The city health department director asks the community health nurse to make a presentation describing the greatest health concern facing the city. How should the nurse begin to collect the data needed for this presentation?

A) Mortality rate in the community:
The mortality rate is an important indicator of overall health in a community and provides information about the number of deaths over a specific period. While it is useful for identifying trends and health outcomes, it does not capture the immediate and current health concerns or priorities of the community members.

B) Expressed needs of community members:
The expressed needs of community members are crucial for understanding the specific health concerns and priorities of the population. This information helps tailor interventions and programs to address the actual needs and preferences of the community, ensuring that the healthcare strategies implemented are relevant and effective.

C) Life expectancy of clients in the community:
Life expectancy is an important measure of general health and longevity in a community. However, it is a broader measure that does not provide specific insights into current health issues or immediate needs. Understanding life expectancy alone does not address the specific concerns or requirements of the community members.

D) Description of health problems by community leaders:
While descriptions of health problems by community leaders can provide valuable context and insight, they may not always reflect the full spectrum of the community’s health needs or the individual concerns of its members. Direct input from community members about their expressed needs offers a more comprehensive and relevant understanding of the health issues that require attention.

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.