WGU D439 Foundations of Nursing Complete OA Prep Bundle 2026/2027 | 160 NCLEX-Style Questions + Study Review with Rationales | INSTANT PDF DOWNLOAD

WGU D439 Foundations of Nursing Complete OA Prep
Bundle 2026/2027 | 160 NCLEX-Style Questions + Study
Review with Rationales | INSTANT PDF DOWNLOAD
WGU D439 Foundations of Nursing OA Prep Bundle. This resource contains 160 NCLEX-style questions
covering care planning, legal and ethical nursing, infection prevention, therapeutic communication, and
evidence-based nursing care. Use this exam to master foundational nursing concepts and prepare for your
objective assessment.
Key Topics Covered
• Care Planning – Nursing process (ADPIE), SMART goals, prioritization (ABCs, Maslow), delegation,
documentation, discharge planning
• Legal & Ethical Nursing – Informed consent, advance directives, HIPAA, patient rights,
negligence/malpractice, ethical principles (autonomy, beneficence, non-maleficence, justice)
• Infection Prevention – Hand hygiene, standard/transmission-based precautions (contact, droplet,
airborne), PPE, sterile technique, isolation
• Communication – Therapeutic communication techniques, SBAR, handoff reporting, patient education,
health literacy, teach-back
• Evidence-Based Nursing Care – Critical thinking, clinical judgment, quality improvement, patient safety
(falls, restraints), pressure injury prevention, medication safety


Questions 1–160
1. A nurse is developing a care plan for a client with impaired mobility. Which SMART goal is most
appropriate?
A) “Client will walk by discharge.”

,B) “Client will ambulate 50 feet with a walker without assistance within 3 days.”
C) “Client will improve mobility.”
D) “Client will use a wheelchair.”
Answer B: “Client will ambulate 50 feet with a walker without assistance within 3 days.”
Rationale: Specific, measurable, attainable, realistic, time-bound (SMART). Walking “with a walker” is
realistic.




2. A client refuses a prescribed blood transfusion due to religious beliefs. The nurse respects the
refusal. This is an example of which ethical principle?
A) Beneficence
B) Autonomy
C) Non-maleficence
D) Justice
Answer B: Autonomy
Rationale: Autonomy respects the client’s right to make their own healthcare decisions.




3. A nurse is caring for a client with methicillin-resistant Staphylococcus aureus (MRSA) in a wound.
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: MRSA is spread by direct contact; use gown and gloves. Contact precautions are required.




4. A nurse receives a telephone order from a provider for a new medication. Which action is most
important to ensure safety?
A) Write the order on a sticky note
B) Repeat the order back to the provider and document it as a telephone order
C) Implement the order immediately
D) Ask the pharmacist to verify the order
Answer B: Repeat the order back to the provider and document it as a telephone order

,Rationale: Read-back verification prevents errors. The order must be signed by the provider within 24
hours.




5. A nurse is caring for a client who is confused and attempting to get out of bed. Which alternative to
restraints should the nurse try first?
A) Apply a vest restraint
B) Use a bed alarm and keep the bed in the lowest position
C) Administer a sedative
D) Raise all side rails
Answer B: Use a bed alarm and keep the bed in the lowest position
Rationale: Least restrictive measures include bed alarms and low beds. Restraints require an order.




6. A nurse is teaching a client about a new medication. The client is able to state the purpose and side
effects. This demonstrates learning in which domain?
A) Affective
B) Cognitive
C) Psychomotor
D) Behavioral
Answer B: Cognitive
Rationale: Cognitive domain involves knowledge and recall of information.




7. A nurse is preparing to delegate a task to a UAP. Which task is appropriate?
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: UAPs can measure I&O. Assessment, tube feedings, and sterile dressings require licensed staff.




8. A client with a new colostomy tells the nurse, “I feel disgusting.” Which response is most
therapeutic?
A) “You shouldn’t feel that way; it’s a life-saving surgery.”

, B) “It sounds like you are having a difficult time adjusting. Tell me more about your concerns.”
C) “Don’t worry, you’ll get used to it.”
D) “Why do you feel disgusting?”
Answer B: “It sounds like you are having a difficult time adjusting. Tell me more about your
concerns.”
Rationale: Validates the feeling and encourages expression. Avoid false reassurance and “why” questions.




9. A nurse is discharging a client with a new prescription for warfarin. Which statement indicates a
need for further teaching?
A) “I will use a soft toothbrush.”
B) “I will avoid contact sports.”
C) “I will take ibuprofen for headaches.”
D) “I will have my INR checked regularly.”
Answer C: “I will take ibuprofen for headaches.”
Rationale: NSAIDs increase bleeding risk with warfarin. Acetaminophen is safer.




10. A nurse is preparing to administer a blood transfusion. Which action is essential to prevent a
hemolytic reaction?
A) Premedicate with acetaminophen
B) Verify the client’s identity and blood product with another nurse
C) Warm the blood in a microwave
D) Use a blood filter for all units
Answer B: Verify the client’s identity and blood product with another nurse
Rationale: Two-nurse verification prevents ABO incompatibility, the most common cause of hemolytic
reaction.




11. A nurse is caring for a client with a pressure injury. Which nursing intervention is most important
for wound healing?
A) Keep the wound dry
B) Reposition the client every 2 hours
C) Massage the surrounding area
D) Use a donut-shaped cushion
Answer B: Reposition the client every 2 hours