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Nursing
DNCB Dermatology Nurse Certified
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Question 1:
A patient presents with thickened skin and impaired barrier function. Histology reveals abnormal
keratinocyte differentiation. Which epidermal layer is most likely dysfunctional?
A. Stratum basale
B. Stratum spinosum
C. Stratum granulosum
D. Stratum corneum
Answer: D
Explanation: The stratum corneum forms the primary barrier via keratinized cells. Dysfunction
causes barrier defects and thickening
Question 2:
A nurse measures transepidermal water loss (TEWL) in a patient using a vapometer. Normal
TEWL is 10 g/m²/h. The patient’s studying is 35 g/m²/h. Which structural component is most
compromised?
A. Lamellar bodies in stratum granulosum
B. Collagen in papillary dermis
C. Sebum from sebaceous glands
D. Eccrine sweat glands
Answer: A
Explanation: Lamellar bodies secrete lipids that form the permeability barrier. Elevated TEWL
indicates defective lipid matrix in the stratum granulosum
Question 3:
Refer to the diagram of a hair follicle below:
A patient has hair loss localized to the isthmus region. Which phase of the hair cycle is disrupted?
A. Anagen
B. Catagen
C. Telogen
D. Exogen
Answer: B
Explanation: The isthmus marks the regression zone during catagen, where follicular degeneration
[Root Bulb] → [Isthmus] → [Infundibulum]
occurs
Question 4:
A patient with burns has impaired thermoregulation. Calculation shows a 40% reduction in
evaporative cooling. Which gland type is primarily affected?
A. Apocrine
B. Sebaceous
C. Eccrine
D. Mammary
Answer: C
Explanation: Eccrine glands produce sweat for evaporative cooling. Reduced function directly
impairs thermoregulation
Question 5:
A formula for vitamin D synthesis is:
7-dehydrocholesterol UVB Previtamin D3
Which epidermal cell type initiates this process?
A. Langerhans cell
B. Melanocyte
C. Keratinocyte
D. Merkel cell
Answer: C
Explanation: Keratinocytes contain 7-dehydrocholesterol and convert it to previtamin D₃ under
UVB
Question 6:
A biopsy shows fragmented elastin fibers in the reticular dermis. Which mechanical property is
most compromised?
A. Tensile strength
B. Barrier integrity
C. Elastic recoil
D. Adhesion
Answer: C
Explanation: Elastin enables skin recoil after stretching. Fragmentation reduces elasticity
Question 7:
A patient has subcutaneous fat necrosis. Using the formula:
Insulation (clo) = 0.08 × fat thickness (mm)
If fat thickness decreases from 20mm to 5mm, insulation drops by:
A. 0.4 clo
B. 1.2 clo
C. 1.6 clo
D. 2.0 clo
Answer: B
Explanation: Initial insulation = 0.08 × 20 = 1.6 clo. Post-reduction = 0.08 × 5 = 0.4 clo.
Difference = 1.2 clo
Question 8:
A diagram shows a nail unit:
Damage to the matrix would directly affect:
A. Nail plate adhesion
B. Nail growth rate
C. Cuticle integrity
D. Lunula visibility
Answer: B
Explanation: The matrix produces nail plate cells; damage slows growth
Question 9:
A patient has defective sebum production (normal = 2 mg/cm²/day). Sebum’s pH is typically:
A. 3.5–4.5
B. 5.0–6.5
C. 7.0–7.4
D. 8.0–8.5
Answer: B
Explanation: Sebum maintains skin pH at 5.0–6.5, critical for antimicrobial defense
Question 10:
A nurse assesses a pressure injury. The dermal papillae are flattened. Which sensation is most
Matrix → Nail Plate → Hyponychium
diminished?
A. Vibration
B. Light touch
C. Pain
D. Temperature
Answer: B
Explanation: Meissner’s corpuscles in dermal papillae detect light touch. Flattening reduces
sensitivity
Question 11:
A burn patient lacks stratum corneum. Which function is immediately compromised?
A. Vitamin D synthesis
B. Thermosensation
C. Pathogen barrier
D. Hair growth
Answer: C
Explanation: The stratum corneum is the primary physical barrier against pathogens
Question 12:
Refer to a sweat gland diagram:
Blockage at the duct would cause:
A. Reduced sebum production
B. Miliaria crystallina
C. Hyperkeratosis
D. Alopecia
Answer: B
Explanation: Duct obstruction traps sweat, causing miliaria (heat rash)
Question 13:
A patient has a collagen disorder. Collagen constitutes approximately what percentage of the
dermis by dry weight?
A. 25%
Coiled Secretory Unit → Duct → Skin Surface
B. 50%
C. 75%
D. 90%
Answer: C
Explanation: Collagen makes up ~75% of the dermis’ dry weight, providing tensile strength
Question 14:
A formula for skin regeneration is:
Healing rate = Cell cycle time
Total epidermal cells
If cell cycle time increases from 30 to 60 hours, healing rate:
A. Doubles
B. Halves
C. Remains unchanged
D. Quadruples
Answer: B
Explanation: Healing rate is inversely proportional to cell cycle time. Doubling cycle time halves
healing
Question 15:
A patient has no Merkel cells. Which sensation is most affected?
