An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago, and she has not yet received any medical care. She smokes but denies any other substance use. Which interventions should the nurse implement? (Select all that apply.)

A) Instruct on technique of "stop, drop & roll" at assembly:
This is a primary prevention intervention aimed at educating students on how to prevent burns in the event of a fire. It does not address a specific identified problem but rather provides general safety education.

B) Involve the parent teacher association (PTA) in a fund raising event for the new gym:
This action focuses on raising funds for a new gym, which is related to school improvement and development rather than addressing an immediate health issue. It does not fall under secondary intervention for an identified problem.

C) Invite 1st grade parents to a "Meet the Teachers" event:
This intervention focuses on fostering relationships between parents and teachers and improving school engagement. While valuable, it does not address a specific health problem that requires secondary intervention.

D) Send letters to parents regarding a recent lice infestation:
This is a secondary prevention intervention aimed at addressing an already identified problem—in this case, a lice infestation. By informing parents, the nurse is helping to manage and control the spread of lice among students, which is a direct response to an identified health issue.

A) Small bruises on the lower extremities:
While bruises should be noted and monitored, small bruises on the lower extremities are relatively common in toddlers due to their active nature and frequent minor falls. They do not immediately indicate abuse unless accompanied by other signs.

B) A one-inch laceration across the center of the forehead:
A laceration, especially if it's recent, should be assessed for proper care and treatment. However, a laceration alone does not necessarily indicate abuse and is less urgent compared to signs of possible abuse such as burns.

C) Refusal to answer simple questions:
A toddler’s reluctance to answer questions might be due to shyness or anxiety related to the visit or the situation. This behavior alone does not indicate an immediate need for intervention unless accompanied by other signs of distress or harm.

D) Several dime-sized circular burns on the back:
Circular burns are a significant concern as they are characteristic of burn injuries that may result from abuse, such as being burned by a hot object or liquid. This finding warrants immediate intervention and further investigation to ensure the child’s safety and well-being.