NURS 3537 Integumentary System Pathophysiology
EXAM 2026-2027 LATEST UPDATED VERSION 120
QUESTIONS A
Section 1: Anatomy and Physiology of the Skin
1. Which layer of the skin is primarily responsible for providing a waterproof
barrier and is composed of dead, keratinized cells?
A. Stratum basale
B. Dermis
C. Hypodermis
D. Stratum corneum
D. Stratum corneum
The stratum corneum is the outermost layer of the epidermis. It consists of
multiple layers of dead, flattened keratinocytes that are constantly being shed
and replaced. This layer is crucial for preventing water loss from the body and
protecting against environmental insults.
2. The primary function of melanocytes, found in the stratum basale, is to:
A. Produce keratin for skin strength.
B. Provide sensory perception.
C. Produce melanin to protect against UV radiation.
D. Anchor the epidermis to the dermis.
C. Produce melanin to protect against UV radiation.
Melanocytes synthesize the pigment melanin, which is transferred to
surrounding keratinocytes. Melanin absorbs ultraviolet (UV) radiation,
protecting the DNA in skin cells from damage that can lead to skin cancer.
3. A patient has a burn that has destroyed the entire epidermis and part of the
dermis. This is classified as which degree of burn?
A. First-degree
B. Second-degree
,C. Third-degree
D. Fourth-degree
B. Second-degree
A second-degree burn (partial-thickness burn) involves both the epidermis
and portions of the dermis. It is characterized by blistering, severe pain, and a
moist, red, and weeping appearance. A first-degree burn involves only the
epidermis, and a third-degree burn destroys the entire dermis and may extend
into subcutaneous tissue.
4. Which of the following is NOT a function of the skin?
A. Vitamin D synthesis
B. Regulation of body temperature
C. Production of red blood cells
D. Excretion of metabolic wastes
C. Production of red blood cells
The production of red blood cells (erythropoiesis) primarily occurs in the red
bone marrow. The skin's functions include acting as a physical barrier, regulating
temperature through sweating and vasoconstriction/vasodilation, synthesizing
vitamin D when exposed to UV light, and excreting small amounts of waste
products like urea and salts through sweat.
5. The layer of the skin that contains blood vessels, nerves, hair follicles, and
glands is the:
A. Epidermis
B. Dermis
C. Hypodermis
D. Stratum corneum
B. Dermis
The dermis is the middle layer of the skin, composed of strong, flexible
connective tissue. It is rich in blood vessels, lymphatic vessels, nerve endings,
hair follicles, and sebaceous and sweat glands, providing structural support and
nourishment to the epidermis.
,6. The subcutaneous tissue (hypodermis) is primarily composed of:
A. Keratinized cells
B. Dense irregular connective tissue
C. Adipose tissue and loose connective tissue
D. Cartilage
C. Adipose tissue and loose connective tissue
The hypodermis, also known as the subcutaneous layer, is the deepest layer
of the skin. It consists mainly of adipose (fat) tissue and loose connective tissue.
Its primary functions are to anchor the skin to underlying structures, provide
insulation, and serve as an energy reserve.
7. What is the primary role of sebaceous glands?
A. To produce sweat for thermoregulation.
B. To secrete sebum, an oily substance that lubricates skin and hair.
C. To produce melanin.
D. To sense pressure and touch.
B. To secrete sebum, an oily substance that lubricates skin and hair.
Sebaceous glands are found in association with hair follicles. They secrete
sebum, a mixture of lipids, which lubricates the skin and hair, helps to
waterproof the skin, and has some antibacterial properties. Sweat glands are
responsible for thermoregulation.
8. The nail structure that is responsible for nail growth is the:
A. Nail plate
B. Eponychium (cuticle)
C. Nail matrix
D. Lunula
C. Nail matrix
The nail matrix is the actively growing part of the nail, located at the
proximal end of the nail bed, deep to the nail root. Cell division in the matrix
produces the keratinized cells that become the nail plate.
, 9. Eccrine sweat glands are most numerous in which area of the body?
A. Axillae and groin
B. Palms, soles, and forehead
C. Back and chest
D. Scalp
B. Palms, soles, and forehead
Eccrine sweat glands are distributed all over the body but are most
concentrated on the palms, soles of the feet, and forehead. They are primarily
responsible for thermoregulation through the production of sweat, which cools
the body as it evaporates.
10. Which cells in the epidermis are involved in the immune response by
presenting antigens to T-lymphocytes?
A. Keratinocytes
B. Melanocytes
C. Langerhans cells
D. Merkel cells
C. Langerhans cells
Langerhans cells are star-shaped macrophages found in the stratum
spinosum of the epidermis. They are a type of dendritic cell that captures and
processes antigens from the skin and presents them to T-lymphocytes, playing a
critical role in cutaneous immune surveillance.
Section 2: Assessment and Diagnostic Procedures
11. A nurse is assessing a patient's skin turgor. Which technique is most
appropriate?
