The nurse is caring for a patient who is immobile and is at risk for skin impairment. The plan of care includes turning the patient. Which is the best method for repositioning the patient?

A) A nurse who works for an insurance company and collects urine samples from clients who have HIV: While this nurse may interact with clients who have HIV, collecting urine samples does not typically pose a significant risk for HIV transmission. HIV is not transmitted through urine, and the nurse would not be in direct contact with blood or bodily fluids that present a risk.

B) A personal trainer who works with a client who has HIV: A personal trainer is at low risk for contracting HIV while working with a client who has the virus, provided there is no direct exposure to blood or open wounds. HIV is transmitted through specific bodily fluids such as blood, semen, vaginal fluids, and breast milk, and not through casual contact or physical activity like exercise.
C) A phlebotomist who collects blood from clients who have HIV: A phlebotomist is at the greatest risk of contracting HIV because they handle blood directly. If proper precautions, such as gloves and safe needle handling, are not followed, there is an increased risk of exposure to HIV-infected blood. Occupational exposure to blood is one of the most significant routes of HIV transmission in healthcare settings.

D) An occupational therapist who works with a client who has HIV: An occupational therapist working with a client who has HIV is at a low risk of contracting HIV, provided the therapist does not come into direct contact with blood or other potentially infectious bodily fluids. Occupational therapy generally involves helping clients with physical or cognitive tasks and does not typically present a risk for HIV transmission unless there is a breach in infection control practices.

A) Complete an incident report: While it is essential to complete an incident report, this is not the first action to take. Completing the report documents the event but should come after immediate steps are taken to prevent further complications and ensure the nurse's safety. The priority is to first address the injury and ensure the site is properly cleaned.

B) Request the risk manager obtain consent for HIV testing from the client: Requesting consent for HIV testing from the client is important, but it is not the first priority. The immediate action should focus on treating the injury and reducing the risk of infection. Once the injury is addressed, the next step is to assess the potential for exposure and initiate testing or other preventive measures.
C) Consent to postexposure treatment with antiretroviral medications: Postexposure prophylaxis (PEP) with antiretroviral medications is an important step after a needle-stick injury, especially if the source patient has an unknown HIV status or is known to be HIV-positive. However, this step should come after immediate wound care and before initiating any further testing or preventive treatments.

D) Wash the site of injury with soap and water: The first and most crucial step after a needle-stick injury is to immediately wash the wound thoroughly with soap and water. This action helps reduce the risk of infection by removing any potential contaminants from the needle or the environment. After cleaning the wound, the nurse should then proceed with further steps, such as reporting the incident, obtaining consent for HIV testing, and considering PEP if indicated.