ABIM IM Practice Test 9

An 81-year-old woman with mild Alzheimer dementia is hospitalized with a displaced femoral neck fracture after a fall. The orthopedic surgeon recommends hemiarthroplasty. She declines surgery, saying she is afraid of anesthesia because her husband died during an operation. She lives in an assisted living facility, where she manages her own medications with reminders. Her son, her designated health care agent, wants the surgery performed and asks the team to proceed. Vital signs are normal. She is alert, oriented to person and place but not date, and her pain is well controlled. Which of the following is the most appropriate next step?