A nurse is assisting in the care of a client who has the hepatitis A virus. Which of the following modes of transmission should the nurse identify as how the client acquired the virus?

A. Blood transfusion: Hepatitis A is not transmitted through blood. Blood transfusions are a risk factor for hepatitis B or C, but hepatitis A is primarily spread via ingestion of contaminated food or water. B. In utero from mother to infant: Vertical transmission is uncommon with hepatitis A. Unlike hepatitis B, the virus rarely crosses the placenta, so perinatal infection is not a typical mode of transmission. C. Sexual contact: While sexual contact can transmit certain hepatitis viruses, hepatitis A is not commonly spread sexually. Transmission through sexual activity is much less frequent than fecal-oral exposure. D. Fecal-to-oral route: Hepatitis A is primarily transmitted via the fecal-oral route, often through ingestion of contaminated food, water, or contact with infected individuals. This mode of transmission is the most common way clients acquire the virus.