Final answer:
The most realistic outcome for a client with a terminal cardiovascular illness is adaptation to living with limitations.
Step-by-step explanation:
When developing the plan of care for a client with a terminal cardiovascular illness, the most realistic outcome that a nurse would identify is adaptation to living with limitations. This means that the client will learn to adjust and manage their condition to maintain the best possible quality of life. While maintenance of adequate comfort is important, it may not be achievable in a terminal illness. Recovery from the cardiovascular problem is unlikely, as the illness is terminal. Acceptance of changes in lifestyle is also important, but adaptation to living with limitations encompasses a broader scope of changes that the client will need to make.