WGU D439 Foundations of Nursing | Objective
Assessment (OA) Actual Exam Questions with
Answers and Explanations Latest Update 2026/2027 |
Instant Pdf Download
Introduction:
This exam is designed to help students preparing for the WGU D439 Foundations of Nursing
Objective Assessment (OA). It contains scenario-based, clinically relevant multiple-choice
questions (MCQs) that emphasize:
Prioritization and delegation – deciding which patient requires immediate attention.
Patient safety and clinical judgment – identifying emergencies, complications, and life-
threatening conditions.
Nursing interventions and best practices – correct and evidence-based actions.
Critical thinking in realistic scenarios – reflecting situations encountered in medical-
surgical, acute care, and community health settings.
Each question includes the correct answer and an explanation, enabling students to understand
reasoning and enhance clinical decision-making skills. The exam simulates the difficulty and
style of the WGU OA, preparing students to confidently demonstrate mastery of foundational
nursing knowledge and practice.
1. A nurse is caring for a 68-year-old patient admitted with pneumonia who suddenly
becomes restless, confused, and short of breath. The patient’s oxygen saturation
drops from 95% to 86% on room air. What is the nurse’s PRIORITY action?
,A) Notify the healthcare provider immediately
B) Apply oxygen via nasal cannula
C) Reassess vital signs in 15 minutes
D) Document the change in condition
Answer: B) Apply oxygen via nasal cannula
**Rationale:** The patient is experiencing acute hypoxia. According to ABCs (airway,
breathing, circulation), oxygenation is the immediate priority. Interventions to stabilize the
patient must occur before notifying the provider.
2. A nurse is preparing to administer morning medications to a patient who states, “I
don’t want to take these pills anymore—they make me feel worse.” What is the most
appropriate nursing response?
A) “You need to take them because they were prescribed.”
B) “What specifically about the medication is bothering you?”
C) “I will document your refusal and leave.”
D) “Your provider will be upset if you don’t take them.”
Answer: B) “What specifically about the medication is bothering you?”
**Rationale:** This response uses therapeutic communication to explore the patient’s
concerns, promotes autonomy, and may reveal issues such as side effects or
misunderstandings.
3. A nurse is assessing four patients at the beginning of the shift. Which patient
should the nurse assess FIRST?
A) A postoperative patient reporting pain of 6/10
B) A patient with diabetes requesting assistance with breakfast
C) A patient with COPD whose oxygen saturation is 88% on 2L nasal cannula
D) A patient awaiting discharge instructions
Answer: C) A patient with COPD whose oxygen saturation is 88% on 2L nasal
cannula
**Rationale:** This patient demonstrates compromised oxygenation, which is a priority
according to ABCs. Hypoxia can rapidly become life-threatening.
,4. A nurse enters a patient’s room and finds the patient lying on the floor next to the
bed. The patient is awake but states, “I slipped.” What is the nurse’s FIRST action?
A) Assist the patient back into bed
B) Notify the healthcare provider
C) Assess the patient for injuries
D) Complete an incident report
Answer: C) Assess the patient for injuries
**Rationale:** Patient safety comes first. The nurse must assess for injury before moving
the patient or initiating other actions.
5. A nurse is caring for a patient with a fever of 102.2°F (39°C). The patient appears
flushed and reports chills. Which interventions should the nurse implement? (Select
the BEST answer)
A) Encourage oral fluids and administer antipyretics
B) Apply warm blankets and restrict fluids
C) Keep the room warm and limit activity
D) Delay treatment until provider evaluation
Answer: A) Encourage oral fluids and administer antipyretics
**Rationale:** Fever increases metabolic demand and fluid loss. Hydration and
antipyretics help regulate body temperature.
6. A nurse is caring for a postoperative patient who suddenly reports chest pain,
shortness of breath, and anxiety. What is the nurse’s PRIORITY action?
A) Administer pain medication
B) Place the patient in high Fowler’s position and apply oxygen
C) Notify the healthcare provider
D) Document the symptoms
Answer: B) Place the patient in high Fowler’s position and apply oxygen
**Rationale:** Suspected pulmonary embolism or cardiac event—priority is oxygenation
and positioning to improve breathing.
, 7. A nurse is educating a patient about infection prevention. Which patient statement
indicates a need for further teaching?
A) “I will wash my hands before meals.”
B) “I should avoid touching my face.”
C) “I only need to wash my hands when they look dirty.”
D) “I should use hand sanitizer when soap is unavailable.”
Answer: C) “I only need to wash my hands when they look dirty.”
**Rationale:** Hand hygiene is required even when hands are not visibly soiled.
8. A nurse is caring for a patient receiving opioids for pain management. Which
assessment finding requires immediate intervention?
A) Respiratory rate of 10 breaths/min
B) Pain score of 4/10
C) Blood pressure of 130/80
D) Heart rate of 78 bpm
Answer: A) Respiratory rate of 10 breaths/min
**Rationale:** Opioids can cause respiratory depression; this is a priority concern.
9. A nurse is preparing to assist a patient out of bed for the first time after surgery.
The patient reports dizziness upon sitting up. What should the nurse do FIRST?
A) Help the patient stand quickly
B) Return the patient to a lying position
C) Encourage deep breathing
D) Continue ambulation
Answer: B) Return the patient to a lying position
**Rationale:** Dizziness indicates possible orthostatic hypotension; patient safety
requires preventing a fall.
10. A nurse is caring for a patient under contact precautions due to a wound
infection. Which action is appropriate?
