WGU D439 Foundations of Nursing Care -
Objective Assessment (OA) Practice Exam | 150
Questions with Detailed Rationales | Latest
2026/2027 Version | Western Governors
University
Batch 1: Nursing Process, Safety, & Professionalism
1. A nurse is gathering a patient’s vital signs and noted a blood pressure of 160/90.
Which step of the nursing process is the nurse performing?
A) Diagnosis
B) Implementation
C) Assessment
D) Planning
Rationale: Assessment is the first step of the nursing process and involves the
systematic collection of objective data (vitals) and subjective data.
2. The nurse enters a room and the patient states, "I feel very dizzy and nauseated."
This data is classified as:
A) Objective
B) Subjective
C) Diagnostic
D) Evaluative
Rationale: Subjective data is what the patient says or feels (symptoms), which cannot
be measured directly by the nurse.
3. Which of the following is an example of an appropriately written SMART goal?
A) Patient will feel better by the end of the shift.
B) Patient will walk in the hallway today.
C) Patient will ambulate 50 feet with a walker by 1400 today.
D) Nurse will assist the patient with walking three times a day.
Rationale: A SMART goal must be Specific, Measurable, Attainable, Relevant, and
Time-bound. Option C meets all criteria.
,4. A nurse is caring for a patient who is at high risk for falls. Which intervention is
the priority?
A) Teaching the patient how to use a walker.
B) Keeping the room light dimmed.
C) Administering a sedative to keep the patient in bed.
D) Placing the call light within the patient's reach.
Rationale: Safety is the priority. Ensuring the patient can call for help is a fundamental
preventative measure.
5. A nurse delegates the task of repositioning a stable patient to an Unlicensed
Assistive Personnel (UAP). This is an example of which "Right" of delegation?
A) Right Person
B) Right Circumstance
C) Right Task
D) Right Supervision
Rationale: Repositioning is within the scope of a UAP's training, making it the "Right
Task" for a stable patient.
6. The nurse is using the SBAR tool to communicate with a physician. The "B" in
SBAR stands for:
A) Belief
B) Background
C) Behavior
D) Blood Pressure
Rationale: SBAR stands for Situation, Background, Assessment, and
Recommendation.
7. Which ethical principle refers to the nurse's obligation to "do no harm"?
A) Beneficence
B) Nonmaleficence
C) Autonomy
D) Fidelity
Rationale: Nonmaleficence specifically means to avoid causing harm to the patient.
8. A patient refuses a scheduled dose of medication. What is the first action the
nurse should take?
A) Document that the patient is being difficult.
B) Explore the reasons why the patient is refusing.
, C) Call the doctor immediately to report the refusal.
D) Administer the medication anyway for the patient's own good.
Rationale: The nurse should first assess the patient's reasoning and provide education
before accepting the refusal or notifying the provider.
9. Which step of the nursing process involves comparing the patient's current
status to the expected outcomes?
A) Implementation
B) Evaluation
C) Planning
D) Assessment
Rationale: Evaluation is where the nurse determines if the goals were met, partially
met, or not met.
10. A nurse notes a small fire in a trash can in a patient's room. Using the RACE
acronym, what is the very first action?
A) Aim the extinguisher at the base of the fire.
B) Rescue the patient from the room.
C) Alarm the hospital by pulling the fire pull.
D) Confine the fire by closing the door.
Rationale: RACE stands for Rescue, Alarm, Confine, Extinguish. Rescuing the patient
is always the first priority.
11. The nurse identifies that a patient is at risk for skin breakdown. Which nursing
diagnosis is most appropriate?
A) Impaired Skin Integrity
B) Chronic Pain
C) Risk for Impaired Skin Integrity
D) Acute Pain
Rationale: Since the breakdown hasn't happened yet, it is a "Risk" diagnosis.
12. When documenting in a medical record, the nurse should:
A) Use "white-out" to fix errors.
B) Document objectively and immediately after care is provided.
C) Wait until the end of the shift to document everything at once.
D) Include personal opinions about the patient's family.
Rationale: Documentation must be objective, factual, and timely to ensure patient
safety.
, 13. A nurse is unsure how to perform a specific sterile dressing change. What is the
best action?
A) Ask a UAP how to do it.
B) Do it anyway and hope for the best.
C) Refer to the facility's policy and procedure manual.
D) Skip the dressing change for this shift.
Rationale: Evidence-based practice and safety require following the validated facility
protocol.
14. The "Five Rights" of medication administration include Right Patient, Right Drug,
Right Dose, Right Route, and:
A) Right Pharmacy
B) Right Room
C) Right Time
D) Right Physician
Rationale: The fifth "Right" is Right Time.
15. Which of the following is a breach of HIPAA?
A) Discussing a patient's care with the assigned physical therapist.
B) Reporting a communicable disease to the health department as required by law.
C) Posting a photo of a "funny" patient comment on social media without using
the patient's name.
D) Giving a report to the oncoming nurse at the bedside.
Rationale: Sharing any patient-related information on social media is a violation of
privacy and professional boundaries.
16. A patient is scheduled for surgery. Who is responsible for obtaining the formal
informed consent?
A) The nurse
B) The nurse manager
C) The surgeon
D) The surgical technician
Rationale: The provider performing the procedure (the surgeon) is legally responsible
for explaining the risks and benefits to obtain consent. The nurse only witnesses the
signature.
17. What is the primary purpose of the State Nurse Practice Act?
A) To ensure nurses get paid fairly.
