A nurse is caring for a client who is HIV positive and is one day postoperative following an appendectomy. The nurse should wear a gown as personal protective equipment when taking which of the following actions?

Choice A rationale Talking to the client involves no direct physical contact with blood, body fluids, or non-intact skin. HIV transmission requires contact with specific body fluids, and casual conversation poses no risk of exposure, thus making the use of a gown unnecessary and inconsistent with Standard Precautions. Choice B rationale A dressing change involves potential contact with wound drainage, which may be serosanguinous or purulent and thus could be contaminated with blood-borne pathogens, including HIV. Applying a gown provides a liquid barrier to protect the nurse's clothing and skin from potential splatter or saturation, adhering to the principles of Standard Precautions. Choice C rationale Administering an IM injection involves skin puncture, but the direct exposure to body fluids is minimal and contained by the syringe/needle. A gown is not typically required for this brief, contained procedure, as the risk of extensive body fluid spray or contamination of clothing is negligible under Standard Precautions. Choice D rationale Administering an intermittent IV bolus involves accessing a closed intravenous system, which has a minimal risk of blood or body fluid exposure. A gown is generally not necessary unless the tubing is being disconnected or there is an anticipated high risk of blood spurt or fluid leakage beyond the scope of a brief access.