WGU D439 Foundations of Nursing: 150 Practice
Questions & Answers with Rationales 2026/2027 |
instant pdf download
Master the Nursing Process, Safety, Delegation, and Ethics for the Objective Assessment
Overview
Prepare for the WGU D439 – Foundations of Nursing Objective Assessment with this
comprehensive set of 150 multiple-choice questions. Each question includes the correct
answer in italic bold and a detailed rationale. Covering safety and infection control,
health assessment, therapeutic communication, professional ethics, prioritization
and delegation, the nursing process (ADPIE), pharmacology, and
growth/development, this guide helps you apply clinical judgment, recognize priority
actions, and understand the “why” behind each answer. Ideal for last-minute review or
systematic content mastery.
Safety & Infection Control (Questions 1–20)
1. A nurse is preparing to insert an indwelling urinary catheter. Which action best maintains
sterile technique?
a) Opening the sterile kit 30 minutes before the procedure
b) Using clean gloves for the entire insertion
c) Placing the sterile drape with the sterile side facing up
d) Wearing the same mask for two consecutive catheterizations
Explanation: Placing the sterile drape with the sterile side facing up prevents contamination
of the field and reduces infection risk during catheter insertion.
2. A client with active tuberculosis requires transport to radiology. Which PPE must the
nurse wear during transport?
a) Surgical mask
b) N95 respirator
,c) Clean gloves only
d) Face shield
Explanation: Active tuberculosis requires airborne precautions, and an N95 respirator
filters 95% of airborne particles, protecting both patient and staff.
3. A patient falls while attempting to walk to the bathroom unassisted. What is the nurse’s
priority action immediately after the fall?
a) Complete an incident report
b) Assess the patient for injuries
c) Notify the primary care provider
d) Place a fall risk sign on the door
Explanation: Assessing the patient for injuries comes first because life-threatening injuries
must be identified and treated before any documentation or notification occurs.
4. Which action demonstrates proper hand hygiene before a sterile procedure?
a) Using alcohol-based hand rub for 5 seconds
b) Washing hands for 10 seconds with cool water
c) Washing with antimicrobial soap for at least 20 seconds
d) Rinsing hands without soap after glove removal
Explanation: Antimicrobial soap with at least 20 seconds of friction removes transient flora
and reduces resident bacteria to maintain a sterile field.
5. A confused patient has wrist restraints applied. How often must the nurse remove the
restraints for range-of-motion exercises?
a) Every 4 hours
b) Every 2 hours
c) Every hour
d) Every shift
*Explanation: Restraints must be removed every 2 hours to allow circulation checks, skin
assessment, and range-of-motion exercises to prevent contractures.*
6. Which finding indicates a need to replace a sterile field?
a) A sterile object touches only the very edge of the sterile drape
b) The nurse reaches across the sterile field to grasp a supply
c) The sterile field is set up immediately before the procedure
d) Sterile items are open but never touched
,Explanation: Reaching across a sterile field contaminates it because non-sterile clothing or
air currents can transfer microorganisms onto exposed sterile surfaces.
7. The nurse is caring for a patient on contact precautions. Which action is correct?
a) Wear an N95 mask and goggles
b) Place the patient in a single room with dedicated equipment
c) Keep the patient’s door completely open for observation
d) Wear a sterile gown for every entry
Explanation: Contact precautions require a single room and dedicated equipment such as
stethoscopes and blood pressure cuffs to reduce cross-contamination.
8. Which clinical situation requires the use of a sterile gown and gloves?
a) Emptying a urinary drainage bag
b) Inserting a central line catheter
c) Taking an oral temperature
d) Changing a simple dry dressing
Explanation: Central line insertion is a major sterile procedure requiring a sterile gown,
gloves, mask, and large sterile drape to prevent bloodstream infections.
9. A nurse spills a biohazardous fluid on the floor. What is the first action?
a) Notify environmental services
b) Apply absorbent powder to contain the spill
c) Place a wet floor sign
d) Mop the spill with hot water
Explanation: Containing the spill with absorbent powder prevents spread to a larger area
and reduces exposure risk for staff and patients.
