ATI RN Med-Surg Proctored Exam Notes 2025–2026 – Concise High-Yield Review + Rationales.

Physiological Adaptation Cardiogenic Shock Cardiogenic shock results from ineffective pumping of the heart, leading to reduced cardiac output and perfusion impairment. It is the correct term for shock related to pump failure. Anaphylactic shock is from severe allergic reaction with chemical release. Distributive shock involves changes in intravascular volume distribution with usually increased cardiac output. Myocardial infarction (MI) is not a shock state itself, though severe MI can lead to cardiogenic shock due to damage to the heart's pumping chamber. Blood Pressure Regulation by Kidneys When blood pressure rises, the kidneys excrete sodium and excess water to reduce blood volume and lower systolic blood pressure. This is the normal compensatory mechanism. Retention of sodium and/or water increases blood pressure. Sodium and water move together across kidney membranes; one cannot be retained or excreted independently without affecting the other. Furosemide (Lasix) in Hypertension Furosemide is a loop diuretic that inhibits reabsorption of sodium and water in the loop of Henle, reducing blood volume and blood pressure. Vasodilators relax vascular smooth muscle directly. Adrenergic blockers decrease sympathetic cardio acceleration. ACE inhibitors act on the angiotensin system to lower blood pressure. Laboratory Findings in Systemic Lupus Erythematosus (SLE) Typical lab findings in SLE include pancytopenia (low RBC, WBC, platelets), elevated antinuclear antibody (ANA) titer, and decreased serum complement levels (due to immune complex formation and complement activation). Elevated complement is not seen in SLE. Thrombocytosis is incorrect; thrombocytopenia is part of pancytopenia. Elevated BUN and creatinine may occur from