Question:
Which summary best captures the overall course shown by the serial data?

Options:
A. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 59, diastolic pressure rose from 17 to 62, and heart rate was roughly stable (70 to 69). The lowest MAP was about 53 around hour 14.7, and the lowest valid SpO2 was 85 around hour 3.7; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 35.7-38.5 C, white count fell from 15.2 to 9, creatinine stayed around 1.1, lactate fell from 4.7 to 3.2, and urine output fell from 1500 to 40.
B. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 57, diastolic pressure rose from 18 to 60, and heart rate was roughly stable (68 to 72). The lowest MAP was about 51 around hour 13.6, and the lowest valid SpO2 was 83 around hour 2.7; respiratory rate rose as high as 25 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 33.5-36.2 C, white count fell from 14.1 to 9, creatinine stayed around 1.2, lactate fell from 4.3 to 2.8, and urine output fell from 1560 to 38.
C. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 63, diastolic pressure rose from 15 to 66, and heart rate was roughly stable (74 to 65). The lowest MAP was about 57 around hour 16.6, and the lowest valid SpO2 was 89 around hour 4.3; respiratory rate rose as high as 26 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 39.5-42.2 C, white count fell from 17.1 to 10, creatinine rose from 1 to 1.2, lactate fell from 4.7 to 3.2, and urine output fell from 1500 to 90.
D. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 54, diastolic pressure rose from 19 to 59, and heart rate was roughly stable (66 to 74). The lowest MAP was about 56 around hour 15.7, and the lowest valid SpO2 was 80 around hour 3.0; respiratory rate rose as high as 26 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 31.2-34.0 C, white count fell from 12.9 to 8, creatinine stayed around 1.4, lactate fell from 4.0 to 2.5, and urine output fell from 1620 to 36.

Answer: A

Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 59, diastolic pressure rose from 17 to 62, and heart rate was roughly stable (70 to 69). The lowest MAP was about 53 around hour 14.7, and the lowest valid SpO2 was 85 around hour 3.7; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature ranged from 35.7 to 98.3, white count fell from 15.2 to 9, creatinine stayed around 1.1, lactate fell from 4.7 to 3.2, and urine output fell from 1500 to 40.


Question:
Which clinical summary is best supported by the time-stamped measurements?

Options:
A. Across the recorded window, the heart rate was roughly stable (73 to 66), MAP stayed around 62, and diastolic pressure moved from 18 to 59. Systolic pressure ranged 30-111 and ended at 108, and SpO2 recovered to 99 after a low of 84 around hour 4.2. Respiratory rate ended at 26; the available labs showed white count fell from 13.7 to 8.2, creatinine stayed around 1.3, lactate fell from 4.2 to 3.7, and urine output fell from 1550 to 37.
B. Across the recorded window, the heart rate was roughly stable (68 to 72), MAP stayed around 57, and diastolic pressure moved from 16 to 59. Systolic pressure ranged 27-116 and ended at 113, and SpO2 recovered to 94 after a low of 87 around hour 3.3. Respiratory rate ended at 23; the available labs showed white count fell from 16.3 to 9, creatinine stayed around 1.0, lactate fell from 5.1 to 2.8, and urine output fell from 1440 to 42.
C. Across the recorded window, the heart rate was roughly stable (70 to 69), MAP stayed around 59, and diastolic pressure moved from 17 to 62. Systolic pressure ranged 28-114 and ended at 111, and SpO2 recovered to 96 after a low of 85 around hour 3.7. Respiratory rate ended at 24; the available labs showed white count fell from 15.2 to 9, creatinine stayed around 1.1, lactate fell from 4.7 to 3.2, and urine output fell from 1500 to 40.
D. Across the recorded window, the heart rate was roughly stable (66 to 74), MAP was roughly stable (54 to 62), and diastolic pressure moved from 17 to 62. Systolic pressure ranged 28-114 and ended at 107, and SpO2 recovered to 96 after a low of 85 around hour 4.7. Respiratory rate ended at 24; the available labs showed white count fell from 15.2 to 9, creatinine stayed around 1.1, lactate fell from 4.7 to 3.2, and urine output fell from 1500 to 40.

Answer: C


Question:
Which summary best represents the patient's recorded course across the episode?

Options:
A. Over the available measurements, the heart rate was roughly stable (80 to 78), MAP was roughly stable (69 to 70), and diastolic pressure moved from 49 to 52. Systolic pressure ranged 99-148 and ended at 127, and SpO2 recovered to 94 after a low of 85 around hour 3.4. Respiratory rate ended at 16; the available labs showed white count rose from 10.9 to 14.6, creatinine rose from 1.5 to 2, lactate fell from 1.6 to 1.3, and urine output fell from 160 to 40.
B. Over the available measurements, the heart rate was roughly stable (78 to 80), MAP was roughly stable (67 to 73), and diastolic pressure moved from 51 to 50. Systolic pressure ranged 97-133 and ended at 123, and SpO2 recovered to 96 after a low of 83 around hour 4.4. Respiratory rate ended at 17; the available labs showed white count rose from 9.8 to 13.5, creatinine rose from 1.6 to 2, lactate fell from 1.5 to 1.3, and urine output fell from 145 to 38.
C. Over the available measurements, the heart rate was roughly stable (84 to 81), MAP was roughly stable (73 to 74), and diastolic pressure moved from 45 to 49. Systolic pressure ranged 100-173 and ended at 152, and SpO2 recovered to 90 after a low of 89 around hour 4.0. Respiratory rate ended at 14; the available labs showed white count rose from 12.8 to 16.5, creatinine rose from 1.2 to 2, lactate fell from 1.9 to 1.1, and urine output fell from 185 to 44.
D. Over the available measurements, the heart rate was roughly stable (76 to 82), MAP was roughly stable (64 to 66), and diastolic pressure moved from 54 to 48. Systolic pressure ranged 94-118 and ended at 97, and SpO2 recovered to 98 after a low of 84 around hour 2.6. Respiratory rate ended at 18; the available labs showed white count rose from 8.7 to 13.8, creatinine rose from 1.8 to 2, lactate fell from 1.3 to 1.1, and urine output fell from 210 to 36.

Answer: A


Question:
Which synopsis best matches the observed sequence rather than a plausible alternative?

Options:
A. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 159 to 108, MAP fell from 104 to 79, and heart rate rose from 86 to 98. SpO2 started at 97, ended at 97, and fell as low as 88 around hour 4; respiratory rate ranged 4-28. For labs and output, white count rose from 9.7 to 20.1, creatinine was roughly stable (0.8 to 0.8), lactate rose from 1.6 to 2.2, and urine output was roughly stable (120 to 185)
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 139 to 111, MAP fell from 101 to 76, and heart rate rose from 89 to 95. SpO2 started at 100, ended at 94, and fell as low as 85 around hour 4; respiratory rate ranged 4-29. For labs and output, white count rose from 11.2 to 18.6, creatinine stayed around 0.7, lactate rose from 1.4 to 2.2, and urine output was roughly stable (120 to 185)
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 164 to 107, MAP fell from 105 to 79, and heart rate rose from 85 to 99. SpO2 started at 96, ended at 98, and fell as low as 84 around hour 3; respiratory rate ranged 5-27. For labs and output, white count rose from 9.3 to 20.5, creatinine stayed around 0.8, lactate rose from 1.1 to 2.5, and urine output was roughly stable (145 to 160)
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 109 to 106, MAP fell from 96 to 72, and heart rate rose from 94 to 98. SpO2 started at 96, ended at 90, and fell as low as 80 around hour 5; respiratory rate ranged 3-31. For labs and output, white count rose from 13.4 to 17.8, creatinine stayed around 0.5, lactate rose from 1.7 to 1.9, and urine output was roughly stable (90 to 215)

Answer: B


Question:
Which handoff summary best matches the measured ICU course?

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 149 to 118, MAP was roughly stable (91 to 91), and heart rate fell from 134 to 104. SpO2 started at 100, ended at 94, and fell as low as 87 around hour 5.4; respiratory rate ranged 9-23. For labs and output, white count was roughly stable (17.6 to 18.4), creatinine fell from 0.7 to 0.5, lactate fell from 182 to 1, and urine output rose from 50 to 220.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 114 to 94, MAP stayed around 86, and heart rate fell from 119 to 106. SpO2 started at 98, ended at 96, and fell as low as 86 around hour 5.0; respiratory rate ranged 9-24. For labs and output, white count was roughly stable (16.5 to 19.5), creatinine was roughly stable (0.6 to 0.6), lactate fell from 182.2 to 1, and urine output rose from 48 to 235.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 129 to 122, MAP stayed around 88, and heart rate fell from 134 to 104. SpO2 started at 100, ended at 94, and fell as low as 88 around hour 5.4; respiratory rate ranged 9-23. For labs and output, white count was roughly stable (17.6 to 18.4), creatinine fell from 0.7 to 0.5, lactate fell from 182 to 1, and urine output rose from 50 to 220.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 99 to 79, MAP stayed around 84, and heart rate fell from 104 to 101. SpO2 started at 96, ended at 98, and fell as low as 84 around hour 4.7; respiratory rate ranged 10-25. For labs and output, white count stayed around 15.4, creatinine fell from 0.7 to 0.5, lactate fell from 182 to 1, and urine output rose from 50 to 220.

Answer: C


Question:
Which option best reflects the important trends and outliers in this episode?

