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Dermatology Nurse Certified Practice Test

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Exam Code: DNCB-DNC
Exam Name: DNCB Dermatology Nurse Certified (DNC)
Number of Questions: The DNC test consists of 175 multiple-choice questions. Approximately 25 of these questions are unscored pretest items.
Time Limit: Candidates are typically given 4 hours to complete the exam.
Administration: The test is computer-based and administered by C-NET at various testing locations.
Passing Score: A score of approximately 75% is generally required to pass.
Credential: Upon successful completion- candidates earn the credential "Dermatology Nurse Certified (DNC)."

I. Core Dermatology Nursing Practice

- Skin Anatomy and Physiology:
- Structure and function of the epidermis- dermis- subcutaneous tissue.
- Appendages: hair- nails- sebaceous glands- sweat glands.
- Skin functions (e.g.- protection- thermoregulation- sensation- vitamin D synthesis).

- Skin Assessment:
- Comprehensive history taking (e.g.- chief complaint- past medical history- social history- medications- allergies).
- Physical examination techniques (inspection- palpation- description of lesions).
- Documentation of skin findings.

- Pharmacology and Therapeutics in Dermatology:
- Topical medications (e.g.- corticosteroids- antifungals- antibiotics- retinoids- emollients- calcineurin inhibitors).
- Systemic medications (e.g.- oral antibiotics- antifungals- corticosteroids- immunosuppressants- biologics).
- Drug administration routes and patient education.
- Adverse effects and contraindications of common dermatologic drugs.

- Patient Education:
- Skin care regimens (e.g.- sun protection- moisturization- wound care).
- Disease specific education (e.g.- trigger avoidance- medication adherence).
- Lifestyle modifications for dermatological conditions.

- Epidermis- Dermis- Subcutaneous tissue- Keratinocytes- Melanocytes- Langerhans cells- Merkel cells- Collagen- Elastin.
- Macule- Papule- Nodule- Plaque- Vesicle- Bulla- Pustule- Wheal- Urticaria- Erosion- Ulcer- Fissure- Crust- Scale- Lichenification- Atrophy- Scar- Excoriation.
- Pruritus- Erythema- Edema- Induration- Purpura- Petechiae- Ecchymosis- Telangiectasia.
- Topical- Systemic- Ointment- Cream- Lotion- Gel- Solution- Foam- Powder- Suspension- Emollient- Humectant- Occlusive.
- Pharmacokinetics- Pharmacodynamics- Half-life- Bioavailability- Side effects- Adverse drug reactions.

II. Dermatological Conditions and Management

- Inflammatory Skin Conditions:
- Acne (vulgaris- rosacea): pathogenesis- clinical presentation- treatment.
- Eczema/Dermatitis (e.g.- atopic- contact- seborrheic- stasis): causes- clinical features- management.
- Psoriasis (e.g.- plaque- guttate- inverse- pustular- erythrodermic): types- pathophysiology- systemic associations- treatment modalities (topical- phototherapy- systemic- biologics).
- Urticaria and Angioedema: causes- acute vs. chronic- management.

- Infectious Skin Conditions:
- Bacterial (e.g.- impetigo- cellulitis- folliculitis- erysipelas): causative agents- clinical signs- antibiotics.
- Fungal (e.g.- tinea infections- candidiasis): types- diagnosis- antifungals.
- Viral (e.g.- herpes simplex- herpes zoster- warts- molluscum contagiosum): presentation- antiviral therapy- other treatments.
- Parasitic (e.g.- scabies- pediculosis): diagnosis- treatment.

- Pigmentary Disorders:
- Hyperpigmentation (e.g.- melasma- post-inflammatory hyperpigmentation).
- Hypopigmentation (e.g.- vitiligo- post-inflammatory hypopigmentation).

- Hair and Nail Disorders:
- Alopecia (e.g.- androgenetic- alopecia areata- telogen effluvium).
- Nail dystrophies (e.g.- onychomycosis- psoriasis of nails).
- Autoimmune and Connective Tissue Diseases with Skin Manifestations:
- Lupus erythematosus (cutaneous forms).
- Scleroderma.
- Dermatomyositis.
- Bullous diseases (e.g.- pemphigus- bullous pemphigoid).

- Pediatric Dermatology:
- Common conditions in children (e.g.- diaper rash- infantile eczema- birthmarks).
- Age-specific considerations for treatment and patient education.

- Geriatric Dermatology:
- Age-related skin changes.
- Common conditions in the elderly (e.g.- xerosis- stasis dermatitis- skin tears).
- Considerations for treatment and education in older adults.

- Acne vulgaris- Rosacea- Comedones- Papules- Pustules- Cysts.
- Atopic dermatitis- Contact dermatitis (irritant- allergic)- Seborrheic dermatitis- Stasis dermatitis.
- Psoriasis (plaque- guttate- inverse- pustular- erythrodermic)- Koebner phenomenon- Auspitz sign.
- Urticaria- Angioedema.
- Impetigo- Cellulitis- Erysipelas- Folliculitis- Abscess- Furuncle- Carbuncle.
- Tinea (pedis- corporis- cruris- capitis)- Candidiasis.
- Herpes simplex- Herpes zoster- Varicella- Warts (verrucae)- Molluscum contagiosum.
- Scabies- Pediculosis.
- Melasma- Vitiligo- Post-inflammatory hyperpigmentation/hypopigmentation.
- Alopecia- Onychomycosis- Onycholysis.
- Lupus- Scleroderma- Dermatomyositis- Pemphigus- Bullous pemphigoid.
- Xerosis- Pruritus senilis.