A. Pushing on the skin over the shins to check for edema.
B. Gently pinching a fold of skin on the back of the hand or sternum.
C. Stroking the skin to assess for texture.
D. Using a Wood's lamp to check for fungal infections.
EXAM 2026-2027 LATEST UPDATED VERSION 120
QUESTIONS A
Section 1: Anatomy and Physiology of the Skin
1. Which layer of the skin is primarily responsible for providing a waterproof
barrier and is composed of dead, keratinized cells?
A. Stratum basale
B. Dermis
C. Hypodermis
D. Stratum corneum
D. Stratum corneum
The stratum corneum is the outermost layer of the epidermis. It consists of
multiple layers of dead, flattened keratinocytes that are constantly being shed
and replaced. This layer is crucial for preventing water loss from the body and
protecting against environmental insults.
2. The primary function of melanocytes, found in the stratum basale, is to:
A. Produce keratin for skin strength.
B. Provide sensory perception.
C. Produce melanin to protect against UV radiation.
D. Anchor the epidermis to the dermis.
C. Produce melanin to protect against UV radiation.
Melanocytes synthesize the pigment melanin, which is transferred to
surrounding keratinocytes. Melanin absorbs ultraviolet (UV) radiation,
protecting the DNA in skin cells from damage that can lead to skin cancer.
3. A patient has a burn that has destroyed the entire epidermis and part of the
dermis. This is classified as which degree of burn?
A. First-degree
B. Second-degree
,C. Third-degree
D. Fourth-degree
B. Second-degree
A second-degree burn (partial-thickness burn) involves both the epidermis
and portions of the dermis. It is characterized by blistering, severe pain, and a
moist, red, and weeping appearance. A first-degree burn involves only the
epidermis, and a third-degree burn destroys the entire dermis and may extend
into subcutaneous tissue.
4. Which of the following is NOT a function of the skin?
A. Vitamin D synthesis
B. Regulation of body temperature
C. Production of red blood cells
D. Excretion of metabolic wastes
C. Production of red blood cells
The production of red blood cells (erythropoiesis) primarily occurs in the red
bone marrow. The skin's functions include acting as a physical barrier, regulating
temperature through sweating and vasoconstriction/vasodilation, synthesizing
vitamin D when exposed to UV light, and excreting small amounts of waste
products like urea and salts through sweat.
5. The layer of the skin that contains blood vessels, nerves, hair follicles, and
glands is the:
A. Epidermis
B. Dermis
C. Hypodermis
D. Stratum corneum
B. Dermis
The dermis is the middle layer of the skin, composed of strong, flexible
connective tissue. It is rich in blood vessels, lymphatic vessels, nerve endings,
hair follicles, and sebaceous and sweat glands, providing structural support and
nourishment to the epidermis.
,6. The subcutaneous tissue (hypodermis) is primarily composed of:
A. Keratinized cells
B. Dense irregular connective tissue
C. Adipose tissue and loose connective tissue
D. Cartilage
C. Adipose tissue and loose connective tissue
The hypodermis, also known as the subcutaneous layer, is the deepest layer
of the skin. It consists mainly of adipose (fat) tissue and loose connective tissue.
Its primary functions are to anchor the skin to underlying structures, provide
insulation, and serve as an energy reserve.
7. What is the primary role of sebaceous glands?
A. To produce sweat for thermoregulation.
B. To secrete sebum, an oily substance that lubricates skin and hair.
C. To produce melanin.
D. To sense pressure and touch.
B. To secrete sebum, an oily substance that lubricates skin and hair.
Sebaceous glands are found in association with hair follicles. They secrete
sebum, a mixture of lipids, which lubricates the skin and hair, helps to
waterproof the skin, and has some antibacterial properties. Sweat glands are
responsible for thermoregulation.
8. The nail structure that is responsible for nail growth is the:
A. Nail plate
B. Eponychium (cuticle)
C. Nail matrix
D. Lunula
C. Nail matrix
The nail matrix is the actively growing part of the nail, located at the
proximal end of the nail bed, deep to the nail root. Cell division in the matrix
produces the keratinized cells that become the nail plate.
, 9. Eccrine sweat glands are most numerous in which area of the body?
A. Axillae and groin
B. Palms, soles, and forehead
C. Back and chest
D. Scalp
B. Palms, soles, and forehead
Eccrine sweat glands are distributed all over the body but are most
concentrated on the palms, soles of the feet, and forehead. They are primarily
responsible for thermoregulation through the production of sweat, which cools
the body as it evaporates.
10. Which cells in the epidermis are involved in the immune response by
presenting antigens to T-lymphocytes?
A. Keratinocytes
B. Melanocytes
C. Langerhans cells
D. Merkel cells
C. Langerhans cells
Langerhans cells are star-shaped macrophages found in the stratum
spinosum of the epidermis. They are a type of dendritic cell that captures and
processes antigens from the skin and presents them to T-lymphocytes, playing a
critical role in cutaneous immune surveillance.
Section 2: Assessment and Diagnostic Procedures
11. A nurse is assessing a patient's skin turgor. Which technique is most
appropriate?
A. Pushing on the skin over the shins to check for edema.
B. Gently pinching a fold of skin on the back of the hand or sternum.
C. Stroking the skin to assess for texture.
D. Using a Wood's lamp to check for fungal infections.
