FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1)
Reference
Ch. 1 — Health Maintenance Guidelines — Cultural Diversity
and Sensitivity
Stem
A 62-year-old Somali man with controlled type 2 diabetes
presents for an annual visit. He speaks limited English and
avoids eye contact when discussing advanced directives. His
daughter translates but frequently answers for him. As the
APRN, what is the best next step to ensure culturally sensitive,
patient-centered care?
Options
A. Continue using the daughter as translator — family is best for
cultural continuity.
Page | 1
,B. Ask the daughter to step out and speak directly to the patient
without interpretation.
C. Arrange a professional medical interpreter and ask the
patient about cultural or religious preferences.
D. Use simplified English and rely on nonverbal cues to assess
understanding.
Correct Answer
C
Rationale — Correct
Professional interpreters reduce miscommunication and ensure
informed consent; asking about cultural/religious preferences
clarifies care preferences and supports autonomy. This
approach aligns with culturally sensitive health maintenance by
centering the patient’s voice and mitigating family-dominant
dynamics.
Rationale — Incorrect
A. Family translation risks inaccuracies and coerced decisions;
not best practice.
B. Excluding the interpreter without support risks
misunderstanding due to language barrier.
D. Simplified English and nonverbal cues are insufficient and can
miss nuanced health beliefs.
Teaching Point
Use professional interpreters and explore cultural preferences
to respect autonomy.
Page | 2
,Citation
Cash, J. C. (2025). Family Practice Guidelines (6th Ed.). Ch. 1.
2)
Reference
Ch. 1 — Health Maintenance Guidelines — Cultural Diversity
and Sensitivity
Stem
A 45-year-old woman from a culture where mental illness is
stigmatized reports fatigue and poor sleep but refuses
“counseling” and says “we don’t talk to strangers about family.”
She accepts medical treatment for insomnia. Which approach
best balances cultural sensitivity with evidence-based care?
Options
A. Respectfully accept medication-only management and avoid
discussing mental health therapies.
B. Insist on psychotherapy referral as standard of care for
insomnia with mood symptoms.
C. Offer culturally adapted psychoeducation and discuss options
(counseling, community supports) with permission.
D. Provide written educational materials only to respect privacy.
Correct Answer
C
Rationale — Correct
Culturally adapted psychoeducation with patient permission
Page | 3
, integrates evidence-based treatments while respecting stigma;
offering a menu of options supports shared decision-making
and incremental engagement with non-stigmatizing supports.
Rationale — Incorrect
A. Medication-only ignores comprehensive care and may miss
underlying causes.
B. Insistence risks alienating the patient and reducing
adherence.
D. Written materials alone may not address beliefs or build
trust.
Teaching Point
Adapt mental health interventions to cultural beliefs; offer
choices and gradual engagement.
Citation
Cash, J. C. (2025). Family Practice Guidelines (6th Ed.). Ch. 1.
3)
Reference
Ch. 1 — Health Maintenance Guidelines — Cultural Diversity
and Sensitivity
Stem
An 18-year-old transgender male requests routine
immunizations and asks that documentation use his chosen
name; his parent is present and insists on legal name use for
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1)
Reference
Ch. 1 — Health Maintenance Guidelines — Cultural Diversity
and Sensitivity
Stem
A 62-year-old Somali man with controlled type 2 diabetes
presents for an annual visit. He speaks limited English and
avoids eye contact when discussing advanced directives. His
daughter translates but frequently answers for him. As the
APRN, what is the best next step to ensure culturally sensitive,
patient-centered care?
Options
A. Continue using the daughter as translator — family is best for
cultural continuity.
Page | 1
,B. Ask the daughter to step out and speak directly to the patient
without interpretation.
C. Arrange a professional medical interpreter and ask the
patient about cultural or religious preferences.
D. Use simplified English and rely on nonverbal cues to assess
understanding.
Correct Answer
C
Rationale — Correct
Professional interpreters reduce miscommunication and ensure
informed consent; asking about cultural/religious preferences
clarifies care preferences and supports autonomy. This
approach aligns with culturally sensitive health maintenance by
centering the patient’s voice and mitigating family-dominant
dynamics.
Rationale — Incorrect
A. Family translation risks inaccuracies and coerced decisions;
not best practice.
B. Excluding the interpreter without support risks
misunderstanding due to language barrier.
D. Simplified English and nonverbal cues are insufficient and can
miss nuanced health beliefs.
Teaching Point
Use professional interpreters and explore cultural preferences
to respect autonomy.
Page | 2
,Citation
Cash, J. C. (2025). Family Practice Guidelines (6th Ed.). Ch. 1.
2)
Reference
Ch. 1 — Health Maintenance Guidelines — Cultural Diversity
and Sensitivity
Stem
A 45-year-old woman from a culture where mental illness is
stigmatized reports fatigue and poor sleep but refuses
“counseling” and says “we don’t talk to strangers about family.”
She accepts medical treatment for insomnia. Which approach
best balances cultural sensitivity with evidence-based care?
Options
A. Respectfully accept medication-only management and avoid
discussing mental health therapies.
B. Insist on psychotherapy referral as standard of care for
insomnia with mood symptoms.
C. Offer culturally adapted psychoeducation and discuss options
(counseling, community supports) with permission.
D. Provide written educational materials only to respect privacy.
Correct Answer
C
Rationale — Correct
Culturally adapted psychoeducation with patient permission
Page | 3
, integrates evidence-based treatments while respecting stigma;
offering a menu of options supports shared decision-making
and incremental engagement with non-stigmatizing supports.
Rationale — Incorrect
A. Medication-only ignores comprehensive care and may miss
underlying causes.
B. Insistence risks alienating the patient and reducing
adherence.
D. Written materials alone may not address beliefs or build
trust.
Teaching Point
Adapt mental health interventions to cultural beliefs; offer
choices and gradual engagement.
Citation
Cash, J. C. (2025). Family Practice Guidelines (6th Ed.). Ch. 1.
3)
Reference
Ch. 1 — Health Maintenance Guidelines — Cultural Diversity
and Sensitivity
Stem
An 18-year-old transgender male requests routine
immunizations and asks that documentation use his chosen
name; his parent is present and insists on legal name use for
Page | 4