Options:
A. Taken together, the heart rate was roughly stable (83 to 75), while MAP rose from 65 to 76. Systolic pressure was labile, ranging 94-107, with the lowest value around hour 50.7. SpO2 briefly dipped to 86 around hour 2 before recovering to 93, while respiratory rate peaked at 28 and later settled at 22. The associated labs and urine output showed that white count fell from 20.4 to 2.4, creatinine rose from 1.6 to 1.8, lactate fell from 3156 to 1661, and urine output fell from 580 to 370, with recorded outputs ranging 33-620.
B. Taken together, the heart rate was roughly stable (80 to 78), while MAP rose from 62 to 73. Systolic pressure was labile, ranging 90-127, with the lowest value around hour 47.7. SpO2 briefly dipped to 85 around hour 0 before recovering to 96, while respiratory rate peaked at 26 and later settled at 21. The associated labs and urine output showed that white count fell from 21.9 to 2.2, creatinine rose from 1.4 to 1.8, lactate fell from 3076 to 1581, and urine output fell from 600 to 350, with recorded outputs ranging 30-600.
C. Taken together, the heart rate was roughly stable (84 to 74), while MAP rose from 66 to 77. Systolic pressure was labile, ranging 86-102, with the lowest value around hour 51.5. SpO2 briefly dipped to 89 around hour 2 before recovering to 92, while respiratory rate peaked at 28 and later settled at 23. The associated labs and urine output showed that white count fell from 20.0 to 1.4, creatinine rose from 1.6 to 1.9, lactate fell from 3176 to 1681, and urine output fell from 575 to 375, with recorded outputs ranging 80-625.
D. Taken together, the heart rate was roughly stable (76 to 82), while MAP rose from 58 to 76. Systolic pressure was labile, ranging 94-157, with the lowest value around hour 43.2. SpO2 briefly dipped to 80 around hour 1 before recovering to 100, while respiratory rate peaked at 24 and later settled at 19. The associated labs and urine output showed that white count fell from 24.1 to 1.9, creatinine rose from 1.1 to 2.1, lactate fell from 2956 to 1461, and urine output fell from 630 to 300, with recorded outputs ranging 26-570.

Answer: B


Question:
Which summary best combines the vital-sign trends with the available labs and output?

Options:
A. In broad terms, the heart rate rose from 73 to 75, while MAP rose from 95 to 106. Systolic pressure was labile, ranging 72-169, with the lowest value around hour 4. SpO2 briefly dipped to 88 around hour 1 before recovering to 92, while respiratory rate peaked at 39 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (7.4 to 9.0), creatinine fell from 7.8 to 4.3, lactate was not available, and urine output was not recorded.
B. In broad terms, the heart rate rose from 68 to 80, while MAP rose from 90 to 101. Systolic pressure was labile, ranging 77-193, with the lowest value around hour 4. SpO2 briefly dipped to 83 around hour 0 before recovering to 97, while respiratory rate peaked at 34 and later settled at 17. The associated labs and urine output showed that white count was roughly stable (8.3 to 7.7), creatinine fell from 6.9 to 4.9, lactate was not available, and urine output was not recorded.
C. In broad terms, the heart rate rose from 70 to 78, while MAP rose from 92 to 103. Systolic pressure was labile, ranging 75-189, with the lowest value around hour 4. SpO2 briefly dipped to 85 around hour 0 before recovering to 95, while respiratory rate peaked at 36 and later settled at 18. The associated labs and urine output showed that white count was roughly stable (7.9 to 8.5), creatinine fell from 7.3 to 4.8, lactate was not available, and urine output was not recorded.
D. In broad terms, the heart rate rose from 66 to 82, while MAP rose from 88 to 100. Systolic pressure was labile, ranging 79-219, with the lowest value around hour 3. SpO2 briefly dipped to 80 around hour 0 before recovering to 100, while respiratory rate peaked at 38 and later settled at 16. The associated labs and urine output showed that white count was roughly stable (8.7 to 7.8), creatinine fell from 6.5 to 5.5, lactate was not available, and urine output was not recorded.

Answer: C


Question:
Which summary most accurately describes the patient's changes over the episode?

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 81 to 66, diastolic pressure fell from 69 to 59, and heart rate fell from 87 to 53. The lowest MAP was about 58 around hour 2, and the lowest valid SpO2 was 88 around hour 0.7; respiratory rate rose as high as 29 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.3-34.7 C, white count was roughly stable (5.0 to 4.1), creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 820 to 300.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 78 to 69, diastolic pressure fell from 66 to 56, and heart rate fell from 90 to 50. The lowest MAP was about 55 around hour 2, and the lowest valid SpO2 was 85 around hour 0.8; respiratory rate rose as high as 27 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 36.3-37.7 C, white count was roughly stable (4.5 to 4.6), creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 800 to 250.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 82 to 65, diastolic pressure fell from 70 to 53, and heart rate fell from 86 to 54. The lowest MAP was about 58 around hour 3, and the lowest valid SpO2 was 89 around hour 0.7; respiratory rate rose as high as 29 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.5-34.0 C, white count was roughly stable (5.1 to 4.0), creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 825 to 225.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 74 to 71, diastolic pressure fell from 62 to 52, and heart rate fell from 94 to 53. The lowest MAP was about 50 around hour 2, and the lowest valid SpO2 was 80 around hour 0; respiratory rate rose as high as 25 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 40.8-42.2 C, white count was roughly stable (3.8 to 5.3), creatinine was 0.4 on its only check, lactate was not available, and urine output fell from 770 to 280.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 78 to 69, diastolic pressure fell from 66 to 56, and heart rate fell from 90 to 50. The lowest MAP was about 55 around hour 2, and the lowest valid SpO2 was 85 around hour 0.8; respiratory rate rose as high as 27 but ended at 20. The lower-frequency data fit that summary: temperature ranged from 97.4 to 99.9, white count was roughly stable (4.5 to 4.6), creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 800 to 250.


Question:
Which option best summarizes the hemodynamic, respiratory, lab, and urine-output pattern?

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 118 to 103, MAP fell from 81 to 72, and heart rate fell from 87 to 53. SpO2 started at 95, ended at 93, and fell as low as 84 around hour 0.7; respiratory rate ranged 12-26. For labs and output, white count was roughly stable (4.0 to 5.1), creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 780 to 270.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 113 to 109, MAP fell from 76 to 67, and heart rate fell from 92 to 48. SpO2 started at 100, ended at 88, and fell as low as 83 around hour 0.9; respiratory rate ranged 9-28. For labs and output, white count was roughly stable (3.7 to 4.2), creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 815 to 235.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 115 to 107, MAP fell from 78 to 69, and heart rate fell from 90 to 50. SpO2 started at 98, ended at 90, and fell as low as 85 around hour 0.8; respiratory rate ranged 10-27. For labs and output, white count was roughly stable (4.5 to 4.6), creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 800 to 250.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 110 to 107, MAP fell from 74 to 64, and heart rate fell from 94 to 53. SpO2 started at 100, ended at 86, and fell as low as 80 around hour 1.0; respiratory rate ranged 8-29. For labs and output, white count was roughly stable (5.2 to 3.8), creatinine was 0.4 on its only check, lactate was not available, and urine output fell from 830 to 220.

Answer: C


Question:
Which option is most consistent with the actual sequence of measurements?

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (108 to 101), diastolic pressure was roughly stable (92 to 85), and heart rate rose from 84 to 96. The lowest MAP was about 59 around hour 13.3, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 26 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 32.9-35.2 C, white count fell from 20.2 to 11.6, creatinine was roughly stable (1.4 to 1.3), lactate fell from 1.3 to 1.0, and urine output rose from 345 to 480.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (103 to 106), diastolic pressure was roughly stable (87 to 86), and heart rate rose from 89 to 96. The lowest MAP was about 54 around hour 13.4, and the lowest valid SpO2 was 83 around hour 2; respiratory rate rose as high as 23 but ended at 10. The lower-frequency data fit that summary: temperature stayed around 38.1-40.5 C, white count fell from 17.6 to 14.2, creatinine was roughly stable (1.0 to 1.0), lactate fell from 1.6 to 0.8, and urine output rose from 310 to 515.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (105 to 104), diastolic pressure was roughly stable (89 to 88), and heart rate rose from 87 to 93. The lowest MAP was about 56 around hour 12.3, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 24 but ended at 11. The lower-frequency data fit that summary: temperature stayed around 35.9-38.2 C, white count fell from 18.7 to 13.1, creatinine was roughly stable (1.2 to 1.1), lactate fell from 1.5 to 0.9, and urine output rose from 325 to 500.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (100 to 108), diastolic pressure was roughly stable (84 to 84), and heart rate rose from 92 to 95. The lowest MAP was about 52 around hour 14.6, and the lowest valid SpO2 was 80 around hour 3; respiratory rate rose as high as 26 but ended at 9. The lower-frequency data fit that summary: temperature stayed around 40.4-42.7 C, white count fell from 16.4 to 15.3, creatinine stayed around 0.9, lactate fell from 1.5 to 0.9, and urine output rose from 325 to 550.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (105 to 104), diastolic pressure was roughly stable (89 to 88), and heart rate rose from 87 to 93. The lowest MAP was about 56 around hour 12.3, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 24 but ended at 11. The lower-frequency data fit that summary: temperature ranged from 96.7 to 100.8, white count fell from 18.7 to 13.1, creatinine was roughly stable (1.2 to 1.1), lactate fell from 1.5 to 0.9, and urine output rose from 325 to 500.


Question:
Which summary should be used for rounds based on the recorded course?

Options:
A. Over the available measurements, the heart rate fell from 88 to 59, while MAP was roughly stable (95 to 96). Systolic pressure was labile, ranging 111-131, with the lowest value around hour 1.7. SpO2 briefly dipped to 88 around hour 0.2 before recovering to 93, while respiratory rate peaked at 28 and later settled at 18. The associated labs and urine output showed that white count fell from 10.2 to 2, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 855 to 270, with recorded outputs ranging 80-895.
B. Over the available measurements, the heart rate fell from 83 to 64, while MAP was roughly stable (96 to 96). Systolic pressure was labile, ranging 116-166, with the lowest value around hour 1.4. SpO2 briefly dipped to 83 around hour 1.1 before recovering to 98, while respiratory rate peaked at 26 and later settled at 16. The associated labs and urine output showed that white count fell from 12.8 to 0, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 890 to 200, with recorded outputs ranging 28-860.
C. Over the available measurements, the heart rate fell from 85 to 62, while MAP was roughly stable (98 to 93). Systolic pressure was labile, ranging 114-151, with the lowest value around hour 1.5. SpO2 briefly dipped to 85 around hour 0.1 before recovering to 96, while respiratory rate peaked at 27 and later settled at 17. The associated labs and urine output showed that white count fell from 11.7 to 0, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 875 to 250, with recorded outputs ranging 30-875.
D. Over the available measurements, the heart rate fell from 80 to 66, while MAP was roughly stable (94 to 88). Systolic pressure was labile, ranging 118-181, with the lowest value around hour 1.2. SpO2 briefly dipped to 86 around hour 0.0 before recovering to 100, while respiratory rate peaked at 29 and later settled at 15. The associated labs and urine output showed that white count fell from 13.9 to 0, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 905 to 220, with recorded outputs ranging 26-845.

