An intravenous bag containing a hazardous antineoplastic drug leaks onto the floor of an infusion room. No one has direct skin or eye exposure. Which action should the nurse take first?

A hazardous-drug spill should be isolated and managed promptly by trained personnel using the designated spill kit and appropriate personal protective equipment. Unprotected wiping, routine housekeeping, or dilution can spread contamination and expose workers.

Quick answer
Keep people away and begin the hazardous-drug spill procedure with the designated kit and required PPE.

Why this is correct
Antineoplastic drugs can harm workers through skin contact, inhalation, or contaminated surfaces. Restricting the area prevents additional contact, while a trained and properly protected response contains and removes the spill safely.

Easy analogy or mental picture
Treat the spill like a small contaminated zone: mark the boundary before entering with the right protective gear. The analogy guides containment, but the exact PPE and cleanup steps still come from the drug and facility spill procedure.

Memory hook
Hazardous-drug spill means restrict, protect, then contain with the spill kit.

NCLEX decision rule
For a hazardous antineoplastic spill without direct personnel exposure, first prevent access and activate the facility spill response. Cleanup should be performed only by trained personnel using the required PPE and spill materials.

Why the other choices are wrong
Standard gloves and paper towels do not provide complete protection. Routine housekeeping may lack training and equipment, and adding water or moving the liquid can enlarge the contaminated area.