III. Surgical and Procedural Dermatology

- Biopsy Techniques:
- Punch biopsy- shave biopsy- excisional biopsy.
- Specimen handling and proper submission.

- Surgical Excisions:
- Indications- pre-operative preparation- sterile technique- wound closure- post-operative care.

- Cryosurgery:
- Indications- technique- post-procedure care.
- Electrosurgery (e.g.- electrocautery- electrodesiccation):
- Principles- indications- post-procedure care.

- Phototherapy (e.g.- UVB- UVA- PUVA):
- Indications- patient selection- dosage- side effects- safety measures.

- Laser Therapy:
- Types of lasers (e.g.- ablative- non-ablative- pulsed dye- Nd:YAG)- indications (e.g.- vascular lesions- pigmentary lesions- hair removal- skin resurfacing)- patient safety.

- Chemical Peels:
- Types (superficial- medium- deep)- indications- pre- and post-peel care.

- Injectables (e.g.- botulinum toxin- dermal fillers):
- Indications- administration- potential complications.

- Wound Care and Management:
- Wound healing phases- types of wounds (e.g.- acute- chronic- pressure injuries)- dressing selection- debridement.

- Infection Control in Dermatologic Procedures:
- Aseptic technique- sterilization- disinfection.

- Biopsy (punch- shave- excisional)- Curettage- Electrocautery- Electrodesiccation.
- Cryosurgery- Liquid nitrogen.
- Phototherapy- UVB- UVA- PUVA- Psoralen.
- Laser (ablative- non-ablative- pulsed dye- Nd:YAG- CO2- Er:YAG)- Chromophore.
- Chemical peel (glycolic acid- salicylic acid- trichloroacetic acid)- Superficial- Medium- Deep.
- Botulinum toxin- Dermal fillers (hyaluronic acid- calcium hydroxylapatite).
- Wound healing (inflammation- proliferation- remodeling)- Primary intention- Secondary intention- Tertiary intention.
- Debridement- Dressings (occlusive- semi-occlusive- hydrocolloid- alginate- foam- silicone).
- Aseptic technique- Sterilization- Disinfection.

IV. Professional Practice and Healthcare Outcomes

- Ethical and Legal Considerations:
- Patient confidentiality (HIPAA)- informed consent- scope of practice- documentation standards.
- Professional boundaries- cultural competence.

- Quality Improvement and Safety:
- Medication safety- patient identification- fall prevention- infection prevention.
- Risk management in dermatology.

- Interdisciplinary Collaboration:
- Working with physicians- physician assistants- medical assistants- aestheticians- and other healthcare professionals.
- Referral processes.

- Research and Evidence-Based Practice:
- Utilizing current research to guide nursing practice.
- Understanding research methodologies and statistical significance.

- Professional Development:
- Continuing education- certification renewal- participation in professional organizations (e.g.- DNA).

- HIPAA- Informed consent- Scope of practice- Malpractice- Negligence.
- Quality improvement- Patient safety- Root cause analysis.
- Interdisciplinary team- Collaboration- Referral.
- Evidence-based practice- Clinical guidelines- Research utilization.
- Continuing education- Certification- Professional organizations.

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Question 1410:
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 1411:
A nurse measures transepidermal water loss (TEWL) in a patient using a vapometer. Normal
TEWL is 10 g/m�/h. The patient�s practicing is 35 g/m�/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 1412:
Refer to the diagram of a hair follicle below:
[Root Bulb] ? [Isthmus] ? [Infundibulum]
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
occurs
Question 1413:
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 1414:
A formula for vitamin D synthesis is:
UVB
7-dehydrocholesterol Previtamin D 3
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 1415:
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 1416:
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 1417:
A diagram shows a nail unit:
Matrix ? Nail Plate ? Hyponychium
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 1418:
A patient has defective sebum production (normal = 2 mg/cm�/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 1419:
A nurse assesses a pressure injury. The dermal papillae are flattened. Which sensation is most
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 1420:
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 1421:
Refer to a sweat gland diagram:
Coiled Secretory Unit ? Duct ? Skin Surface
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 1422:
A patient has a collagen disorder. Collagen constitutes approximately what percentage of the
dermis by dry weight?
A. 25%
B. 50%
C. 75%
D. 90%
Answer: C
Explanation: Collagen makes up ~75% of the dermis� dry weight, providing tensile strength
Question 1423:
A formula for skin regeneration is:
Healing rate = Total epidermal cells
Cell cycle time
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 1424:
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 1425:
A nurse calculates body surface area (BSA. using the Mosteller formula:
BSA = Height (cm)�Weight (kg)
3600
For a patient (height 170 cm, weight 70 kg), BSA is:
A. 1.73 m�
B. 1.85 m�
C. 1.92 m�
D. 2.05 m�
Answer: A
Explanation: BSA = 170�70 = 11900 = 3.305 � 1.73 m�
3600
3600
Question 1426:
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 1427:
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 1428:
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 1429:
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 1430:
Refer to a cross-section of the epidermis:
Stratum Basale ? Stratum Spinosum ? Stratum Granulosum ? Stratum Corneum
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 1431:
A patient has hypohidrosis. The nurse measures sweat production at 15 ml/m�/hr (normal: 30�120
ml/m�/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 1432:
A formula for skin protection is:
SPF = UV dose with protection
UV dose without protection
If SPF 30 blocks 96.7% of UVB, the transmitted UVB is:
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 1433:
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 1434:
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 1435:
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 1436:
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 1437:
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 1438:
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 1439:
Refer to a schematic of skin layers:
Epidermis (0.1 mm) ? Dermis (2 mm) ? Subcutis (10 mm)
A drug with log P = 3.5 is applied. Where does it accumulate?
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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