A) Wear gloves only
B) Wear gown and gloves when entering room
Assessment (OA) Actual Exam Questions with
Answers and Explanations Latest Update 2026/2027 |
Instant Pdf Download
Introduction:
This exam is designed to help students preparing for the WGU D439 Foundations of Nursing
Objective Assessment (OA). It contains scenario-based, clinically relevant multiple-choice
questions (MCQs) that emphasize:
Prioritization and delegation – deciding which patient requires immediate attention.
Patient safety and clinical judgment – identifying emergencies, complications, and life-
threatening conditions.
Nursing interventions and best practices – correct and evidence-based actions.
Critical thinking in realistic scenarios – reflecting situations encountered in medical-
surgical, acute care, and community health settings.
Each question includes the correct answer and an explanation, enabling students to understand
reasoning and enhance clinical decision-making skills. The exam simulates the difficulty and
style of the WGU OA, preparing students to confidently demonstrate mastery of foundational
nursing knowledge and practice.
1. A nurse is caring for a 68-year-old patient admitted with pneumonia who suddenly
becomes restless, confused, and short of breath. The patient’s oxygen saturation
drops from 95% to 86% on room air. What is the nurse’s PRIORITY action?
,A) Notify the healthcare provider immediately
B) Apply oxygen via nasal cannula
C) Reassess vital signs in 15 minutes
D) Document the change in condition
Answer: B) Apply oxygen via nasal cannula
**Rationale:** The patient is experiencing acute hypoxia. According to ABCs (airway,
breathing, circulation), oxygenation is the immediate priority. Interventions to stabilize the
patient must occur before notifying the provider.
2. A nurse is preparing to administer morning medications to a patient who states, “I
don’t want to take these pills anymore—they make me feel worse.” What is the most
appropriate nursing response?
A) “You need to take them because they were prescribed.”
B) “What specifically about the medication is bothering you?”
C) “I will document your refusal and leave.”
D) “Your provider will be upset if you don’t take them.”
Answer: B) “What specifically about the medication is bothering you?”
**Rationale:** This response uses therapeutic communication to explore the patient’s
concerns, promotes autonomy, and may reveal issues such as side effects or
misunderstandings.
3. A nurse is assessing four patients at the beginning of the shift. Which patient
should the nurse assess FIRST?
A) A postoperative patient reporting pain of 6/10
B) A patient with diabetes requesting assistance with breakfast
C) A patient with COPD whose oxygen saturation is 88% on 2L nasal cannula
D) A patient awaiting discharge instructions
Answer: C) A patient with COPD whose oxygen saturation is 88% on 2L nasal
cannula
**Rationale:** This patient demonstrates compromised oxygenation, which is a priority
according to ABCs. Hypoxia can rapidly become life-threatening.
,4. A nurse enters a patient’s room and finds the patient lying on the floor next to the
bed. The patient is awake but states, “I slipped.” What is the nurse’s FIRST action?
A) Assist the patient back into bed
B) Notify the healthcare provider
C) Assess the patient for injuries
D) Complete an incident report
Answer: C) Assess the patient for injuries
**Rationale:** Patient safety comes first. The nurse must assess for injury before moving
the patient or initiating other actions.
5. A nurse is caring for a patient with a fever of 102.2°F (39°C). The patient appears
flushed and reports chills. Which interventions should the nurse implement? (Select
the BEST answer)
A) Encourage oral fluids and administer antipyretics
B) Apply warm blankets and restrict fluids
C) Keep the room warm and limit activity
D) Delay treatment until provider evaluation
Answer: A) Encourage oral fluids and administer antipyretics
**Rationale:** Fever increases metabolic demand and fluid loss. Hydration and
antipyretics help regulate body temperature.
6. A nurse is caring for a postoperative patient who suddenly reports chest pain,
shortness of breath, and anxiety. What is the nurse’s PRIORITY action?
A) Administer pain medication
B) Place the patient in high Fowler’s position and apply oxygen
C) Notify the healthcare provider
D) Document the symptoms
Answer: B) Place the patient in high Fowler’s position and apply oxygen
**Rationale:** Suspected pulmonary embolism or cardiac event—priority is oxygenation
and positioning to improve breathing.
, 7. A nurse is educating a patient about infection prevention. Which patient statement
indicates a need for further teaching?
A) “I will wash my hands before meals.”
B) “I should avoid touching my face.”
C) “I only need to wash my hands when they look dirty.”
D) “I should use hand sanitizer when soap is unavailable.”
Answer: C) “I only need to wash my hands when they look dirty.”
**Rationale:** Hand hygiene is required even when hands are not visibly soiled.
8. A nurse is caring for a patient receiving opioids for pain management. Which
assessment finding requires immediate intervention?
A) Respiratory rate of 10 breaths/min
B) Pain score of 4/10
C) Blood pressure of 130/80
D) Heart rate of 78 bpm
Answer: A) Respiratory rate of 10 breaths/min
**Rationale:** Opioids can cause respiratory depression; this is a priority concern.
9. A nurse is preparing to assist a patient out of bed for the first time after surgery.
The patient reports dizziness upon sitting up. What should the nurse do FIRST?
A) Help the patient stand quickly
B) Return the patient to a lying position
C) Encourage deep breathing
D) Continue ambulation
Answer: B) Return the patient to a lying position
**Rationale:** Dizziness indicates possible orthostatic hypotension; patient safety
requires preventing a fall.
10. A nurse is caring for a patient under contact precautions due to a wound
infection. Which action is appropriate?
A) Wear gloves only
B) Wear gown and gloves when entering room
