A nurse in a community health clinic is assessing a client who has two preschoolers, was recently divorced, and is seeking help for managing depression. Which of the following questions should the nurse ask first?

Explanation: Heroin is a central nervous system depressant that can cause various physiological effects on the body. Dilated pupils are a common sign of heroin use, along with a decrease in blood pressure, respiratory rate, and heart rate. The pupils will appear larger than usual because heroin depresses the parasympathetic nervous system, which controls the size of the pupils.

Tachypnea, or rapid breathing, is not typically associated with heroin use, as it is a central nervous system depressant. Euphoria, or a feeling of intense pleasure or happiness, is a common effect of heroin use, but it is not the most reliable sign of heroin use, as other drugs can also produce this effect. Nystagmus, an involuntary movement of the eyes, is not a common sign of heroin use. Dilated pupils are a reliable sign of heroin use and should be documented in the client's medical record. It is important for the nurse to assess for other signs of drug use and to provide appropriate care and support to the client, which may include referrals for substance abuse treatment. The nurse should also follow agency policies and procedures for reporting drug use and abuse to appropriate authorities.

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The correct answer is choice B, "Educate children at a day care center about nutrition and exercise." Primary prevention strategies aim to prevent the occurrence of a health problem before it happens. Educating children about healthy eating habits and regular exercise can help prevent obesity from developing in the first place. This is a more effective strategy than simply measuring the BMI of older adults, distributing health-risk appraisal questionnaires, or encouraging enrollment in weight-reduction programs.