FAMILY PRACTICE GUIDELINES
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
Q1
Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 62-year-old woman from a rural community with
limited English proficiency presents for an annual exam. She has
poorly controlled hypertension and mentions using a traditional
herbal tea recommended by family. The patient seems hesitant
to discuss medication changes. As the APRN, what is the best
next step to ensure culturally sensitive, evidence-based care
while addressing blood pressure control?
A. Insist on immediate medication titration and provide printed
pamphlets in English.
Page | 1
,B. Use a professional medical interpreter, explore beliefs about
the herbal tea, and negotiate a shared plan integrating safety
monitoring.
C. Ask a family member to interpret, discontinue the herbal tea,
and change medications.
D. Delay treatment changes until the patient brings a family
elder to the visit.
Correct Answer: B
Rationale — Correct: Using a professional interpreter and
exploring the patient’s beliefs allows assessment of potential
herb–drug interactions and builds trust; negotiating an agreed
monitoring plan aligns with culturally sensitive, guideline-based
preventive care. This supports adherence and safe BP control.
Rationale — A (incorrect): Forcing changes without addressing
cultural context and using English-only materials risks poor
adherence and miscommunication.
Rationale — C (incorrect): Family members are unreliable
interpreters and may bias communication; immediate
discontinuation without discussion risks alienation.
Rationale — D (incorrect): Delaying evidence-based care
pending family elder involvement risks uncontrolled
hypertension and is unnecessary if respectful negotiation can
occur now.
Teaching Point: Always use professional interpreters and
integrate cultural beliefs into shared management.
Page | 2
,Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
Q2
Reference: Ch. 1 — Health Maintenance Guidelines — Health
Maintenance During the Life Span
Stem: A 28-year-old woman is planning pregnancy in the next
year. She has a BMI of 34, uses combined oral contraceptives,
and has a history of chlamydia treated two years ago. Which
preventive counseling/assessment should you prioritize now to
optimize maternal–fetal outcomes?
A. Recommend immediate discontinuation of OCPs and start
preconception folic acid only.
B. Counsel on preconception weight optimization, arrange STI
screening, review immunizations (MMR, varicella), and start
folic acid 400–800 mcg daily.
C. Schedule an annual pelvic exam only and advise to stop
smoking (if applicable) when she becomes pregnant.
D. Advise weight loss after conception and defer immunization
review until pregnancy is confirmed.
Correct Answer: B
Rationale — Correct: Preconception care includes optimizing
BMI, screening/treating STIs, ensuring immunity (MMR,
varicella) before pregnancy, and starting folic acid; these
measures reduce adverse pregnancy outcomes per preventive
Page | 3
, health principles.
Rationale — A (incorrect): OCP discontinuation is premature
without contraceptive planning; folic acid alone is insufficient.
Rationale — C (incorrect): A pelvic exam alone misses
important interventions (weight, immunizations, STI screening).
Rationale — D (incorrect): Weight loss and immunizations are
most effective before conception; delaying increases
teratogenic and perinatal risks.
Teaching Point: Provide comprehensive preconception
counseling: weight, immunizations, STI screening, folic acid.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
Q3
Reference: Ch. 1 — Health Maintenance Guidelines — Other
Collaborating Providers
Stem: A 48-year-old man with type 2 diabetes and diabetic foot
neuropathy presents with a nonhealing plantar ulcer. He lives
alone and has limited mobility. Which collaborating-provider
referral will most directly reduce his immediate risk of limb-
threatening complications?
A. Referral to a dermatologist for topical wound care.
B. Referral to a podiatrist for debridement, offloading, and
footwear assessment.
C. Referral to a dietitian for glycemic control counseling only.
Page | 4
6TH EDITION
• AUTHOR(S)JILL C. CASH
TEST BANK
Q1
Reference: Ch. 1 — Health Maintenance Guidelines — Cultural
Diversity and Sensitivity
Stem: A 62-year-old woman from a rural community with
limited English proficiency presents for an annual exam. She has
poorly controlled hypertension and mentions using a traditional
herbal tea recommended by family. The patient seems hesitant
to discuss medication changes. As the APRN, what is the best
next step to ensure culturally sensitive, evidence-based care
while addressing blood pressure control?
A. Insist on immediate medication titration and provide printed
pamphlets in English.
Page | 1
,B. Use a professional medical interpreter, explore beliefs about
the herbal tea, and negotiate a shared plan integrating safety
monitoring.
C. Ask a family member to interpret, discontinue the herbal tea,
and change medications.
D. Delay treatment changes until the patient brings a family
elder to the visit.
Correct Answer: B
Rationale — Correct: Using a professional interpreter and
exploring the patient’s beliefs allows assessment of potential
herb–drug interactions and builds trust; negotiating an agreed
monitoring plan aligns with culturally sensitive, guideline-based
preventive care. This supports adherence and safe BP control.
Rationale — A (incorrect): Forcing changes without addressing
cultural context and using English-only materials risks poor
adherence and miscommunication.
Rationale — C (incorrect): Family members are unreliable
interpreters and may bias communication; immediate
discontinuation without discussion risks alienation.
Rationale — D (incorrect): Delaying evidence-based care
pending family elder involvement risks uncontrolled
hypertension and is unnecessary if respectful negotiation can
occur now.
Teaching Point: Always use professional interpreters and
integrate cultural beliefs into shared management.
Page | 2
,Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
Q2
Reference: Ch. 1 — Health Maintenance Guidelines — Health
Maintenance During the Life Span
Stem: A 28-year-old woman is planning pregnancy in the next
year. She has a BMI of 34, uses combined oral contraceptives,
and has a history of chlamydia treated two years ago. Which
preventive counseling/assessment should you prioritize now to
optimize maternal–fetal outcomes?
A. Recommend immediate discontinuation of OCPs and start
preconception folic acid only.
B. Counsel on preconception weight optimization, arrange STI
screening, review immunizations (MMR, varicella), and start
folic acid 400–800 mcg daily.
C. Schedule an annual pelvic exam only and advise to stop
smoking (if applicable) when she becomes pregnant.
D. Advise weight loss after conception and defer immunization
review until pregnancy is confirmed.
Correct Answer: B
Rationale — Correct: Preconception care includes optimizing
BMI, screening/treating STIs, ensuring immunity (MMR,
varicella) before pregnancy, and starting folic acid; these
measures reduce adverse pregnancy outcomes per preventive
Page | 3
, health principles.
Rationale — A (incorrect): OCP discontinuation is premature
without contraceptive planning; folic acid alone is insufficient.
Rationale — C (incorrect): A pelvic exam alone misses
important interventions (weight, immunizations, STI screening).
Rationale — D (incorrect): Weight loss and immunizations are
most effective before conception; delaying increases
teratogenic and perinatal risks.
Teaching Point: Provide comprehensive preconception
counseling: weight, immunizations, STI screening, folic acid.
Citation: Cash, J. C. (2025). Family Practice Guidelines (6th Ed.).
Ch. 1.
Q3
Reference: Ch. 1 — Health Maintenance Guidelines — Other
Collaborating Providers
Stem: A 48-year-old man with type 2 diabetes and diabetic foot
neuropathy presents with a nonhealing plantar ulcer. He lives
alone and has limited mobility. Which collaborating-provider
referral will most directly reduce his immediate risk of limb-
threatening complications?
A. Referral to a dermatologist for topical wound care.
B. Referral to a podiatrist for debridement, offloading, and
footwear assessment.
C. Referral to a dietitian for glycemic control counseling only.
Page | 4
