A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis B. What preventative measures should the educator promote? Select all that apply.

A. Patient stopped smoking five years prior to hospitalization: Smoking cessation materials are typically targeted to current smokers or those who have quit very recently (usually within the last year). This patient may not need smoking cessation materials as they have been smoke-free for a significant period.

B. Patient smokes five cigars a week: Smoking cigars still carries health risks similar to cigarettes and indicates the need for smoking cessation materials.

C. Patient uses chewing tobacco: Chewing tobacco is a form of smokeless tobacco, and while harmful, it would require different educational materials focused on smokeless tobacco cessation rather than smoking cessation.

D. Patient smoked cigarettes any time during the last year prior to hospitalization: This indicates current or recent smoking behavior which is a significant risk factor that needs to be addressed.

A. Inability of the liver to manufacture bile: This does not directly cause esophageal varices or bleeding.

B. A scarred liver results in Portal Hypertension: Cirrhosis leads to scarring of the liver, which increases resistance to blood flow and causes portal hypertension. This elevated pressure in the portal venous system leads to the development of esophageal varices, which can rupture and bleed.

C. An elevated level of copper: Elevated copper levels are associated with Wilson's disease, not the cause of esophageal variceal bleeding in cirrhosis.

D. Inability of the liver to convert NH3 to urea: This causes hepatic encephalopathy but is not related to variceal bleeding.