2 MAXE • 152 SRUN
Penn State University
PSU Ross and Carol Nese College of Nursing
MAKING LIFE BETTER
EST. 1855
NURS 251 — Health Assessment
E X A M I N AT I O N I I • S K I N , H E E N T, H E A LT H H I STO R Y & F U N C T I O N A L A SS E SS M E N T
INSTITUTION Penn State University — College of COURSE CODE NURS 251
Nursing
PROGRAM Bachelor of Science in Nursing (B.S.N.) ACADEMIC YEAR
EXAM TITLE Health Assessment — Exam II TOTAL QUESTIONS 50 Questions
FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question based on NURS 251 course content.
▸ Questions cover skin assessment (layers, lesions, ABCDE rule), HEENT assessment, health history, review of systems, functional
assessment, and cultural/spiritual assessment.
▸ Pay close attention to normal vs. abnormal findings, age-related variations, and proper documentation.
▸ Correct answers and detailed rationales appear below each question for exam preparation.
SECTION I — SKIN, HEENT, HEALTH HISTORY & FUNCTIONAL Questions 1 –
ASSESSMENT 50
1. What are the three layers of the skin from outermost to innermost?
A. Dermis, Epidermis, Subcutaneous tissue
B. Epidermis, Dermis, Subcutaneous tissue
C. Subcutaneous tissue, Dermis, Epidermis
D. Epidermis, Subcutaneous tissue, Dermis
CORRECT ANSWER B — Epidermis, Dermis, Subcutaneous tissue
RATIONALE The skin consists of three distinct layers: the Epidermis (outermost layer — provides barrier protection), the
Dermis (middle layer — contains blood vessels, nerves, and glands), and the Subcutaneous tissue (innermost
layer — serves as insulation and energy storage). The epidermis is avascular and relies on the dermis for
nutrient supply. The dermis contains collagen and elastin fibers that give skin its strength and elasticity. The
subcutaneous layer (hypodermis) consists primarily of adipose tissue that provides thermal insulation and
cushioning. Understanding skin anatomy is foundational to skin assessment — pathological changes in each
layer produce distinct clinical findings.
, 2. Which skin layer provides barrier protection?
A. Dermis
B. Subcutaneous tissue
C. Epidermis
D. Hypodermis
CORRECT ANSWER C — Epidermis
RATIONALE The epidermis is the outermost layer of the skin and provides the primary barrier against environmental
threats — pathogens, chemicals, UV radiation, and water loss. It consists of stratified squamous epithelium
with keratinocytes that produce keratin, a protective protein. The outermost layer (stratum corneum) consists
of dead, flattened cells that are continuously shed and replaced. The dermis provides structural support and
contains blood vessels, nerves, and glands. The subcutaneous tissue provides insulation and energy storage.
Damage to the epidermal barrier (burns, abrasions, skin tears) increases the risk of infection, fluid loss, and
temperature dysregulation.
3. What are the three major functions of the skin?
A. Digestion, circulation, and respiration
B. Protection, temperature regulation, and vitamin D production
C. Hormone production, filtration, and excretion
D. Metabolism, detoxification, and immunity
CORRECT ANSWER B — Protection, temperature regulation, and vitamin D production
RATIONALE The skin serves three major functions: Protection — serves as a physical barrier against microorganisms,
chemicals, and UV radiation; Temperature Regulation — through vasodilation (heat loss) and vasoconstriction
(heat conservation), sweating, and shivering; Vitamin D Production — when exposed to UVB radiation, the
skin synthesizes vitamin D, essential for calcium absorption and bone health. Additional functions include:
sensory perception (touch, pain, temperature, pressure), fluid and electrolyte balance, and serving as a blood
reservoir — the skin can hold approximately 30% of the body's circulating blood volume at once, which can
be shunted to vital organs during shock or hemorrhage.
4. What are the two parts of a skin assessment?
A. Inspection and palpation
B. Subjective data (health history) and objective data (physical exam)
C. Primary and secondary lesion assessment
D. Temperature and turgor assessment
CORRECT ANSWER B — Subjective data (health history) and objective data (physical exam)
RATIONALE Skin assessment, like all health assessments, consists of two components: Subjective Data (health history) —
the patient reports rashes, dryness, lesions, itching, sun exposure, medications, and family history of skin
conditions; Objective Data (physical exam) — the nurse inspects and palpates the skin to evaluate color,
texture, moisture, temperature, turgor, and the presence of lesions. The health history should include
questions about previous skin conditions, changes in moles or lesions, sun exposure history, occupational
exposures, allergies, and medications. The physical exam requires adequate lighting and exposure of the skin
surface, with attention to intertriginous areas, pressure points, and the entire body surface.
