WGU D439 — Foundations of Nursing OA (Objective Assessment) 2026 Update | 109 Questions | 100 pts
WGU D439 FOUNDATIONS OF NURSING
OA OBJECTIVE ASSESSMENT | 109 QUESTIONS AND ANSWERS | 2026 UPDATE | 100%
CORRECT
Western Governors University • Foundations of Nursing (D439)
Aligned with 2026 | 2027 academic standards • ADPIE · Safety · Basic Skills · Ethics
Questions 109 multiple-choice (4 sections) Time (suggested) 150 minutes
Points 100 (~0.92 pts per question) Passing ≥ 70 (Competent)
Cognitive Mix 30% recall · 50% application · 20% analysis Format 75% scenario / 25% direct
Examination Instructions
This Objective Assessment mirrors the structure, rigor, and scenario-based application style of the actual WGU
D439 Foundations of Nursing OA. Each question presents four options (A–D) with exactly one correct answer.
Rationales include step-by-step clinical justifications grounded in the nursing process (ADPIE), the NGN
Clinical Judgment Measurement Model (CJMM), National Patient Safety Goals (NPSGs), infection-control
standards, basic nursing skills, therapeutic communication, and legal/ethical principles. Distractors represent
plausible but clinically inappropriate actions, out-of-scope delegation choices, or subtle violations of aseptic
technique. Section 4 integrates 2026|2027 modern contexts: AI-assisted clinical documentation, telehealth
nursing fundamentals, updated NGN scoring, and contemporary ethical frameworks in digital healthcare.
Section 1: Nursing Process (ADPIE), Clinical Judgment, & Fundamentals of Care
(Q1–Q28)
ADPIE steps; NANDA-I PES diagnoses; NGN CJMM layers; prioritization (ABC, Maslow); 5 Rights of Delegation;
SMART goals; independent/dependent interventions; care-plan revision; documentation formats (DAR, SOAP).
Q1. Which step of the nursing process (ADPIE) involves establishing measurable, patient-centered goals and
outcomes?
A. Planning [CORRECT]
B. Assessment
C. Diagnosis
D. Evaluation
Correct Answer: A — Planning
Rationale: Planning is where the nurse sets measurable, patient-centered goals/outcomes and a care plan.
Assessment collects data; diagnosis identifies problems; evaluation measures goal achievement.
Q2. During assessment, the nurse observes a patient's pallor and records it. This is an example of:
A. Subjective data
B. Objective data [CORRECT]
C. A nursing diagnosis
D. An intervention
Correct Answer: B — Objective data
Rationale: Objective data are observable/measurable ('signs') like pallor. Subjective data are patient-reported
('symptoms'); diagnosis and intervention are later ADPIE steps.
Western Governors University • Confidential OA Study Tool Page 1
,WGU D439 — Foundations of Nursing OA (Objective Assessment) 2026 Update | 109 Questions | 100 pts
Q3. A patient states, 'I'm in pain.' This information is best documented as:
A. Subjective data [CORRECT]
B. Objective data
C. A medical diagnosis
D. An evaluation outcome
Correct Answer: A — Subjective data
Rationale: Patient-reported statements are subjective data. Objective data are observed; medical diagnosis is
physician-determined; evaluation compares to goals.
Q4. A NANDA-I nursing diagnosis is best described as:
A. A clinical judgment about actual/potential health problems a nurse is licensed to treat [CORRECT]
B. A medical disease classification
C. A physician's diagnostic statement
D. A laboratory test result
Correct Answer: A — A clinical judgment about actual/potential health problems a nurse is licensed to
treat
Rationale: A nursing diagnosis (NANDA-I) is a clinical judgment about a human response the nurse treats. B/C
describe medical diagnoses; D is diagnostic data.
Q5. Which is a correctly written nursing diagnosis using the PES format?
