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Interpreter use — USMLE Step 3 MCQ

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HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeInterpreter useUSMLE Step 3

An unvaccinated nurse sustains a needlestick from a source whose HBsAg result is unavailable. What is the best immediate management?

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Correct answer: B — Give HBIG and HepB vaccine now at separate injection sites

The best answer is “Give HBIG and HepB vaccine now at separate injection sites”. Unknown source status is managed like positive status in an unvaccinated exposed clinician. After exposure to an HBsAg-positive or unknown source, an unvaccinated clinician receives HBIG plus HepB vaccine immediately; a documented vaccine responder needs no action. The alternatives use a different threshold, timing, population, or intervention and therefore do not match the clinical facts presented.

Reference: CDC: Responding to HBV Exposures in Health Care Settings: https://www.cdc.gov/hepatitis-b/hcp/infection-control/index.html