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

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 93 to 69, diastolic pressure rose from 26 to 58, and heart rate was roughly stable (91 to 95). The lowest MAP was about 66 around hour 24.8, and the lowest valid SpO2 was 88 around hour 2.3; respiratory rate rose as high as 28 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 32.8-34.4 C, white count rose from 16.9 to 18.4, creatinine stayed around 0.5, lactate was checked once at 1.3, and urine output fell from 650 to 520.
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 72, diastolic pressure rose from 24 to 61, and heart rate was roughly stable (94 to 92). The lowest MAP was about 63 around hour 23.8, and the lowest valid SpO2 was 85 around hour 2.5; respiratory rate rose as high as 26 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 35.8-37.4 C, white count rose from 15.4 to 16.5, creatinine stayed around 0.4, lactate was checked once at 1.1, and urine output fell from 670 to 500.
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 68, diastolic pressure rose from 26 to 65, and heart rate was roughly stable (90 to 95). The lowest MAP was about 67 around hour 21.9, and the lowest valid SpO2 was 89 around hour 1.5; respiratory rate rose as high as 28 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 32.0-33.6 C, white count rose from 17.3 to 18.8, creatinine stayed around 0.5, lactate was checked once at 1.4, and urine output fell from 645 to 525.
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 76, diastolic pressure rose from 22 to 56, and heart rate was roughly stable (98 to 88). The lowest MAP was about 58 around hour 26.1, and the lowest valid SpO2 was 80 around hour 2.8; respiratory rate rose as high as 28 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 40.3-41.9 C, white count rose from 13.2 to 18.8, creatinine was roughly stable (0.2 to 0.5), lactate was checked once at 1.1, and urine output fell from 670 to 550.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 72, diastolic pressure rose from 24 to 61, and heart rate was roughly stable (94 to 92). The lowest MAP was about 63 around hour 23.8, and the lowest valid SpO2 was 85 around hour 2.5; respiratory rate rose as high as 26 but ended at 14. The lower-frequency data fit that summary: temperature ranged from 35.8 to 99, white count rose from 15.4 to 16.5, creatinine stayed around 0.4, lactate was checked once at 1.1, and urine output fell from 670 to 500.


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

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 42 to 105, MAP fell from 93 to 75, and heart rate was roughly stable (91 to 95). SpO2 started at 97, ended at 100, and fell as low as 84 around hour 2.3; respiratory rate ranged 10-24. For labs and output, white count rose from 13.9 to 18.0, creatinine stayed around 0.5, lactate was checked once at 0.9, and urine output fell from 690 to 520.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 37 to 111, MAP fell from 88 to 70, and heart rate was roughly stable (96 to 90). SpO2 started at 98, ended at 95, and fell as low as 83 around hour 2.6; respiratory rate ranged 9-27. For labs and output, white count rose from 16.5 to 18.0, creatinine was roughly stable (0.3 to 0.5), lactate was checked once at 1.3, and urine output fell from 670 to 500.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 39 to 109, MAP fell from 90 to 72, and heart rate was roughly stable (94 to 92). SpO2 started at 100, ended at 97, and fell as low as 85 around hour 2.5; respiratory rate ranged 9-26. For labs and output, white count rose from 15.4 to 16.5, creatinine stayed around 0.4, lactate was checked once at 1.1, and urine output fell from 670 to 500.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 34 to 114, MAP fell from 86 to 68, and heart rate was roughly stable (98 to 95). SpO2 started at 96, ended at 92, and fell as low as 80 around hour 2.8; respiratory rate ranged 8-28. For labs and output, white count was roughly stable (17.6 to 15.7), creatinine stayed around 0.2, lactate was checked once at 1.4, and urine output fell from 640 to 470.

Answer: C


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

Options:
A. Taken together, the heart rate fell from 149 to 93, while MAP fell from 110 to 80. Systolic pressure was labile, ranging 66-175, with the lowest value around hour 21.1. SpO2 briefly dipped to 89 around hour 0.8 before recovering to 93, while respiratory rate peaked at 33 and later settled at 16. The associated labs and urine output showed that white count fell from 11.8 to 9.7, creatinine fell from 0.8 to 0.4, lactate was not available, and urine output fell from 140 to 43, with recorded outputs ranging 27-330.
B. Taken together, the heart rate fell from 129 to 96, while MAP fell from 107 to 77. Systolic pressure was labile, ranging 62-195, with the lowest value around hour 19.6. SpO2 briefly dipped to 88 around hour 0.7 before recovering to 96, while respiratory rate peaked at 31 and later settled at 15. The associated labs and urine output showed that white count fell from 13.3 to 9.2, creatinine fell from 0.7 to 0.5, lactate was not available, and urine output fell from 120 to 40, with recorded outputs ranging 30-350.
C. Taken together, the heart rate fell from 154 to 92, while MAP fell from 111 to 80. Systolic pressure was labile, ranging 58-170, with the lowest value around hour 21.5. SpO2 briefly dipped to 92 around hour 1.7 before recovering to 92, while respiratory rate peaked at 35 and later settled at 17. The associated labs and urine output showed that white count fell from 11.4 to 9.8, creatinine fell from 0.8 to 0.4, lactate was not available, and urine output fell from 145 to 0, with recorded outputs ranging 0-325.
D. Taken together, the heart rate fell from 99 to 96, while MAP fell from 102 to 72. Systolic pressure was labile, ranging 66-225, with the lowest value around hour 17.4. SpO2 briefly dipped to 84 around hour 0.5 before recovering to 100, while respiratory rate peaked at 26 and later settled at 13. The associated labs and urine output showed that white count fell from 15.6 to 8.4, creatinine was roughly stable (0.5 to 0.6), lactate was not available, and urine output fell from 90 to 36, with recorded outputs ranging 40-380.

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 110 to 74, diastolic pressure fell from 92 to 65, and heart rate fell from 109 to 99. The lowest MAP was about 54 around hour 18.1, and the lowest valid SpO2 was 91 around hour 0.6; respiratory rate rose as high as 33 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 34.5-35.8 C, white count fell from 14.8 to 8.7, creatinine was roughly stable (0.8 to 0.6), lactate was not available, and urine output was roughly stable (100 to 90)
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 105 to 79, diastolic pressure fell from 87 to 59, and heart rate fell from 144 to 94. The lowest MAP was about 54 around hour 20.6, and the lowest valid SpO2 was 86 around hour 0.8; respiratory rate rose as high as 29 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 39.8-41.0 C, white count fell from 12.2 to 9.6, creatinine fell from 0.6 to 0.4, lactate was not available, and urine output fell from 135 to 38.
C. 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 89 to 62, and heart rate fell from 129 to 96. The lowest MAP was about 51 around hour 19.6, and the lowest valid SpO2 was 88 around hour 0.7; respiratory rate rose as high as 31 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 37.5-38.8 C, white count fell from 13.3 to 9.2, creatinine fell from 0.7 to 0.5, lactate was not available, and urine output fell from 120 to 40.
D. 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 fell from 84 to 58, and heart rate fell from 159 to 99. The lowest MAP was about 46 around hour 21.9, and the lowest valid SpO2 was 84 around hour 0; respiratory rate rose as high as 26 but ended at 13. The lower-frequency data fit that summary: temperature stayed around 42.0-43.3 C, white count fell from 11.1 to 9.9, creatinine fell from 0.5 to 0.3, lactate was not available, and urine output fell from 150 to 36.

Answer: C

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 89 to 62, and heart rate fell from 129 to 96. The lowest MAP was about 51 around hour 19.6, and the lowest valid SpO2 was 88 around hour 0.7; respiratory rate rose as high as 31 but ended at 15. The lower-frequency data fit that summary: temperature ranged from 37.8 to 100.8, white count fell from 13.3 to 9.2, creatinine fell from 0.7 to 0.5, lactate was not available, and urine output fell from 120 to 40.


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

Options:
A. In broad terms, the heart rate fell from 129 to 96, MAP fell from 107 to 77, and diastolic pressure moved from 89 to 62. Systolic pressure ranged 62-195 and ended at 151, and SpO2 recovered to 96 after a low of 88 around hour 0.7. Respiratory rate ended at 15; the available labs showed white count fell from 13.3 to 9.2, creatinine fell from 0.7 to 0.5, lactate was not available, and urine output fell from 120 to 40.
B. In broad terms, the heart rate fell from 114 to 99, MAP fell from 105 to 75, and diastolic pressure moved from 91 to 59. Systolic pressure ranged 60-180 and ended at 136, and SpO2 recovered to 98 after a low of 86 around hour 0.6. Respiratory rate ended at 16; the available labs showed white count fell from 12.2 to 8.8, creatinine fell from 0.8 to 0.4, lactate was not available, and urine output fell from 105 to 42.
C. In broad terms, the heart rate fell from 154 to 92, MAP fell from 111 to 80, and diastolic pressure moved from 85 to 66. Systolic pressure ranged 66-220 and ended at 147, and SpO2 recovered to 92 after a low of 92 around hour 1.7. Respiratory rate ended at 13; the available labs showed white count fell from 15.2 to 9.8, creatinine fell from 0.6 to 0.5, lactate was not available, and urine output fell from 145 to 36.
D. In broad terms, the heart rate fell from 99 to 96, MAP fell from 102 to 72, and diastolic pressure moved from 94 to 58. Systolic pressure ranged 58-165 and ended at 121, and SpO2 recovered to 100 after a low of 87 around hour 0.5. Respiratory rate ended at 17; the available labs showed white count fell from 11.1 to 8.4, creatinine fell from 0.8 to 0.3, lactate was not available, and urine output fell from 170 to 44.

