NSG 6020 3P 2026/2027 | Advanced Nursing 3P Exam
Study Guide, Practice Questions & Answers,
Pathophysiology, Pharmacology & Physical Assessment
Review
Question 1: Which layer of the epidermis is primarily composed of
dead, keratinized cells that are continuously shed and replaced?
A. Stratum basale
B. Stratum spinosum
C. Stratum granulosum
D. Stratum corneum
CORRECT ANSWER: D. Stratum corneum
Rationale: The stratum corneum is the outermost epidermal layer,
consisting of 15 to 30 layers of flattened, fully keratinized corneocytes.
These cells lack nuclei and organelles, making them biologically "dead."
This layer serves as the primary barrier against environmental insults,
pathogens, and transepidermal water loss. It is continuously desquamated
and replaced by cells from deeper layers.
Question 2: A client presents with a history of cold sores. Which of
the following is the most appropriate action before performing a
facial treatment?
A. Proceed with the treatment if no active lesions are visible
B. Apply a topical antiviral and continue
C. Reschedule the appointment until lesions have completely healed
D. Wear double gloves during the treatment
CORRECT ANSWER: C. Reschedule the appointment until lesions
have completely healed
Rationale: Herpes simplex virus is highly contagious, and treatment
manipulation can trigger viral shedding even in prodromal stages.
Performing esthetic services on a client with active or recent cold sores
risks autoinoculation to other facial areas and transmission to the
esthetician. DOPL standards require postponing treatment until lesions are
fully resolved.
,Question 3: Which of the following best describes the Fitzpatrick
skin type classification system?
A. A method for determining appropriate chemical peel strengths
B. A scale measuring skin's reaction to ultraviolet radiation based on
melanin content
C. A diagnostic tool for identifying skin cancer
D. A grading system for acne severity
CORRECT ANSWER: B. A scale measuring skin's reaction to
ultraviolet radiation based on melanin content
Rationale: The Fitzpatrick scale classifies skin types I through VI based on
the amount of melanin present and the skin's tendency to burn or tan upon
UV exposure. This classification is critical in esthetics for selecting
appropriate laser settings, chemical peel depths, and predicting risk of post-
inflammatory hyperpigmentation.
Question 4: Which anatomical structure is responsible for
anchoring the epidermis to the dermis?
A. Dermal papillae
B. Basement membrane zone
C. Reticular layer
D. Subcutaneous tissue
CORRECT ANSWER: B. Basement membrane zone
Rationale: The basement membrane zone is a complex structure at the
dermo-epidermal junction that provides adhesion between the epidermis
and dermis. It consists of the lamina lucida and lamina densa and serves as
a selective barrier for nutrient exchange. Disruption of this zone is
implicated in blistering disorders.
Question 5: What is the primary function of sebaceous glands?
A. Production of sweat for thermoregulation
B. Secretion of sebum to lubricate skin and hair
C. Synthesis of vitamin D
D. Regulation of body temperature through vasoconstriction
,CORRECT ANSWER: B. Secretion of sebum to lubricate skin and
hair
Rationale: Sebaceous glands are holocrine glands attached to hair follicles
that secrete sebum, a waxy, lipid-rich substance. Sebum lubricates the skin
and hair, provides antimicrobial protection, and contributes to the skin's
acid mantle. Overactivity of these glands is a primary factor in acne
development.
Question 6: Which of the following is a contraindication for
microdermabrasion?
A. Hyperpigmentation
B. Enlarged pores
C. Active acne with pustules
D. Fine lines and wrinkles
CORRECT ANSWER: C. Active acne with pustules
Rationale: Microdermabrasion is contraindicated on skin with active
pustular acne because the mechanical abrasion can rupture lesions,
spreading bacteria and causing further inflammation or scarring. It may
also exacerbate inflammatory acne. Clients should be treated for active
acne before receiving exfoliation treatments.
