A healthcare worker experiences an accidental needle-stick injury from an HIV-positive patient. Within what time frame should post-exposure prophylaxis be started?

1. A

   Within 72 hours of the needle-stick injury

2. B

   After 7 days of exposure

3. C

   Within 1 month

4. D

   Only when clinical symptoms appear

Appeared in: PGIMER Nursing Officer - 2025

Explanation

• PEP must be started as soon as possible, ideally within hours, and no later than 72 hours after exposure.
• Effectiveness of PEP drops sharply after 72 hours due to early HIV replication in lymph nodes.
• Prompt initiation is a medical emergency and should not be delayed for test results.
• Delaying PEP beyond 72 hours is not recommended as benefits do not outweigh risks.

Why Other Options Were Wrong

• Option B: Starting PEP after 7 days is too late. By this time, HIV replication and systemic spread may have already occurred, making prophylaxis ineffective.
• Option C: Initiating PEP within 1 month is far outside the effective window. HIV would have already established infection by then.
• Option D: Waiting for clinical symptoms to appear before starting PEP is incorrect. By the time symptoms develop, HIV infection is already established and PEP is no longer useful.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Time frame for initiation of HIV post-exposure prophylaxis (PEP) after occupational exposure to guide bedside assessment, documentation, and the next nursing action.
• Nurses and healthcare workers must act quickly after occupational exposure to HIV to prevent infection.
• Immediate reporting and PEP initiation are essential for personal safety and public health.
• What if? If PEP is started after 72 hours, the risk of HIV infection increases and PEP may not be effective.

How to Approach the Question

• Read the scenario carefully to identify the type of exposure and the infectious agent.
• Recall the evidence-based time frame for starting PEP (within 72 hours).
• Eliminate options that suggest delayed or symptom-based initiation.
• Select the answer that matches the recommended guideline for PEP timing.
• Remember that early action is critical in occupational exposures.

Concept Tested & Keywords

• Concept Tested: Time frame for initiation of HIV post-exposure prophylaxis (PEP) after occupational exposure
• Stem keywords: needle-stick injury, HIV-positive patient, healthcare worker, post-exposure prophylaxis, time frame
• Lead-in keywords: Within what time frame
• Clinical cues: Accidental needle-stick injury
• Clinical cues: HIV-positive source

Question ID

Q0_evKJffOfz_hVUpxxTAM

Copy ID

Reference Book

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 20-22

E6 Medicine Harrison 22e Part 1 p. 1666-1668