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Hepatocellular carcinoma (HCC) risk remains substantial in certain chronic hepatitis B populations even without cirrhosis, including Asian men >40 years and Asian women >50 years, persons with a family history of HCC, and those with high viral activity or other cofactors. Semiannual abdominal ultrasound—with or without alpha-fetoprotein (AFP)—is the recommended surveillance modality, balancing sensitivity, safety, and cost. Six-month intervals align with typical HCC growth kinetics to improve detection at curable stages (resection, ablation, transplant). AFP alone (Option B) has variable sensitivity/specificity and is not sufficient as a sole test. Annual CT (Option D) increases radiation exposure and cost and is not necessary for routine surveillance unless ultrasound quality is poor (e.g., obesity, steatosis), in which case MRI/CT may be substituted per radiology assessment. Forgoing surveillance (Option A) ignores persistent risk in defined HBV subgroups. The APRN should ensure reliable recall systems, address antiviral management with hepatology, counsel on alcohol avoidance and weight control, and document surveillance results with prompt referral for indeterminate nodules per LI-RADS recommendations.