After assessing the health care needs of an elementary school, the nurse determines that an increased prevalence of pediculosis capitis is a priority problem. The nurse develops a 2-month program with the goal to eradicate the condition in the school. The program includes educational pamphlets sent home to parents and regular assessment of children by the school nurse. Which action should the nurse implement to evaluate the effectiveness of the program?

A) Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year:
Directly contacting parents before the school year begins is the most effective intervention for ensuring that students receive the necessary immunizations. By reminding parents ahead of time, the school nurse can help ensure that the second dose of the MMR vaccine is administered before the start of kindergarten, which is crucial for meeting school entry requirements and protecting public health.

B) Send notices home with the children on the first day of class advising that MMR vaccine series must be completed:
Sending notices on the first day of class might be too late for many parents to act on promptly. Ensuring that children have received the second dose of the MMR vaccine before the school year starts is important for compliance and preventing potential outbreaks.

C) Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade:
While noting the requirement in student records is important for long-term tracking, it does not address the immediate need to ensure that students are up-to-date with their vaccinations before starting kindergarten. Immediate action is necessary to ensure compliance at the beginning of the school year.

D) Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children:
While educating parents about the benefits of immunization is valuable, it does not directly address the immediate need for the second dose of the MMR vaccine. Direct reminders and actions to ensure vaccinations are up-to-date are more effective in achieving timely compliance.

A. Rescreen the entire prison population in 6 weeks:
While rescreening may be necessary at some point, it is not the immediate priority. The focus should be on diagnosing and managing the individuals who have already tested positive.

B. Start the two inmates on antitubercular medications:
Starting antitubercular medications is important, but it should only be done after confirming that the individuals have active TB. The positive skin test indicates exposure but does not confirm active TB disease.

C. Refer the two inmates for chest x-rays:
A chest x-ray is crucial to determine whether the positive skin test indicates active TB disease or latent TB infection. This step is essential for accurate diagnosis and appropriate management. It helps distinguish between active TB, which requires treatment, and latent TB, which may require different management strategies.

D. Screen the prison guards for TB:
While screening the prison guards could be a part of a broader infection control plan, it is not the most immediate priority. The focus should be on further evaluating and managing the inmates who have tested positive.