Which client is most likely to develop CAD based on total cholesterol level?

The client with a total cholesterol level of 260 mg/dL is at the highest risk for developing coronary artery disease (CAD) due to the significantly elevated cholesterol level. Total cholesterol levels are a strong indicator of potential cardiovascular risk, and guidelines suggest that a total cholesterol level above 240 mg/dL is considered high and is associated with an increased risk for cardiovascular events.

In this context, while other factors like age, ethnicity, and lifestyle can contribute to an individual's overall risk for CAD, the total cholesterol level serves as a primary biological marker. The 62-year-old White client has a level that exceeds this critical threshold, highlighting a potential for plaque buildup in arteries that can lead to CAD. Lower total cholesterol levels, such as those in the other clients, do not indicate the same level of risk, especially when they are below the 200 mg/dL level which is generally considered desirable. Thus, the elevated total cholesterol of the 62-year-old client makes them the most likely to develop CAD among the given choices.