10. Which patient is at highest risk for a fall-related injury?
a) A 25-year-old with a sprained ankle
b) *An 80-year-old taking antihypertensives and sedatives*
c) A 40-year-old post-appendectomy day 2
d) A 15-year-old with a wrist fracture
Explanation: Advanced age combined with antihypertensives (causing orthostasis) and
sedatives (causing confusion) significantly increases fall risk.
11. A nurse observes a fire in a patient’s trash can. What is the correct first action using
RACE?
a) Extinguish the fire
, b) Alarm – activate the fire alarm
c) Rescue – remove the patient from immediate danger
d) Close all doors and windows
Explanation: RACE prioritizes Rescue first because moving the patient away from the fire
prevents burns and smoke inhalation before other actions.
12. Which statement about applying physical restraints is accurate?
a) Restraints can be applied based on verbal orders only
b) A provider’s written order must be obtained before application
c) Restraints may be used as punishment for aggression
d) Restraints do not require monitoring once applied
Explanation: Written provider orders are legally required before restraint application,
except in emergency situations, to protect patient rights.
13. The nurse is preparing to don PPE for a sterile dressing change. What is the correct
order?
a) Mask → gown → gloves
b) Gown → mask → gloves
c) Gloves → gown → mask
d) Mask → gloves → gown
Explanation: Donning gown first protects the torso, then the mask covers airway, and
gloves last to keep hands sterile until touching the patient.
14. Which finding indicates a pressure injury has progressed to Stage 3?
a) Non-blanchable redness on the sacrum
b) Full-thickness skin loss with visible subcutaneous fat
c) Intact blister filled with clear fluid
d) Deep tissue injury with purple discoloration
Explanation: Stage 3 pressure injuries extend through the dermis into subcutaneous fat,
but bone, tendon, and muscle are not yet exposed.
15. A nurse needs to safely transfer a hemiplegic patient from bed to chair. Which device is
most appropriate?
a) Mechanical lift without sling
b) Gait belt with two assistive personnel
c) Single-person drag method
d) Slide board without belt
Questions & Answers with Rationales 2026/2027 |
instant pdf download
Master the Nursing Process, Safety, Delegation, and Ethics for the Objective Assessment
Overview
Prepare for the WGU D439 – Foundations of Nursing Objective Assessment with this
comprehensive set of 150 multiple-choice questions. Each question includes the correct
answer in italic bold and a detailed rationale. Covering safety and infection control,
health assessment, therapeutic communication, professional ethics, prioritization
and delegation, the nursing process (ADPIE), pharmacology, and
growth/development, this guide helps you apply clinical judgment, recognize priority
actions, and understand the “why” behind each answer. Ideal for last-minute review or
systematic content mastery.
Safety & Infection Control (Questions 1–20)
1. A nurse is preparing to insert an indwelling urinary catheter. Which action best maintains
sterile technique?
a) Opening the sterile kit 30 minutes before the procedure
b) Using clean gloves for the entire insertion
c) Placing the sterile drape with the sterile side facing up
d) Wearing the same mask for two consecutive catheterizations
Explanation: Placing the sterile drape with the sterile side facing up prevents contamination
of the field and reduces infection risk during catheter insertion.
2. A client with active tuberculosis requires transport to radiology. Which PPE must the
nurse wear during transport?
a) Surgical mask
b) N95 respirator
,c) Clean gloves only
d) Face shield
Explanation: Active tuberculosis requires airborne precautions, and an N95 respirator
filters 95% of airborne particles, protecting both patient and staff.
3. A patient falls while attempting to walk to the bathroom unassisted. What is the nurse’s
priority action immediately after the fall?
a) Complete an incident report
b) Assess the patient for injuries
c) Notify the primary care provider
d) Place a fall risk sign on the door
Explanation: Assessing the patient for injuries comes first because life-threatening injuries
must be identified and treated before any documentation or notification occurs.
