WGU D026
Quality Outcomes in a Culture of Value-Based Nursing Care
Comprehensive Examination with Complete Solutions
(WGU Elements of Value Based Care PowerPoint)
Edition
Section Topic Questions
1 Foundations of Value-Based Care 1 - 15 (15 Q)
2 Quality Outcomes & Measurement 16 - 30 (15 Q)
3 Healthcare Economics & Reimbursement 31 - 42 (12 Q)
4 Patient-Centered Care & Shared Decision-Making 43 - 54 (12 Q)
5 Care Coordination & Transitions of Care 55 - 66 (12 Q)
6 Population Health & Social Determinants 67 - 78 (12 Q)
7 Quality Improvement & Patient Safety 79 - 90 (12 Q)
8 Nursing Leadership in Value-Based Care 91 - 100 (10 Q)
TOTAL 100 Questions
Aligned with: WGU D026 Course Syllabus · AACN Essentials of Master's Education in Nursing · QSEN
Competencies · CMS Quality & Value-Based Purchasing Programs · IHI Triple / Quadruple Aim · IOM (National
Academy of Medicine) Six Aims for Improvement
Cognitive Distribution: 25% Recall · 50% Application · 25% Analysis
Question Style: 75% Scenario-Based · 25% Direct Knowledge
Format: 100 Multiple-Choice Questions, 4 Options (A–D), One Correct Answer, with Detailed Rationale per
Question
,D026 • Comprehensive Examination — Complete Solutions
Instructions to the Candidate: Read each stem carefully. Select the single best answer from options A–D. The
correct answer is marked *[CORRECT]* and is repeated in the “Correct Answer” line. Use the rationale to
reinforce WGU D026 concepts.
WGU D026 • Quality Outcomes in a Culture of Value-Based Nursing Care • 2026/2027 Edition Page 2
,D026 • Comprehensive Examination — Complete Solutions
Examination Orientation
This comprehensive examination is designed to evaluate mastery of the WGU D026 course, Quality Outcomes in a
Culture of Value-Based Nursing Care. The examination reflects the 2026/2027 edition of the course, drawing on the
WGU Elements of Value-Based Care PowerPoint and the broader value-based care knowledge base. Each item is
mapped to one of eight content domains that mirror the course structure and the AACN Essentials of Master's
Education in Nursing, the QSEN competencies, and the CMS Quality and Value-Based Purchasing programs.
Items are written at three cognitive levels: approximately 25% assess recall of foundational concepts, 50% assess
application to clinical or administrative scenarios, and 25% assess analysis, including case analysis, quality
improvement planning, data interpretation, and value-based decision-making. Approximately 75% of items are
scenario-based, reflecting the real-world complexity of value-based nursing practice, while 25% are direct
knowledge items that test core definitions, frameworks, and policy provisions.
Each question provides a complete rationale that explains why the keyed answer is correct and why the distractors
are incorrect, citing the relevant WGU D026 curriculum, AACN standards, and value-based care principles. Use the
rationale to deepen understanding, not merely to verify the answer. The examination is designed for self-assessment,
course review, faculty-led debriefing, and preparation for the WGU D026 course examination.
Section 1: Foundations of Value-Based Care
Questions 1 - 15 (15 Questions)
*Q1:* A nurse executive is presenting the case for transitioning a health system from fee-for-service to
value-based care. Which statement most accurately captures the defining feature of value-based care as
taught in the WGU D026 curriculum?
A. Value-based care pays providers based on the volume of services delivered, with bonuses tied to patient
volume growth.
B. Value-based care holds providers accountable for both the cost and quality of care delivered to a
defined population across the continuum. *[CORRECT]*
C. Value-based care eliminates all financial risk for providers by guaranteeing fixed payments regardless of
outcomes.
D. Value-based care restricts clinical decisions to a single standardized pathway for every patient regardless of
preference.
Correct Answer: B
Rationale
Value-based care (VBC) is defined as a delivery model in which providers, including health systems and payers, share
accountability for both the total cost of care and the quality outcomes for a defined population across the continuum. The
other options describe common misconceptions: paying for volume is fee-for-service (A), eliminating all financial risk
contradicts the shared-risk principle (C), and standardizing all care regardless of preference violates patient-centeredness
(D). The WGU D026 PowerPoint emphasizes the shift from volume to value as the central tenet of the value-based care
transformation.
WGU D026 • Quality Outcomes in a Culture of Value-Based Nursing Care • 2026/2027 Edition Page 3
, D026 • Comprehensive Examination — Complete Solutions
*Q2:* A primary care clinic operating under fee-for-service reimbursement is being compared with a
clinic participating in a Medicare Accountable Care Organization (ACO). Which contrast best reflects
the structural difference between the two models?
A. Both models reward the volume of services, but the ACO adds a quality bonus on top of fee-for-service
payments.