Answer: C


Question:
Which summary best captures the overall course shown by the serial data?

Options:
A. Viewed chronologically, the heart rate fell from 88 to 65, MAP was roughly stable (100 to 96), and diastolic pressure moved from 67 to 61. Systolic pressure ranged 117-171 and ended at 161, and SpO2 recovered to 93 after a low of 88 around hour 0.2. Respiratory rate ended at 16; the available labs showed white count fell from 13.2 to 2, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 895 to 270.
B. Viewed chronologically, the heart rate fell from 85 to 62, MAP was roughly stable (98 to 93), and diastolic pressure moved from 70 to 64. Systolic pressure ranged 114-151 and ended at 141, and SpO2 recovered to 96 after a low of 85 around hour 0.1. Respiratory rate ended at 17; the available labs showed white count fell from 11.7 to 0, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 875 to 250.
C. Viewed chronologically, the heart rate fell from 89 to 58, MAP was roughly stable (100 to 97), and diastolic pressure moved from 66 to 68. Systolic pressure ranged 118-176 and ended at 166, and SpO2 recovered to 92 after a low of 84 around hour 0.2. Respiratory rate ended at 15; the available labs showed white count fell from 13.6 to 2, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 925 to 275.
D. Viewed chronologically, the heart rate fell from 80 to 66, MAP was roughly stable (94 to 96), and diastolic pressure moved from 74 to 60. Systolic pressure ranged 110-121 and ended at 137, and SpO2 recovered to 100 after a low of 80 around hour 1.1. Respiratory rate ended at 19; the available labs showed white count fell from 9.4 to 0, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 845 to 220.

Answer: B


Question:
Which clinical summary is best supported by the time-stamped measurements?

Options:
A. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 155 to 101, MAP fell from 97 to 92, and heart rate stayed around 86. SpO2 started at 99, ended at 91, and fell as low as 88 around hour 0.2; respiratory rate ranged 10-24. For labs and output, white count rose from 12.7 to 14.2, creatinine stayed around 1.0, lactate was not available, and urine output rose from 0 to 450.
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 135 to 121, MAP fell from 100 to 89, and heart rate stayed around 89. SpO2 started at 96, ended at 94, and fell as low as 85 around hour 0.1; respiratory rate ranged 12-25. For labs and output, white count rose from 11.2 to 13.3, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 50 to 450.
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 160 to 117, MAP fell from 96 to 92, and heart rate stayed around 85. SpO2 started at 100, ended at 90, and fell as low as 84 around hour 0.2; respiratory rate ranged 10-23. For labs and output, white count rose from 13.1 to 14.6, creatinine was roughly stable (1.0 to 0.9), lactate was not available, and urine output rose from 46 to 475.
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 105 to 85, MAP fell from 96 to 84, and heart rate was roughly stable (94 to 92). SpO2 started at 96, ended at 94, and fell as low as 85 around hour 0.1; respiratory rate ranged 12-27. For labs and output, white count rose from 11.2 to 12.5, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 50 to 450.

Answer: B


Question:
Which synopsis best matches the observed sequence rather than a plausible alternative?

Options:
A. Overall, the heart rate stayed around 92, MAP fell from 97 to 92, and diastolic pressure moved from 80 to 77. Systolic pressure ranged 97-129 and ended at 101, and SpO2 recovered to 97 after a low of 84 around hour 0.2. Respiratory rate ended at 22; the available labs showed white count rose from 9.7 to 12.5, creatinine was roughly stable (1.0 to 0.7), lactate was not available, and urine output rose from 100 to 470.
B. Overall, the heart rate stayed around 87, MAP fell from 98 to 92, and diastolic pressure moved from 75 to 82. Systolic pressure ranged 98-164 and ended at 117, and SpO2 recovered to 92 after a low of 87 around hour 1.1. Respiratory rate ended at 19; the available labs showed white count rose from 12.3 to 13.8, creatinine was roughly stable (0.8 to 0.9), lactate was not available, and urine output rose from 48 to 435.
C. Overall, the heart rate stayed around 89, MAP fell from 100 to 89, and diastolic pressure moved from 77 to 80. Systolic pressure ranged 100-149 and ended at 121, and SpO2 recovered to 94 after a low of 85 around hour 0.1. Respiratory rate ended at 20; the available labs showed white count rose from 11.2 to 13.3, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 50 to 450.
D. Overall, the heart rate was roughly stable (84 to 92), MAP fell from 100 to 89, and diastolic pressure moved from 77 to 77. Systolic pressure ranged 100-149 and ended at 121, and SpO2 recovered to 94 after a low of 85 around hour 0.1. Respiratory rate ended at 20; the available labs showed white count rose from 11.2 to 13.3, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 50 to 450.

Answer: C


Question:
After reviewing the recorded vitals, labs, and urine output, which summary is most accurate?

Options:
A. Taken together, the heart rate fell from 87 to 43, while MAP fell from 93 to 79. Systolic pressure was labile, ranging 94-123, with the lowest value around hour 24.6. SpO2 briefly dipped to 89 around hour 0.4 before recovering to 95, while respiratory rate peaked at 26 and later settled at 22. The associated labs and urine output showed that white count was 17.1 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output stayed around 520, with recorded outputs ranging 480-500.
B. Taken together, the heart rate fell from 84 to 46, while MAP fell from 90 to 76. Systolic pressure was labile, ranging 90-143, with the lowest value around hour 23.1. SpO2 briefly dipped to 88 around hour 0.3 before recovering to 98, while respiratory rate peaked at 24 and later settled at 20. The associated labs and urine output showed that white count was 18.6 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output stayed around 500, with recorded outputs ranging 500-500.
C. Taken together, the heart rate fell from 88 to 42, while MAP fell from 94 to 80. Systolic pressure was labile, ranging 86-118, with the lowest value around hour 25.0. SpO2 briefly dipped to 92 around hour 0.4 before recovering to 94, while respiratory rate peaked at 26 and later settled at 22. The associated labs and urine output showed that white count was 16.7 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (450 to 475), with recorded outputs ranging 450-550.
D. Taken together, the heart rate fell from 80 to 50, while MAP fell from 86 to 79. Systolic pressure was labile, ranging 94-173, with the lowest value around hour 20.9. SpO2 briefly dipped to 84 around hour 1.3 before recovering to 100, while respiratory rate peaked at 22 and later settled at 18. The associated labs and urine output showed that white count was 20.9 on its only check, creatinine was 0.3 on its only check, lactate was not available, and urine output was roughly stable (470 to 450), with recorded outputs ranging 450-500.

Answer: B


Question:
Which option best reflects the important trends and outliers in this episode?

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 93 to 73, diastolic pressure fell from 78 to 58, and heart rate fell from 81 to 49. The lowest MAP was about 67 around hour 23.1, and the lowest valid SpO2 was 91 around hour 0.2; respiratory rate rose as high as 26 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.4-34.4 C, white count was 20.1 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output was roughly stable (520 to 520)
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 88 to 78, diastolic pressure fell from 73 to 59, and heart rate fell from 86 to 44. The lowest MAP was about 62 around hour 23.2, and the lowest valid SpO2 was 86 around hour 0.4; respiratory rate rose as high as 26 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 38.6-39.6 C, white count was 17.5 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (485 to 550)
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 76, diastolic pressure fell from 75 to 61, and heart rate fell from 84 to 46. The lowest MAP was about 64 around hour 22.1, and the lowest valid SpO2 was 88 around hour 0.3; respiratory rate rose as high as 24 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 36.4-37.4 C, white count was 18.6 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (500 to 500)
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 80, diastolic pressure fell from 70 to 56, and heart rate fell from 88 to 49. The lowest MAP was about 60 around hour 24.4, and the lowest valid SpO2 was 84 around hour 0; respiratory rate rose as high as 22 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 40.9-41.9 C, white count was 16.4 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (470 to 470)

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 76, diastolic pressure fell from 75 to 61, and heart rate fell from 84 to 46. The lowest MAP was about 64 around hour 22.1, and the lowest valid SpO2 was 88 around hour 0.3; respiratory rate rose as high as 24 but ended at 20. The lower-frequency data fit that summary: temperature ranged from 97.5 to 99.4, white count was 18.6 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (500 to 500)


Question:
Which option best reflects the important trends and outliers in this episode?

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 104 to 126, MAP rose from 69 to 78, and heart rate rose from 50 to 91. SpO2 started at 85, ended at 98, and fell as low as 85 around hour 0.1; respiratory rate ranged 14-28. For labs and output, white count was roughly stable (5.2 to 4.3), creatinine was roughly stable (0.6 to 0.5), lactate rose from 1.9 to 351, and urine output was roughly stable (200 to 125)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 102 to 141, MAP rose from 67 to 76, and heart rate rose from 52 to 94. SpO2 started at 87, ended at 96, and fell as low as 83 around hour 0.2; respiratory rate ranged 13-30. For labs and output, white count fell from 5.6 to 3.5, creatinine was roughly stable (0.5 to 0.6), lactate rose from 1.8 to 336, and urine output was roughly stable (215 to 110)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 108 to 111, MAP rose from 73 to 82, and heart rate rose from 46 to 95. SpO2 started at 81, ended at 100, and fell as low as 89 around hour 0.0; respiratory rate ranged 16-26. For labs and output, white count was roughly stable (4.6 to 4.9), creatinine stayed around 0.7, lactate rose from 2.1 to 351, and urine output was roughly stable (200 to 125)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 100 to 122, MAP rose from 64 to 81, and heart rate rose from 54 to 86. SpO2 started at 90, ended at 94, and fell as low as 84 around hour 0.2; respiratory rate ranged 12-30. For labs and output, white count was roughly stable (6.0 to 3.5), creatinine was roughly stable (0.4 to 0.7), lactate rose from 1.6 to 321, and urine output was roughly stable (230 to 95)

Answer: A


Question:
Which summary best avoids misstating the observed ICU course?

