A nurse is caring for a patient who has cirrhosis of the liver and is having difficulty eliminating alcohol consumption because many of their friends drink alcohol socially.
Which of the following steps should the nurse include to motivate the patient to change?

Choice C rationale
Hepatic encephalopathy is a condition that can cause confusion or delirium in patients with end-stage liver disease and increasing ascites. It occurs when the liver is unable to remove toxins from the blood, such as ammonia, which can then accumulate in the brain and affect mental function. This condition is common in patients with cirrhosis or end-stage liver disease, and can manifest as confusion, changes in sleep patterns, mood alterations, and, in severe cases, coma.
Choice A rationale
While dementia can cause confusion and changes in mental status, it is typically a progressive condition that develops over time. In the context of a patient with end-stage liver failure and

increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice B rationale
Schizophrenia is a chronic mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. It is not typically associated with end-stage liver disease or ascites. In the context of a patient with end-stage liver failure and increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice D rationale
While a urinary tract infection (UTI) can cause confusion, especially in older adults, it would not typically be the primary suspect in a patient with end-stage liver failure and increasing ascites. In such a patient, hepatic encephalopathy is a more likely cause of confusion or delirium.

Choice A rationale
Donating blood after completing the medication regimen is not typically recommended for patients with hepatitis B. Hepatitis B is a bloodborne virus, and individuals with the virus should not donate blood.
Choice B rationale
Resting frequently throughout the day is a key part of self-management for patients with hepatitis B. Rest can help the body recover and fight off the virus.
Choice C rationale

Taking acetaminophen every 4 hours for discomfort is not typically recommended for patients with hepatitis B. Overuse of acetaminophen can lead to liver damage, which can be particularly harmful for individuals with liver diseases like hepatitis B56.
Choice D rationale
Consuming a high-protein diet is not typically recommended for patients with hepatitis B. A balanced diet is important for overall health, but there are no specific dietary recommendations for hepatitis B56.