Answer: A


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

Options:
A. In broad terms, the heart rate fell from 83 to 47, while MAP fell from 91 to 68. Systolic pressure was labile, ranging 62-115, with the lowest value around hour 3.9. SpO2 briefly dipped to 88 around hour 3.0 before recovering to 85, while respiratory rate peaked at 27 and later settled at 22. The associated labs and urine output showed that white count fell from 12.0 to 10.1, creatinine stayed around 0.6, lactate was checked once at 2, and urine output rose from 78 to 520, with recorded outputs ranging 18-480.
B. In broad terms, the heart rate fell from 78 to 52, while MAP fell from 86 to 68. Systolic pressure was labile, ranging 60-150, with the lowest value around hour 3.0. SpO2 briefly dipped to 83 around hour 3.8 before recovering to 90, while respiratory rate peaked at 24 and later settled at 19. The associated labs and urine output showed that white count fell from 14.6 to 9.2, creatinine stayed around 0.4, lactate was checked once at 3, and urine output rose from 73 to 450, with recorded outputs ranging 21-515.
C. In broad terms, the heart rate fell from 80 to 50, while MAP fell from 88 to 65. Systolic pressure was labile, ranging 58-135, with the lowest value around hour 3.4. SpO2 briefly dipped to 85 around hour 2.8 before recovering to 88, while respiratory rate peaked at 25 and later settled at 20. The associated labs and urine output showed that white count fell from 13.5 to 9.6, creatinine stayed around 0.5, lactate was checked once at 3, and urine output rose from 75 to 500, with recorded outputs ranging 20-500.
D. In broad terms, the heart rate fell from 76 to 54, while MAP fell from 84 to 60. Systolic pressure was labile, ranging 62-165, with the lowest value around hour 2.6. SpO2 briefly dipped to 80 around hour 2.5 before recovering to 92, while respiratory rate peaked at 23 and later settled at 18. The associated labs and urine output showed that white count fell from 15.8 to 8.8, creatinine was roughly stable (0.3 to 0.6), lactate was checked once at 3, and urine output rose from 75 to 500, with recorded outputs ranging 70-500.

Answer: C


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 91 to 62, diastolic pressure fell from 70 to 60, and heart rate fell from 77 to 53. The lowest MAP was about 49 around hour 2.9, and the lowest valid SpO2 was 88 around hour 1.8; respiratory rate rose as high as 26 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.6-34.4 C, white count fell from 15.0 to 9.1, creatinine stayed around 0.6, lactate was checked once at 4, and urine output rose from 72 to 520.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 67, diastolic pressure fell from 65 to 54, and heart rate fell from 82 to 48. The lowest MAP was about 49 around hour 4.4, and the lowest valid SpO2 was 83 around hour 2.9; respiratory rate rose as high as 24 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 38.9-39.6 C, white count fell from 12.4 to 10.0, creatinine stayed around 0.4, lactate was checked once at 3, and urine output rose from 77 to 485.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 92 to 61, diastolic pressure fell from 71 to 61, and heart rate fell from 76 to 54. The lowest MAP was about 50 around hour 2.8, and the lowest valid SpO2 was 89 around hour 2.5; respiratory rate rose as high as 27 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.9-33.6 C, white count fell from 15.4 to 9.0, creatinine was roughly stable (0.6 to 0.6), lactate was checked once at 3, and urine output rose from 75 to 550.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 88 to 65, diastolic pressure fell from 67 to 57, and heart rate fell from 80 to 50. The lowest MAP was about 46 around hour 3.4, and the lowest valid SpO2 was 85 around hour 2.8; respiratory rate rose as high as 25 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 36.6-37.4 C, white count fell from 13.5 to 9.6, creatinine stayed around 0.5, lactate was checked once at 3, and urine output rose from 75 to 500.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 88 to 65, diastolic pressure fell from 67 to 57, and heart rate fell from 80 to 50. The lowest MAP was about 46 around hour 3.4, and the lowest valid SpO2 was 85 around hour 2.8; respiratory rate rose as high as 25 but ended at 20. The lower-frequency data fit that summary: temperature ranged from 97.8 to 99.4, white count fell from 13.5 to 9.6, creatinine stayed around 0.5, lactate was checked once at 3, and urine output rose from 75 to 500.


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 121 to 100, MAP fell from 88 to 65, and heart rate fell from 80 to 50. SpO2 started at 85, ended at 88, and fell as low as 85 around hour 2.8; respiratory rate ranged 6-25. For labs and output, white count fell from 13.5 to 9.6, creatinine stayed around 0.5, lactate was checked once at 3, and urine output rose from 75 to 500.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 106 to 98, MAP fell from 86 to 63, and heart rate fell from 82 to 53. SpO2 started at 87, ended at 86, and fell as low as 83 around hour 2.9; respiratory rate ranged 6-27. For labs and output, white count fell from 14.6 to 8.8, creatinine stayed around 0.4, lactate was checked once at 3, and urine output rose from 73 to 485.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 146 to 96, MAP fell from 92 to 68, and heart rate fell from 76 to 54. SpO2 started at 81, ended at 92, and fell as low as 84 around hour 2.5; respiratory rate ranged 7-23. For labs and output, white count fell from 11.6 to 10.2, creatinine stayed around 0.6, lactate was checked once at 2, and urine output rose from 79 to 525.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 91 to 88, MAP fell from 84 to 60, and heart rate fell from 84 to 46. SpO2 started at 90, ended at 84, and fell as low as 80 around hour 3.1; respiratory rate ranged 5-27. For labs and output, white count fell from 15.8 to 8.8, creatinine was roughly stable (0.3 to 0.6), lactate was checked once at 3.2, and urine output rose from 75 to 500.

Answer: A


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

Options:
A. For handoff, the heart rate fell from 83 to 53, MAP fell from 91 to 68, and diastolic pressure moved from 64 to 54. Systolic pressure ranged 61-155 and ended at 97, and SpO2 recovered to 85 after a low of 88 around hour 3.0. Respiratory rate ended at 18; the available labs showed white count fell from 15.0 to 10.1, creatinine stayed around 0.4, lactate was checked once at 4, and urine output rose from 78 to 480.
B. For handoff, the heart rate fell from 80 to 50, MAP fell from 88 to 65, and diastolic pressure moved from 67 to 57. Systolic pressure ranged 58-135 and ended at 100, and SpO2 recovered to 88 after a low of 85 around hour 2.8. Respiratory rate ended at 20; the available labs showed white count fell from 13.5 to 9.6, creatinine stayed around 0.5, lactate was checked once at 3, and urine output rose from 75 to 500.
C. For handoff, the heart rate fell from 84 to 46, MAP fell from 92 to 68, and diastolic pressure moved from 63 to 61. Systolic pressure ranged 62-160 and ended at 96, and SpO2 recovered to 84 after a low of 89 around hour 3.8. Respiratory rate ended at 18; the available labs showed white count fell from 15.4 to 10.2, creatinine stayed around 0.4, lactate was checked once at 4, and urine output rose from 79 to 475.
D. For handoff, the heart rate fell from 76 to 54, MAP fell from 84 to 60, and diastolic pressure moved from 72 to 52. Systolic pressure ranged 54-105 and ended at 96, and SpO2 recovered to 92 after a low of 84 around hour 2.5. Respiratory rate ended at 22; the available labs showed white count fell from 11.2 to 8.8, creatinine stayed around 0.7, lactate was checked once at 2, and urine output rose from 125 to 530.

Answer: B


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

Options:
A. For handoff, the heart rate fell from 97 to 72, while MAP fell from 100 to 78. Systolic pressure was labile, ranging 110-149, with the lowest value around hour 27.6. SpO2 briefly dipped to 88 around hour 1.8 before recovering to 82, while respiratory rate peaked at 34 and later settled at 20. The associated labs and urine output showed that white count fell from 9.0 to 8.3, creatinine fell from 77 to 0.5, lactate was checked once at 0.7, and urine output was roughly stable (520 to 475), with recorded outputs ranging 370-530.
B. For handoff, the heart rate fell from 92 to 77, while MAP fell from 96 to 73. Systolic pressure was labile, ranging 115-184, with the lowest value around hour 25.0. SpO2 briefly dipped to 83 around hour 0.7 before recovering to 87, while respiratory rate peaked at 29 and later settled at 18. The associated labs and urine output showed that white count fell from 11.6 to 7, creatinine fell from 72 to 0.7, lactate was checked once at 0.5, and urine output was roughly stable (485 to 540), with recorded outputs ranging 400-565.
C. For handoff, the heart rate fell from 98 to 71, while MAP fell from 95 to 79. Systolic pressure was labile, ranging 116-144, with the lowest value around hour 28.0. SpO2 briefly dipped to 89 around hour 0.9 before recovering to 81, while respiratory rate peaked at 33 and later settled at 21. The associated labs and urine output showed that white count fell from 8.6 to 8.4, creatinine fell from 78 to 0.5, lactate was checked once at 0.7, and urine output was roughly stable (525 to 500), with recorded outputs ranging 375-525.
D. For handoff, the heart rate fell from 94 to 75, while MAP fell from 98 to 75. Systolic pressure was labile, ranging 113-169, with the lowest value around hour 26.1. SpO2 briefly dipped to 85 around hour 0.8 before recovering to 85, while respiratory rate peaked at 31 and later settled at 19. The associated labs and urine output showed that white count fell from 10.5 to 7.8, creatinine fell from 74 to 0.6, lactate was checked once at 0.6, and urine output was roughly stable (500 to 525), with recorded outputs ranging 350-550.