Options:
A. For handoff, the heart rate rose from 53 to 94, MAP rose from 72 to 81, and diastolic pressure moved from 55 to 64. Systolic pressure ranged 75-152 and ended at 146, and SpO2 recovered to 95 after a low of 88 around hour 0.2. Respiratory rate ended at 16; the available labs showed white count was roughly stable (5.7 to 4.8), creatinine was roughly stable (0.5 to 0.6), lactate rose from 2.1 to 331, and urine output was roughly stable (220 to 145)
B. For handoff, the heart rate rose from 50 to 91, MAP rose from 69 to 78, and diastolic pressure moved from 58 to 67. Systolic pressure ranged 72-132 and ended at 126, and SpO2 recovered to 98 after a low of 85 around hour 0.1. Respiratory rate ended at 18; the available labs showed white count was roughly stable (5.2 to 4.3), creatinine was roughly stable (0.6 to 0.5), lactate rose from 1.9 to 351, and urine output was roughly stable (200 to 125)
C. For handoff, the heart rate rose from 54 to 87, MAP rose from 73 to 82, and diastolic pressure moved from 54 to 71. Systolic pressure ranged 76-157 and ended at 151, and SpO2 recovered to 94 after a low of 84 around hour 0.2. Respiratory rate ended at 16; the available labs showed white count fell from 5.8 to 3.5, creatinine was roughly stable (0.5 to 0.6), lactate rose from 2.1 to 326, and urine output fell from 250 to 150.
D. For handoff, the heart rate rose from 46 to 96, MAP rose from 64 to 81, and diastolic pressure moved from 62 to 62. Systolic pressure ranged 68-102 and ended at 122, and SpO2 recovered to 100 after a low of 80 around hour 1.1. Respiratory rate ended at 20; the available labs showed white count was roughly stable (4.5 to 3.5), creatinine was roughly stable (0.8 to 0.3), lactate rose from 1.6 to 381, and urine output was roughly stable (170 to 95)

Answer: B


Question:
Which option correctly summarizes the serial measurements for this ICU stay?

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (121 to 116), MAP was roughly stable (69 to 70), and heart rate was roughly stable (98 to 108). SpO2 started at 93, ended at 97, and fell as low as 84 around hour 3.2; respiratory rate ranged 12-26. For labs and output, white count rose from 4 to 7.1, creatinine stayed around 0.8, lactate fell from 2 to 1.5, and urine output was roughly stable (83 to 97)
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (118 to 120), MAP was roughly stable (66 to 67), and heart rate was roughly stable (101 to 105). SpO2 started at 96, ended at 94, and fell as low as 85 around hour 3.7; respiratory rate ranged 10-28. For labs and output, white count rose from 5 to 6.6, creatinine stayed around 0.7, lactate fell from 2 to 1.3, and urine output was roughly stable (80 to 100)
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (122 to 95), MAP was roughly stable (70 to 71), and heart rate rose from 97 to 108. SpO2 started at 92, ended at 98, and fell as low as 89 around hour 3.1; respiratory rate ranged 12-30. For labs and output, white count stayed around 5.8, creatinine stayed around 0.7, lactate fell from 2 to 1.3, and urine output was roughly stable (80 to 100)
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (114 to 150), MAP was roughly stable (62 to 62), and heart rate was roughly stable (106 to 100). SpO2 started at 100, ended at 90, and fell as low as 80 around hour 4.5; respiratory rate ranged 8-30. For labs and output, white count rose from 6 to 6.5, creatinine was roughly stable (0.5 to 0.8), lactate fell from 2.2 to 1.3, and urine output was roughly stable (80 to 100)

Answer: B


Question:
After reviewing the serial ICU measurements, which summary is most accurate?

Options:
A. Across the recorded window, the heart rate rose from 50 to 68, while MAP fell from 94 to 88. Systolic pressure was labile, ranging 103-148, with the lowest value around hour 13.3. SpO2 briefly dipped to 85 around hour 0.5 before recovering to 100, while respiratory rate peaked at 22 and later settled at 19. The associated labs and urine output showed that white count was 15.4 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 800 to 350, with recorded outputs ranging 50-800.
B. Across the recorded window, the heart rate rose from 48 to 70, while MAP fell from 92 to 86. Systolic pressure was labile, ranging 107-163, with the lowest value around hour 12.2. SpO2 briefly dipped to 86 around hour 0.4 before recovering to 98, while respiratory rate peaked at 24 and later settled at 18. The associated labs and urine output showed that white count was 16.5 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 785 to 365, with recorded outputs ranging 48-815.
C. Across the recorded window, the heart rate rose from 54 to 64, while MAP fell from 98 to 92. Systolic pressure was labile, ranging 99-123, with the lowest value around hour 15.2. SpO2 briefly dipped to 89 around hour 0.6 before recovering to 96, while respiratory rate peaked at 24 and later settled at 21. The associated labs and urine output showed that white count was 13.5 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 825 to 325, with recorded outputs ranging 100-775.
D. Across the recorded window, the heart rate rose from 46 to 72, while MAP was roughly stable (90 to 91). Systolic pressure was labile, ranging 108-178, with the lowest value around hour 11.1. SpO2 briefly dipped to 80 around hour 1.5 before recovering to 96, while respiratory rate peaked at 20 and later settled at 17. The associated labs and urine output showed that white count was 17.6 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 770 to 300, with recorded outputs ranging 46-830.

Answer: A


Question:
Which handoff summary best matches the measured ICU course?

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 97 to 85, diastolic pressure rose from 68 to 71, and heart rate rose from 47 to 71. The lowest MAP was about 61 around hour 2.8, and the lowest valid SpO2 was 88 around hour 0.4; respiratory rate rose as high as 24 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.7-34 C, white count was 16.9 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 820 to 370.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 88, diastolic pressure rose from 65 to 74, and heart rate rose from 50 to 68. The lowest MAP was about 58 around hour 1.8, and the lowest valid SpO2 was 85 around hour 0.5; respiratory rate rose as high as 22 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 36.7-37 C, white count was 15.4 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 800 to 350.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 98 to 84, diastolic pressure rose from 69 to 78, and heart rate rose from 46 to 71. The lowest MAP was about 62 around hour 1.6, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 24 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 33.0-33 C, white count was 17.3 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 825 to 375.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 87, diastolic pressure rose from 60 to 70, and heart rate rose from 54 to 64. The lowest MAP was about 54 around hour 2.1, and the lowest valid SpO2 was 80 around hour 0.7; respiratory rate rose as high as 24 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 41.2-42 C, white count was 13.2 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output fell from 770 to 400.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 88, diastolic pressure rose from 65 to 74, and heart rate rose from 50 to 68. The lowest MAP was about 58 around hour 1.8, and the lowest valid SpO2 was 85 around hour 0.5; respiratory rate rose as high as 22 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 98 to 98.6, white count was 15.4 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 800 to 350.


Question:
Which summary most accurately describes the patient's changes over the episode?

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 167 to 108, MAP fell from 97 to 91, and heart rate rose from 47 to 71. SpO2 started at 85, ended at 97, and fell as low as 88 around hour 0.4; respiratory rate ranged 10-24. For labs and output, white count was 13.9 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 820 to 330.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 132 to 112, MAP fell from 92 to 86, and heart rate rose from 52 to 66. SpO2 started at 90, ended at 98, and fell as low as 83 around hour 0.6; respiratory rate ranged 9-20. For labs and output, white count was 16.5 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 850 to 365.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 147 to 128, MAP fell from 94 to 88, and heart rate rose from 50 to 68. SpO2 started at 88, ended at 100, and fell as low as 85 around hour 0.5; respiratory rate ranged 9-22. For labs and output, white count was 15.4 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 800 to 350.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 117 to 97, MAP was roughly stable (90 to 91), and heart rate rose from 54 to 64. SpO2 started at 92, ended at 96, and fell as low as 84 around hour 0.7; respiratory rate ranged 8-24. For labs and output, white count was 17.6 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 770 to 380.

Answer: C


Question:
Which summary best combines the vital-sign trends with the available labs and output?

Options:
A. Viewed chronologically, the heart rate fell from 83 to 68, MAP rose from 66 to 72, and diastolic pressure moved from 10 to 58. Systolic pressure ranged 26-116 and ended at 109, and SpO2 recovered to 88 after a low of 88 around hour 11.2. Respiratory rate ended at 18; the available labs showed white count was roughly stable (13.9 to 14.0), creatinine stayed around 0.9, lactate fell from 1.7 to 1.3, and urine output fell from 680 to 48.
B. Viewed chronologically, the heart rate fell from 80 to 71, MAP rose from 63 to 69, and diastolic pressure moved from 11 to 55. Systolic pressure ranged 24-113 and ended at 113, and SpO2 recovered to 91 after a low of 85 around hour 10.2. Respiratory rate ended at 19; the available labs showed white count was roughly stable (12.4 to 12.5), creatinine stayed around 1.1, lactate fell from 1.5 to 1.1, and urine output fell from 700 to 45.
C. Viewed chronologically, the heart rate fell from 84 to 74, MAP rose from 67 to 73, and diastolic pressure moved from 9 to 52. Systolic pressure ranged 26-117 and ended at 117, and SpO2 recovered to 87 after a low of 89 around hour 12.1. Respiratory rate ended at 17; the available labs showed white count was roughly stable (14.3 to 14.4), creatinine stayed around 0.9, lactate fell from 1.8 to 1.4, and urine output fell from 675 to 49.
D. Viewed chronologically, the heart rate fell from 76 to 73, MAP rose from 58 to 64, and diastolic pressure moved from 13 to 50. Systolic pressure ranged 22-108 and ended at 108, and SpO2 recovered to 96 after a low of 84 around hour 7.9. Respiratory rate ended at 21; the available labs showed white count was roughly stable (10.2 to 11.7), creatinine stayed around 1.4, lactate fell from 1.2 to 0.8, and urine output fell from 750 to 40.

