WGU D659 Objective Assessment
ACTUAL EXAM 2026/2027 | WGU
D659 OA | Verified Q&A | Pass
Guaranteed - A+ Graded
Section A: Multiple Choice (Questions 1–50)
Q1: A charge nurse on a busy medical-surgical unit notices that two staff nurses are arguing loudly at the
nurses' station about patient assignment fairness. Other staff and visitors are observing the conflict.
What is the charge nurse's best initial action?
A. Ignore the conflict and allow the nurses to resolve it independently
B. Privately address both nurses, acknowledge the concern, and facilitate a solution-focused discussion
[CORRECT]
C. Immediately reassign both nurses to different units
D. Document the incident for human resources without intervening
Correct Answer: B
Rationale: Effective nurse leaders address conflict promptly and directly while maintaining
professionalism and psychological safety. Privately acknowledging concerns and facilitating solution-
focused discussion aligns with WGU's intrapersonal leadership competency and ANA standards for nurse
administrators, which emphasize emotional intelligence, constructive conflict resolution, and creating
collaborative work environments
.
Q2: A nurse manager is implementing a quality improvement project to reduce hospital-acquired
pressure injuries. Which action best demonstrates application of the QSEN safety competency?
A. Assigning one nurse to monitor all high-risk patients
B. Analyzing incident data, identifying system gaps, and implementing evidence-based prevention
protocols [CORRECT]
,C. Increasing documentation requirements without staff input
D. Purchasing new equipment without evaluating current processes
Correct Answer: B
Rationale: The QSEN safety competency requires nurses to minimize risk of harm through system-level
effectiveness and individual performance. Analyzing data, identifying root causes, and implementing
evidence-based protocols reflects the WGU competency of using outcome data for improvement and
aligns with AONL standards for quality and safety leadership
.
Q3: A home health nurse is visiting a client with diabetes who lives in a rural area with limited access to
fresh food. The client's HbA1c is 9.2%. Which community health nursing intervention is most
appropriate?
A. Refer the client to an endocrinologist in the nearest city
B. Assess social determinants of health and connect the client with local food assistance and telehealth
resources [CORRECT]
C. Increase the client's insulin dose independently
D. Advise the client to move to an urban area for better care
Correct Answer: B
Rationale: Community health nursing addresses social determinants of health and leverages local
resources to improve outcomes. Connecting vulnerable rural clients with food assistance and telehealth
reflects WGU's global and population health competency, which emphasizes understanding healthcare
access, quality, and costs for diverse populations
.
Q4: A nurse discovers that a colleague has posted a patient's laboratory results on a social media
platform without identifying information. Which legal principle has been violated?
A. The Health Insurance Portability and Accountability Act (HIPAA) [CORRECT]
B. The Americans with Disabilities Act (ADA)
C. The Nurse Practice Act
D. The Patient Self-Determination Act
Correct Answer: A
Rationale: HIPAA protects all individually identifiable health information, including laboratory results,
regardless of whether direct identifiers are removed. Posting any protected health information on social
, media constitutes an unauthorized disclosure and violates HIPAA's Privacy Rule, which carries significant
civil and criminal penalties for healthcare professionals
.
Q5: A nurse leader is conducting a root cause analysis (RCA) after a patient fall resulting in a hip fracture.
Which step represents the most appropriate application of RCA principles?
A. Identifying the nurse assigned to the patient as the primary cause
B. Analyzing system factors such as staffing levels, call light accessibility, and environmental hazards
[CORRECT]
C. Implementing a new policy without investigating contributing factors
D. Filing an incident report and concluding the investigation
Correct Answer: B
Rationale: RCA focuses on system-level causes rather than individual blame. Analyzing staffing,
equipment, and environmental factors identifies underlying process failures that can be corrected to
prevent recurrence. This aligns with WGU's organizational systems competency and the Joint
Commission's RCA framework, which emphasizes system improvement over punitive approaches
.
Q6: A nurse is caring for a patient who has a living will stating "no heroic measures" and now requires
intubation for respiratory failure. The patient's adult child demands that "everything be done." What is
the nurse's best action?
A. Intubate the patient immediately per the family's request
B. Honor the living will, notify the provider, and facilitate a family meeting with ethics consultation if
needed [CORRECT]
C. Ignore the advance directive and follow the family's wishes
D. Transfer the patient to another facility
Correct Answer: B
Rationale: Advance directives are legally binding documents that express patient autonomy regarding
end-of-life care. Nurses must honor valid living wills, support family understanding through
communication, and involve ethics consultation when conflicts arise. This reflects WGU's ethical
competency and the ANA Code of Ethics, which prioritizes patient self-determination
.
