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An 80-yeаr-оld resident оf а lоng-term cаre facility who has a history of multiinfarct dementia (MID) is alert but disoriented to person, place, and situation. His only health problems are MID and osteoarthritis. Over the past 2 weeks, he has become agitated, has demonstrated exit-seeking behavior, and has been noted to be continually rubbing his knees. The nurse practitioner suspects that this client is likely experiencing: