Integumentary Pathophysiology: Epidermal involves pathological changes in skin structure and function through disruptions in keratinocyte differentiation, melanocyte function, or immune surveillance within the cutaneous microenvironment. Connect Integumentary to bedside cues you will reassess first: vitals trends, work of breathing, perfusion, mentation, and pain or ischemic equivalents when relevant. NCLEX items often reward recognizing when subtle instability outweighs reassurance, then selecting nursing actions that protect airway, circulation, and neurologic status before routine tasks.