An older adult client had hip replacement surgery 1 day ago, and the nurse thinks that the client is also demonstrating dementia. Which client assessment does the nurse use to determine whether this client is experiencing pain?

Choice A reason: Changing facial expression is not a likely action to be observed during the assessment, as PD causes reduced facial expression or mask-like face. The client may have difficulty blinking, smiling, or showing emotions.

Choice B reason: Frequent movement is not a likely action to be observed during the assessment, as PD causes slowed movement or bradykinesia. The client may have difficulty initiating, continuing, or completing movements.

Choice C reason: Resting hand tremors is a likely action to be observed during the assessment, as PD causes rhythmic shaking of the hands, fingers, or other body parts. The tremors usually occur when the affected limb is at rest and may decrease when the client is performing tasks.

Choice D reason: Fast movements is not a likely action to be observed during the assessment, as PD causes impaired movement or dyskinesia. The client may have involuntary, jerky, or twisting movements that are often unpredictable and uncontrollable.

Choice E reason: None of the above is not the correct answer, as there is one choice that is a likely action to be observed during the assessment.

Choice A reason: Altering modifiable risk factors is a good goal for anyone who wants to improve their health and wellness, but it is not specific to the case of the African American man who already has a normal blood pressure and no apparent health problems. Modifiable risk factors are those that can be changed by lifestyle choices, such as smoking, diet, exercise, stress, or alcohol consumption.

Choice B reason: Maintaining tight glycemic control is a relevant goal for people who have diabetes or prediabetes, as it can help prevent or delay the complications of high blood sugar, such as nerve damage, kidney damage, or eye damage. However, there is no indication that the African American man has diabetes or prediabetes, so this goal is not applicable to him.

Choice C reason: Recognizing disease in its early stages is a general goal for everyone who wants to prevent or treat health problems, but it is not specific to the case of the African American man who has no signs or symptoms of any disease. Moreover, this goal is more reactive than proactive, as it implies waiting for disease to occur rather than preventing it.

Choice D reason: Preventing cardiovascular disease is the best goal for the nurse to use to assist the African American man in maintaining his health and wellness into older age, as it is specific, proactive, and evidence-based. According to the American Heart Association, high blood pressure is a major risk factor for cardiovascular disease, and it is more prevalent and severe among African Americans than other racial groups. Therefore, the nurse would advise the African American man to monitor his blood pressure regularly, follow a healthy diet, exercise moderately, avoid smoking, and take medication if needed to prevent cardiovascular disease.