A nurse is providing an educational program for guardians of toddlers. Which of the following activity recommendations should the nurse include in the program? (Select all that apply.)

A. A client who has undergone radiation therapy within the last 3 years: Radiation therapy may suppress the immune response, potentially leading to a false-negative rather than a false-positive Mantoux test due to reduced ability to mount a reaction.

B. A client who has received the bacille Calmette-Guerin vaccine within the last 10 years: The BCG vaccine can cause a false-positive Mantoux result because the vaccine uses a strain of Mycobacterium bovis, which can trigger a reaction similar to TB exposure in skin testing.

C. A client who has acquired immune deficiency syndrome: Clients with AIDS are immunocompromised, which increases the likelihood of a false-negative Mantoux result, as their immune systems may not respond sufficiently to the test.

D. A client who has lived in a country where tuberculosis is endemic: This client is at higher risk for true TB exposure, and a positive result is more likely to reflect actual infection rather than a false-positive reaction.

• Nurse 1: Arranging meetings and establishing screening tools are activities related to the planning and implementation phases rather than evaluation, focusing on preparing and initiating the program.
• Nurse 2: Explaining informed consent and meeting with clients to explain services are part of the implementation phase, ensuring clients understand and receive services.
• Nurse 3: Examining emergency department visit frequency after program implementation reflects evaluation by assessing outcomes and the program’s impact on client health and service utilization.
• Nurse 4: Meeting with mental health providers and sending contracts relate to planning and implementation phases, focusing on resource coordination and service agreements.
• Nurse 5: Reviewing satisfaction surveys after caregiver meetings involves evaluation, as it collects and analyzes feedback to measure program effectiveness and identify areas for improvement.