A. Acute Pain r/t surgical incision AEB patient rating 7/10 and grimacing [CORRECT]
B. Acute Pain
C. Pain from surgery
D. Patient is in pain
Correct Answer: A — Acute Pain r/t surgical incision AEB patient rating 7/10 and grimacing
Rationale: PES = Problem (P) related-to (r/t) Etiology (E) as evidenced-by (AEB) Signs/symptoms (S). Only A
includes all three components.
Q6. Which prioritization framework should the nurse apply first when triaging multiple patients?
A. ABC (Airway, Breathing, Circulation) [CORRECT]
B. Maslow's hierarchy
C. FIFO (first-in, first-out)
D. Alphabetical by name
Correct Answer: A — ABC (Airway, Breathing, Circulation)
Rationale: ABC addresses life threats first (airway/breathing/circulation). Maslow is useful after life threats are ruled
out; FIFO/alphabetical are not clinical prioritization frameworks.
Q7. Using Maslow's hierarchy, which patient need should the nurse address first?
A. Physiological needs (e.g., oxygenation) [CORRECT]
B. Self-esteem needs
C. Love and belonging needs
D. Self-actualization needs
Correct Answer: A — Physiological needs (e.g., oxygenation)
Rationale: Physiological needs sit at the base of Maslow's hierarchy and take priority over higher-level needs. B/C/D
are higher-level needs addressed after physiological stability.
Q8. In the NGN Clinical Judgment Measurement Model (CJMM), which is the first layer?
Western Governors University • Confidential OA Study Tool Page 2
, WGU D439 — Foundations of Nursing OA (Objective Assessment) 2026 Update | 109 Questions | 100 pts
A. Recognize Cues [CORRECT]
B. Take Action
C. Evaluate Outcomes
D. Analyze Cues
Correct Answer: A — Recognize Cues
Rationale: The NGN CJMM begins with Recognize Cues (identify relevant data), followed by Analyze Cues, Prioritize
Hypotheses, Generate Solutions, Take Action, Evaluate Outcomes.
Q9. The correct sequence of the nursing process is:
A. Assessment, Diagnosis, Planning, Implementation, Evaluation [CORRECT]
B. Diagnosis, Assessment, Planning, Evaluation, Implementation
C. Planning, Assessment, Diagnosis, Implementation, Evaluation
D. Assessment, Planning, Diagnosis, Evaluation, Implementation
Correct Answer: A — Assessment, Diagnosis, Planning, Implementation, Evaluation
Rationale: ADPIE = Assessment → Diagnosis → Planning → Implementation → Evaluation. Any other ordering
missequences the process.
Q10. A short-term goal is best defined as one expected to be achieved within:
A. Hours to a few days (typically within the shift or a few days) [CORRECT]
B. Months to years
C. After discharge only
D. Five years
Correct Answer: A — Hours to a few days (typically within the shift or a few days)
Rationale: Short-term goals are met within hours to a few days, often during the current admission. B/D are
long-term; C is post-discharge planning.
Q11. Which action by the nurse represents the 'Implementation' step of the nursing process?
A. Administering prescribed analgesic for reported pain [CORRECT]
B. Reassessing pain after medication
C. Writing a care plan
D. Identifying a nursing diagnosis
Correct Answer: A — Administering prescribed analgesic for reported pain
Rationale: Implementation = carrying out interventions (administering the analgesic). B is evaluation; C is planning; D
is diagnosis.
Q12. The 'Evaluation' step of the nursing process primarily involves:
A. Comparing patient outcomes against the established goals [CORRECT]
B. Collecting new admission data
C. Writing new diagnoses
D. Delegating care
Correct Answer: A — Comparing patient outcomes against the established goals
Rationale: Evaluation compares actual outcomes to the goals to determine effectiveness. B is assessment; C is
diagnosis; D is implementation.
Q13. Which outcome is written in SMART format for a postoperative patient?