Answer: D


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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 175 to 113, MAP fell from 100 to 78, and heart rate fell from 91 to 78. SpO2 started at 93, ended at 88, and fell as low as 88 around hour 0.7; respiratory rate ranged 12-28. For labs and output, white count fell from 9.0 to 8.3, creatinine fell from 77 to 0.7, lactate was checked once at 0.8, and urine output was roughly stable (520 to 505)
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 155 to 116, MAP fell from 98 to 75, and heart rate fell from 94 to 75. SpO2 started at 96, ended at 85, and fell as low as 85 around hour 0.8; respiratory rate ranged 10-31. For labs and output, white count fell from 10.5 to 7.8, creatinine fell from 74 to 0.6, lactate was checked once at 0.6, and urine output was roughly stable (500 to 525)
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 180 to 112, MAP fell from 100 to 78, and heart rate fell from 90 to 79. SpO2 started at 92, ended at 89, and fell as low as 84 around hour 0.7; respiratory rate ranged 12-27. For labs and output, white count fell from 8.6 to 8.4, creatinine fell from 78 to 0.5, lactate was checked once at 0.7, and urine output was roughly stable (525 to 500)
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 125 to 120, MAP fell from 94 to 70, and heart rate fell from 98 to 78. SpO2 started at 100, ended at 80, and fell as low as 80 around hour 1.0; respiratory rate ranged 8-33. For labs and output, white count fell from 12.8 to 7, creatinine fell from 70 to 0.8, lactate was checked once at 0.4, and urine output was roughly stable (470 to 555)

Answer: B


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

Options:
A. Across the recorded window, the heart rate was roughly stable (50 to 54), while MAP was roughly stable (87 to 92). Systolic pressure was labile, ranging 116-201, with the lowest value around hour 2.6. SpO2 briefly dipped to 88 around hour 0.5 before recovering to 95, while respiratory rate peaked at 33 and later settled at 23. The associated labs and urine output showed that white count stayed around 8.8, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 10 to 300, with recorded outputs ranging 10-400.
B. Across the recorded window, the heart rate was roughly stable (48 to 56), while MAP was roughly stable (85 to 90). Systolic pressure was labile, ranging 118-216, with the lowest value around hour 2.5. SpO2 briefly dipped to 86 around hour 0.4 before recovering to 97, while respiratory rate peaked at 31 and later settled at 22. The associated labs and urine output showed that white count was roughly stable (9.2 to 8), creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 10 to 300, with recorded outputs ranging 10-400.
C. Across the recorded window, the heart rate was roughly stable (54 to 50), while MAP rose from 91 to 95. Systolic pressure was labile, ranging 112-176, with the lowest value around hour 2.9. SpO2 briefly dipped to 92 around hour 1.4 before recovering to 91, while respiratory rate peaked at 37 and later settled at 25. The associated labs and urine output showed that white count stayed around 8.2, creatinine was 0.9 on its only check, lactate was not available, and urine output rose from 12 to 250, with recorded outputs ranging 12-375.
D. Across the recorded window, the heart rate was roughly stable (46 to 58), while MAP was roughly stable (82 to 88). Systolic pressure was labile, ranging 120-231, with the lowest value around hour 2.3. SpO2 briefly dipped to 84 around hour 0.3 before recovering to 100, while respiratory rate peaked at 35 and later settled at 21. The associated labs and urine output showed that white count stayed around 9.6, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 8 to 330, with recorded outputs ranging 8-430.

Answer: A


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 roughly stable (90 to 89), diastolic pressure was roughly stable (68 to 70), and heart rate was roughly stable (47 to 57). The lowest MAP was about 65 around hour 2.4, and the lowest valid SpO2 was 91 around hour 0.4; respiratory rate rose as high as 35 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.7-33.8 C, white count stayed around 9.3, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 12 to 350.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (87 to 92), diastolic pressure was roughly stable (65 to 67), and heart rate was roughly stable (50 to 54). The lowest MAP was about 62 around hour 2.6, and the lowest valid SpO2 was 88 around hour 0.5; respiratory rate rose as high as 33 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 36.7-36.8 C, white count stayed around 8.8, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 10 to 300.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (91 to 88), diastolic pressure was roughly stable (69 to 71), and heart rate rose from 46 to 57. The lowest MAP was about 66 around hour 2.4, and the lowest valid SpO2 was 92 around hour 0; respiratory rate rose as high as 37 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 33.0-33.0 C, white count stayed around 9.4, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 12 to 325.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (82 to 96), diastolic pressure was roughly stable (60 to 64), and heart rate was roughly stable (54 to 50). The lowest MAP was about 65 around hour 3.6, and the lowest valid SpO2 was 84 around hour 0.7; respiratory rate rose as high as 28 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 41.2-41.3 C, white count stayed around 8.1, creatinine was 1.0 on its only check, lactate was not available, and urine output rose from 8 to 270.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (87 to 92), diastolic pressure was roughly stable (65 to 67), and heart rate was roughly stable (50 to 54). The lowest MAP was about 62 around hour 2.6, and the lowest valid SpO2 was 88 around hour 0.5; respiratory rate rose as high as 33 but ended at 23. The lower-frequency data fit that summary: temperature ranged from 98 to 98.2, white count stayed around 8.8, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 10 to 300.


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

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (170 to 151), MAP rose from 90 to 95, and heart rate was roughly stable (47 to 57). SpO2 started at 85, ended at 98, and fell as low as 87 around hour 0.4; respiratory rate ranged 16-30. For labs and output, white count stayed around 8.3, creatinine was 0.9 on its only check, lactate was not available, and urine output rose from 12 to 280.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (135 to 170), MAP was roughly stable (85 to 90), and heart rate rose from 52 to 57. SpO2 started at 90, ended at 93, and fell as low as 86 around hour 0.6; respiratory rate ranged 13-35. For labs and output, white count was roughly stable (9.2 to 8), creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 10 to 300.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (150 to 155), MAP was roughly stable (87 to 92), and heart rate was roughly stable (50 to 54). SpO2 started at 88, ended at 95, and fell as low as 88 around hour 0.5; respiratory rate ranged 14-33. For labs and output, white count stayed around 8.8, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 10 to 300.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (120 to 185), MAP was roughly stable (82 to 88), and heart rate was roughly stable (54 to 50). SpO2 started at 92, ended at 90, and fell as low as 84 around hour 0.7; respiratory rate ranged 12-38. For labs and output, white count was roughly stable (9.6 to 8), creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 60 to 300.

Answer: C


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

Options:
A. Clinically, the heart rate rose from 53 to 57, MAP was roughly stable (90 to 95), and diastolic pressure moved from 62 to 64. Systolic pressure ranged 119-221 and ended at 175, and SpO2 recovered to 92 after a low of 91 around hour 0.6. Respiratory rate ended at 22; the available labs showed white count stayed around 9.3, creatinine was 0.9 on its only check, lactate was not available, and urine output rose from 8 to 320.
B. Clinically, the heart rate was roughly stable (48 to 56), MAP rose from 85 to 95, and diastolic pressure moved from 67 to 65. Systolic pressure ranged 114-186 and ended at 151, and SpO2 recovered to 97 after a low of 86 around hour 1.4. Respiratory rate ended at 24; the available labs showed white count stayed around 8.4, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 11 to 285.
C. Clinically, the heart rate was roughly stable (54 to 50), MAP was roughly stable (91 to 96), and diastolic pressure moved from 61 to 71. Systolic pressure ranged 120-226 and ended at 180, and SpO2 recovered to 91 after a low of 87 around hour 0.6. Respiratory rate ended at 21; the available labs showed white count was roughly stable (9.4 to 8), creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 60 to 300.
D. Clinically, the heart rate was roughly stable (50 to 54), MAP was roughly stable (87 to 92), and diastolic pressure moved from 65 to 67. Systolic pressure ranged 116-201 and ended at 155, and SpO2 recovered to 95 after a low of 88 around hour 0.5. Respiratory rate ended at 23; the available labs showed white count stayed around 8.8, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 10 to 300.

Answer: D


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

Options:
A. Clinically, the heart rate was roughly stable (141 to 113), while MAP fell from 67 to 50. Systolic pressure was labile, ranging 41-238, with the lowest value around hour 19.7. SpO2 briefly dipped to 82 around hour 182.3 before recovering to 76, while respiratory rate peaked at 47 and later settled at 40. The associated labs and urine output showed that white count rose from 17.3 to 46.8, creatinine rose from 2.3 to 5.0, lactate stayed broadly stable from 4.9 to 13.7, and urine output fell from 97 to 12, with recorded outputs ranging 6-415.
B. Clinically, the heart rate was roughly stable (121 to 116), while MAP fell from 64 to 47. Systolic pressure was labile, ranging 37-258, with the lowest value around hour 18.2. SpO2 briefly dipped to 79 around hour 162.3 before recovering to 79, while respiratory rate peaked at 45 and later settled at 37. The associated labs and urine output showed that white count rose from 18.8 to 43.8, creatinine rose from 2.1 to 5.5, lactate stayed broadly stable from 4.4 to 12.2, and urine output fell from 100 to 10, with recorded outputs ranging 5-395.
C. Clinically, the heart rate was roughly stable (146 to 112), while MAP fell from 68 to 51. Systolic pressure was labile, ranging 33-233, with the lowest value around hour 20.1. SpO2 briefly dipped to 83 around hour 187.3 before recovering to 75, while respiratory rate peaked at 49 and later settled at 41. The associated labs and urine output showed that white count rose from 16.9 to 43, creatinine rose from 2.4 to 5.6, lactate stayed broadly stable from 5.0 to 14.1, and urine output fell from 96 to 12, with recorded outputs ranging 10-420.
D. Clinically, the heart rate was roughly stable (91 to 120), while MAP fell from 60 to 50. Systolic pressure was labile, ranging 42-288, with the lowest value around hour 15.9. SpO2 briefly dipped to 74 around hour 162 before recovering to 84, while respiratory rate peaked at 40 and later settled at 32. The associated labs and urine output showed that white count rose from 21.1 to 39.3, creatinine rose from 1.8 to 6.2, lactate stayed broadly stable from 3.7 to 9.9, and urine output fell from 96 to 0, with recorded outputs ranging 0-365.

Answer: B


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 (121 to 116), MAP fell from 64 to 47, and diastolic pressure moved from 56 to 38. Systolic pressure ranged 37-258 and ended at 90, and SpO2 recovered to 79 after a low of 79 around hour 162.3. Respiratory rate ended at 37; the available labs showed white count rose from 18.8 to 43.8, creatinine rose from 2.1 to 5.5, lactate stayed broadly stable from 4.4 to 12.2, and urine output fell from 100 to 10.
B. Over the available measurements, the heart rate was roughly stable (106 to 119), MAP fell from 62 to 45, and diastolic pressure moved from 58 to 35. Systolic pressure ranged 35-243 and ended at 88, and SpO2 recovered to 81 after a low of 77 around hour 147.3. Respiratory rate ended at 39; the available labs showed white count rose from 17.7 to 41.5, creatinine rose from 2.2 to 5.1, lactate stayed broadly stable from 4.0 to 13.3, and urine output fell from 98 to 9.
C. Over the available measurements, the heart rate was roughly stable (146 to 112), MAP fell from 68 to 50, and diastolic pressure moved from 52 to 42. Systolic pressure ranged 41-283 and ended at 86, and SpO2 recovered to 75 after a low of 83 around hour 162. Respiratory rate ended at 33; the available labs showed white count rose from 20.7 to 47.5, creatinine rose from 1.9 to 6.1, lactate stayed broadly stable from 5.0 to 10.3, and urine output fell from 96 to 12.
D. Over the available measurements, the heart rate was roughly stable (91 to 120), MAP fell from 60 to 42, and diastolic pressure moved from 60 to 34. Systolic pressure ranged 32-228 and ended at 86, and SpO2 recovered to 84 after a low of 78 around hour 132.3. Respiratory rate ended at 42; the available labs showed white count rose from 16.6 to 43, creatinine rose from 2.4 to 4.8, lactate stayed broadly stable from 3.7 to 14.4, and urine output fell from 150 to 8.

