WGU D439 Foundations of Nursing OA Practice Exam
2026/2027 | 200 NCLEX-Style Questions with Verified
Answers & Rationales | INSTANT PDF DOWNLOAD
WGU D439 Foundations of Nursing practice exam. This resource contains 200 NCLEX-style questions
covering the nursing process, patient safety, infection control, therapeutic communication, ethics, and basic
clinical judgment. Each question includes the correct answer and a rationale. Use this exam to prepare for
your objective assessment and strengthen foundational nursing concepts.
Key Topics Covered
• Nursing Process – Assessment, diagnosis, planning, implementation, evaluation; ADPIE, prioritization
(Maslow, ABCs)
• Patient Safety – Fall prevention, restraints, medical errors, sentinel events, fire safety, safe medication
administration
• Infection Control – Hand hygiene, standard/transmission-based precautions (contact, droplet, airborne),
PPE, sterile technique
• Therapeutic Communication – Active listening, empathy, open-ended questions, therapeutic vs non-
therapeutic responses, defense mechanisms
• Ethics & Legal – Informed consent, advance directives, HIPAA, confidentiality, patient rights, negligence,
malpractice, ethical principles (autonomy, beneficence, justice, non-maleficence)
• Basic Clinical Judgment – Prioritization, delegation (RN, LPN, UAP), critical thinking, clinical reasoning
Questions 1–200
1. A nurse is caring for a client who is post-operative day 1 after abdominal surgery. Which finding
requires immediate action?
,A) Client reports pain 5/10
B) Temperature 38.9°C (102°F) with chills
C) Blood pressure 110/70 mmHg
D) Client requests pain medication
Answer B: Temperature 38.9°C (102°F) with chills
Rationale: Fever with chills post-op may indicate sepsis; assess and notify provider. Pain is lower priority.
2. A nurse is preparing to insert a urinary catheter. Which action is most important to prevent
infection?
A) Use a large-bore catheter
B) Use sterile technique throughout
C) Lubricate the catheter with petroleum jelly
D) Deflate the balloon before insertion
Answer B: Use sterile technique throughout
Rationale: Maintaining sterile technique prevents introduction of bacteria into the bladder. Petroleum jelly
can damage latex.
3. A client with a history of falls is being discharged home. Which intervention should the nurse
include in the discharge plan?
A) Keep the room completely dark at night
B) Remove loose rugs and clutter
C) Use smooth-soled socks for walking
D) Limit fluid intake to reduce bathroom trips
Answer B: Remove loose rugs and clutter
Rationale: Removing tripping hazards reduces fall risk. Night lights and non-slip footwear are also
recommended.
4. A nurse is using therapeutic communication with a client who is anxious. Which statement is most
appropriate?
A) “Don’t worry, everything will be fine.”
B) “Tell me more about what is making you feel anxious.”
C) “You should calm down now.”
D) “Why are you so upset?”
,Answer B: “Tell me more about what is making you feel anxious.”
Rationale: Open-ended questions encourage expression of feelings. False reassurance and “why” questions
are non-therapeutic.
5. A client refuses a life-saving blood transfusion due to religious beliefs. The nurse’s first action
should be to:
A) Notify the hospital attorney
B) Respect the client’s decision and notify the provider
C) Administer the transfusion under emergency consent
D) Ask the family to override the decision
Answer B: Respect the client’s decision and notify the provider
Rationale: A competent adult has the right to refuse treatment based on religious beliefs (autonomy). Notify
provider for alternative care.
6. A nurse is caring for a client with Clostridium difficile infection. Which type of precautions should
the nurse implement?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
Answer C: Contact precautions
Rationale: C. diff is transmitted via spores through contact; use gloves, gown, and hand hygiene with soap
and water (alcohol ineffective).
7. A nurse is delegating tasks to a UAP. Which task is appropriate to delegate?
A) Assess a client’s pain level
B) Measure a client’s intake and output
C) Administer a tube feeding
D) Change a sterile dressing
Answer B: Measure a client’s intake and output
Rationale: I&O measurement is within UAP scope. Assessment, tube feedings, and sterile dressings require
licensed staff.
, 8. A client with dementia is wandering the unit at night. Which safety measure should the nurse
implement first?
A) Apply soft wrist restraints
B) Provide a low-stimulation environment and redirect the client
C) Administer a sedative
D) Place the client in seclusion
Answer B: Provide a low-stimulation environment and redirect the client
Rationale: Least restrictive interventions first: redirection, orientation, and a calm environment. Restraints
are a last resort.
9. A nurse discovers a small fire in a client’s room. What is the first action?
A) Pull the fire alarm
B) Rescue the client from the room
C) Extinguish the fire
D) Close the door to contain smoke
Answer B: Rescue the client from the room
Rationale: RACE: Rescue, Alarm, Contain, Extinguish. Move the client to safety first.
10. Which ethical principle is violated when a nurse fails to provide prescribed pain medication to a
client in severe pain?
A) Autonomy
B) Beneficence
C) Justice
D) Fidelity
Answer B: Beneficence
Rationale: Beneficence requires acting in the best interest of the client. Withholding pain medication causes
harm, violating beneficence.
11. A nurse is preparing to administer a medication. Which action is part of the “rights” of medication
administration?