Penn State University
PSU Ross and Carol Nese College of Nursing
MAKING LIFE BETTER
EST. 1855
NURS 251 — Health Assessment
E X A M I N AT I O N I I • S K I N , H E E N T, H E A LT H H I STO R Y & F U N C T I O N A L A SS E SS M E N T
INSTITUTION Penn State University — College of COURSE CODE NURS 251
Nursing
PROGRAM Bachelor of Science in Nursing (B.S.N.) ACADEMIC YEAR
EXAM TITLE Health Assessment — Exam II TOTAL QUESTIONS 50 Questions
FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question based on NURS 251 course content.
▸ Questions cover skin assessment (layers, lesions, ABCDE rule), HEENT assessment, health history, review of systems, functional
assessment, and cultural/spiritual assessment.
▸ Pay close attention to normal vs. abnormal findings, age-related variations, and proper documentation.
▸ Correct answers and detailed rationales appear below each question for exam preparation.
SECTION I — SKIN, HEENT, HEALTH HISTORY & FUNCTIONAL Questions 1 –
ASSESSMENT 50
1. What are the three layers of the skin from outermost to innermost?
A. Dermis, Epidermis, Subcutaneous tissue
B. Epidermis, Dermis, Subcutaneous tissue
C. Subcutaneous tissue, Dermis, Epidermis
D. Epidermis, Subcutaneous tissue, Dermis
CORRECT ANSWER B — Epidermis, Dermis, Subcutaneous tissue
RATIONALE The skin consists of three distinct layers: the Epidermis (outermost layer — provides barrier protection), the
Dermis (middle layer — contains blood vessels, nerves, and glands), and the Subcutaneous tissue (innermost
layer — serves as insulation and energy storage). The epidermis is avascular and relies on the dermis for
nutrient supply. The dermis contains collagen and elastin fibers that give skin its strength and elasticity. The
subcutaneous layer (hypodermis) consists primarily of adipose tissue that provides thermal insulation and
cushioning. Understanding skin anatomy is foundational to skin assessment — pathological changes in each
layer produce distinct clinical findings.
, 2. Which skin layer provides barrier protection?
A. Dermis
B. Subcutaneous tissue
C. Epidermis
D. Hypodermis
CORRECT ANSWER C — Epidermis
RATIONALE The epidermis is the outermost layer of the skin and provides the primary barrier against environmental
threats — pathogens, chemicals, UV radiation, and water loss. It consists of stratified squamous epithelium
with keratinocytes that produce keratin, a protective protein. The outermost layer (stratum corneum) consists
of dead, flattened cells that are continuously shed and replaced. The dermis provides structural support and
contains blood vessels, nerves, and glands. The subcutaneous tissue provides insulation and energy storage.
Damage to the epidermal barrier (burns, abrasions, skin tears) increases the risk of infection, fluid loss, and
temperature dysregulation.
3. What are the three major functions of the skin?
A. Digestion, circulation, and respiration
B. Protection, temperature regulation, and vitamin D production
C. Hormone production, filtration, and excretion
D. Metabolism, detoxification, and immunity
CORRECT ANSWER B — Protection, temperature regulation, and vitamin D production
RATIONALE The skin serves three major functions: Protection — serves as a physical barrier against microorganisms,
chemicals, and UV radiation; Temperature Regulation — through vasodilation (heat loss) and vasoconstriction
(heat conservation), sweating, and shivering; Vitamin D Production — when exposed to UVB radiation, the
skin synthesizes vitamin D, essential for calcium absorption and bone health. Additional functions include:
sensory perception (touch, pain, temperature, pressure), fluid and electrolyte balance, and serving as a blood
reservoir — the skin can hold approximately 30% of the body's circulating blood volume at once, which can
be shunted to vital organs during shock or hemorrhage.
4. What are the two parts of a skin assessment?
A. Inspection and palpation
B. Subjective data (health history) and objective data (physical exam)
C. Primary and secondary lesion assessment
D. Temperature and turgor assessment
CORRECT ANSWER B — Subjective data (health history) and objective data (physical exam)
RATIONALE Skin assessment, like all health assessments, consists of two components: Subjective Data (health history) —
the patient reports rashes, dryness, lesions, itching, sun exposure, medications, and family history of skin
conditions; Objective Data (physical exam) — the nurse inspects and palpates the skin to evaluate color,
texture, moisture, temperature, turgor, and the presence of lesions. The health history should include
questions about previous skin conditions, changes in moles or lesions, sun exposure history, occupational
exposures, allergies, and medications. The physical exam requires adequate lighting and exposure of the skin
surface, with attention to intertriginous areas, pressure points, and the entire body surface.