4. Which action demonstrates proper hand hygiene before a sterile procedure?
a) Using alcohol-based hand rub for 5 seconds
b) Washing hands for 10 seconds with cool water
c) Washing with antimicrobial soap for at least 20 seconds
d) Rinsing hands without soap after glove removal
Explanation: Antimicrobial soap with at least 20 seconds of friction removes transient flora
and reduces resident bacteria to maintain a sterile field.
5. A confused patient has wrist restraints applied. How often must the nurse remove the
restraints for range-of-motion exercises?
a) Every 4 hours
b) Every 2 hours
c) Every hour
d) Every shift
*Explanation: Restraints must be removed every 2 hours to allow circulation checks, skin
assessment, and range-of-motion exercises to prevent contractures.*
6. Which finding indicates a need to replace a sterile field?
a) A sterile object touches only the very edge of the sterile drape
b) The nurse reaches across the sterile field to grasp a supply
c) The sterile field is set up immediately before the procedure
d) Sterile items are open but never touched
,Explanation: Reaching across a sterile field contaminates it because non-sterile clothing or
air currents can transfer microorganisms onto exposed sterile surfaces.
7. The nurse is caring for a patient on contact precautions. Which action is correct?
a) Wear an N95 mask and goggles
b) Place the patient in a single room with dedicated equipment
c) Keep the patient’s door completely open for observation
d) Wear a sterile gown for every entry
Explanation: Contact precautions require a single room and dedicated equipment such as
stethoscopes and blood pressure cuffs to reduce cross-contamination.
8. Which clinical situation requires the use of a sterile gown and gloves?
a) Emptying a urinary drainage bag
b) Inserting a central line catheter
c) Taking an oral temperature
d) Changing a simple dry dressing
Explanation: Central line insertion is a major sterile procedure requiring a sterile gown,
gloves, mask, and large sterile drape to prevent bloodstream infections.
9. A nurse spills a biohazardous fluid on the floor. What is the first action?
a) Notify environmental services
b) Apply absorbent powder to contain the spill
c) Place a wet floor sign
d) Mop the spill with hot water
Explanation: Containing the spill with absorbent powder prevents spread to a larger area
and reduces exposure risk for staff and patients.
10. Which patient is at highest risk for a fall-related injury?
a) A 25-year-old with a sprained ankle
b) *An 80-year-old taking antihypertensives and sedatives*
c) A 40-year-old post-appendectomy day 2
d) A 15-year-old with a wrist fracture
Explanation: Advanced age combined with antihypertensives (causing orthostasis) and
sedatives (causing confusion) significantly increases fall risk.
11. A nurse observes a fire in a patient’s trash can. What is the correct first action using
RACE?
a) Extinguish the fire
, b) Alarm – activate the fire alarm
c) Rescue – remove the patient from immediate danger
d) Close all doors and windows
Explanation: RACE prioritizes Rescue first because moving the patient away from the fire
prevents burns and smoke inhalation before other actions.
12. Which statement about applying physical restraints is accurate?
a) Restraints can be applied based on verbal orders only
b) A provider’s written order must be obtained before application
c) Restraints may be used as punishment for aggression
d) Restraints do not require monitoring once applied
Explanation: Written provider orders are legally required before restraint application,
except in emergency situations, to protect patient rights.
13. The nurse is preparing to don PPE for a sterile dressing change. What is the correct
order?
a) Mask → gown → gloves
b) Gown → mask → gloves
c) Gloves → gown → mask
d) Mask → gloves → gown
Explanation: Donning gown first protects the torso, then the mask covers airway, and
gloves last to keep hands sterile until touching the patient.
14. Which finding indicates a pressure injury has progressed to Stage 3?
a) Non-blanchable redness on the sacrum
b) Full-thickness skin loss with visible subcutaneous fat
c) Intact blister filled with clear fluid
d) Deep tissue injury with purple discoloration
Explanation: Stage 3 pressure injuries extend through the dermis into subcutaneous fat,
but bone, tendon, and muscle are not yet exposed.
15. A nurse needs to safely transfer a hemiplegic patient from bed to chair. Which device is
most appropriate?
a) Mechanical lift without sling
b) Gait belt with two assistive personnel
c) Single-person drag method
d) Slide board without belt
