A nurse has just drawn blood from a client whose HIV, hepatitis B, and hepatitis C status is unknown. While the nurse is discarding the needle, the safety device fails to engage and the hollow-bore needle, which has visible blood in its hub, punctures the nurse's gloved index finger. After removing the glove, the nurse sees a small puncture wound with minimal bleeding. The nurse has no other cuts on the hands, and no blood splashed onto the face or eyes. The nurse completed the hepatitis B vaccine series 8 years ago. Complete the diagram by selecting the type of exposure the nurse has most likely experienced, 2 actions the nurse should take to address that exposure, and 2 parameters that should be monitored in the nurse to assess the outcome of the exposure.

Quick answer
Percutaneous blood exposure from a used hollow-bore needle; wash with soap and water and report now for same-day evaluation; monitor HIV and hepatitis C test results at baseline and follow-up.

Why this is correct
The glove did not prevent penetration, the needle had just been used for venipuncture, and blood was visible in the hub, so this is a percutaneous exposure to blood rather than surface contamination or a sterile-needle injury. Hollow-bore needles carry the highest transmission risk. Washing removes surface contamination, and prompt reporting lets the employee-health or emergency team arrange source testing and start HIV postexposure prophylaxis, ideally within hours.

Easy analogy or mental picture
Think of the needle as a tiny syringe that delivered a droplet of the client's blood under the skin. The goal now is to rinse the entry point and start the PEP clock, then check later whether any infection took hold.

Memory hook
"Wash, Report, Test" — soap and water, same-day report, baseline and follow-up labs.

NCLEX decision rule
After a percutaneous blood exposure, choose gentle soap-and-water cleansing and immediate reporting; choose monitoring that detects seroconversion to the bloodborne pathogens involved.

Why the other choices are wrong
Milking or squeezing the wound was once taught but adds tissue trauma without proven benefit. Waiting for source results delays PEP, which works best when started within hours. The exposed nurse should not personally draw the source client's blood; source testing is arranged through the exposure protocol with consent. Glove contamination, mucous-membrane splash, and sterile-needle injury are ruled out by the skin puncture, the absence of splash, and visible blood in a used needle. Tuberculin testing tracks airborne TB exposure, and local redness or temperature checks detect a wound infection, not bloodborne-pathogen transmission.