Answer: B


Question:
Which option gives the best clinical synopsis of these ICU measurements?

Options:
A. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 167 to 125, MAP fell from 109 to 90, and heart rate rose from 47 to 104. SpO2 started at 82, ended at 96, and fell as low as 84 around hour 0.0; respiratory rate ranged 12-22. For labs and output, white count fell from 12.1 to 8.8, creatinine stayed around 1.0, lactate was checked once at 610, and urine output rose from 220 to 320.
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 147 to 129, MAP fell from 106 to 87, and heart rate rose from 50 to 101. SpO2 started at 85, ended at 93, and fell as low as 85 around hour 0.1; respiratory rate ranged 11-23. For labs and output, white count fell from 13.6 to 8.3, creatinine stayed around 0.9, lactate was checked once at 630, and urine output rose from 200 to 300.
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 172 to 104, MAP fell from 110 to 91, and heart rate rose from 46 to 104. SpO2 started at 81, ended at 97, and fell as low as 89 around hour 0.0; respiratory rate ranged 13-25. For labs and output, white count fell from 11.7 to 7.5, creatinine stayed around 1.0, lactate was checked once at 605, and urine output rose from 225 to 325.
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 117 to 97, MAP fell from 102 to 82, and heart rate rose from 54 to 96. SpO2 started at 90, ended at 88, and fell as low as 80 around hour 0.2; respiratory rate ranged 9-25. For labs and output, white count fell from 15.8 to 7.6, creatinine was roughly stable (0.8 to 1), lactate was checked once at 630.2, and urine output rose from 200 to 300.

Answer: B


Question:
Which option is most consistent with the actual sequence of measurements?

Options:
A. Taken together, the heart rate rose from 63 to 75, while MAP fell from 89 to 77. Systolic pressure was labile, ranging 94-120, with the lowest value around hour 14. SpO2 briefly dipped to 91 around hour 1.2 before recovering to 92, while respiratory rate peaked at 24 and later settled at 20. The associated labs and urine output showed that white count was 3.8 on its only check, creatinine was roughly stable (1.0 to 0.9), lactate was checked once at 0.9, and urine output fell from 420 to 0, with recorded outputs ranging 0-380.
B. Taken together, the heart rate rose from 60 to 78, while MAP fell from 86 to 74. Systolic pressure was labile, ranging 97-140, with the lowest value around hour 12. SpO2 briefly dipped to 88 around hour 0.2 before recovering to 95, while respiratory rate peaked at 22 and later settled at 19. The associated labs and urine output showed that white count was 4.3 on its only check, creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 1.1, and urine output fell from 400 to 50, with recorded outputs ranging 25-400.
C. Taken together, the heart rate rose from 64 to 74, while MAP fell from 90 to 78. Systolic pressure was labile, ranging 93-115, with the lowest value around hour 14. SpO2 briefly dipped to 92 around hour 0.3 before recovering to 91, while respiratory rate peaked at 24 and later settled at 21. The associated labs and urine output showed that white count was 3.7 on its only check, creatinine stayed around 1.0, lactate was checked once at 1.1, and urine output fell from 400 to 50, with recorded outputs ranging 54-400.
D. Taken together, the heart rate rose from 56 to 82, while MAP fell from 82 to 70. Systolic pressure was labile, ranging 101-170, with the lowest value around hour 10. SpO2 briefly dipped to 84 around hour 0.0 before recovering to 100, while respiratory rate peaked at 24 and later settled at 17. The associated labs and urine output showed that white count was 5.0 on its only check, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 1.4, and urine output fell from 370 to 46, with recorded outputs ranging 27-430.

Answer: B


Question:
Which summary best represents the patient's recorded course across the episode?

Options:
A. In broad terms, the heart rate rose from 60 to 78, MAP fell from 86 to 74, and diastolic pressure moved from 69 to 58. Systolic pressure ranged 97-140 and ended at 122, and SpO2 recovered to 95 after a low of 88 around hour 0.2. Respiratory rate ended at 19; the available labs showed white count was 4.3 on its only check, creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 1.1, and urine output fell from 400 to 50.
B. In broad terms, the heart rate rose from 58 to 81, MAP fell from 84 to 72, and diastolic pressure moved from 71 to 55. Systolic pressure ranged 95-125 and ended at 107, and SpO2 recovered to 97 after a low of 86 around hour 0.1. Respiratory rate ended at 20; the available labs showed white count was 3.9 on its only check, creatinine was roughly stable (0.8 to 0.9), lactate was checked once at 1.0, and urine output fell from 385 to 52.
C. In broad terms, the heart rate rose from 64 to 74, MAP fell from 90 to 77, and diastolic pressure moved from 65 to 62. Systolic pressure ranged 100-165 and ended at 118, and SpO2 recovered to 91 after a low of 92 around hour 1.2. Respiratory rate ended at 17; the available labs showed white count was 4.9 on its only check, creatinine was roughly stable (1.0 to 0.7), lactate was checked once at 1.4, and urine output fell from 425 to 46.
D. In broad terms, the heart rate rose from 56 to 82, MAP fell from 82 to 70, and diastolic pressure moved from 74 to 54. Systolic pressure ranged 92-110 and ended at 92, and SpO2 recovered to 100 after a low of 87 around hour 0.0. Respiratory rate ended at 21; the available labs showed white count was 3.5 on its only check, creatinine was roughly stable (0.8 to 1.0), lactate was checked once at 0.8, and urine output fell from 450 to 54.

Answer: A


Question:
Which summary best avoids misstating the observed ICU course?

Options:
A. In broad terms, the heart rate was roughly stable (53 to 50), while MAP fell from 74 to 66. Systolic pressure was labile, ranging 87-136, with the lowest value around hour 18.5. SpO2 briefly dipped to 85 around hour 0 before recovering to 85, while respiratory rate peaked at 40 and later settled at 21. The associated labs and urine output showed that white count fell from 10.8 to 9.1, creatinine fell from 1.7 to 1.1, lactate fell from 1.3 to 1, and urine output rose from 35 to 160, with recorded outputs ranging 15-500.
B. In broad terms, the heart rate stayed around 48, while MAP was roughly stable (76 to 69). Systolic pressure was labile, ranging 81-121, with the lowest value around hour 17.4. SpO2 briefly dipped to 87 around hour 1 before recovering to 83, while respiratory rate peaked at 40 and later settled at 20. The associated labs and urine output showed that white count fell from 9.7 to 9.5, creatinine fell from 1.5 to 1.0, lactate fell from 1.5 to 1, and urine output was roughly stable (33 to 110), with recorded outputs ranging 14-515.
C. In broad terms, the heart rate stayed around 50, while MAP fell from 74 to 66. Systolic pressure was labile, ranging 83-136, with the lowest value around hour 18.5. SpO2 briefly dipped to 85 around hour 0 before recovering to 85, while respiratory rate peaked at 38 and later settled at 21. The associated labs and urine output showed that white count fell from 10.8 to 9.1, creatinine fell from 1.7 to 1.1, lactate fell from 1.3 to 1, and urine output rose from 35 to 160, with recorded outputs ranging 15-500.
D. In broad terms, the heart rate stayed around 46, while MAP fell from 78 to 62. Systolic pressure was labile, ranging 78-106, with the lowest value around hour 16.2. SpO2 briefly dipped to 90 around hour 0 before recovering to 80, while respiratory rate peaked at 42 and later settled at 19. The associated labs and urine output showed that white count fell from 8.6 to 8.3, creatinine fell from 1.4 to 1.2, lactate fell from 1.6 to 1, and urine output rose from 30 to 190, with recorded outputs ranging 35-530.

Answer: C


Question:
After reviewing the recorded vitals, labs, and urine output, which summary is most accurate?

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 134 to 124, MAP fell from 74 to 66, and heart rate stayed around 50. SpO2 started at 85, ended at 85, and fell as low as 85 around hour 0; respiratory rate ranged 14-38. For labs and output, white count fell from 10.8 to 9.1, creatinine fell from 1.7 to 1.1, lactate fell from 1.3 to 1, and urine output rose from 35 to 160.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 119 to 99, MAP fell from 72 to 64, and heart rate stayed around 52. SpO2 started at 83, ended at 87, and fell as low as 83 around hour 0; respiratory rate ranged 15-40. For labs and output, white count fell from 9.7 to 9.5, creatinine fell from 1.5 to 1.2, lactate fell from 1.5 to 1, and urine output rose from 33 to 175.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 159 to 99, MAP fell from 78 to 70, and heart rate was roughly stable (46 to 53). SpO2 started at 81, ended at 89, and fell as low as 85 around hour 0; respiratory rate ranged 14-40. For labs and output, white count fell from 10.8 to 8.3, creatinine fell from 1.7 to 1.1, lactate fell from 1.3 to 1, and urine output rose from 35 to 160.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 104 to 84, MAP was roughly stable (70 to 69), and heart rate stayed around 54. SpO2 started at 80, ended at 90, and fell as low as 84 around hour 0; respiratory rate ranged 16-42. For labs and output, white count fell from 8.6 to 8.1, creatinine fell from 1.4 to 0.8, lactate fell from 1.6 to 1, and urine output rose from 30 to 190.

Answer: A


Question:
Which summary best avoids misstating the observed ICU course?