A) Right room number
B) Right dose
2026/2027 | 200 NCLEX-Style Questions with Verified
Answers & Rationales | INSTANT PDF DOWNLOAD
WGU D439 Foundations of Nursing practice exam. This resource contains 200 NCLEX-style questions
covering the nursing process, patient safety, infection control, therapeutic communication, ethics, and basic
clinical judgment. Each question includes the correct answer and a rationale. Use this exam to prepare for
your objective assessment and strengthen foundational nursing concepts.
Key Topics Covered
• Nursing Process – Assessment, diagnosis, planning, implementation, evaluation; ADPIE, prioritization
(Maslow, ABCs)
• Patient Safety – Fall prevention, restraints, medical errors, sentinel events, fire safety, safe medication
administration
• Infection Control – Hand hygiene, standard/transmission-based precautions (contact, droplet, airborne),
PPE, sterile technique
• Therapeutic Communication – Active listening, empathy, open-ended questions, therapeutic vs non-
therapeutic responses, defense mechanisms
• Ethics & Legal – Informed consent, advance directives, HIPAA, confidentiality, patient rights, negligence,
malpractice, ethical principles (autonomy, beneficence, justice, non-maleficence)
• Basic Clinical Judgment – Prioritization, delegation (RN, LPN, UAP), critical thinking, clinical reasoning
Questions 1–200
1. A nurse is caring for a client who is post-operative day 1 after abdominal surgery. Which finding
requires immediate action?
,A) Client reports pain 5/10
B) Temperature 38.9°C (102°F) with chills
C) Blood pressure 110/70 mmHg
D) Client requests pain medication
Answer B: Temperature 38.9°C (102°F) with chills
Rationale: Fever with chills post-op may indicate sepsis; assess and notify provider. Pain is lower priority.
2. A nurse is preparing to insert a urinary catheter. Which action is most important to prevent
infection?
A) Use a large-bore catheter
B) Use sterile technique throughout
C) Lubricate the catheter with petroleum jelly
D) Deflate the balloon before insertion
Answer B: Use sterile technique throughout
Rationale: Maintaining sterile technique prevents introduction of bacteria into the bladder. Petroleum jelly
can damage latex.
3. A client with a history of falls is being discharged home. Which intervention should the nurse
include in the discharge plan?
A) Keep the room completely dark at night
B) Remove loose rugs and clutter
C) Use smooth-soled socks for walking
D) Limit fluid intake to reduce bathroom trips
Answer B: Remove loose rugs and clutter
Rationale: Removing tripping hazards reduces fall risk. Night lights and non-slip footwear are also
recommended.
4. A nurse is using therapeutic communication with a client who is anxious. Which statement is most
appropriate?
A) “Don’t worry, everything will be fine.”
B) “Tell me more about what is making you feel anxious.”
C) “You should calm down now.”
D) “Why are you so upset?”
,Answer B: “Tell me more about what is making you feel anxious.”
Rationale: Open-ended questions encourage expression of feelings. False reassurance and “why” questions
are non-therapeutic.
5. A client refuses a life-saving blood transfusion due to religious beliefs. The nurse’s first action
should be to:
A) Notify the hospital attorney
B) Respect the client’s decision and notify the provider
C) Administer the transfusion under emergency consent
D) Ask the family to override the decision
Answer B: Respect the client’s decision and notify the provider
Rationale: A competent adult has the right to refuse treatment based on religious beliefs (autonomy). Notify
provider for alternative care.
6. A nurse is caring for a client with Clostridium difficile infection. Which type of precautions should
the nurse implement?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
Answer C: Contact precautions
Rationale: C. diff is transmitted via spores through contact; use gloves, gown, and hand hygiene with soap
and water (alcohol ineffective).
7. A nurse is delegating tasks to a UAP. Which task is appropriate to delegate?
A) Assess a client’s pain level
B) Measure a client’s intake and output
C) Administer a tube feeding
D) Change a sterile dressing
Answer B: Measure a client’s intake and output
Rationale: I&O measurement is within UAP scope. Assessment, tube feedings, and sterile dressings require
licensed staff.
, 8. A client with dementia is wandering the unit at night. Which safety measure should the nurse
implement first?
A) Apply soft wrist restraints
B) Provide a low-stimulation environment and redirect the client
C) Administer a sedative
D) Place the client in seclusion
Answer B: Provide a low-stimulation environment and redirect the client
Rationale: Least restrictive interventions first: redirection, orientation, and a calm environment. Restraints
are a last resort.
9. A nurse discovers a small fire in a client’s room. What is the first action?
A) Pull the fire alarm
B) Rescue the client from the room
C) Extinguish the fire
D) Close the door to contain smoke
Answer B: Rescue the client from the room
Rationale: RACE: Rescue, Alarm, Contain, Extinguish. Move the client to safety first.
10. Which ethical principle is violated when a nurse fails to provide prescribed pain medication to a
client in severe pain?
A) Autonomy
B) Beneficence
C) Justice
D) Fidelity
Answer B: Beneficence
Rationale: Beneficence requires acting in the best interest of the client. Withholding pain medication causes
harm, violating beneficence.
11. A nurse is preparing to administer a medication. Which action is part of the “rights” of medication
administration?
A) Right room number
B) Right dose