Objective Assessment (OA) Practice Exam | 150
Questions with Detailed Rationales | Latest
2026/2027 Version | Western Governors
University
Batch 1: Nursing Process, Safety, & Professionalism
1. A nurse is gathering a patient’s vital signs and noted a blood pressure of 160/90.
Which step of the nursing process is the nurse performing?
A) Diagnosis
B) Implementation
C) Assessment
D) Planning
Rationale: Assessment is the first step of the nursing process and involves the
systematic collection of objective data (vitals) and subjective data.
2. The nurse enters a room and the patient states, "I feel very dizzy and nauseated."
This data is classified as:
A) Objective
B) Subjective
C) Diagnostic
D) Evaluative
Rationale: Subjective data is what the patient says or feels (symptoms), which cannot
be measured directly by the nurse.
3. Which of the following is an example of an appropriately written SMART goal?
A) Patient will feel better by the end of the shift.
B) Patient will walk in the hallway today.
C) Patient will ambulate 50 feet with a walker by 1400 today.
D) Nurse will assist the patient with walking three times a day.
Rationale: A SMART goal must be Specific, Measurable, Attainable, Relevant, and
Time-bound. Option C meets all criteria.
,4. A nurse is caring for a patient who is at high risk for falls. Which intervention is
the priority?
A) Teaching the patient how to use a walker.
B) Keeping the room light dimmed.
C) Administering a sedative to keep the patient in bed.
D) Placing the call light within the patient's reach.
Rationale: Safety is the priority. Ensuring the patient can call for help is a fundamental
preventative measure.
5. A nurse delegates the task of repositioning a stable patient to an Unlicensed
Assistive Personnel (UAP). This is an example of which "Right" of delegation?
A) Right Person
B) Right Circumstance
C) Right Task
D) Right Supervision
Rationale: Repositioning is within the scope of a UAP's training, making it the "Right
Task" for a stable patient.
6. The nurse is using the SBAR tool to communicate with a physician. The "B" in
SBAR stands for:
A) Belief
B) Background
C) Behavior
D) Blood Pressure
Rationale: SBAR stands for Situation, Background, Assessment, and
Recommendation.
7. Which ethical principle refers to the nurse's obligation to "do no harm"?
A) Beneficence
B) Nonmaleficence
C) Autonomy
D) Fidelity
Rationale: Nonmaleficence specifically means to avoid causing harm to the patient.
8. A patient refuses a scheduled dose of medication. What is the first action the
nurse should take?
A) Document that the patient is being difficult.
B) Explore the reasons why the patient is refusing.
, C) Call the doctor immediately to report the refusal.
D) Administer the medication anyway for the patient's own good.
Rationale: The nurse should first assess the patient's reasoning and provide education
before accepting the refusal or notifying the provider.
9. Which step of the nursing process involves comparing the patient's current
status to the expected outcomes?
A) Implementation
B) Evaluation
C) Planning
D) Assessment
Rationale: Evaluation is where the nurse determines if the goals were met, partially
met, or not met.
10. A nurse notes a small fire in a trash can in a patient's room. Using the RACE
acronym, what is the very first action?
A) Aim the extinguisher at the base of the fire.
B) Rescue the patient from the room.
C) Alarm the hospital by pulling the fire pull.
D) Confine the fire by closing the door.
Rationale: RACE stands for Rescue, Alarm, Confine, Extinguish. Rescuing the patient
is always the first priority.
11. The nurse identifies that a patient is at risk for skin breakdown. Which nursing
diagnosis is most appropriate?
A) Impaired Skin Integrity
B) Chronic Pain
C) Risk for Impaired Skin Integrity
D) Acute Pain
Rationale: Since the breakdown hasn't happened yet, it is a "Risk" diagnosis.
12. When documenting in a medical record, the nurse should:
A) Use "white-out" to fix errors.
B) Document objectively and immediately after care is provided.
C) Wait until the end of the shift to document everything at once.
D) Include personal opinions about the patient's family.
Rationale: Documentation must be objective, factual, and timely to ensure patient
safety.
, 13. A nurse is unsure how to perform a specific sterile dressing change. What is the
best action?
A) Ask a UAP how to do it.
B) Do it anyway and hope for the best.
C) Refer to the facility's policy and procedure manual.
D) Skip the dressing change for this shift.
Rationale: Evidence-based practice and safety require following the validated facility
protocol.
14. The "Five Rights" of medication administration include Right Patient, Right Drug,
Right Dose, Right Route, and:
A) Right Pharmacy
B) Right Room
C) Right Time
D) Right Physician
Rationale: The fifth "Right" is Right Time.
15. Which of the following is a breach of HIPAA?
A) Discussing a patient's care with the assigned physical therapist.
B) Reporting a communicable disease to the health department as required by law.
C) Posting a photo of a "funny" patient comment on social media without using
the patient's name.
D) Giving a report to the oncoming nurse at the bedside.
Rationale: Sharing any patient-related information on social media is a violation of
privacy and professional boundaries.
16. A patient is scheduled for surgery. Who is responsible for obtaining the formal
informed consent?
A) The nurse
B) The nurse manager
C) The surgeon
D) The surgical technician
Rationale: The provider performing the procedure (the surgeon) is legally responsible
for explaining the risks and benefits to obtain consent. The nurse only witnesses the
signature.
17. What is the primary purpose of the State Nurse Practice Act?
A) To ensure nurses get paid fairly.