Options:
A. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (63 to 66), diastolic pressure rose from 49 to 56, and heart rate was roughly stable (86 to 91). The lowest MAP was about 55 around hour 303.1, and the lowest valid SpO2 was 85 around hour 302.3; respiratory rate rose as high as 39 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 36.2-38.4 C, white count rose from 9.5 to 11.5, creatinine was roughly stable (3.5 to 2.4), lactate was checked once at 1, and urine output fell from 550 to 100.
B. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (61 to 68), diastolic pressure was roughly stable (47 to 53), and heart rate was roughly stable (88 to 89). The lowest MAP was about 58 around hour 304.1, and the lowest valid SpO2 was 83 around hour 317.3; respiratory rate rose as high as 37 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 38.5-40.6 C, white count rose from 9.1 to 12.6, creatinine was roughly stable (3.1 to 2.2), lactate was checked once at 1, and urine output fell from 535 to 98.
C. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (67 to 62), diastolic pressure rose from 53 to 60, and heart rate rose from 82 to 94. The lowest MAP was about 59 around hour 278.1, and the lowest valid SpO2 was 89 around hour 301.3; respiratory rate rose as high as 43 but ended at 27. The lower-frequency data fit that summary: temperature stayed around 32.5-34.6 C, white count rose from 10.1 to 11.6, creatinine was roughly stable (4.1 to 2.6), lactate was checked once at 1, and urine output fell from 575 to 96.
D. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (58 to 70), diastolic pressure rose from 44 to 52, and heart rate was roughly stable (90 to 86). The lowest MAP was about 50 around hour 333.1, and the lowest valid SpO2 was 80 around hour 332.3; respiratory rate rose as high as 41 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 40.7-42.9 C, white count rose from 8.8 to 13.8, creatinine was roughly stable (2.8 to 2.5), lactate was checked once at 1, and urine output fell from 520 to 150.

Answer: A

Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (63 to 66), diastolic pressure rose from 49 to 56, and heart rate was roughly stable (86 to 91). The lowest MAP was about 55 around hour 303.1, and the lowest valid SpO2 was 85 around hour 302.3; respiratory rate rose as high as 39 but ended at 25. The lower-frequency data fit that summary: temperature ranged from 97.1 to 101.1, white count rose from 9.5 to 11.5, creatinine was roughly stable (3.5 to 2.4), lactate was checked once at 1, and urine output fell from 550 to 100.


Question:
Which synopsis best matches the observed sequence rather than a plausible alternative?

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 111 to 94, MAP was roughly stable (66 to 69), and heart rate was roughly stable (83 to 94). SpO2 started at 97, ended at 97, and fell as low as 88 around hour 282.3; respiratory rate ranged 12-36. For labs and output, white count rose from 9.0 to 13.0, creatinine was roughly stable (4.0 to 2.5), lactate was checked once at 1.2, and urine output fell from 570 to 97.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 108 to 97, MAP was roughly stable (63 to 66), and heart rate was roughly stable (86 to 91). SpO2 started at 100, ended at 100, and fell as low as 85 around hour 302.3; respiratory rate ranged 10-39. For labs and output, white count rose from 9.5 to 11.5, creatinine was roughly stable (3.5 to 2.4), lactate was checked once at 1, and urine output fell from 550 to 100.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 112 to 93, MAP was roughly stable (67 to 70), and heart rate rose from 82 to 94. SpO2 started at 96, ended at 96, and fell as low as 89 around hour 277.3; respiratory rate ranged 12-41. For labs and output, white count rose from 8.9 to 10.7, creatinine was roughly stable (4.1 to 2.1), lactate was checked once at 1, and urine output fell from 575 to 96.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 104 to 93, MAP rose from 58 to 69, and heart rate was roughly stable (90 to 86). SpO2 started at 96, ended at 96, and fell as low as 84 around hour 332.3; respiratory rate ranged 8-44. For labs and output, white count rose from 10.2 to 11.7, creatinine was roughly stable (2.8 to 2.7), lactate was checked once at 1, and urine output fell from 520 to 96.

Answer: B


Question:
Which option correctly summarizes the serial measurements for this ICU stay?

Options:
A. Across the recorded window, the heart rate rose from 89 to 94, MAP was roughly stable (66 to 69), and diastolic pressure moved from 46 to 53. Systolic pressure ranged 95-181 and ended at 100, and SpO2 recovered to 97 after a low of 88 around hour 322.3. Respiratory rate ended at 24; the available labs showed white count rose from 10.0 to 13.0, creatinine was roughly stable (3.0 to 2.6), lactate was checked once at 1, and urine output fell from 530 to 97.
B. Across the recorded window, the heart rate was roughly stable (84 to 93), MAP was roughly stable (61 to 64), and diastolic pressure moved from 51 to 54. Systolic pressure ranged 90-146 and ended at 95, and SpO2 recovered to 98 after a low of 84 around hour 287.3. Respiratory rate ended at 26; the available labs showed white count rose from 9.1 to 10.7, creatinine was roughly stable (3.9 to 2.2), lactate was checked once at 1, and urine output fell from 600 to 98.
C. Across the recorded window, the heart rate was roughly stable (86 to 91), MAP was roughly stable (63 to 66), and diastolic pressure moved from 49 to 56. Systolic pressure ranged 92-161 and ended at 97, and SpO2 recovered to 100 after a low of 85 around hour 302.3. Respiratory rate ended at 25; the available labs showed white count rose from 9.5 to 11.5, creatinine was roughly stable (3.5 to 2.4), lactate was checked once at 1, and urine output fell from 550 to 100.
D. Across the recorded window, the heart rate was roughly stable (82 to 96), MAP rose from 58 to 69, and diastolic pressure moved from 54 to 52. Systolic pressure ranged 88-131 and ended at 93, and SpO2 recovered to 96 after a low of 80 around hour 303.3. Respiratory rate ended at 27; the available labs showed white count rose from 8.8 to 9.2, creatinine was roughly stable (4.2 to 2.1), lactate was checked once at 1, and urine output fell from 580 to 96.

Answer: C


Question:
Which brief chart summary best matches the measurement sequence?

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 107 to 64, diastolic pressure fell from 88 to 63, and heart rate rose from 57 to 102. The lowest MAP was about 52 around hour 41.5, and the lowest valid SpO2 was 84 around hour 38.5; respiratory rate rose as high as 30 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.1-33.8 C, white count fell from 14.8 to 8.1, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 0.7, and urine output fell from 540 to 53.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 102 to 69, diastolic pressure fell from 83 to 58, and heart rate rose from 62 to 97. The lowest MAP was about 47 around hour 46.8, and the lowest valid SpO2 was 79 around hour 41.8; respiratory rate rose as high as 30 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 38.4-39.0 C, white count fell from 12.2 to 9.0, creatinine stayed around 0.6, lactate was checked once at 0.8, and urine output fell from 520 to 100.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 104 to 67, diastolic pressure fell from 85 to 60, and heart rate rose from 60 to 99. The lowest MAP was about 49 around hour 44.5, and the lowest valid SpO2 was 81 around hour 39.5; respiratory rate rose as high as 28 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.1-36.8 C, white count fell from 13.3 to 8.6, creatinine was roughly stable (0.7 to 0.6), lactate was checked once at 0.8, and urine output fell from 520 to 50.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 72, diastolic pressure fell from 80 to 57, and heart rate rose from 64 to 94. The lowest MAP was about 52 around hour 45.5, and the lowest valid SpO2 was 76 around hour 44.0; respiratory rate rose as high as 26 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 40.6-41.3 C, white count fell from 11.1 to 9.3, creatinine was roughly stable (0.5 to 0.4), lactate was checked once at 1.0, and urine output fell from 490 to 46.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 104 to 67, diastolic pressure fell from 85 to 60, and heart rate rose from 60 to 99. The lowest MAP was about 49 around hour 44.5, and the lowest valid SpO2 was 81 around hour 39.5; respiratory rate rose as high as 28 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 97 to 98.3, white count fell from 13.3 to 8.6, creatinine was roughly stable (0.7 to 0.6), lactate was checked once at 0.8, and urine output fell from 520 to 50.


Question:
Which handoff summary best matches the measured ICU course?

Options:
A. Over the available measurements, the heart rate rose from 60 to 99, MAP fell from 104 to 67, and diastolic pressure moved from 85 to 60. Systolic pressure ranged 78-135 and ended at 90, and SpO2 recovered to 98 after a low of 81 around hour 39.5. Respiratory rate ended at 17; the available labs showed white count fell from 13.3 to 8.6, creatinine was roughly stable (0.7 to 0.6), lactate was checked once at 0.8, and urine output fell from 520 to 50.
B. Over the available measurements, the heart rate rose from 58 to 100, MAP fell from 102 to 70, and diastolic pressure moved from 87 to 58. Systolic pressure ranged 76-120 and ended at 86, and SpO2 recovered to 100 after a low of 79 around hour 40.5. Respiratory rate ended at 18; the available labs showed white count fell from 12.2 to 8.2, creatinine was roughly stable (0.8 to 0.5), lactate was checked once at 0.7, and urine output fell from 535 to 48.
C. Over the available measurements, the heart rate rose from 64 to 102, MAP fell from 108 to 71, and diastolic pressure moved from 81 to 57. Systolic pressure ranged 82-160 and ended at 94, and SpO2 recovered to 94 after a low of 85 around hour 43.2. Respiratory rate ended at 15; the available labs showed white count fell from 15.2 to 9.2, creatinine was roughly stable (0.6 to 0.7), lactate was checked once at 0.9, and urine output fell from 495 to 54.
D. Over the available measurements, the heart rate rose from 56 to 100, MAP fell from 100 to 62, and diastolic pressure moved from 90 to 56. Systolic pressure ranged 74-105 and ended at 86, and SpO2 recovered to 100 after a low of 80 around hour 35.0. Respiratory rate ended at 19; the available labs showed white count fell from 11.1 to 7.8, creatinine was roughly stable (0.8 to 0.4), lactate was checked once at 0.7, and urine output fell from 570 to 46.

Answer: A


Question:
Which summary most accurately describes the patient's changes over the episode?

