Never recap, bend, or break needles; recapping is a leading cause of sharps injuries.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A nurse experiences a needlestick injury from a needle used on a client with HIV. What is the nurse's FIRST action?
Answer: A. The immediate first action after a needlestick is to wash the exposure site thoroughly with soap and water to reduce the viral inoculum. After this, the nurse reports the exposure, has baseline labs drawn, and post-exposure prophylaxis is initiated as soon as possible. Squeezing the wound or applying caustic agents is not recommended.
Question 2 of 5
A nurse accidentally sustains a needlestick injury from a needle used on a client with hepatitis B. What is the nurse's first action?
Answer: B. The first action after a needlestick exposure is to immediately wash the site with soap and running water. Reporting, baseline labs, and post-exposure prophylaxis follow afterward.
Question 3 of 5
A nurse is preparing to give an intramuscular injection. Which practice prevents a needlestick injury?
Answer: B. To prevent needlestick injuries, used needles should be activated with a safety device and disposed of immediately in a puncture-resistant sharps container without recapping. Recapping with two hands, bending or breaking needles, and overfilling the sharps container all sharply increase the risk of injury and bloodborne pathogen exposure.
Question 4 of 5
A nurse sustains a needlestick from a used needle. The FIRST action is to:
Answer: B. Immediately wash the site with soap and water (let it bleed; don't squeeze), then report and follow post-exposure protocol with source testing.
Question 5 of 5
A nurse is exposed to a client's blood through non-intact skin. After washing the area, the priority is to:
Answer: B. Report the exposure immediately and follow the post-exposure protocol (source testing, baseline labs, and prophylaxis as indicated within the time window). Delaying reduces the effectiveness of prophylaxis.
Keep the streak going with more questions like these, each with a full rationale.
What is needlestick exposure?
Immediate first aid plus rapid reporting drives effective post-exposure prophylaxis. The first action after the injury is to wash the site, not to report; time matters most for HIV prophylaxis.
Key points to remember
- Bloodborne pathogens of greatest concern are hepatitis B, hepatitis C, and HIV.
- The first action is to wash the site with soap and water; mucous membranes are flushed with water or saline.
- Do not squeeze the wound to bleed it; this can worsen tissue trauma without reducing risk.
- HIV post-exposure prophylaxis is most effective when started within hours, ideally within 1 to 2 hours.
- Most needlesticks are preventable by never recapping needles and using safety-engineered devices.
- Both the source patient and the exposed worker are tested per protocol after consent.
Nursing priorities
- Immediately wash the wound with soap and water and flush mucous membranes with water or saline.
- Report the exposure to the supervisor and occupational/employee health without delay.
- Initiate baseline and source-patient bloodborne pathogen testing per facility protocol.
- Start prescribed HIV post-exposure prophylaxis as soon as possible after exposure.
Labs & values
Patient teaching
- Report every needlestick even if it seems minor; do not self-manage exposures.
- Stay up to date on the hepatitis B vaccine series for protection.
Red flags: report now
- Never recap, bend, or break needles; recapping is a leading cause of sharps injuries.
- Do not delay reporting; HIV prophylaxis effectiveness drops sharply with time.
- Report any failure of a sharps safety device so it can be removed from use.
References
Clinical references for this topic
