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?
1Wipe up the liquid with paper towels while wearing standard examination gloves
2Call environmental services and leave the area open for routine floor cleaning
3Dilute the spilled drug with water and direct the solution toward a floor drain
4Restrict access and use the hazardous-drug spill kit with the required PPE now✓ Correct answer
Explanation
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.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
OSHA: Controlling Occupational Exposure to Hazardous DrugsOccupational Safety and Health Administration
[3]
NIOSH: Managing Hazardous Drug Exposures in Healthcare SettingsCenters for Disease Control and Prevention