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 94, diastolic pressure rose from 61 to 91, and heart rate rose from 79 to 118. The lowest MAP was about 50 around hour 20.8, and the lowest valid SpO2 was 91 around hour 0.9; respiratory rate rose as high as 37 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 32.7-34.8 C, white count was roughly stable (12 to 9.0), creatinine stayed around 0.6, lactate fell from 4.1 to 2.4, and urine output fell from 600 to 330.
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 69 to 97, diastolic pressure rose from 58 to 88, and heart rate rose from 82 to 115. The lowest MAP was about 47 around hour 22.3, and the lowest valid SpO2 was 88 around hour 1.1; respiratory rate rose as high as 35 but ended at 27. The lower-frequency data fit that summary: temperature stayed around 35.7-37.8 C, white count was roughly stable (11 to 10.5), creatinine was roughly stable (0.5 to 0.4), lactate fell from 4.1 to 2.4, and urine output fell from 600 to 280.
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 73 to 93, diastolic pressure rose from 62 to 92, and heart rate rose from 78 to 118. The lowest MAP was about 51 around hour 20.4, and the lowest valid SpO2 was 92 around hour 0.1; respiratory rate rose as high as 39 but ended at 29. The lower-frequency data fit that summary: temperature stayed around 32.0-34.0 C, white count was roughly stable (13 to 8.6), creatinine was roughly stable (0.6 to 0.5), lactate fell from 3.5 to 2.6, and urine output fell from 625 to 255.
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 64 to 100, diastolic pressure rose from 54 to 85, and heart rate rose from 86 to 110. The lowest MAP was about 50 around hour 23.3, and the lowest valid SpO2 was 84 around hour 1.4; respiratory rate rose as high as 30 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 40.2-42.3 C, white count was roughly stable (9 to 12.8), creatinine was roughly stable (0.3 to 0.2), lactate fell from 4.8 to 2.1, and urine output fell from 570 to 310.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 69 to 97, diastolic pressure rose from 58 to 88, and heart rate rose from 82 to 115. The lowest MAP was about 47 around hour 22.3, and the lowest valid SpO2 was 88 around hour 1.1; respiratory rate rose as high as 35 but ended at 27. The lower-frequency data fit that summary: temperature ranged from 96.2 to 100.1, white count was roughly stable (11 to 10.5), creatinine was roughly stable (0.5 to 0.4), lactate fell from 4.1 to 2.4, and urine output fell from 600 to 280.


Question:
Which option best summarizes the hemodynamic, respiratory, lab, and urine-output pattern?

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 93 to 123, MAP rose from 72 to 100, and heart rate rose from 79 to 118. SpO2 started at 94, ended at 99, and fell as low as 87 around hour 0.9; respiratory rate ranged 8-32. For labs and output, white count was roughly stable (10 to 12.0), creatinine was roughly stable (0.6 to 0.3), lactate fell from 4.6 to 2.6, and urine output fell from 580 to 300.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 88 to 142, MAP rose from 67 to 95, and heart rate rose from 84 to 118. SpO2 started at 99, ended at 94, and fell as low as 86 around hour 1.2; respiratory rate ranged 8-37. For labs and output, white count fell from 12 to 9.7, creatinine was roughly stable (0.4 to 0.5), lactate fell from 3.7 to 2.2, and urine output fell from 615 to 265.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 90 to 127, MAP rose from 69 to 97, and heart rate rose from 82 to 115. SpO2 started at 97, ended at 96, and fell as low as 88 around hour 1.1; respiratory rate ranged 8-35. For labs and output, white count was roughly stable (11 to 10.5), creatinine was roughly stable (0.5 to 0.4), lactate fell from 4.1 to 2.4, and urine output fell from 600 to 280.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 86 to 157, MAP rose from 64 to 92, and heart rate rose from 86 to 110. SpO2 started at 100, ended at 92, and fell as low as 84 around hour 1.4; respiratory rate ranged 7-40. For labs and output, white count was roughly stable (13 to 8.2), creatinine stayed around 0.3, lactate fell from 4.3 to 2.4, and urine output fell from 600 to 280.

Answer: C


Question:
Which option is most consistent with the actual sequence of measurements?

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 160, MAP rose from 100 to 111, and heart rate rose from 60 to 105. SpO2 started at 85, ended at 99, and fell as low as 85 around hour 0; respiratory rate ranged 12-22. For labs and output, white count rose from 9.2 to 15.2, creatinine stayed around 0.7, lactate was not available, and urine output was roughly stable (400 to 350)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 145, MAP rose from 98 to 109, and heart rate rose from 58 to 107. SpO2 started at 84, ended at 100, and fell as low as 84 around hour 0; respiratory rate ranged 13-23. For labs and output, white count rose from 8.8 to 16.3, creatinine was roughly stable (0.6 to 0.8), lactate was not available, and urine output was roughly stable (400 to 350)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (185 to 156), MAP rose from 100 to 114, and heart rate rose from 60 to 105. SpO2 started at 85, ended at 99, and fell as low as 84 around hour 0; respiratory rate ranged 12-22. For labs and output, white count rose from 9.2 to 15.2, creatinine stayed around 0.7, lactate was not available, and urine output was roughly stable (400 to 350)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 130, MAP rose from 96 to 106, and heart rate rose from 56 to 108. SpO2 started at 80, ended at 100, and fell as low as 80 around hour 0; respiratory rate ranged 14-24. For labs and output, white count rose from 8.4 to 14.4, creatinine stayed around 0.5, lactate was not available, and urine output was roughly stable (370 to 380)

Answer: A


Question:
Which summary best captures the overall course shown by the serial data?

Options:
A. For handoff, the heart rate rose from 63 to 102, MAP rose from 97 to 114, and diastolic pressure moved from 79 to 96. Systolic pressure ranged 100-215 and ended at 156, and SpO2 recovered to 96 after a low of 88 around hour 1. Respiratory rate ended at 16; the available labs showed white count rose from 9.7 to 16.7, creatinine stayed around 0.6, lactate was not available, and urine output was roughly stable (420 to 370)
B. For handoff, the heart rate rose from 60 to 105, MAP rose from 100 to 111, and diastolic pressure moved from 82 to 93. Systolic pressure ranged 99-195 and ended at 160, and SpO2 recovered to 99 after a low of 85 around hour 0. Respiratory rate ended at 18; the available labs showed white count rose from 9.2 to 15.2, creatinine stayed around 0.7, lactate was not available, and urine output was roughly stable (400 to 350)
C. For handoff, the heart rate rose from 64 to 108, MAP rose from 96 to 115, and diastolic pressure moved from 78 to 90. Systolic pressure ranged 100-220 and ended at 185, and SpO2 recovered to 95 after a low of 89 around hour 2. Respiratory rate ended at 16; the available labs showed white count rose from 9.8 to 17.1, creatinine stayed around 0.6, lactate was not available, and urine output was roughly stable (425 to 375)
D. For handoff, the heart rate rose from 56 to 110, MAP rose from 96 to 106, and diastolic pressure moved from 86 to 88. Systolic pressure ranged 94-165 and ended at 130, and SpO2 recovered to 100 after a low of 84 around hour 0. Respiratory rate ended at 20; the available labs showed white count rose from 8.4 to 14.4, creatinine stayed around 0.8, lactate was not available, and urine output fell from 450 to 320.

Answer: B


Question:
After checking the full sequence of measurements, which handoff is most accurate?

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 148 to 87, diastolic pressure fell from 143 to 72, and heart rate fell from 93 to 84. The lowest MAP was about 67 around hour 5.3, and the lowest valid SpO2 was 88 around hour 0.6; respiratory rate rose as high as 30 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.4-34.2 C, white count rose from 23.1 to 23.6, creatinine fell from 1.4 to 0.9, lactate was checked once at 1.6, and urine output fell from 720 to 160.
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 113 to 92, diastolic pressure fell from 108 to 73, and heart rate fell from 98 to 79. The lowest MAP was about 62 around hour 4.7, and the lowest valid SpO2 was 83 around hour 0.8; respiratory rate rose as high as 30 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 38.6-39.5 C, white count rose from 20.5 to 26.2, creatinine fell from 1.0 to 0.9, lactate was checked once at 2.0, and urine output fell from 685 to 190.
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 128 to 90, diastolic pressure fell from 123 to 75, and heart rate fell from 96 to 81. The lowest MAP was about 64 around hour 4.3, and the lowest valid SpO2 was 85 around hour 0.7; respiratory rate rose as high as 28 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 36.4-37.2 C, white count rose from 21.6 to 25.1, creatinine fell from 1.2 to 0.8, lactate was checked once at 1.8, and urine output fell from 700 to 140.
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 98 to 94, diastolic pressure fell from 93 to 70, and heart rate fell from 100 to 84. The lowest MAP was about 60 around hour 5.0, and the lowest valid SpO2 was 80 around hour 0; respiratory rate rose as high as 26 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 40.9-41.7 C, white count rose from 19.4 to 27.4, creatinine fell from 0.9 to 0.7, lactate was checked once at 2.1, and urine output fell from 670 to 110.

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 128 to 90, diastolic pressure fell from 123 to 75, and heart rate fell from 96 to 81. The lowest MAP was about 64 around hour 4.3, and the lowest valid SpO2 was 85 around hour 0.7; respiratory rate rose as high as 28 but ended at 22. The lower-frequency data fit that summary: temperature ranged from 97.5 to 99, white count rose from 21.6 to 25.1, creatinine fell from 1.2 to 0.8, lactate was checked once at 1.8, and urine output fell from 700 to 140.


Question:
Which clinical summary is best supported by the time-stamped measurements?

