The nurse is caring for a patient with active hepatitis C and recalls that the disease is spread by which route?

Choice A rationale
Increasing calorie intake by 200 cal per day may not be beneficial for this client. The client has a BMI of 26, which is considered overweight. Therefore, a goal to increase calorie intake may contribute to further weight gain.
Choice B rationale
Listing foods that are high in calcium which should be avoided is not a relevant goal for this client. Calcium is an essential nutrient and there is no indication that the client needs to avoid it.
Choice C rationale
Replacing cigarettes with smokeless tobacco products is not a healthy goal. Smokeless tobacco products also contain harmful chemicals and can lead to health problems.
Choice D rationale

Walking for 30 min 5 days a week is a beneficial goal for this client. Regular physical activity can help manage weight, lower blood pressure, and reduce the risk of heart disease. It can also help the client quit smoking by reducing cravings and withdrawal symptoms.

Choice A rationale

While an elevated serum ammonia level can indicate liver dysfunction, it is not typically a contraindication for liver biopsy. Ammonia is a byproduct of protein metabolism and is normally converted into urea by the liver, which is then excreted in the urine. Elevated levels can occur in liver disease, but they are not typically a direct concern in the context of a liver biopsy.
Choice B rationale
A hemoglobin level of 11 g/dL is slightly low, but it is not typically a contraindication for a liver biopsy. Hemoglobin is the protein in red blood cells that carries oxygen. While a low hemoglobin level can indicate anemia, it would not typically prevent a patient from undergoing a liver biopsy.
Choice C rationale
A white blood cell count of 14.2 x 103/uL is slightly elevated, indicating a possible infection or inflammation. However, this would not typically be a contraindication for a liver biopsy.
Choice D rationale
A prothrombin time of 32 seconds is significantly prolonged, indicating a potential problem with blood clotting. This would be a major concern for a nurse caring for a patient scheduled for a liver biopsy, as the procedure involves inserting a needle into the liver and could lead to bleeding. Patients with a prolonged prothrombin time are at an increased risk of bleeding complications.