Answer: A


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

Options:
A. Over the available measurements, the heart rate rose from 53 to 107, while MAP fell from 105 to 86. Systolic pressure was labile, ranging 55-148, with the lowest value around hour 9.8. SpO2 briefly dipped to 78 around hour 6.7 before recovering to 92, while respiratory rate peaked at 45 and later settled at 26. The associated labs and urine output showed that white count fell from 16.0 to 11.4, creatinine rose from 0.9 to 1.2, lactate was checked once at 1.9, and urine output fell from 370 to 180, with recorded outputs ranging 50-380.
B. Over the available measurements, the heart rate rose from 48 to 112, while MAP fell from 100 to 86. Systolic pressure was labile, ranging 60-183, with the lowest value around hour 8.9. SpO2 briefly dipped to 73 around hour 7.2 before recovering to 97, while respiratory rate peaked at 40 and later settled at 23. The associated labs and urine output showed that white count fell from 18.6 to 11.1, creatinine rose from 0.7 to 1.2, lactate was checked once at 1.5, and urine output fell from 335 to 150, with recorded outputs ranging 0-415.
C. Over the available measurements, the heart rate rose from 50 to 110, while MAP fell from 102 to 83. Systolic pressure was labile, ranging 58-168, with the lowest value around hour 9.3. SpO2 briefly dipped to 75 around hour 6.2 before recovering to 95, while respiratory rate peaked at 42 and later settled at 24. The associated labs and urine output showed that white count fell from 17.5 to 12.2, creatinine rose from 0.8 to 1.1, lactate was checked once at 1.7, and urine output fell from 350 to 200, with recorded outputs ranging 0-400.
D. Over the available measurements, the heart rate rose from 46 to 114, while MAP fell from 98 to 78. Systolic pressure was labile, ranging 62-198, with the lowest value around hour 8.6. SpO2 briefly dipped to 76 around hour 5.5 before recovering to 100, while respiratory rate peaked at 44 and later settled at 22. The associated labs and urine output showed that white count fell from 19.8 to 9.9, creatinine rose from 0.7 to 1.4, lactate was checked once at 1.4, and urine output fell from 320 to 230, with recorded outputs ranging 0-430.

Answer: C


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 168 to 112, MAP fell from 102 to 83, and heart rate rose from 50 to 110. SpO2 started at 90, ended at 95, and fell as low as 75 around hour 6.2; respiratory rate ranged 11-42. For labs and output, white count fell from 17.5 to 12.2, creatinine rose from 0.8 to 1.1, lactate was checked once at 1.7, and urine output fell from 350 to 200.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 153 to 114, MAP fell from 100 to 81, and heart rate rose from 52 to 113. SpO2 started at 92, ended at 93, and fell as low as 73 around hour 6.6; respiratory rate ranged 10-44. For labs and output, white count fell from 18.6 to 11.4, creatinine rose from 0.7 to 1.2, lactate was checked once at 1.5, and urine output fell from 335 to 215.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 193 to 108, MAP fell from 106 to 87, and heart rate rose from 46 to 114. SpO2 started at 86, ended at 99, and fell as low as 79 around hour 5.6; respiratory rate ranged 13-38. For labs and output, white count fell from 15.6 to 14.1, creatinine rose from 0.9 to 1.2, lactate was checked once at 1.9, and urine output fell from 375 to 175.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 138 to 108, MAP fell from 98 to 86, and heart rate rose from 54 to 106. SpO2 started at 94, ended at 90, and fell as low as 74 around hour 7.0; respiratory rate ranged 9-46. For labs and output, white count fell from 19.8 to 9.9, creatinine rose from 0.7 to 1.4, lactate was checked once at 1.4, and urine output fell from 320 to 230.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate rose from 53 to 107, MAP fell from 105 to 86, and diastolic pressure moved from 72 to 74. Systolic pressure ranged 61-188 and ended at 108, and SpO2 recovered to 92 after a low of 78 around hour 7.2. Respiratory rate ended at 22; the available labs showed white count fell from 19.0 to 13.7, creatinine rose from 0.7 to 1.3, lactate was checked once at 1.9, and urine output fell from 330 to 220.
B. Viewed chronologically, the heart rate rose from 50 to 110, MAP fell from 102 to 83, and diastolic pressure moved from 75 to 71. Systolic pressure ranged 58-168 and ended at 112, and SpO2 recovered to 95 after a low of 75 around hour 6.2. Respiratory rate ended at 24; the available labs showed white count fell from 17.5 to 12.2, creatinine rose from 0.8 to 1.1, lactate was checked once at 1.7, and urine output fell from 350 to 200.
C. Viewed chronologically, the heart rate rose from 54 to 113, MAP fell from 106 to 87, and diastolic pressure moved from 71 to 68. Systolic pressure ranged 62-193 and ended at 116, and SpO2 recovered to 91 after a low of 79 around hour 6.8. Respiratory rate ended at 22; the available labs showed white count fell from 19.4 to 14.1, creatinine rose from 0.7 to 1.4, lactate was checked once at 1.9, and urine output fell from 325 to 225.
D. Viewed chronologically, the heart rate rose from 46 to 114, MAP fell from 98 to 78, and diastolic pressure moved from 80 to 66. Systolic pressure ranged 54-138 and ended at 108, and SpO2 recovered to 100 after a low of 74 around hour 5.5. Respiratory rate ended at 26; the available labs showed white count fell from 15.2 to 11.4, creatinine rose from 1.0 to 1.2, lactate was checked once at 1.4, and urine output fell from 400 to 170.

Answer: B


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

Options:
A. Viewed chronologically, the heart rate fell from 86 to 64, while MAP was roughly stable (94 to 89). Systolic pressure was labile, ranging 96-166, with the lowest value around hour 18. SpO2 briefly dipped to 91 around hour 1.5 before recovering to 93, while respiratory rate peaked at 38 and later settled at 20. The associated labs and urine output showed that white count rose from 4.8 to 8.9, creatinine rose from 0.2 to 0.4, lactate was checked once at 1, and urine output rose from 83 to 225, with recorded outputs ranging 33-480.
B. Viewed chronologically, the heart rate fell from 81 to 69, while MAP was roughly stable (89 to 84). Systolic pressure was labile, ranging 100-201, with the lowest value around hour 15. SpO2 briefly dipped to 86 around hour 0.4 before recovering to 98, while respiratory rate peaked at 33 and later settled at 17. The associated labs and urine output showed that white count rose from 5.7 to 7.6, creatinine rose from 0.0 to 0.6, lactate was checked once at 1, and urine output rose from 78 to 290, with recorded outputs ranging 80-515.
C. Viewed chronologically, the heart rate fell from 87 to 63, while MAP was roughly stable (95 to 90). Systolic pressure was labile, ranging 103-161, with the lowest value around hour 18. SpO2 briefly dipped to 89 around hour 0.6 before recovering to 92, while respiratory rate peaked at 37 and later settled at 20. The associated labs and urine output showed that white count rose from 4.7 to 9.0, creatinine rose from 0.2 to 0.4, lactate was checked once at 1, and urine output rose from 84 to 250, with recorded outputs ranging 34-475.
D. Viewed chronologically, the heart rate fell from 83 to 67, while MAP was roughly stable (91 to 86). Systolic pressure was labile, ranging 99-186, with the lowest value around hour 16. SpO2 briefly dipped to 88 around hour 0.5 before recovering to 96, while respiratory rate peaked at 35 and later settled at 18. The associated labs and urine output showed that white count rose from 5.3 to 8.4, creatinine rose from 0.1 to 0.5, lactate was checked once at 1, and urine output rose from 80 to 275, with recorded outputs ranging 30-500.

Answer: D


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 151 to 109, MAP was roughly stable (94 to 89), and heart rate fell from 80 to 70. SpO2 started at 97, ended at 99, and fell as low as 91 around hour 0.4; respiratory rate ranged 12-37. For labs and output, white count rose from 4.8 to 7.6, creatinine rose from 0.2 to 0.4, lactate was checked once at 1, and urine output rose from 83 to 255.
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 131 to 112, MAP was roughly stable (91 to 86), and heart rate fell from 83 to 67. SpO2 started at 100, ended at 96, and fell as low as 88 around hour 0.5; respiratory rate ranged 11-35. For labs and output, white count rose from 5.3 to 8.4, creatinine rose from 0.1 to 0.5, lactate was checked once at 1, and urine output rose from 80 to 275.
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 156 to 108, MAP was roughly stable (95 to 89), and heart rate fell from 79 to 71. SpO2 started at 96, ended at 100, and fell as low as 87 around hour 0.4; respiratory rate ranged 13-31. For labs and output, white count rose from 4.7 to 9.0, creatinine rose from 0.2 to 0.4, lactate was checked once at 1, and urine output rose from 84 to 250.
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 101 to 98, MAP was roughly stable (86 to 82), and heart rate fell from 88 to 62. SpO2 started at 96, ended at 92, and fell as low as 84 around hour 0.7; respiratory rate ranged 9-40. For labs and output, white count rose from 6.0 to 7.7, creatinine rose from 0.0 to 0.6, lactate was checked once at 1.2, and urine output rose from 76 to 305.