A. Pressure
B. Itch
C. Static touch
D. Vibration
Answer: C
Explanation: Merkel cells detect static touch and texture
Question 16:
A nurse calculates body surface area (BSA. using the Mosteller formula:
BSA = 3600
Height (cm)×Weight (kg)
For a patient (height 170 cm, weight 70 kg), BSA is:
A. 1.73 m²
B. 1.85 m²
C. 1.92 m²
D. 2.05 m²
Answer: A
Explanation: BSA = 3600
170×70 = 3600
11900 = 3.305 ≈ 1.73 m²
Question 17:
A diagram shows a sebaceous gland draining into a hair follicle. Blockage would cause:
A. Anhidrosis
B. Comedone formation
C. Telogen effluvium
D. Onycholysis
Answer: B
Explanation: Sebaceous glands secrete sebum into follicles. Blockage forms comedones
(blackheads/whiteheads)
Question 18:
A patient has impaired apocrine glands. Which function is unaffected?
A. Thermoregulation
B. Pheromone release
C. Axillary odor
D. Emotional sweating
Answer: A
Explanation: Apocrine glands contribute to odor/pheromones but not thermoregulation (eccrine
function)
Question 19:
Using the rule of nines for burns, a patient with full-thickness burns on the entire left arm has:
A. 4.5% BSA
B. 9% BSA
C. 13.5% BSA
D. 18% BSA
Answer: B
Explanation: Each arm represents 9% BSA (4.5% anterior, 4.5% posterior)
Question 20:
A patient lacks subcutaneous fat. Which parameter decreases?
A. Skin pH
B. Vitamin D synthesis
C. Insulative capacity
D. Barrier function
Answer: C
Explanation: Subcutaneous fat provides insulation against heat loss
Question 21:
Refer to a cross-section of the epidermis:
A drug targets rapidly dividing cells. Which layer is affected?
A. Stratum basale
B. Stratum spinosum
C. Stratum granulosum
D. Stratum corneum
Answer: A
Explanation: Stratum basale contains mitotically active stem cells
Question 22:
A patient has hypohidrosis. The nurse measures sweat production at 15 ml/m²/hr (normal: 30–120
ml/m²/hr). Which gland is deficient?
A. Sebaceous
B. Apocrine
C. Eccrine
D. Meibomian
Answer: C
Explanation: Eccrine glands produce thermoregulatory sweat. Hypohidrosis indicates eccrine
dysfunction
Question 23:
A formula for skin protection is:
SPF = UV dose without protection
UV dose with protection
If SPF 30 blocks 96.7% of UVB, the transmitted UVB is:
Stratum Basale → Stratum Spinosum → Stratum Granulosum → Stratum Corneum
A. 0.33%
B. 3.3%
C. 33%
D. 66%
Answer: B
Explanation: SPF 30 blocks 96.7% UVB, so transmitted UVB = 100% – 96.7% = 3.3%
Question 24:
A patient has onychomycosis. Which nail structure is invaded by fungi?
A. Nail bed
B. Lunula
C. Cuticle
D. Hyponychium
Answer: A
Explanation: Fungal infections primarily invade the nail bed (ventral layer)
Question 25:
A nurse uses a dermatoscope. Which dermal feature is visualized?
A. Papillary ridges
B. Subcutaneous fat
C. Arrector pili muscle
D. Eccrine duct
Answer: A
Explanation: Dermatoscopy visualizes papillary ridges (fingerprints) in the dermoepidermal
junction
Question 26:
A patient has defective melanocytes. Which radiation type is most harmful?
A. UVA
B. UVB
C. UVC
D. Infrared
Answer: B
Explanation: Melanin absorbs UVB. Defective melanocytes increase UVB-induced DNA damage
Question 27:
A diagram shows a hair follicle with attached arrector pili muscle. Contraction causes:
A. Sebum release
B. Goosebumps
C. Sweat secretion
D. Vasodilation
Answer: B
Explanation: Arrector pili contraction erects hairs, causing piloerection (goosebumps)
Question 28:
A nurse calculates epidermal turnover time. If basal cell division rate is 0.5/day and epidermal
thickness is 0.1 mm, turnover time is:
A. 14 days
B. 28 days
C. 42 days
D. 56 days
Answer: B
Explanation: Turnover time = epidermal thickness / division rate. Standard is 28 days
Question 29:
A patient has no Langerhans cells. Which immune response is impaired?
A. Antibody production
B. Complement activation
C. Antigen presentation
D. Neutrophil chemotaxis
Answer: C
Explanation: Langerhans cells are epidermal antigen-presenting cells
Question 30:
Refer to a schematic of skin layers:
A drug with log P = 3.5 is applied. Where does it accumulate?
Epidermis (0.1 mm) → Dermis (2 mm) → Subcutis (10 mm)
A. Epidermis
B. Dermis
C. Subcutis
D. All equally
Answer: C
Explanation: High log P (lipophilicity) favors partitioning into subcutaneous fat

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