Question 7: The acid mantle of the skin has an approximate pH of:
A. 2.0 to 3.0
B. 4.5 to 5.5
C. 6.5 to 7.5
D. 7.5 to 8.5
CORRECT ANSWER: B. 4.5 to 5.5
Rationale: The acid mantle is a thin, slightly acidic film on the skin's surface
composed of sebum, sweat, and keratinocyte breakdown products. Its pH
of approximately 4.5 to 5.5 inhibits pathogenic bacterial growth and
maintains barrier function. Disruption of this pH can lead to irritation and
increased susceptibility to infection.
, Question 8: Which type of chemical peel uses trichloroacetic acid?
A. Superficial peel
B. Medium-depth peel
C. Deep peel
D. Enzyme peel
CORRECT ANSWER: B. Medium-depth peel
Rationale: Trichloroacetic acid (TCA) at concentrations of 10% to 30% is
classified as a medium-depth peeling agent, penetrating the epidermis into
the papillary dermis. At higher concentrations (35% and above), it can
reach the reticular dermis, classifying it as a deep peel. TCA is commonly
used for pigment irregularities and fine lines.
Question 9: What is the correct order of the epidermal layers from
deepest to most superficial?
A. Corneum, lucidum, granulosum, spinosum, basale
B. Basale, spinosum, granulosum, lucidum, corneum
C. Granulosum, basale, spinosum, corneum, lucidum
D. Spinosum, basale, granulosum, corneum, lucidum
CORRECT ANSWER: B. Basale, spinosum, granulosum, lucidum,
corneum
Rationale: The epidermis consists of five layers in ascending order: stratum
basale (germinative layer), stratum spinosum (prickle cell layer), stratum
granulosum (granular layer), stratum lucidum (clear layer, present only in
thick skin), and stratum corneum (horny layer). Keratinocytes migrate
upward through these layers as they differentiate.
Question 10: A client receiving isotretinoin (Accutane) should not
receive waxing or exfoliation treatments for at least:
A. 3 months after discontinuing the medication
B. 6 months after discontinuing the medication
C. 12 months after discontinuing the medication
D. The treatment can be performed with caution at any time
Study Guide, Practice Questions & Answers,
Pathophysiology, Pharmacology & Physical Assessment
Review
Question 1: Which layer of the epidermis is primarily composed of
dead, keratinized cells that are continuously shed and replaced?
A. Stratum basale
B. Stratum spinosum
C. Stratum granulosum
D. Stratum corneum
CORRECT ANSWER: D. Stratum corneum
Rationale: The stratum corneum is the outermost epidermal layer,
consisting of 15 to 30 layers of flattened, fully keratinized corneocytes.
These cells lack nuclei and organelles, making them biologically "dead."
This layer serves as the primary barrier against environmental insults,
pathogens, and transepidermal water loss. It is continuously desquamated
and replaced by cells from deeper layers.
Question 2: A client presents with a history of cold sores. Which of
the following is the most appropriate action before performing a
facial treatment?
A. Proceed with the treatment if no active lesions are visible
B. Apply a topical antiviral and continue
C. Reschedule the appointment until lesions have completely healed
D. Wear double gloves during the treatment
CORRECT ANSWER: C. Reschedule the appointment until lesions
have completely healed
Rationale: Herpes simplex virus is highly contagious, and treatment
manipulation can trigger viral shedding even in prodromal stages.
Performing esthetic services on a client with active or recent cold sores
risks autoinoculation to other facial areas and transmission to the
esthetician. DOPL standards require postponing treatment until lesions are
fully resolved.
,Question 3: Which of the following best describes the Fitzpatrick
skin type classification system?
A. A method for determining appropriate chemical peel strengths
B. A scale measuring skin's reaction to ultraviolet radiation based on
melanin content
C. A diagnostic tool for identifying skin cancer
D. A grading system for acne severity
CORRECT ANSWER: B. A scale measuring skin's reaction to
ultraviolet radiation based on melanin content
Rationale: The Fitzpatrick scale classifies skin types I through VI based on
the amount of melanin present and the skin's tendency to burn or tan upon
UV exposure. This classification is critical in esthetics for selecting
appropriate laser settings, chemical peel depths, and predicting risk of post-
inflammatory hyperpigmentation.