Answer: B


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

Options:
A. Overall, the heart rate fell from 86 to 64, MAP was roughly stable (94 to 89), and diastolic pressure moved from 76 to 81. Systolic pressure ranged 100-206 and ended at 115, and SpO2 recovered to 93 after a low of 87 around hour 0.6. Respiratory rate ended at 16; the available labs showed white count rose from 5.8 to 7.6, creatinine rose from 0.0 to 0.6, lactate was checked once at 1, and urine output rose from 130 to 295.
B. Overall, the heart rate fell from 81 to 69, MAP was roughly stable (89 to 89), and diastolic pressure moved from 81 to 76. Systolic pressure ranged 97-171 and ended at 108, and SpO2 recovered to 98 after a low of 86 around hour 1.5. Respiratory rate ended at 19; the available labs showed white count rose from 4.9 to 8.0, creatinine rose from 0.2 to 0.4, lactate was checked once at 1, and urine output rose from 82 to 260.
C. Overall, the heart rate fell from 83 to 67, MAP was roughly stable (91 to 86), and diastolic pressure moved from 79 to 78. Systolic pressure ranged 99-186 and ended at 112, and SpO2 recovered to 96 after a low of 88 around hour 0.5. Respiratory rate ended at 18; the available labs showed white count rose from 5.3 to 8.4, creatinine rose from 0.1 to 0.5, lactate was checked once at 1, and urine output rose from 80 to 275.
D. Overall, the heart rate fell from 78 to 70, MAP was roughly stable (86 to 82), and diastolic pressure moved from 84 to 75. Systolic pressure ranged 94-156 and ended at 108, and SpO2 recovered to 100 after a low of 84 around hour 0.3. Respiratory rate ended at 20; the available labs showed white count rose from 4.5 to 7.7, creatinine rose from 0.2 to 0.3, lactate was checked once at 1, and urine output rose from 84 to 245.

Answer: C


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 91 to 103, diastolic pressure rose from 61 to 98, and heart rate rose from 75 to 99. The lowest MAP was about 62 around hour 9.4, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 34 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 34-34.8 C, white count fell from 17.0 to 10.8, creatinine stayed around 1.4, lactate fell from 490 to 0.8, and urine output rose from 38 to 620.
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 88 to 106, diastolic pressure rose from 58 to 95, and heart rate rose from 78 to 96. The lowest MAP was about 59 around hour 9.9, and the lowest valid SpO2 was 85 around hour 0.9; respiratory rate rose as high as 31 but ended at 27. The lower-frequency data fit that summary: temperature stayed around 37-37.8 C, white count fell from 15.5 to 12.3, creatinine stayed around 1.2, lactate fell from 470 to 0.9, and urine output rose from 35 to 600.
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 92 to 102, diastolic pressure rose from 62 to 92, and heart rate rose from 74 to 100. The lowest MAP was about 62 around hour 10.9, and the lowest valid SpO2 was 89 around hour 0.8; respiratory rate rose as high as 35 but ended at 29. The lower-frequency data fit that summary: temperature stayed around 33-34.0 C, white count fell from 17.4 to 10.4, creatinine stayed around 1.4, lactate fell from 495 to 0.8, and urine output rose from 39 to 625.
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 84 to 110, diastolic pressure rose from 54 to 90, and heart rate rose from 82 to 92. The lowest MAP was about 54 around hour 10.7, and the lowest valid SpO2 was 80 around hour 1.1; respiratory rate rose as high as 33 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 42-42.3 C, white count fell from 13.2 to 11.7, creatinine was roughly stable (0.9 to 1.3), lactate fell from 470 to 0.9, and urine output rose from 35 to 650.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 88 to 106, diastolic pressure rose from 58 to 95, and heart rate rose from 78 to 96. The lowest MAP was about 59 around hour 9.9, and the lowest valid SpO2 was 85 around hour 0.9; respiratory rate rose as high as 31 but ended at 27. The lower-frequency data fit that summary: temperature ranged from 98.6 to 100.1, white count fell from 15.5 to 12.3, creatinine stayed around 1.2, lactate fell from 470 to 0.9, and urine output rose from 35 to 600.


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 rose from 116 to 127, MAP rose from 91 to 109, and heart rate rose from 75 to 99. SpO2 started at 96, ended at 98, and fell as low as 84 around hour 0.8; respiratory rate ranged 16-28. For labs and output, white count fell from 14.0 to 13.8, creatinine stayed around 1.4, lactate fell from 450 to 1.0, and urine output rose from 38 to 580.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 111 to 146, MAP rose from 86 to 104, and heart rate rose from 80 to 99. SpO2 started at 100, ended at 93, and fell as low as 83 around hour 1.0; respiratory rate ranged 13-33. For labs and output, white count fell from 16.6 to 11.5, creatinine stayed around 1.0, lactate fell from 485 to 0.8, and urine output rose from 33 to 615.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 113 to 131, MAP rose from 88 to 106, and heart rate rose from 78 to 96. SpO2 started at 99, ended at 95, and fell as low as 85 around hour 0.9; respiratory rate ranged 14-31. For labs and output, white count fell from 15.5 to 12.3, creatinine stayed around 1.2, lactate fell from 470 to 0.9, and urine output rose from 35 to 600.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 108 to 161, MAP rose from 84 to 102, and heart rate rose from 82 to 92. SpO2 started at 100, ended at 90, and fell as low as 80 around hour 1.1; respiratory rate ranged 12-36. For labs and output, white count fell from 17.8 to 10.1, creatinine was roughly stable (0.9 to 1.3), lactate fell from 470.2 to 0.9, and urine output rose from 35 to 600.

Answer: C


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

Options:
A. Taken together, the heart rate rose from 81 to 99, MAP rose from 91 to 109, and diastolic pressure moved from 55 to 92. Systolic pressure ranged 70-156 and ended at 151, and SpO2 recovered to 92 after a low of 88 around hour 1.0. Respiratory rate ended at 26; the available labs showed white count fell from 17.0 to 13.8, creatinine stayed around 1.0, lactate fell from 490 to 1.0, and urine output rose from 32 to 620.
B. Taken together, the heart rate rose from 76 to 98, MAP rose from 86 to 109, and diastolic pressure moved from 60 to 93. Systolic pressure ranged 65-121 and ended at 127, and SpO2 recovered to 97 after a low of 83 around hour 1.9. Respiratory rate ended at 28; the available labs showed white count fell from 14.4 to 11.2, creatinine stayed around 1.4, lactate fell from 455 to 0.8, and urine output rose from 37 to 585.
C. Taken together, the heart rate rose from 82 to 92, MAP rose from 92 to 110, and diastolic pressure moved from 54 to 99. Systolic pressure ranged 71-161 and ended at 156, and SpO2 recovered to 91 after a low of 84 around hour 1.0. Respiratory rate ended at 25; the available labs showed white count fell from 17.4 to 11.5, creatinine stayed around 0.9, lactate fell from 495 to 1.0, and urine output rose from 85 to 625.
D. Taken together, the heart rate rose from 78 to 96, MAP rose from 88 to 106, and diastolic pressure moved from 58 to 95. Systolic pressure ranged 67-136 and ended at 131, and SpO2 recovered to 95 after a low of 85 around hour 0.9. Respiratory rate ended at 27; the available labs showed white count fell from 15.5 to 12.3, creatinine stayed around 1.2, lactate fell from 470 to 0.9, and urine output rose from 35 to 600.

Answer: D


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

Options:
A. Taken together, the heart rate fell from 140 to 80, while MAP fell from 118 to 85. Systolic pressure was labile, ranging 76-145, with the lowest value around hour 47.2. SpO2 briefly dipped to 91 around hour 14 before recovering to 97, while respiratory rate peaked at 48 and later settled at 18. The associated labs and urine output showed that white count fell from 17.2 to 5.8, creatinine was roughly stable (1.0 to 1), lactate stayed broadly stable from 6.2 to 1.2, and urine output was roughly stable (175 to 275), with recorded outputs ranging 70-4750.
B. Taken together, the heart rate fell from 120 to 83, while MAP fell from 115 to 82. Systolic pressure was labile, ranging 79-165, with the lowest value around hour 44.2. SpO2 briefly dipped to 88 around hour 13 before recovering to 100, while respiratory rate peaked at 45 and later settled at 17. The associated labs and urine output showed that white count fell from 18.7 to 6.6, creatinine stayed around 0.9, lactate stayed broadly stable from 6.2 to 1.2, and urine output was roughly stable (175 to 275), with recorded outputs ranging 20-4750.
C. Taken together, the heart rate fell from 145 to 79, while MAP fell from 119 to 85. Systolic pressure was labile, ranging 75-140, with the lowest value around hour 48.0. SpO2 briefly dipped to 92 around hour 14 before recovering to 96, while respiratory rate peaked at 49 and later settled at 19. The associated labs and urine output showed that white count fell from 16.8 to 7.2, creatinine stayed around 1.0, lactate stayed broadly stable from 5.6 to 1.4, and urine output was roughly stable (200 to 225), with recorded outputs ranging 22-4650.
D. Taken together, the heart rate fell from 90 to 88, while MAP fell from 110 to 78. Systolic pressure was labile, ranging 83-195, with the lowest value around hour 39.7. SpO2 briefly dipped to 89 around hour 11 before recovering to 96, while respiratory rate peaked at 47 and later settled at 15. The associated labs and urine output showed that white count fell from 20.9 to 5.8, creatinine stayed around 0.8, lactate stayed broadly stable from 7.0 to 0.9, and urine output was roughly stable (145 to 305), with recorded outputs ranging 18-4870.