A. Patient will ambulate 100 feet in hallway by post-op day 2 with no assistive device [CORRECT]
B. Patient will feel better
Western Governors University • Confidential OA Study Tool Page 3
WGU D439 FOUNDATIONS OF NURSING
OA OBJECTIVE ASSESSMENT | 109 QUESTIONS AND ANSWERS | 2026 UPDATE | 100%
CORRECT
Western Governors University • Foundations of Nursing (D439)
Aligned with 2026 | 2027 academic standards • ADPIE · Safety · Basic Skills · Ethics
Questions 109 multiple-choice (4 sections) Time (suggested) 150 minutes
Points 100 (~0.92 pts per question) Passing ≥ 70 (Competent)
Cognitive Mix 30% recall · 50% application · 20% analysis Format 75% scenario / 25% direct
Examination Instructions
This Objective Assessment mirrors the structure, rigor, and scenario-based application style of the actual WGU
D439 Foundations of Nursing OA. Each question presents four options (A–D) with exactly one correct answer.
Rationales include step-by-step clinical justifications grounded in the nursing process (ADPIE), the NGN
Clinical Judgment Measurement Model (CJMM), National Patient Safety Goals (NPSGs), infection-control
standards, basic nursing skills, therapeutic communication, and legal/ethical principles. Distractors represent
plausible but clinically inappropriate actions, out-of-scope delegation choices, or subtle violations of aseptic
technique. Section 4 integrates 2026|2027 modern contexts: AI-assisted clinical documentation, telehealth
nursing fundamentals, updated NGN scoring, and contemporary ethical frameworks in digital healthcare.
Section 1: Nursing Process (ADPIE), Clinical Judgment, & Fundamentals of Care
(Q1–Q28)
ADPIE steps; NANDA-I PES diagnoses; NGN CJMM layers; prioritization (ABC, Maslow); 5 Rights of Delegation;
SMART goals; independent/dependent interventions; care-plan revision; documentation formats (DAR, SOAP).
Q1. Which step of the nursing process (ADPIE) involves establishing measurable, patient-centered goals and
outcomes?
A. Planning [CORRECT]
B. Assessment
C. Diagnosis
D. Evaluation
Correct Answer: A — Planning
Rationale: Planning is where the nurse sets measurable, patient-centered goals/outcomes and a care plan.
Assessment collects data; diagnosis identifies problems; evaluation measures goal achievement.
Q2. During assessment, the nurse observes a patient's pallor and records it. This is an example of:
A. Subjective data
B. Objective data [CORRECT]
C. A nursing diagnosis
D. An intervention
Correct Answer: B — Objective data
Rationale: Objective data are observable/measurable ('signs') like pallor. Subjective data are patient-reported
('symptoms'); diagnosis and intervention are later ADPIE steps.
Western Governors University • Confidential OA Study Tool Page 1
,WGU D439 — Foundations of Nursing OA (Objective Assessment) 2026 Update | 109 Questions | 100 pts
Q3. A patient states, 'I'm in pain.' This information is best documented as:
A. Subjective data [CORRECT]
B. Objective data
C. A medical diagnosis
D. An evaluation outcome
Correct Answer: A — Subjective data
Rationale: Patient-reported statements are subjective data. Objective data are observed; medical diagnosis is
physician-determined; evaluation compares to goals.
Q4. A NANDA-I nursing diagnosis is best described as:
A. A clinical judgment about actual/potential health problems a nurse is licensed to treat [CORRECT]
B. A medical disease classification
C. A physician's diagnostic statement
D. A laboratory test result
Correct Answer: A — A clinical judgment about actual/potential health problems a nurse is licensed to
treat
Rationale: A nursing diagnosis (NANDA-I) is a clinical judgment about a human response the nurse treats. B/C
describe medical diagnoses; D is diagnostic data.
Q5. Which is a correctly written nursing diagnosis using the PES format?