ACTUAL EXAM 2026/2027 | WGU
D659 OA | Verified Q&A | Pass
Guaranteed - A+ Graded
Section A: Multiple Choice (Questions 1–50)
Q1: A charge nurse on a busy medical-surgical unit notices that two staff nurses are arguing loudly at the
nurses' station about patient assignment fairness. Other staff and visitors are observing the conflict.
What is the charge nurse's best initial action?
A. Ignore the conflict and allow the nurses to resolve it independently
B. Privately address both nurses, acknowledge the concern, and facilitate a solution-focused discussion
[CORRECT]
C. Immediately reassign both nurses to different units
D. Document the incident for human resources without intervening
Correct Answer: B
Rationale: Effective nurse leaders address conflict promptly and directly while maintaining
professionalism and psychological safety. Privately acknowledging concerns and facilitating solution-
focused discussion aligns with WGU's intrapersonal leadership competency and ANA standards for nurse
administrators, which emphasize emotional intelligence, constructive conflict resolution, and creating
collaborative work environments
.
Q2: A nurse manager is implementing a quality improvement project to reduce hospital-acquired
pressure injuries. Which action best demonstrates application of the QSEN safety competency?
A. Assigning one nurse to monitor all high-risk patients
B. Analyzing incident data, identifying system gaps, and implementing evidence-based prevention
protocols [CORRECT]
,C. Increasing documentation requirements without staff input
D. Purchasing new equipment without evaluating current processes
Correct Answer: B
Rationale: The QSEN safety competency requires nurses to minimize risk of harm through system-level
effectiveness and individual performance. Analyzing data, identifying root causes, and implementing
evidence-based protocols reflects the WGU competency of using outcome data for improvement and
aligns with AONL standards for quality and safety leadership
.
Q3: A home health nurse is visiting a client with diabetes who lives in a rural area with limited access to
fresh food. The client's HbA1c is 9.2%. Which community health nursing intervention is most
appropriate?
A. Refer the client to an endocrinologist in the nearest city
B. Assess social determinants of health and connect the client with local food assistance and telehealth
resources [CORRECT]
C. Increase the client's insulin dose independently
D. Advise the client to move to an urban area for better care
Correct Answer: B
Rationale: Community health nursing addresses social determinants of health and leverages local
resources to improve outcomes. Connecting vulnerable rural clients with food assistance and telehealth
reflects WGU's global and population health competency, which emphasizes understanding healthcare
access, quality, and costs for diverse populations
.
Q4: A nurse discovers that a colleague has posted a patient's laboratory results on a social media
platform without identifying information. Which legal principle has been violated?
A. The Health Insurance Portability and Accountability Act (HIPAA) [CORRECT]
B. The Americans with Disabilities Act (ADA)
C. The Nurse Practice Act
D. The Patient Self-Determination Act
Correct Answer: A
Rationale: HIPAA protects all individually identifiable health information, including laboratory results,
regardless of whether direct identifiers are removed. Posting any protected health information on social
, media constitutes an unauthorized disclosure and violates HIPAA's Privacy Rule, which carries significant
civil and criminal penalties for healthcare professionals
.
Q5: A nurse leader is conducting a root cause analysis (RCA) after a patient fall resulting in a hip fracture.
Which step represents the most appropriate application of RCA principles?
A. Identifying the nurse assigned to the patient as the primary cause
B. Analyzing system factors such as staffing levels, call light accessibility, and environmental hazards
[CORRECT]
C. Implementing a new policy without investigating contributing factors
D. Filing an incident report and concluding the investigation
Correct Answer: B
Rationale: RCA focuses on system-level causes rather than individual blame. Analyzing staffing,
equipment, and environmental factors identifies underlying process failures that can be corrected to
prevent recurrence. This aligns with WGU's organizational systems competency and the Joint
Commission's RCA framework, which emphasizes system improvement over punitive approaches
.
Q6: A nurse is caring for a patient who has a living will stating "no heroic measures" and now requires
intubation for respiratory failure. The patient's adult child demands that "everything be done." What is
the nurse's best action?
A. Intubate the patient immediately per the family's request
B. Honor the living will, notify the provider, and facilitate a family meeting with ethics consultation if
needed [CORRECT]
C. Ignore the advance directive and follow the family's wishes
D. Transfer the patient to another facility
Correct Answer: B
Rationale: Advance directives are legally binding documents that express patient autonomy regarding
end-of-life care. Nurses must honor valid living wills, support family understanding through
communication, and involve ethics consultation when conflicts arise. This reflects WGU's ethical
competency and the ANA Code of Ethics, which prioritizes patient self-determination
.
