended window.
Page | 3
, Incorrect D: Coercion undermines informed consent and may
entrench hesitancy.
Teaching point: Frame vaccines as disease-prevention; use
respectful, culturally relevant education.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
3
Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity & Sensitivity
Stem: An older adult with limited health literacy asks for a
written smoking-cessation handout. You notice the patient
prefers oral traditions over written materials. Which
intervention best matches their communication style while
promoting cessation?
A. Give the handout and assume they will read it at home.
B. Use a brief teach-back conversation and arrange a follow-up
phone call with a culturally familiar community health worker.
C. Refer them to an online smoking-cessation module.
D. Provide only pharmacotherapy and skip behavioral
counseling.
Correct answer: B
Rationales:
Correct: Teach-back plus involvement of a culturally congruent
community health worker aligns with low-literacy strategies and
Page | 4
