While a client receives an intravenous cyclophosphamide infusion, a loose tubing connection leaks about 10 mL of the solution onto the floor beside the bed. The nurse is trained in hazardous drug handling, and the unit's hazardous drug spill kit is in the hallway. No drug reached the client's skin, the linens, or the nurse. After clamping the tubing, which actions should the nurse take? Select all that apply.

Quick answer
Don double chemo gloves, gown, and eye/face protection, absorb from the outside in, and report the spill.

Why this is correct
Because the nurse is trained, the kit is at hand, and the volume is small, this is a contained spill managed at the bedside. USP 800 and OSHA guidance call for full protective equipment from the kit and absorbing liquid with pads before any deactivation or cleaning, working from the least to the most contaminated area so the spill is not pushed outward. Spills are documented so the facility can track hazardous drug events, whether or not a person was exposed.

Easy analogy or mental picture
Treat the puddle like spilled ink on a table: blot it up from the edges inward, never spray it first.

Memory hook
Kit, cover, blot in, write it up.

NCLEX decision rule
For a hazardous drug spill, protect yourself with spill-kit PPE, contain and absorb before cleaning, and report every spill.

Why the other choices are wrong
Spraying bleach sounds protective because deactivating agents are part of cleanup, but they are applied only after the liquid is absorbed; spraying first can aerosolize the drug. Skipping the report is tempting because the scenario emphasizes that no one was contaminated and exposure reports are what many staff remember, yet the spill itself must be documented. A surgical mask looks like respiratory protection, but it does not filter hazardous drug aerosols; a fit-tested respirator is used when respiratory protection is needed.