An older aphasic client has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribes analgesic medications to be administered around-the-clock, with as-needed doses to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective? (Select all that apply.)

Choice A reason: Regular exercise should exceed 30 minutes three times a week, not not exceed. Exercise helps lower blood glucose levels and improve insulin sensitivity.

Choice B reason: A walking program is recommended for an older adult with diabetes, not not recommended. Walking is a low-impact, moderate-intensity exercise that can benefit people with diabetes.

Choice C reason: Insulin can not be discontinued if the individual adheres to the walking program, not most probably. Insulin is a vital hormone that regulates blood glucose levels and prevents complications from diabetes. Exercise alone is not enough to replace insulin therapy.

Choice D reason: This is the correct answer because it helps the individual maintain a consistent blood glucose level and avoid hypoglycemia or hyperglycemia. It also helps the individual plan their insulin doses and meals accordingly.

Choice A reason: This statement is incorrect because the zoster vaccine Shingrix can be given to individuals who have had a previous episode of Herpes Zoster (HZ), as long as they are not currently experiencing an acute outbreak. The vaccine can help prevent future recurrences of HZ, as well as reduce the risk of postherpetic neuralgia, a painful complication of HZ.

Choice B reason: This statement is correct because the zoster vaccine Shingrix is recommended for all individuals over age 50 that have no contraindications to the vaccine, such as a history of severe allergic reaction to any component of the vaccine, or a current severe immunodeficiency. The vaccine can help prevent HZ and its complications, which are more common and severe in older adults.

Choice C reason: This statement is incorrect because the zoster vaccine Shingrix can be given to individuals with a chronic cardiac or respiratory condition, as long as they are not immunocompromised. The vaccine is not a live vaccine, so it does not pose a risk of causing or worsening the underlying condition. The vaccine can help protect the individuals from HZ and its complications, which can exacerbate their condition or interfere with their treatment.

Choice D reason: This statement is incorrect because the zoster vaccine Shingrix does not always prevent an individual from developing Herpes Zoster. The vaccine has a high efficacy rate of about 90%, but it is not 100%. The vaccine can reduce the severity and duration of HZ, as well as the risk of postherpetic neuralgia, if it does occur..