B. Fee-for-service incentivizes service volume and duplication, while the ACO links payment to quality,
cost, and population outcomes through shared savings. *[CORRECT]*
C. Fee-for-service shifts financial risk to payers, while the ACO shifts all financial risk to individual clinicians.
D. Both models use bundled payments, but the ACO adds a per-member-per-month capitation fee.
Correct Answer: B
Rationale
Fee-for-service (FFS) reimbursement rewards volume, encouraging duplication and overuse, whereas an Accountable Care
Organization (ACO) links payment to quality and total cost performance, often through shared savings if quality and cost
benchmarks are met. Option A mischaracterizes ACOs as merely FFS plus a bonus. Option C is incorrect because ACOs
share—not solely transfer—risk. Option D is wrong because bundled payments and capitation are distinct models not
intrinsic to either FFS or the ACO comparison. The WGU D026 PowerPoint frames this contrast as the central economic
driver of the volume-to-value transition.
*Q3:* When teaching new graduate nurses about the Institute for Healthcare Improvement (IHI) Triple
Aim, which set of three objectives must the nurse include?
A. Better patient experience, better clinician experience, and lower per-capita cost.
B. Better population health, better individual patient experience of care, and lower per-capita cost of care.
*[CORRECT]*
C. Higher service volume, greater patient throughput, and reduced operating margins.
D. Improved technology adoption, increased market share, and lower labor costs.
Correct Answer: B
Rationale
The IHI Triple Aim comprises three interdependent objectives: improving the health of populations, improving the
experience of care for individuals, and reducing per-capita cost of care. Option A describes the Quadruple Aim (which
adds clinician well-being). Options C and D reflect business-efficiency metrics that are not part of the Triple Aim
framework. The WGU D026 curriculum emphasizes that the Triple Aim provides the conceptual foundation for
value-based care and population health management.
*Q4:* A medical-surgical unit has experienced rising rates of nurse burnout, increased absenteeism, and
turnover above the national average. Nurse leaders are revising their value-based care strategy.
According to the Quadruple Aim, which element must be added to the Triple Aim to address this
situation effectively?
A. Improving the experience of the healthcare workforce, including burnout reduction and well-being.
*[CORRECT]*
B. Increasing the deployment of advanced technology at the bedside to reduce documentation burden.
C. Achieving financial profitability to fund additional nursing positions.
D. Standardizing clinical pathways to reduce variation in nurse workload.
Correct Answer: A
WGU D026 • Quality Outcomes in a Culture of Value-Based Nursing Care • 2026/2027 Edition Page 4
Quality Outcomes in a Culture of Value-Based Nursing Care
Comprehensive Examination with Complete Solutions
(WGU Elements of Value Based Care PowerPoint)
Edition
Section Topic Questions
1 Foundations of Value-Based Care 1 - 15 (15 Q)
2 Quality Outcomes & Measurement 16 - 30 (15 Q)
3 Healthcare Economics & Reimbursement 31 - 42 (12 Q)
4 Patient-Centered Care & Shared Decision-Making 43 - 54 (12 Q)
5 Care Coordination & Transitions of Care 55 - 66 (12 Q)
6 Population Health & Social Determinants 67 - 78 (12 Q)
7 Quality Improvement & Patient Safety 79 - 90 (12 Q)
8 Nursing Leadership in Value-Based Care 91 - 100 (10 Q)
TOTAL 100 Questions
Aligned with: WGU D026 Course Syllabus · AACN Essentials of Master's Education in Nursing · QSEN
Competencies · CMS Quality & Value-Based Purchasing Programs · IHI Triple / Quadruple Aim · IOM (National
Academy of Medicine) Six Aims for Improvement
Cognitive Distribution: 25% Recall · 50% Application · 25% Analysis
Question Style: 75% Scenario-Based · 25% Direct Knowledge
Format: 100 Multiple-Choice Questions, 4 Options (A–D), One Correct Answer, with Detailed Rationale per
Question
,D026 • Comprehensive Examination — Complete Solutions
Instructions to the Candidate: Read each stem carefully. Select the single best answer from options A–D. The
correct answer is marked *[CORRECT]* and is repeated in the “Correct Answer” line. Use the rationale to
reinforce WGU D026 concepts.
WGU D026 • Quality Outcomes in a Culture of Value-Based Nursing Care • 2026/2027 Edition Page 2
,D026 • Comprehensive Examination — Complete Solutions
Examination Orientation
This comprehensive examination is designed to evaluate mastery of the WGU D026 course, Quality Outcomes in a
Culture of Value-Based Nursing Care. The examination reflects the 2026/2027 edition of the course, drawing on the
WGU Elements of Value-Based Care PowerPoint and the broader value-based care knowledge base. Each item is
mapped to one of eight content domains that mirror the course structure and the AACN Essentials of Master's
Education in Nursing, the QSEN competencies, and the CMS Quality and Value-Based Purchasing programs.