Options:
A. Across the recorded window, the heart rate was roughly stable (83 to 82), MAP was roughly stable (89 to 84), and diastolic pressure moved from 65 to 66. Systolic pressure ranged 85-194 and ended at 113, and SpO2 recovered to 97 after a low of 88 around hour 4.7. Respiratory rate ended at 22; the available labs showed white count fell from 22 to 18.3, creatinine rose from 0.7 to 1.3, lactate stayed broadly stable from 2.1 to 2, and urine output fell from 445 to 26.
B. Across the recorded window, the heart rate was roughly stable (78 to 81), MAP was roughly stable (84 to 79), and diastolic pressure moved from 70 to 67. Systolic pressure ranged 80-159 and ended at 108, and SpO2 recovered to 98 after a low of 84 around hour 3.8. Respiratory rate ended at 25; the available labs showed white count fell from 19 to 16, creatinine rose from 0.9 to 1.0, lactate stayed broadly stable from 1.8 to 2, and urine output fell from 475 to 24.
C. Across the recorded window, the heart rate was roughly stable (80 to 79), MAP was roughly stable (86 to 81), and diastolic pressure moved from 68 to 69. Systolic pressure ranged 82-174 and ended at 110, and SpO2 recovered to 100 after a low of 85 around hour 4.2. Respiratory rate ended at 24; the available labs showed white count fell from 20 to 16.8, creatinine rose from 0.8 to 1.1, lactate stayed broadly stable from 1.9 to 2, and urine output fell from 425 to 25.
D. Across the recorded window, the heart rate was roughly stable (76 to 84), MAP was roughly stable (82 to 84), and diastolic pressure moved from 72 to 64. Systolic pressure ranged 78-144 and ended at 106, and SpO2 recovered to 96 after a low of 80 around hour 5.2. Respiratory rate ended at 26; the available labs showed white count fell from 18 to 14.6, creatinine rose from 1.0 to 1.2, lactate stayed broadly stable from 1.6 to 2, and urine output fell from 395 to 23.

Answer: C


Question:
Which option best summarizes the hemodynamic, respiratory, lab, and urine-output pattern?

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was not recorded, diastolic pressure was roughly stable (63 to 57), and heart rate rose from 50 to 84. The lowest MAP was about not recorded around hour unknown, and the lowest valid SpO2 was 85 around hour 38; respiratory rate rose as high as 16 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 37.2-37.2 C, white count fell from 9.7 to 5.6, creatinine rose from 1 to 1.6, lactate was not available, and urine output was roughly stable (220 to 200)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was not recorded, diastolic pressure stayed around 60, and heart rate rose from 50 to 84. The lowest MAP was about not recorded around hour unknown, and the lowest valid SpO2 was 85 around hour 38; respiratory rate rose as high as 17 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 37.2-37.2 C, white count fell from 9.7 to 5.6, creatinine rose from 1 to 1.6, lactate was not available, and urine output was roughly stable (200 to 200)
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was not recorded, diastolic pressure stayed around 64, and heart rate rose from 46 to 87. The lowest MAP was about not recorded around hour unknown, and the lowest valid SpO2 was 81 around hour 37; respiratory rate rose as high as 19 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 41.0-33.5 C, white count fell from 9.1 to 6.2, creatinine rose from 1 to 1.4, lactate was not available, and urine output was roughly stable (225 to 225)
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was not recorded, diastolic pressure stayed around 56, and heart rate rose from 54 to 80. The lowest MAP was about not recorded around hour unknown, and the lowest valid SpO2 was 90 around hour 34; respiratory rate rose as high as 19 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 32.7-41.7 C, white count fell from 10.4 to 4.8, creatinine rose from 1 to 1.7, lactate was not available, and urine output was roughly stable (170 to 250)

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was not recorded, diastolic pressure stayed around 60, and heart rate rose from 50 to 84. The lowest MAP was about not recorded around hour unknown, and the lowest valid SpO2 was 85 around hour 38; respiratory rate rose as high as 17 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 99 to 99, white count fell from 9.7 to 5.6, creatinine rose from 1 to 1.6, lactate was not available, and urine output was roughly stable (200 to 200)


Question:
Which clinical synopsis would you choose after reviewing the data chronologically?

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 86 to 94, diastolic pressure rose from 66 to 76, and heart rate fell from 77 to 72. The lowest MAP was about 65 around hour 8.3, and the lowest valid SpO2 was 88 around hour 6.4; respiratory rate rose as high as 26 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 33.3-33.9 C, white count was roughly stable (19.1 to 15.3), creatinine was roughly stable (1.0 to 1), lactate fell from 1.5 to 1.3, and urine output was roughly stable (97 to 27)
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 83 to 97, diastolic pressure rose from 63 to 79, and heart rate fell from 80 to 69. The lowest MAP was about 62 around hour 7.3, and the lowest valid SpO2 was 85 around hour 6.9; respiratory rate rose as high as 25 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 36.3-36.9 C, white count was roughly stable (17.6 to 16.8), creatinine was roughly stable (0.9 to 1), lactate fell from 1.7 to 1.4, and urine output was roughly stable (100 to 30)
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 87 to 93, diastolic pressure rose from 67 to 83, and heart rate fell from 76 to 72. The lowest MAP was about 66 around hour 6.7, and the lowest valid SpO2 was 89 around hour 5.9; respiratory rate rose as high as 27 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 32.5-33.1 C, white count was roughly stable (19.5 to 14.9), creatinine was roughly stable (1.0 to 1), lactate fell from 1.4 to 1.2, and urine output was roughly stable (96 to 26)
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 78 to 100, diastolic pressure rose from 58 to 74, and heart rate fell from 84 to 64. The lowest MAP was about 58 around hour 8.1, and the lowest valid SpO2 was 80 around hour 7.7; respiratory rate rose as high as 27 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 40.8-41.4 C, white count was roughly stable (15.4 to 19.1), creatinine rose from 0.8 to 1.1, lactate fell from 2.0 to 1.1, and urine output was roughly stable (96 to 80)

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 83 to 97, diastolic pressure rose from 63 to 79, and heart rate fell from 80 to 69. The lowest MAP was about 62 around hour 7.3, and the lowest valid SpO2 was 85 around hour 6.9; respiratory rate rose as high as 25 but ended at 24. The lower-frequency data fit that summary: temperature ranged from 97.4 to 98.5, white count was roughly stable (17.6 to 16.8), creatinine was roughly stable (0.9 to 1), lactate fell from 1.7 to 1.4, and urine output was roughly stable (100 to 30)


Question:
Which brief chart summary best matches the measurement sequence?

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 107 to 77, diastolic pressure fell from 72 to 61, and heart rate rose from 37 to 79. The lowest MAP was about 78 around hour 10.3, and the lowest valid SpO2 was 91 around hour 0.1; respiratory rate rose as high as 38 but ended at 8. The lower-frequency data fit that summary: temperature stayed around 33.4-33.9 C, white count was 12.2 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 195 to 720.
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 102 to 82, diastolic pressure was roughly stable (67 to 62), and heart rate rose from 42 to 74. The lowest MAP was about 73 around hour 9.7, and the lowest valid SpO2 was 86 around hour 0.3; respiratory rate rose as high as 37 but ended at 8. The lower-frequency data fit that summary: temperature stayed around 38.6-39.1 C, white count was 9.6 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 160 to 750.
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 104 to 80, diastolic pressure was roughly stable (69 to 64), and heart rate rose from 40 to 76. The lowest MAP was about 75 around hour 9.3, and the lowest valid SpO2 was 88 around hour 0.2; respiratory rate rose as high as 35 but ended at 8. The lower-frequency data fit that summary: temperature stayed around 36.4-36.9 C, white count was 10.7 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 175 to 700.
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 84, diastolic pressure was roughly stable (64 to 60), and heart rate rose from 44 to 79. The lowest MAP was about 70 around hour 10.1, and the lowest valid SpO2 was 87 around hour 0; respiratory rate rose as high as 30 but ended at 7. The lower-frequency data fit that summary: temperature stayed around 40.9-41.4 C, white count was 8.4 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 145 to 670.

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 104 to 80, diastolic pressure was roughly stable (69 to 64), and heart rate rose from 40 to 76. The lowest MAP was about 75 around hour 9.3, and the lowest valid SpO2 was 88 around hour 0.2; respiratory rate rose as high as 35 but ended at 8. The lower-frequency data fit that summary: temperature ranged from 97.6 to 98.5, white count was 10.7 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 175 to 700.


Question:
Which summary best preserves the direction and size of the recorded changes?

Options:
A. For handoff, the heart rate fell from 114 to 84, MAP fell from 95 to 80, and diastolic pressure moved from 64 to 64. Systolic pressure ranged 99-193 and ended at 155, and SpO2 recovered to 95 after a low of 84 around hour 89.7. Respiratory rate ended at 20; the available labs showed white count fell from 6 to 4.2, creatinine was roughly stable (0.5 to 0.6), lactate fell from 284 to 0.5, and urine output was roughly stable (200 to 220)
B. For handoff, the heart rate fell from 111 to 87, MAP fell from 92 to 77, and diastolic pressure moved from 67 to 61. Systolic pressure ranged 96-173 and ended at 135, and SpO2 recovered to 98 after a low of 85 around hour 86.7. Respiratory rate ended at 21; the available labs showed white count was roughly stable (6 to 5), creatinine was roughly stable (0.6 to 0.5), lactate fell from 264 to 0.6, and urine output was roughly stable (150 to 200)
C. For handoff, the heart rate fell from 115 to 83, MAP fell from 96 to 80, and diastolic pressure moved from 63 to 65. Systolic pressure ranged 100-198 and ended at 131, and SpO2 recovered to 94 after a low of 89 around hour 87.7. Respiratory rate ended at 19; the available labs showed white count was roughly stable (7 to 6), creatinine was roughly stable (0.5 to 0.6), lactate fell from 289 to 0.5, and urine output was roughly stable (175 to 225)
D. For handoff, the heart rate fell from 106 to 90, MAP fell from 88 to 72, and diastolic pressure moved from 72 to 58. Systolic pressure ranged 92-143 and ended at 105, and SpO2 recovered to 100 after a low of 80 around hour 82.2. Respiratory rate ended at 23; the available labs showed white count was roughly stable (5 to 4), creatinine was roughly stable (0.8 to 0.3), lactate fell from 234 to 0.8, and urine output was roughly stable (120 to 170)

Answer: B