NU 518 Exam 3 Study Guide (2026/2027) (PDF) | Nursing Theory | University of South Alabama

NU 518
EXAM 3
STUDY GUIDE
University of South Alabama.

This document provides a focused
study guide
It summarizes key concepts, lecture highlights, and
exam-relevant material to support efficient last-
minute review. The guide is structured to help
students reinforce understanding, identify weak areas, and
prepare confidently for the assessment.

, Exam 3 Study Guide
NU 518 Advanced Nursing
Assessment
Topic
Chapter 10 (Skin, Hair, and Nails)
Skin color p.282-283
 The amount of melanin, a brownish pigment, is genetically determined and increased by
exposure to sunlight
 Pallor indicates anemia
 Cyanosis, a blue color, can indicate decreased oxygen in the blood or decreased blood flow in
response to a cold environment
 Carotene, a yellow pigment, is found in the subq fat and heavily keratinized areas such as the
palms and soles
 Bilirubin, a yellow-brown pigment, arises from the breakdown of heme in the red blood cells
 Jaundice or yellowing of the skin, results from increased bilirubin

Skin lesions p.286-291 Table 10-1 Table 10-4
 Flat spots – if you run your finger over the lesion but do not feel the lesion, the lesion is flat
o If a flat spot is small <1cm, it is a macule
o If a flat spot is larger >1cm, it is a patch
 Raised spots – if you run your finger over the lesion and it is palpable above the skin, it is
raised
o If a raised spot is small <1cm, it is a papule
o If a raised spot is larger >1cm, it is a plaque
 Fluid filled lesions – if the lesion is raised, filled with fluid
o Small <1cm called a vesicle
o Larger >1cm called a bulla
 Actinic keratosis
o Actinic keratosis after field therapy with 5-fluorouracil
o Often easier to feel than to see
o Superficial keratotic papules “come and go” on sun-damaged skin
 Superficial xerosis or seborrheic dermatitis
o May occur in same distribution on forehead, central face
o Scale is less keratotic and will improve with moisturizers, mild topical steroids
 Cutaneous horn/keratotic warts scale
o The prototypic keratotic scale of actinic keratoses and SCC is formed by keratin and
can result in a cutaneous horn
o Cutaneous horns should generally be biopsied to rule out SCC
o Usually skin – colored pink, texture ore verrucous than keratotic
o May be filiform
o Often have hemorrhagic punctae that can be seen with a magnifying glass or
dermatoscope
 Squamous cell carcinoma
o Keratoacanthomas are SCCs that arise rapidly and have a crateriform center

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, o Often have a smooth but firm border
o SCCs can become quite large if left untreated (note: highest sites of metastasis are the
scalp, lips, and ears)
 Seborrheic keratosis
o Often have a verrucous texture
o Appear like a “stuck on” or flattened ball of wax
o May crumble or bleed if picked
o Specific features on dermoscopy such as milia-like cysts or comedone-like openings
are reassuring, if present
o May be erythematous, if inflamed

Hair loss p.322 Table 10-8
 Decrease in hair density is usually caused by male or female pattern hair loss
 Generalized diffuse hair loss – look at front hairline regression and thinning on the posterior
vertex for men and look for thinning those spreads from the crown down without hairline
regression in women
o Telogen effluvium – the patient’s scalp and hair distribution appear normal but a
positive hair pull test reeals mot hairs have telogen bulbs
o Anagen effluvium – there is diffuse hair loss from the roots, the hair pull test shows
few if any hairs with telogen bulbs
 Focal hair loss
o Alopecia areata – sudden onset of clearly demarcated, usually localized, round or
oval patches of hair loss leaving smooth skin without hairs
o Tinea capitis (ringworm) - round scaling patches of alopecia, mostly seen in
children, may be black dots of broken hairs and comma or corkscrew hairs of
dermoscopy
o Scarring alopecia – scarring on the scalp is characterized by shiny skin, complete loss
of hair follicles, and often discoloration; presence of any scarring should prompt
referral to a dermatologist for possible scalp biopsy
o Hair shaft disorders – patients with abnormal hair from birth, as in this patient with a
genetic condition called monilethrix, should be referred to dermatology

Findings in or near the nail p. 324 Table 10-9
 Paronychia – a superficial infection of the proximal and lateral nail folds adjacent to the nail
plate; the nail folds are often red, swollen, and tender
 Clubbing of the fingers – a bulbous swelling of the soft tissue at the nail base, with loss of
the normal angle between the nail and the proximal nail fold, the angle increases to 180
degrees or more, and the nail bed feels spongy or floating
 Habit tic deformity – there is a depression of the central nail with a “Christmas tree”
appearance from small horizontal depressions, resulting from repetitive trauma from rubbing
the index finger over the thumb or vice versa
 Melanonychia – caused by increased pigmentation of the nail matrix, leading to a streak as
the nail grows out
 Onycholysis – a painless separation of the whitened opaque nail plate from the pinker
translucent nail bed
 Onychomycosis – the most common cause of nail thickening and subungual debris, most
often from the dermatophyte, trichophyton rubrum
 Terry nails – nail plate turns white with a ground-glass appearance, a distal band of reddish
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