Tuberculosis (TB) screening at a federal prison reveals that two inmates have a positive skin test. Which action is most important for the nurse to take?

A) Weight and height:
While measuring weight and height is important for assessing growth and overall health, it may not address the most critical health issues or concerns for high school students in the context of a health fair. Weight and height provide general health information but may not reflect more immediate or significant health needs specific to this population.

B) Sexual activity:
Assessing sexual activity is crucial in a health fair setting for high school students, as it directly relates to important health issues such as sexual health, risk of sexually transmitted infections (STIs), and unintended pregnancies. Understanding students’ sexual activity can help tailor educational programs and provide necessary resources and counseling, making it a priority assessment for addressing relevant health concerns.

C) Immunization history:
Immunization history is important for identifying gaps in vaccinations and ensuring that students are protected against preventable diseases. However, while relevant, it may not address the specific behavioral and health education needs that can be more directly assessed through discussions about sexual activity and associated risks.

D) Visual acuity:
Assessing visual acuity is important for identifying potential vision problems but may not address the broader range of health issues and behavioral concerns that are relevant for high school students. Visual acuity is one aspect of health but does not capture the comprehensive needs that can be identified through an assessment of sexual activity.

A) Obtain a restraining order against the father:
Obtaining a restraining order is a legal action that can be taken to protect the child but is not typically within the scope of the nurse’s immediate responsibilities. This action would involve law enforcement and the legal system rather than being an immediate next step in the healthcare setting. The nurse's role is to report the suspected abuse and ensure that appropriate protective services are involved.

B) Encourage the mother to file a police report:
Encouraging the mother to file a police report is a potential step in addressing the situation, but it should not be the nurse's immediate next action. The nurse's primary responsibility is to ensure that the appropriate child protective services are notified and involved, as they are equipped to handle investigations and interventions in cases of suspected child abuse.

C) Ask the child if his father ever spanks him:
Asking the child about specific forms of discipline, such as spanking, could potentially place the child in a difficult or unsafe position, especially if abuse is suspected. It is not the nurse's role to investigate or interrogate the child directly. Instead, the focus should be on ensuring that the proper authorities are notified to handle the investigation.

D) Refer the family to protective service agencies:
Referring the family to protective service agencies is the most appropriate next step. These agencies are specialized in handling cases of suspected abuse and can provide the necessary intervention and support for the child’s safety and well-being. The nurse's role includes reporting suspected abuse to the appropriate authorities and ensuring that protective services are contacted to investigate and address the situation.