Items are written at three cognitive levels: approximately 25% assess recall of foundational concepts, 50% assess
application to clinical or administrative scenarios, and 25% assess analysis, including case analysis, quality
improvement planning, data interpretation, and value-based decision-making. Approximately 75% of items are
scenario-based, reflecting the real-world complexity of value-based nursing practice, while 25% are direct
knowledge items that test core definitions, frameworks, and policy provisions.
Each question provides a complete rationale that explains why the keyed answer is correct and why the distractors
are incorrect, citing the relevant WGU D026 curriculum, AACN standards, and value-based care principles. Use the
rationale to deepen understanding, not merely to verify the answer. The examination is designed for self-assessment,
course review, faculty-led debriefing, and preparation for the WGU D026 course examination.
Section 1: Foundations of Value-Based Care
Questions 1 - 15 (15 Questions)
*Q1:* A nurse executive is presenting the case for transitioning a health system from fee-for-service to
value-based care. Which statement most accurately captures the defining feature of value-based care as
taught in the WGU D026 curriculum?
A. Value-based care pays providers based on the volume of services delivered, with bonuses tied to patient
volume growth.
B. Value-based care holds providers accountable for both the cost and quality of care delivered to a
defined population across the continuum. *[CORRECT]*
C. Value-based care eliminates all financial risk for providers by guaranteeing fixed payments regardless of
outcomes.
D. Value-based care restricts clinical decisions to a single standardized pathway for every patient regardless of
preference.
Correct Answer: B
Rationale
Value-based care (VBC) is defined as a delivery model in which providers, including health systems and payers, share
accountability for both the total cost of care and the quality outcomes for a defined population across the continuum. The
other options describe common misconceptions: paying for volume is fee-for-service (A), eliminating all financial risk
contradicts the shared-risk principle (C), and standardizing all care regardless of preference violates patient-centeredness
(D). The WGU D026 PowerPoint emphasizes the shift from volume to value as the central tenet of the value-based care
transformation.
WGU D026 • Quality Outcomes in a Culture of Value-Based Nursing Care • 2026/2027 Edition Page 3
, D026 • Comprehensive Examination — Complete Solutions
*Q2:* A primary care clinic operating under fee-for-service reimbursement is being compared with a
clinic participating in a Medicare Accountable Care Organization (ACO). Which contrast best reflects
the structural difference between the two models?
A. Both models reward the volume of services, but the ACO adds a quality bonus on top of fee-for-service
payments.
B. Fee-for-service incentivizes service volume and duplication, while the ACO links payment to quality,
cost, and population outcomes through shared savings. *[CORRECT]*
C. Fee-for-service shifts financial risk to payers, while the ACO shifts all financial risk to individual clinicians.
D. Both models use bundled payments, but the ACO adds a per-member-per-month capitation fee.
Correct Answer: B
Rationale
Fee-for-service (FFS) reimbursement rewards volume, encouraging duplication and overuse, whereas an Accountable Care
Organization (ACO) links payment to quality and total cost performance, often through shared savings if quality and cost
benchmarks are met. Option A mischaracterizes ACOs as merely FFS plus a bonus. Option C is incorrect because ACOs
share—not solely transfer—risk. Option D is wrong because bundled payments and capitation are distinct models not
intrinsic to either FFS or the ACO comparison. The WGU D026 PowerPoint frames this contrast as the central economic
driver of the volume-to-value transition.
*Q3:* When teaching new graduate nurses about the Institute for Healthcare Improvement (IHI) Triple
Aim, which set of three objectives must the nurse include?
A. Better patient experience, better clinician experience, and lower per-capita cost.
B. Better population health, better individual patient experience of care, and lower per-capita cost of care.
*[CORRECT]*
C. Higher service volume, greater patient throughput, and reduced operating margins.
D. Improved technology adoption, increased market share, and lower labor costs.
Correct Answer: B
Rationale
The IHI Triple Aim comprises three interdependent objectives: improving the health of populations, improving the
experience of care for individuals, and reducing per-capita cost of care. Option A describes the Quadruple Aim (which
adds clinician well-being). Options C and D reflect business-efficiency metrics that are not part of the Triple Aim
framework. The WGU D026 curriculum emphasizes that the Triple Aim provides the conceptual foundation for
value-based care and population health management.
*Q4:* A medical-surgical unit has experienced rising rates of nurse burnout, increased absenteeism, and
turnover above the national average. Nurse leaders are revising their value-based care strategy.
According to the Quadruple Aim, which element must be added to the Triple Aim to address this
situation effectively?
A. Improving the experience of the healthcare workforce, including burnout reduction and well-being.
*[CORRECT]*
B. Increasing the deployment of advanced technology at the bedside to reduce documentation burden.
C. Achieving financial profitability to fund additional nursing positions.
D. Standardizing clinical pathways to reduce variation in nurse workload.
Correct Answer: A
WGU D026 • Quality Outcomes in a Culture of Value-Based Nursing Care • 2026/2027 Edition Page 4