Answer: B


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 118 to 79, diastolic pressure was roughly stable (70 to 72), and heart rate fell from 100 to 86. The lowest MAP was about 49 around hour 45.2, and the lowest valid SpO2 was 91 around hour 12; respiratory rate rose as high as 47 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.8-35.1 C, white count fell from 20.2 to 6.1, creatinine was roughly stable (1.0 to 1), lactate stayed broadly stable from 6.2 to 1.2, and urine output was roughly stable (175 to 325)
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 113 to 84, diastolic pressure was roughly stable (65 to 66), and heart rate fell from 135 to 81. The lowest MAP was about 49 around hour 49.2, and the lowest valid SpO2 was 86 around hour 14; respiratory rate rose as high as 43 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 39.0-40.4 C, white count fell from 17.6 to 7.0, creatinine stayed around 0.8, lactate stayed broadly stable from 5.8 to 1.4, and urine output was roughly stable (160 to 260)
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 115 to 82, diastolic pressure was roughly stable (67 to 69), and heart rate fell from 120 to 83. The lowest MAP was about 46 around hour 48.2, and the lowest valid SpO2 was 88 around hour 13; respiratory rate rose as high as 45 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.8-38.1 C, white count fell from 18.7 to 6.6, creatinine stayed around 0.9, lactate stayed broadly stable from 6.2 to 1.2, and urine output was roughly stable (175 to 275)
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 110 to 86, diastolic pressure was roughly stable (62 to 64), and heart rate fell from 150 to 86. The lowest MAP was about 42 around hour 52.7, and the lowest valid SpO2 was 84 around hour 12; respiratory rate rose as high as 40 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 41.3-42.6 C, white count fell from 16.4 to 7.3, creatinine stayed around 0.8, lactate stayed broadly stable from 5.5 to 1.5, and urine output was roughly stable (145 to 245)

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 115 to 82, diastolic pressure was roughly stable (67 to 69), and heart rate fell from 120 to 83. The lowest MAP was about 46 around hour 48.2, and the lowest valid SpO2 was 88 around hour 13; respiratory rate rose as high as 45 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 21 to 100.5, white count fell from 18.7 to 6.6, creatinine stayed around 0.9, lactate stayed broadly stable from 6.2 to 1.2, and urine output was roughly stable (175 to 275)


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

Options:
A. In broad terms, the heart rate fell from 120 to 83, MAP fell from 115 to 82, and diastolic pressure moved from 67 to 69. Systolic pressure ranged 79-165 and ended at 130, and SpO2 recovered to 100 after a low of 88 around hour 13. Respiratory rate ended at 17; the available labs showed white count fell from 18.7 to 6.6, creatinine stayed around 0.9, lactate stayed broadly stable from 6.2 to 1.2, and urine output was roughly stable (175 to 275)
B. In broad terms, the heart rate fell from 105 to 86, MAP fell from 113 to 80, and diastolic pressure moved from 69 to 66. Systolic pressure ranged 77-150 and ended at 115, and SpO2 recovered to 98 after a low of 86 around hour 12. Respiratory rate ended at 18; the available labs showed white count fell from 17.6 to 6.2, creatinine stayed around 1.0, lactate stayed broadly stable from 5.8 to 1.0, and urine output was roughly stable (190 to 260)
C. In broad terms, the heart rate fell from 145 to 79, MAP fell from 119 to 86, and diastolic pressure moved from 63 to 73. Systolic pressure ranged 83-190 and ended at 155, and SpO2 recovered to 96 after a low of 87 around hour 15. Respiratory rate ended at 15; the available labs showed white count fell from 20.6 to 5.8, creatinine stayed around 0.8, lactate stayed broadly stable from 6.8 to 1.4, and urine output was roughly stable (225 to 300)
D. In broad terms, the heart rate fell from 90 to 88, MAP fell from 110 to 85, and diastolic pressure moved from 72 to 64. Systolic pressure ranged 74-135 and ended at 126, and SpO2 recovered to 96 after a low of 84 around hour 14. Respiratory rate ended at 19; the available labs showed white count fell from 16.4 to 5.8, creatinine stayed around 1.1, lactate stayed broadly stable from 5.5 to 0.9, and urine output was roughly stable (205 to 245)

Answer: A


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 32 to 130, MAP fell from 97 to 67, and heart rate rose from 80 to 86. SpO2 started at 100, ended at 96, and fell as low as 85 around hour 2.1; respiratory rate ranged 13-51. For labs and output, white count fell from 14.1 to 10.6, creatinine was roughly stable (0.6 to 0.7), lactate stayed broadly stable from 1.5 to 1.6, and urine output was roughly stable (185 to 220)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 30 to 126, MAP fell from 95 to 70, and heart rate rose from 82 to 84. SpO2 started at 98, ended at 94, and fell as low as 84 around hour 2.2; respiratory rate ranged 12-53. For labs and output, white count fell from 15.2 to 9.5, creatinine was roughly stable (0.5 to 0.8), lactate stayed broadly stable from 1.4 to 1.5, and urine output was roughly stable (200 to 205)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 36 to 105, MAP fell from 100 to 71, and heart rate rose from 76 to 89. SpO2 started at 96, ended at 100, and fell as low as 89 around hour 1.9; respiratory rate ranged 15-53. For labs and output, white count fell from 12.2 to 9.8, creatinine was roughly stable (0.7 to 0.6), lactate stayed broadly stable from 1.8 to 1.9, and urine output was roughly stable (160 to 245)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 28 to 160, MAP fell from 92 to 62, and heart rate rose from 84 to 87. SpO2 started at 96, ended at 92, and fell as low as 80 around hour 2.4; respiratory rate ranged 11-56. For labs and output, white count fell from 16.4 to 8.3, creatinine rose from 0.4 to 0.8, lactate stayed broadly stable from 1.7 to 1.3, and urine output was roughly stable (215 to 190)

Answer: A


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

Options:
A. For handoff, the heart rate rose from 83 to 86, MAP fell from 100 to 70, and diastolic pressure moved from 18 to 57. Systolic pressure ranged 16-176 and ended at 126, and SpO2 recovered to 93 after a low of 88 around hour 3.1. Respiratory rate ended at 18; the available labs showed white count fell from 15.6 to 12.1, creatinine was roughly stable (0.5 to 0.8), lactate stayed broadly stable from 1.7 to 1.4, and urine output was roughly stable (205 to 240)
B. For handoff, the heart rate rose from 80 to 86, MAP fell from 97 to 67, and diastolic pressure moved from 20 to 54. Systolic pressure ranged 14-156 and ended at 130, and SpO2 recovered to 96 after a low of 85 around hour 2.1. Respiratory rate ended at 20; the available labs showed white count fell from 14.1 to 10.6, creatinine was roughly stable (0.6 to 0.7), lactate stayed broadly stable from 1.5 to 1.6, and urine output was roughly stable (185 to 220)
C. For handoff, the heart rate rose from 84 to 89, MAP fell from 100 to 71, and diastolic pressure moved from 18 to 51. Systolic pressure ranged 16-181 and ended at 155, and SpO2 recovered to 92 after a low of 89 around hour 2.4. Respiratory rate ended at 18; the available labs showed white count fell from 16.0 to 12.5, creatinine was roughly stable (0.5 to 0.8), lactate stayed broadly stable from 1.8 to 1.4, and urine output was roughly stable (210 to 245)
D. For handoff, the heart rate rose from 76 to 90, MAP fell from 92 to 62, and diastolic pressure moved from 22 to 50. Systolic pressure ranged 12-126 and ended at 100, and SpO2 recovered to 100 after a low of 84 around hour 1.8. Respiratory rate ended at 22; the available labs showed white count fell from 11.8 to 9.8, creatinine was roughly stable (0.8 to 0.5), lactate stayed broadly stable from 1.2 to 1.9, and urine output was roughly stable (235 to 190)

Answer: B


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

Options:
A. For handoff, the heart rate rose from 73 to 75, while MAP rose from 71 to 100. Systolic pressure was labile, ranging 90-152, with the lowest value around hour 5.9. SpO2 briefly dipped to 91 around hour 1.0 before recovering to 93, while respiratory rate peaked at 36 and later settled at 22. The associated labs and urine output showed that white count fell from 10.6 to 9.9, creatinine stayed around 1.0, lactate was not available, and urine output fell from 400 to 110, with recorded outputs ranging 75-400.
B. For handoff, the heart rate rose from 68 to 80, while MAP rose from 66 to 100. Systolic pressure was labile, ranging 95-187, with the lowest value around hour 5.0. SpO2 briefly dipped to 86 around hour 1.9 before recovering to 98, while respiratory rate peaked at 31 and later settled at 20. The associated labs and urine output showed that white count fell from 13.2 to 9.6, creatinine was roughly stable (0.8 to 0.9), lactate was not available, and urine output fell from 385 to 60, with recorded outputs ranging 26-415.
C. For handoff, the heart rate rose from 74 to 77, while MAP rose from 72 to 100. Systolic pressure was labile, ranging 97-147, with the lowest value around hour 6.0. SpO2 briefly dipped to 89 around hour 1.0 before recovering to 92, while respiratory rate peaked at 35 and later settled at 23. The associated labs and urine output showed that white count fell from 10.2 to 8.7, creatinine was roughly stable (1.0 to 0.7), lactate was not available, and urine output fell from 425 to 114, with recorded outputs ranging 23-375.
D. For handoff, the heart rate rose from 70 to 78, while MAP rose from 68 to 97. Systolic pressure was labile, ranging 93-172, with the lowest value around hour 5.4. SpO2 briefly dipped to 88 around hour 0.9 before recovering to 96, while respiratory rate peaked at 33 and later settled at 21. The associated labs and urine output showed that white count fell from 12.1 to 10.7, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output fell from 400 to 110, with recorded outputs ranging 25-400.

Answer: D


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

Options:
A. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 97, diastolic pressure rose from 53 to 75, and heart rate rose from 70 to 78. The lowest MAP was about 54 around hour 3.4, and the lowest valid SpO2 was 88 around hour 0.9; respiratory rate rose as high as 33 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.6-37.2 C, white count fell from 12.1 to 10.7, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output fell from 400 to 110.
B. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 66 to 99, diastolic pressure rose from 51 to 73, and heart rate rose from 72 to 81. The lowest MAP was about 52 around hour 3.8, and the lowest valid SpO2 was 86 around hour 0; respiratory rate rose as high as 31 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 38.9-39.5 C, white count fell from 11.0 to 9.5, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output fell from 415 to 108.
C. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 93, diastolic pressure rose from 57 to 72, and heart rate rose from 66 to 82. The lowest MAP was about 57 around hour 4.4, and the lowest valid SpO2 was 92 around hour 0.8; respiratory rate rose as high as 37 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 32.9-33.5 C, white count fell from 14.0 to 8.8, creatinine was roughly stable (1.0 to 0.9), lactate was not available, and urine output fell from 375 to 114.
D. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 64 to 100, diastolic pressure rose from 48 to 70, and heart rate rose from 74 to 77. The lowest MAP was about 50 around hour 4.2, and the lowest valid SpO2 was 84 around hour 1.1; respiratory rate rose as high as 35 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 41.1-41.7 C, white count fell from 9.8 to 8.3, creatinine stayed around 0.8, lactate was not available, and urine output fell from 400 to 160.

