Final answer:
The client with the greatest risk for heart disease is the 68 year old African American male with diabetes due to the high-risk combination of advanced age, ethnic background known for higher health disparities, and a serious condition like diabetes that is a major risk factor for cardiovascular diseases.
Step-by-step explanation:
Considering the information provided and known risk factors for heart disease, the nurse would determine the 68 year old African American male with diabetes as having the greatest risk for heart disease. This decision is based on several criteria, including the patient's age, as the risk of cardiovascular diseases increases with age. Additionally, diabetes is a significant risk factor for cardiovascular disease because it can cause bodily changes such as high cholesterol levels. Furthermore, the individual's ethnic background as an African American may contribute to health disparities, including higher rates of hypertension and other factors that increase cardiovascular risk.
Although the other individuals described also have risk factors for heart disease, such as smoking or anemia, the combination of age, ethnicity, and diabetes presents the most significant risk profile according to the risk factors identified by sources such as the World Health Organization and others focused on heart disease prevention and management.