Question 4: Which anatomical structure is responsible for
anchoring the epidermis to the dermis?
A. Dermal papillae
B. Basement membrane zone
C. Reticular layer
D. Subcutaneous tissue
CORRECT ANSWER: B. Basement membrane zone
Rationale: The basement membrane zone is a complex structure at the
dermo-epidermal junction that provides adhesion between the epidermis
and dermis. It consists of the lamina lucida and lamina densa and serves as
a selective barrier for nutrient exchange. Disruption of this zone is
implicated in blistering disorders.
Question 5: What is the primary function of sebaceous glands?
A. Production of sweat for thermoregulation
B. Secretion of sebum to lubricate skin and hair
C. Synthesis of vitamin D
D. Regulation of body temperature through vasoconstriction
,CORRECT ANSWER: B. Secretion of sebum to lubricate skin and
hair
Rationale: Sebaceous glands are holocrine glands attached to hair follicles
that secrete sebum, a waxy, lipid-rich substance. Sebum lubricates the skin
and hair, provides antimicrobial protection, and contributes to the skin's
acid mantle. Overactivity of these glands is a primary factor in acne
development.
Question 6: Which of the following is a contraindication for
microdermabrasion?
A. Hyperpigmentation
B. Enlarged pores
C. Active acne with pustules
D. Fine lines and wrinkles
CORRECT ANSWER: C. Active acne with pustules
Rationale: Microdermabrasion is contraindicated on skin with active
pustular acne because the mechanical abrasion can rupture lesions,
spreading bacteria and causing further inflammation or scarring. It may
also exacerbate inflammatory acne. Clients should be treated for active
acne before receiving exfoliation treatments.
Question 7: The acid mantle of the skin has an approximate pH of:
A. 2.0 to 3.0
B. 4.5 to 5.5
C. 6.5 to 7.5
D. 7.5 to 8.5
CORRECT ANSWER: B. 4.5 to 5.5
Rationale: The acid mantle is a thin, slightly acidic film on the skin's surface
composed of sebum, sweat, and keratinocyte breakdown products. Its pH
of approximately 4.5 to 5.5 inhibits pathogenic bacterial growth and
maintains barrier function. Disruption of this pH can lead to irritation and
increased susceptibility to infection.
, Question 8: Which type of chemical peel uses trichloroacetic acid?
A. Superficial peel
B. Medium-depth peel
C. Deep peel
D. Enzyme peel
CORRECT ANSWER: B. Medium-depth peel
Rationale: Trichloroacetic acid (TCA) at concentrations of 10% to 30% is
classified as a medium-depth peeling agent, penetrating the epidermis into
the papillary dermis. At higher concentrations (35% and above), it can
reach the reticular dermis, classifying it as a deep peel. TCA is commonly
used for pigment irregularities and fine lines.
Question 9: What is the correct order of the epidermal layers from
deepest to most superficial?
A. Corneum, lucidum, granulosum, spinosum, basale
B. Basale, spinosum, granulosum, lucidum, corneum
C. Granulosum, basale, spinosum, corneum, lucidum
D. Spinosum, basale, granulosum, corneum, lucidum
CORRECT ANSWER: B. Basale, spinosum, granulosum, lucidum,
corneum
Rationale: The epidermis consists of five layers in ascending order: stratum
basale (germinative layer), stratum spinosum (prickle cell layer), stratum
granulosum (granular layer), stratum lucidum (clear layer, present only in
thick skin), and stratum corneum (horny layer). Keratinocytes migrate
upward through these layers as they differentiate.
Question 10: A client receiving isotretinoin (Accutane) should not
receive waxing or exfoliation treatments for at least:
A. 3 months after discontinuing the medication
B. 6 months after discontinuing the medication
C. 12 months after discontinuing the medication
D. The treatment can be performed with caution at any time