Answer: A

Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 97, diastolic pressure rose from 53 to 75, and heart rate rose from 70 to 78. The lowest MAP was about 54 around hour 3.4, and the lowest valid SpO2 was 88 around hour 0.9; respiratory rate rose as high as 33 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 97.89 to 99, white count fell from 12.1 to 10.7, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output fell from 400 to 110.


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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 152 to 172, MAP rose from 71 to 100, and heart rate rose from 67 to 81. SpO2 started at 93, ended at 99, and fell as low as 91 around hour 0.8; respiratory rate ranged 16-35. For labs and output, white count fell from 10.6 to 9.1, creatinine stayed around 1.0, lactate was not available, and urine output fell from 400 to 110.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 132 to 166, MAP rose from 68 to 97, and heart rate rose from 70 to 78. SpO2 started at 96, ended at 96, and fell as low as 88 around hour 0.9; respiratory rate ranged 14-33. For labs and output, white count fell from 12.1 to 10.7, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output fell from 400 to 110.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 157 to 177, MAP rose from 72 to 100, and heart rate rose from 66 to 81. SpO2 started at 92, ended at 100, and fell as low as 92 around hour 0.8; respiratory rate ranged 16-35. For labs and output, white count fell from 10.2 to 9.9, creatinine was roughly stable (1.0 to 0.7), lactate was not available, and urine output fell from 425 to 114.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 102 to 162, MAP rose from 64 to 100, and heart rate rose from 74 to 77. SpO2 started at 100, ended at 92, and fell as low as 87 around hour 1.1; respiratory rate ranged 12-38. For labs and output, white count fell from 14.3 to 8.4, creatinine was roughly stable (0.8 to 1.0), lactate was not available, and urine output fell from 370 to 106.

Answer: B


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

Options:
A. Across the recorded window, the heart rate rose from 73 to 75, MAP rose from 71 to 100, and diastolic pressure moved from 50 to 78. Systolic pressure ranged 96-192 and ended at 186, and SpO2 recovered to 93 after a low of 87 around hour 1.0. Respiratory rate ended at 20; the available labs showed white count fell from 13.6 to 9.9, creatinine was roughly stable (0.8 to 0.9), lactate was not available, and urine output fell from 450 to 107.
B. Across the recorded window, the heart rate rose from 68 to 81, MAP rose from 66 to 95, and diastolic pressure moved from 55 to 72. Systolic pressure ranged 91-157 and ended at 151, and SpO2 recovered to 98 after a low of 86 around hour 0.8. Respiratory rate ended at 22; the available labs showed white count fell from 11.0 to 9.6, creatinine was roughly stable (1.0 to 0.7), lactate was not available, and urine output fell from 385 to 112.
C. Across the recorded window, the heart rate rose from 70 to 78, MAP rose from 68 to 97, and diastolic pressure moved from 53 to 75. Systolic pressure ranged 93-172 and ended at 166, and SpO2 recovered to 96 after a low of 88 around hour 0.9. Respiratory rate ended at 21; the available labs showed white count fell from 12.1 to 10.7, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output fell from 400 to 110.
D. Across the recorded window, the heart rate rose from 66 to 82, MAP rose from 64 to 100, and diastolic pressure moved from 58 to 70. Systolic pressure ranged 88-142 and ended at 162, and SpO2 recovered to 100 after a low of 84 around hour 1.9. Respiratory rate ended at 23; the available labs showed white count fell from 9.8 to 8.4, creatinine was roughly stable (1.1 to 0.7), lactate was not available, and urine output fell from 370 to 114.

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 100 to 82, diastolic pressure fell from 74 to 53, and heart rate rose from 43 to 77. The lowest MAP was about 76 around hour 7.5, and the lowest valid SpO2 was 91 around hour 0.4; respiratory rate rose as high as 37 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.4-34.4 C, white count was 10.0 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 585 to 320.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 97 to 85, diastolic pressure fell from 71 to 56, and heart rate rose from 46 to 74. The lowest MAP was about 73 around hour 6.5, and the lowest valid SpO2 was 88 around hour 0.5; respiratory rate rose as high as 34 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 36.4-37.4 C, white count was 9.5 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 565 to 300.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 81, diastolic pressure fell from 75 to 60, and heart rate rose from 42 to 77. The lowest MAP was about 77 around hour 5.9, and the lowest valid SpO2 was 92 around hour 0; respiratory rate rose as high as 38 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.6-33.6 C, white count was 10.1 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 590 to 325.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 92 to 90, diastolic pressure fell from 66 to 52, and heart rate rose from 50 to 70. The lowest MAP was about 68 around hour 7.2, and the lowest valid SpO2 was 84 around hour 0.7; respiratory rate rose as high as 36 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 40.9-41.9 C, white count was 8.8 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 535 to 350.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 97 to 85, diastolic pressure fell from 71 to 56, and heart rate rose from 46 to 74. The lowest MAP was about 73 around hour 6.5, and the lowest valid SpO2 was 88 around hour 0.5; respiratory rate rose as high as 34 but ended at 18. The lower-frequency data fit that summary: temperature ranged from 97.5 to 99.4, white count was 9.5 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 565 to 300.


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 rose from 172 to 192, MAP fell from 100 to 88, and heart rate rose from 43 to 77. SpO2 started at 94, ended at 99, and fell as low as 91 around hour 0.4; respiratory rate ranged 10-31. For labs and output, white count was 9.0 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 585 to 280.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (137 to 172), MAP fell from 95 to 83, and heart rate rose from 48 to 77. SpO2 started at 99, ended at 94, and fell as low as 86 around hour 0.6; respiratory rate ranged 9-36. For labs and output, white count was 9.9 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 550 to 315.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (152 to 157), MAP fell from 97 to 85, and heart rate rose from 46 to 74. SpO2 started at 97, ended at 96, and fell as low as 88 around hour 0.5; respiratory rate ranged 9-34. For labs and output, white count was 9.5 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 565 to 300.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (122 to 153), MAP fell from 92 to 88, and heart rate rose from 50 to 70. SpO2 started at 100, ended at 92, and fell as low as 87 around hour 0.7; respiratory rate ranged 8-38. For labs and output, white count was 10.2 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 535 to 330.

Answer: C


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

Options:
A. Clinically, the heart rate rose from 49 to 71, MAP fell from 100 to 88, and diastolic pressure moved from 68 to 59. Systolic pressure ranged 143-189 and ended at 177, and SpO2 recovered to 93 after a low of 87 around hour 0.6. Respiratory rate ended at 16; the available labs showed white count was 10.0 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 615 to 320.
B. Clinically, the heart rate rose from 44 to 76, MAP fell from 95 to 88, and diastolic pressure moved from 73 to 54. Systolic pressure ranged 108-154 and ended at 153, and SpO2 recovered to 98 after a low of 86 around hour 1.5. Respiratory rate ended at 19; the available labs showed white count was 9.1 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 580 to 285.
C. Clinically, the heart rate rose from 50 to 77, MAP fell from 100 to 89, and diastolic pressure moved from 67 to 53. Systolic pressure ranged 148-194 and ended at 182, and SpO2 recovered to 92 after a low of 92 around hour 0.6. Respiratory rate ended at 16; the available labs showed white count was 10.1 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 540 to 325.
D. Clinically, the heart rate rose from 46 to 74, MAP fell from 97 to 85, and diastolic pressure moved from 71 to 56. Systolic pressure ranged 123-169 and ended at 157, and SpO2 recovered to 96 after a low of 88 around hour 0.5. Respiratory rate ended at 18; the available labs showed white count was 9.5 on its only check, creatinine was 1 on its only check, lactate was not available, and urine output fell from 565 to 300.

Answer: D


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

Options:
A. Clinically, the heart rate fell from 119 to 75, while MAP fell from 92 to 85. Systolic pressure was labile, ranging 101-147, with the lowest value around hour 88.8. SpO2 briefly dipped to 89 around hour 2.9 before recovering to 97, while respiratory rate peaked at 44 and later settled at 24. The associated labs and urine output showed that white count fell from 8.7 to 8.2, creatinine was roughly stable (0.9 to 0.6), lactate was not available, and urine output was roughly stable (320 to 295), with recorded outputs ranging 27-630.
B. Clinically, the heart rate fell from 116 to 78, while MAP fell from 89 to 82. Systolic pressure was labile, ranging 97-167, with the lowest value around hour 85.8. SpO2 briefly dipped to 88 around hour 2.7 before recovering to 100, while respiratory rate peaked at 42 and later settled at 22. The associated labs and urine output showed that white count fell from 10.2 to 9.1, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output was roughly stable (300 to 275), with recorded outputs ranging 30-650.
C. Clinically, the heart rate fell from 120 to 74, while MAP was roughly stable (93 to 85). Systolic pressure was labile, ranging 93-142, with the lowest value around hour 89.5. SpO2 briefly dipped to 92 around hour 3.7 before recovering to 96, while respiratory rate peaked at 46 and later settled at 24. The associated labs and urine output showed that white count fell from 8.3 to 7.8, creatinine was roughly stable (0.9 to 0.6), lactate was not available, and urine output was roughly stable (325 to 225), with recorded outputs ranging 26-625.
D. Clinically, the heart rate fell from 112 to 82, while MAP fell from 84 to 78. Systolic pressure was labile, ranging 100-197, with the lowest value around hour 81.3. SpO2 briefly dipped to 84 around hour 2.4 before recovering to 96, while respiratory rate peaked at 38 and later settled at 20. The associated labs and urine output showed that white count fell from 12.4 to 8.3, creatinine stayed around 0.7, lactate was not available, and urine output was roughly stable (300 to 275), with recorded outputs ranging 80-650.

