FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. 1 — Cultural Diversity and Sensitivity — Cross-
cultural communication in health maintenance
Stem: A 42-year-old Somali woman with hypertension attends
for routine follow-up. She prefers traditional remedies and uses
herbal teas. Her BP today is 152/94 mmHg; she reports
occasional dizziness when taking prescribed ACE inhibitor. As an
APRN, which next step best balances cultural sensitivity with
safe management?
A. Stop the ACE inhibitor immediately and advise herbal
remedies only.
B. Continue ACE inhibitor unchanged and insist she stop herbal
teas.
C. Explore her beliefs about the herbal remedies, assess for
Page | 1
,interactions, and consider switching to an antihypertensive with
fewer side effects while arranging follow-up.
D. Dismiss cultural concerns and refer to cardiology for
management.
Correct answer: C
Rationale (correct): Exploring beliefs respects cultural
sensitivity and identifies potential herb–drug interactions;
switching to an agent she tolerates (e.g., low-dose ARB if ACE
cough or side effects suspected) while arranging closer follow-
up aligns with family practice guidance to integrate cultural
competence with safety.
Rationale (incorrect):
A — Stopping evidence-based therapy risks uncontrolled BP and
harm.
B — Insisting she stop herbs without exploring beliefs
undermines trust and adherence.
D — Immediate referral is unnecessary; primary care can
manage with culturally sensitive negotiation.
Teaching point: Ask about health beliefs and interactions;
adjust therapy collaboratively.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Reference: Ch. 1 — Health Maintenance During the Life Span —
Adult preventive visit scheduling
Page | 2
,Stem: A 28-year-old woman presents for a new patient
preventive visit. She is sexually active with multiple partners,
has no chronic disease, and declined HPV vaccination as a teen.
Which action best matches evidence-based health maintenance
for her age?
A. Offer HPV vaccination up to age 45 and provide STI screening
based on risk.
B. Defer HPV vaccination because she is older than the typical
adolescent target.
C. Only provide contraception counseling; vaccinations are not
indicated.
D. Order a full autoimmune workup given sexual activity.
Correct answer: A
Rationale (correct): Current family practice guidance supports
shared decision-making and offering HPV vaccination up to age
45 based on prior exposure and risk; STI screening should be
risk-based. This integrates lifespan preventive care.
Rationale (incorrect):
B — Age alone is not an absolute contraindication; vaccination
can still benefit some adults.
C — Vaccination and STI screening are core preventive
measures beyond contraception.
D — Autoimmune testing is not indicated by sexual activity
history alone.
Teaching point: Offer HPV vaccination and risk-based STI
screening during adult preventive visits.
Page | 3
, Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
3
Reference: Ch. 1 — Other Collaborating Providers —
Interprofessional referrals for complex psychosocial needs
Stem: A 67-year-old widower with poorly controlled diabetes
reports loneliness, insomnia, and decreased appetite. A1c is
9.4%. Which collaborative plan best addresses medical and
psychosocial needs in primary care?
A. Increase diabetes meds only and schedule routine follow-up
in 6 months.
B. Refer to mental health/social work, optimize diabetic
regimen, and coordinate community resources.
C. Suggest over-the-counter sleep aids and advise self-help
websites.
D. Discharge him to emergency services for psych evaluation.
Correct answer: B
Rationale (correct): Multidisciplinary collaboration (mental
health, social work, community resources) plus optimization of
diabetes management addresses both medical control and
psychosocial determinants, consistent with family practice
guidance on collaborative care.
Rationale (incorrect):
A — Medication change alone ignores psychosocial drivers of
poor control.
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
1
Reference: Ch. 1 — Cultural Diversity and Sensitivity — Cross-
cultural communication in health maintenance
Stem: A 42-year-old Somali woman with hypertension attends
for routine follow-up. She prefers traditional remedies and uses
herbal teas. Her BP today is 152/94 mmHg; she reports
occasional dizziness when taking prescribed ACE inhibitor. As an
APRN, which next step best balances cultural sensitivity with
safe management?
A. Stop the ACE inhibitor immediately and advise herbal
remedies only.
B. Continue ACE inhibitor unchanged and insist she stop herbal
teas.
C. Explore her beliefs about the herbal remedies, assess for
Page | 1
,interactions, and consider switching to an antihypertensive with
fewer side effects while arranging follow-up.
D. Dismiss cultural concerns and refer to cardiology for
management.
Correct answer: C
Rationale (correct): Exploring beliefs respects cultural
sensitivity and identifies potential herb–drug interactions;
switching to an agent she tolerates (e.g., low-dose ARB if ACE
cough or side effects suspected) while arranging closer follow-
up aligns with family practice guidance to integrate cultural
competence with safety.
Rationale (incorrect):
A — Stopping evidence-based therapy risks uncontrolled BP and
harm.
B — Insisting she stop herbs without exploring beliefs
undermines trust and adherence.
D — Immediate referral is unnecessary; primary care can
manage with culturally sensitive negotiation.
Teaching point: Ask about health beliefs and interactions;
adjust therapy collaboratively.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
2
Reference: Ch. 1 — Health Maintenance During the Life Span —
Adult preventive visit scheduling
Page | 2
,Stem: A 28-year-old woman presents for a new patient
preventive visit. She is sexually active with multiple partners,
has no chronic disease, and declined HPV vaccination as a teen.
Which action best matches evidence-based health maintenance
for her age?
A. Offer HPV vaccination up to age 45 and provide STI screening
based on risk.
B. Defer HPV vaccination because she is older than the typical
adolescent target.
C. Only provide contraception counseling; vaccinations are not
indicated.
D. Order a full autoimmune workup given sexual activity.
Correct answer: A
Rationale (correct): Current family practice guidance supports
shared decision-making and offering HPV vaccination up to age
45 based on prior exposure and risk; STI screening should be
risk-based. This integrates lifespan preventive care.
Rationale (incorrect):
B — Age alone is not an absolute contraindication; vaccination
can still benefit some adults.
C — Vaccination and STI screening are core preventive
measures beyond contraception.
D — Autoimmune testing is not indicated by sexual activity
history alone.
Teaching point: Offer HPV vaccination and risk-based STI
screening during adult preventive visits.
Page | 3
, Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
3
Reference: Ch. 1 — Other Collaborating Providers —
Interprofessional referrals for complex psychosocial needs
Stem: A 67-year-old widower with poorly controlled diabetes
reports loneliness, insomnia, and decreased appetite. A1c is
9.4%. Which collaborative plan best addresses medical and
psychosocial needs in primary care?
A. Increase diabetes meds only and schedule routine follow-up
in 6 months.
B. Refer to mental health/social work, optimize diabetic
regimen, and coordinate community resources.
C. Suggest over-the-counter sleep aids and advise self-help
websites.
D. Discharge him to emergency services for psych evaluation.
Correct answer: B
Rationale (correct): Multidisciplinary collaboration (mental
health, social work, community resources) plus optimization of
diabetes management addresses both medical control and
psychosocial determinants, consistent with family practice
guidance on collaborative care.
Rationale (incorrect):
A — Medication change alone ignores psychosocial drivers of
poor control.
Page | 4