A. Acute Pain r/t surgical incision AEB patient rating 7/10 and grimacing [CORRECT]
B. Acute Pain
C. Pain from surgery
D. Patient is in pain
Correct Answer: A — Acute Pain r/t surgical incision AEB patient rating 7/10 and grimacing
Rationale: PES = Problem (P) related-to (r/t) Etiology (E) as evidenced-by (AEB) Signs/symptoms (S). Only A
includes all three components.
Q6. Which prioritization framework should the nurse apply first when triaging multiple patients?
A. ABC (Airway, Breathing, Circulation) [CORRECT]
B. Maslow's hierarchy
C. FIFO (first-in, first-out)
D. Alphabetical by name
Correct Answer: A — ABC (Airway, Breathing, Circulation)
Rationale: ABC addresses life threats first (airway/breathing/circulation). Maslow is useful after life threats are ruled
out; FIFO/alphabetical are not clinical prioritization frameworks.
Q7. Using Maslow's hierarchy, which patient need should the nurse address first?
A. Physiological needs (e.g., oxygenation) [CORRECT]
B. Self-esteem needs
C. Love and belonging needs
D. Self-actualization needs
Correct Answer: A — Physiological needs (e.g., oxygenation)
Rationale: Physiological needs sit at the base of Maslow's hierarchy and take priority over higher-level needs. B/C/D
are higher-level needs addressed after physiological stability.
Q8. In the NGN Clinical Judgment Measurement Model (CJMM), which is the first layer?
Western Governors University • Confidential OA Study Tool Page 2
, WGU D439 — Foundations of Nursing OA (Objective Assessment) 2026 Update | 109 Questions | 100 pts
A. Recognize Cues [CORRECT]
B. Take Action
C. Evaluate Outcomes
D. Analyze Cues
Correct Answer: A — Recognize Cues
Rationale: The NGN CJMM begins with Recognize Cues (identify relevant data), followed by Analyze Cues, Prioritize
Hypotheses, Generate Solutions, Take Action, Evaluate Outcomes.
Q9. The correct sequence of the nursing process is:
A. Assessment, Diagnosis, Planning, Implementation, Evaluation [CORRECT]
B. Diagnosis, Assessment, Planning, Evaluation, Implementation
C. Planning, Assessment, Diagnosis, Implementation, Evaluation
D. Assessment, Planning, Diagnosis, Evaluation, Implementation
Correct Answer: A — Assessment, Diagnosis, Planning, Implementation, Evaluation
Rationale: ADPIE = Assessment → Diagnosis → Planning → Implementation → Evaluation. Any other ordering
missequences the process.
Q10. A short-term goal is best defined as one expected to be achieved within:
A. Hours to a few days (typically within the shift or a few days) [CORRECT]
B. Months to years
C. After discharge only
D. Five years
Correct Answer: A — Hours to a few days (typically within the shift or a few days)
Rationale: Short-term goals are met within hours to a few days, often during the current admission. B/D are
long-term; C is post-discharge planning.
Q11. Which action by the nurse represents the 'Implementation' step of the nursing process?
A. Administering prescribed analgesic for reported pain [CORRECT]
B. Reassessing pain after medication
C. Writing a care plan
D. Identifying a nursing diagnosis
Correct Answer: A — Administering prescribed analgesic for reported pain
Rationale: Implementation = carrying out interventions (administering the analgesic). B is evaluation; C is planning; D
is diagnosis.
Q12. The 'Evaluation' step of the nursing process primarily involves:
A. Comparing patient outcomes against the established goals [CORRECT]
B. Collecting new admission data
C. Writing new diagnoses
D. Delegating care
Correct Answer: A — Comparing patient outcomes against the established goals
Rationale: Evaluation compares actual outcomes to the goals to determine effectiveness. B is assessment; C is
diagnosis; D is implementation.
Q13. Which outcome is written in SMART format for a postoperative patient?
A. Patient will ambulate 100 feet in hallway by post-op day 2 with no assistive device [CORRECT]
B. Patient will feel better
Western Governors University • Confidential OA Study Tool Page 3
