The nurse is evaluating how a client with hepatitis A understands the discharge teaching given. Which client statements indicate that further teaching is needed? Select all that apply.

Rationale: A. Hepatitis A is highly contagious via the fecal-oral route. There is no specific medication to prevent transmission once infected. Family members need to practice strict hygiene, including handwashing and avoiding shared utensils, to prevent spread. B. Towels and personal items can harbor the virus, and not sharing them reduces the risk of transmission. No further teaching is needed for this statement. C. This indicates misunderstanding. Hepatitis A is not transmitted via airborne droplets, so masks are unnecessary. Transmission occurs primarily through fecal-oral contamination, not respiratory secretions. D. Alcohol is hepatotoxic and should be completely avoided during hepatitis A infection and recovery to prevent additional liver damage. This statement indicates a need for further teaching. E. Sexual activity, especially oral-anal contact, can spread hepatitis A. Close contact and kissing may also pose a risk if hand hygiene is inadequate. The client needs further teaching about precautions to prevent transmission to intimate partners.