Answer: B


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (106 to 101), MAP was roughly stable (79 to 78), and heart rate fell from 99 to 91. SpO2 started at 100, ended at 98, and fell as low as 85 around hour 0.1; respiratory rate ranged 12-25. For labs and output, white count fell from 9.2 to 7.1, creatinine stayed around 0.4, lactate was not available, and urine output rose from 150 to 380.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (104 to 103), MAP was roughly stable (77 to 76), and heart rate fell from 100 to 89. SpO2 started at 98, ended at 96, and fell as low as 86 around hour 0.2; respiratory rate ranged 11-26. For labs and output, white count fell from 9.6 to 6.7, creatinine was roughly stable (0.3 to 0.5), lactate was not available, and urine output rose from 150 to 380.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 110 to 97, MAP was roughly stable (83 to 81), and heart rate fell from 95 to 92. SpO2 started at 96, ended at 100, and fell as low as 84 around hour 0.0; respiratory rate ranged 14-23. For labs and output, white count fell from 8.6 to 7.7, creatinine stayed around 0.5, lactate was not available, and urine output rose from 125 to 405.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (102 to 106), MAP was roughly stable (74 to 74), and heart rate was roughly stable (100 to 94). SpO2 started at 96, ended at 94, and fell as low as 80 around hour 0.2; respiratory rate ranged 10-27. For labs and output, white count fell from 9.9 to 6.3, creatinine stayed around 0.2, lactate was not available, and urine output rose from 180 to 350.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate fell from 100 to 88, MAP was roughly stable (82 to 81), and diastolic pressure moved from 67 to 75. Systolic pressure ranged 89-146 and ended at 97, and SpO2 recovered to 95 after a low of 88 around hour 1.1. Respiratory rate ended at 14; the available labs showed white count fell from 9.7 to 7.6, creatinine stayed around 0.3, lactate was not available, and urine output rose from 170 to 400.
B. Viewed chronologically, the heart rate fell from 99 to 91, MAP was roughly stable (79 to 78), and diastolic pressure moved from 70 to 72. Systolic pressure ranged 86-126 and ended at 101, and SpO2 recovered to 98 after a low of 85 around hour 0.1. Respiratory rate ended at 16; the available labs showed white count fell from 9.2 to 7.1, creatinine stayed around 0.4, lactate was not available, and urine output rose from 150 to 380.
C. Viewed chronologically, the heart rate was roughly stable (100 to 94), MAP was roughly stable (83 to 82), and diastolic pressure moved from 66 to 69. Systolic pressure ranged 90-151 and ended at 105, and SpO2 recovered to 94 after a low of 89 around hour 0.2. Respiratory rate ended at 14; the available labs showed white count fell from 9.8 to 7.7, creatinine stayed around 0.3, lactate was not available, and urine output rose from 175 to 405.
D. Viewed chronologically, the heart rate fell from 94 to 91, MAP was roughly stable (74 to 74), and diastolic pressure moved from 74 to 68. Systolic pressure ranged 82-96 and ended at 96, and SpO2 recovered to 100 after a low of 84 around hour 0.0. Respiratory rate ended at 18; the available labs showed white count fell from 8.4 to 6.3, creatinine stayed around 0.6, lactate was not available, and urine output rose from 200 to 350.

Answer: B


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

Options:
A. Viewed chronologically, the heart rate rose from 33 to 99, while MAP fell from 93 to 86. Systolic pressure was labile, ranging 94-125, with the lowest value around hour 4.9. SpO2 briefly dipped to 86 around hour 34.4 before recovering to 80, while respiratory rate peaked at 37 and later settled at 20. The associated labs and urine output showed that white count rose from 0 to 13.0, creatinine rose from 0.7 to 0.8, lactate rose from 1.4 to 277, and urine output rose from 57 to 320, with recorded outputs ranging 12-470.
B. Viewed chronologically, the heart rate rose from 28 to 104, while MAP was roughly stable (88 to 86). Systolic pressure was labile, ranging 92-160, with the lowest value around hour 4.0. SpO2 briefly dipped to 81 around hour 31 before recovering to 85, while respiratory rate peaked at 33 and later settled at 18. The associated labs and urine output showed that white count rose from 2 to 10.4, creatinine rose from 0.5 to 0.9, lactate rose from 1.0 to 242, and urine output rose from 62 to 250, with recorded outputs ranging 9-435.
C. Viewed chronologically, the heart rate rose from 34 to 98, while MAP fell from 94 to 87. Systolic pressure was labile, ranging 86-120, with the lowest value around hour 5.0. SpO2 briefly dipped to 87 around hour 35.1 before recovering to 79, while respiratory rate peaked at 39 and later settled at 21. The associated labs and urine output showed that white count rose from 0 to 10.7, creatinine rose from 0.7 to 0.9, lactate rose from 1.4 to 282, and urine output rose from 56 to 325, with recorded outputs ranging 60-475.
D. Viewed chronologically, the heart rate rose from 30 to 102, while MAP fell from 90 to 83. Systolic pressure was labile, ranging 90-145, with the lowest value around hour 4.4. SpO2 briefly dipped to 83 around hour 31.4 before recovering to 83, while respiratory rate peaked at 35 and later settled at 19. The associated labs and urine output showed that white count rose from 0 to 11.5, creatinine rose from 0.6 to 0.8, lactate rose from 1.2 to 257, and urine output rose from 60 to 300, with recorded outputs ranging 10-450.

Answer: D


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

Options:
A. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 83, diastolic pressure was roughly stable (69 to 68), and heart rate rose from 30 to 102. The lowest MAP was about 66 around hour 2.4, and the lowest valid SpO2 was 83 around hour 31.4; respiratory rate rose as high as 35 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 36.1-36.8 C, white count rose from 0 to 11.5, creatinine rose from 0.6 to 0.8, lactate rose from 1.2 to 257, and urine output rose from 60 to 300.
B. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 88 to 85, diastolic pressure was roughly stable (67 to 66), and heart rate rose from 32 to 105. The lowest MAP was about 64 around hour 2.5, and the lowest valid SpO2 was 82 around hour 30.4; respiratory rate rose as high as 33 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 38.4-39.0 C, white count rose from 0 to 12.6, creatinine rose from 0.5 to 0.7, lactate rose from 1.4 to 242, and urine output rose from 58 to 315.
C. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 79, diastolic pressure was roughly stable (73 to 65), and heart rate rose from 26 to 106. The lowest MAP was about 69 around hour 3.4, and the lowest valid SpO2 was 87 around hour 27.6; respiratory rate rose as high as 39 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 32.4-33.0 C, white count rose from 2 to 9.6, creatinine rose from 0.7 to 0.9, lactate rose from 0.9 to 282, and urine output rose from 64 to 275.
D. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 83, diastolic pressure was roughly stable (64 to 64), and heart rate rose from 34 to 98. The lowest MAP was about 62 around hour 2.7, and the lowest valid SpO2 was 78 around hour 35.9; respiratory rate rose as high as 37 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 40.6-41.3 C, white count rose from 0 to 13.8, creatinine rose from 0.4 to 0.9, lactate rose from 1.5 to 227, and urine output rose from 56 to 350.

Answer: A

In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 83, diastolic pressure was roughly stable (69 to 68), and heart rate rose from 30 to 102. The lowest MAP was about 66 around hour 2.4, and the lowest valid SpO2 was 83 around hour 31.4; respiratory rate rose as high as 35 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 97 to 98.2, white count rose from 0 to 11.5, creatinine rose from 0.6 to 0.8, lactate rose from 1.2 to 257, and urine output rose from 60 to 300.


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 165 to 107, MAP was roughly stable (93 to 86), and heart rate rose from 27 to 105. SpO2 started at 86, ended at 86, and fell as low as 82 around hour 28.4; respiratory rate ranged 8-32. For labs and output, white count rose from 0 to 13.0, creatinine rose from 0.7 to 0.8, lactate rose from 1.4 to 277, and urine output rose from 57 to 320.
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 145 to 111, MAP fell from 90 to 83, and heart rate rose from 30 to 102. SpO2 started at 89, ended at 83, and fell as low as 83 around hour 31.4; respiratory rate ranged 7-35. For labs and output, white count rose from 0 to 11.5, creatinine rose from 0.6 to 0.8, lactate rose from 1.2 to 257, and urine output rose from 60 to 300.
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 170 to 107, MAP fell from 94 to 87, and heart rate rose from 26 to 105. SpO2 started at 85, ended at 87, and fell as low as 87 around hour 27.6; respiratory rate ranged 8-37. For labs and output, white count rose from 0 to 10.7, creatinine rose from 0.7 to 0.8, lactate rose from 1.4 to 282, and urine output rose from 56 to 325.
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 115 to 112, MAP fell from 86 to 78, and heart rate rose from 34 to 98. SpO2 started at 94, ended at 78, and fell as low as 78 around hour 35.9; respiratory rate ranged 6-40. For labs and output, white count rose from 3 to 9.2, creatinine rose from 0.4 to 0.9, lactate rose from 1.4 to 227, and urine output rose from 64 to 270.

Answer: B


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

Options:
A. Overall, the heart rate rose from 33 to 105, MAP fell from 93 to 86, and diastolic pressure moved from 66 to 65. Systolic pressure ranged 93-165 and ended at 114, and SpO2 recovered to 80 after a low of 86 around hour 34.4. Respiratory rate ended at 18; the available labs showed white count rose from 2 to 13.0, creatinine rose from 0.5 to 0.9, lactate rose from 1.4 to 237, and urine output rose from 63 to 320.
B. Overall, the heart rate rose from 28 to 104, MAP was roughly stable (88 to 86), and diastolic pressure moved from 71 to 66. Systolic pressure ranged 88-130 and ended at 107, and SpO2 recovered to 85 after a low of 81 around hour 31. Respiratory rate ended at 20; the available labs showed white count rose from 0 to 10.4, creatinine rose from 0.7 to 0.8, lactate rose from 1.0 to 272, and urine output rose from 58 to 285.
C. Overall, the heart rate rose from 30 to 102, MAP fell from 90 to 83, and diastolic pressure moved from 69 to 68. Systolic pressure ranged 90-145 and ended at 111, and SpO2 recovered to 83 after a low of 83 around hour 31.4. Respiratory rate ended at 19; the available labs showed white count rose from 0 to 11.5, creatinine rose from 0.6 to 0.8, lactate rose from 1.2 to 257, and urine output rose from 60 to 300.
D. Overall, the heart rate rose from 26 to 106, MAP fell from 86 to 78, and diastolic pressure moved from 74 to 64. Systolic pressure ranged 86-115 and ended at 106, and SpO2 recovered to 88 after a low of 82 around hour 26.9. Respiratory rate ended at 21; the available labs showed white count rose from 0 to 10.7, creatinine rose from 0.8 to 0.9, lactate rose from 0.9 to 287, and urine output rose from 110 to 270.

Answer: C