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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 180 to 54, diastolic pressure fell from 69 to 57, and heart rate fell from 79 to 75. The lowest MAP was about 52 around hour 57.8, and the lowest valid SpO2 was 88 around hour 2.6; respiratory rate rose as high as 36 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 33.4-34.8 C, white count rose from 7.2 to 7.8, creatinine rose from 0.9 to 1, lactate was checked once at 1.3, and urine output fell from 620 to 270.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 160 to 57, diastolic pressure fell from 66 to 54, and heart rate fell from 82 to 72. The lowest MAP was about 49 around hour 60.8, and the lowest valid SpO2 was 85 around hour 3.1; respiratory rate rose as high as 34 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 36.4-37.8 C, white count rose from 6.7 to 8.3, creatinine was roughly stable (0.8 to 0.9), lactate was checked once at 1.5, and urine output fell from 600 to 220.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 185 to 53, diastolic pressure fell from 70 to 58, and heart rate fell from 78 to 75. The lowest MAP was about 53 around hour 57.0, and the lowest valid SpO2 was 89 around hour 2.1; respiratory rate rose as high as 38 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 32.6-34.0 C, white count rose from 7.3 to 7.7, creatinine was roughly stable (0.9 to 1.0), lactate was checked once at 1.2, and urine output fell from 625 to 245.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 130 to 62, diastolic pressure fell from 62 to 51, and heart rate fell from 86 to 68. The lowest MAP was about 52 around hour 61.8, and the lowest valid SpO2 was 80 around hour 3.9; respiratory rate rose as high as 30 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 40.9-42.3 C, white count rose from 6.0 to 9.1, creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 1.8, and urine output fell from 570 to 190.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 160 to 57, diastolic pressure fell from 66 to 54, and heart rate fell from 82 to 72. The lowest MAP was about 49 around hour 60.8, and the lowest valid SpO2 was 85 around hour 3.1; respiratory rate rose as high as 34 but ended at 24. The lower-frequency data fit that summary: temperature ranged from 97.5 to 100, white count rose from 6.7 to 8.3, creatinine was roughly stable (0.8 to 0.9), lactate was checked once at 1.5, and urine output fell from 600 to 220.


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

Options:
A. Over the available measurements, the heart rate fell from 110 to 50, MAP rose from 115 to 137, and diastolic pressure moved from 95 to 109. Systolic pressure ranged 100-195 and ended at 195, and SpO2 recovered to 92 after a low of 91 around hour 16.2. Respiratory rate ended at 23; the available labs showed white count was roughly stable (11.2 to 11.1), creatinine was roughly stable (0.7 to 0.6), lactate was not available, and urine output fell from 650 to 450.
B. Over the available measurements, the heart rate fell from 108 to 52, MAP rose from 113 to 122, and diastolic pressure moved from 97 to 107. Systolic pressure ranged 98-180 and ended at 180, and SpO2 recovered to 94 after a low of 90 around hour 15.1. Respiratory rate ended at 24; the available labs showed white count was roughly stable (10.1 to 10.3), creatinine was roughly stable (0.8 to 0.5), lactate was not available, and urine output fell from 700 to 465.
C. Over the available measurements, the heart rate fell from 114 to 46, MAP rose from 119 to 140, and diastolic pressure moved from 91 to 113. Systolic pressure ranged 96-220 and ended at 191, and SpO2 recovered to 88 after a low of 95 around hour 17.2. Respiratory rate ended at 21; the available labs showed white count was roughly stable (13.1 to 13.0), creatinine was roughly stable (0.6 to 0.7), lactate was not available, and urine output fell from 675 to 425.
D. Over the available measurements, the heart rate fell from 106 to 53, MAP rose from 110 to 113, and diastolic pressure moved from 100 to 106. Systolic pressure ranged 96-165 and ended at 165, and SpO2 recovered to 96 after a low of 86 around hour 13.9. Respiratory rate ended at 25; the available labs showed white count was roughly stable (8.9 to 8.8), creatinine was roughly stable (0.8 to 0.4), lactate was not available, and urine output fell from 620 to 480.

Answer: A


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 79 to 64, diastolic pressure stayed around 65, and heart rate rose from 109 to 144. The lowest MAP was about 62 around hour 20.4, and the lowest valid SpO2 was 88 around hour 18.4; respiratory rate rose as high as 45 but ended at 33. The lower-frequency data fit that summary: temperature stayed around 39.7-40.9 C, white count rose from 13.9 to 17.4, creatinine rose from 1.0 to 1.7, lactate stayed broadly stable from 1.7 to 5.6, and urine output fell from 195 to 55.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 74 to 69, diastolic pressure was roughly stable (60 to 59), and heart rate rose from 106 to 164. The lowest MAP was about 62 around hour 19.9, and the lowest valid SpO2 was 85 around hour 16.9; respiratory rate rose as high as 43 but ended at 30. The lower-frequency data fit that summary: temperature stayed around 36.7-37.9 C, white count rose from 12.4 to 15.9, creatinine rose from 1.2 to 1.6, lactate stayed broadly stable from 1.5 to 6.1, and urine output fell from 175 to 5.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 80 to 63, diastolic pressure stayed around 66, and heart rate rose from 110 to 167. The lowest MAP was about 63 around hour 20.8, and the lowest valid SpO2 was 89 around hour 15.9; respiratory rate rose as high as 39 but ended at 34. The lower-frequency data fit that summary: temperature stayed around 40.5-41.6 C, white count rose from 14.3 to 17.8, creatinine rose from 0.9 to 1.9, lactate stayed broadly stable from 1.8 to 5.5, and urine output fell from 200 to 6.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 76 to 67, diastolic pressure stayed around 62, and heart rate rose from 106 to 164. The lowest MAP was about 59 around hour 18.9, and the lowest valid SpO2 was 85 around hour 16.9; respiratory rate rose as high as 43 but ended at 30. The lower-frequency data fit that summary: temperature stayed around 36.7-37.9 C, white count rose from 12.4 to 15.9, creatinine rose from 1.2 to 1.6, lactate stayed broadly stable from 1.5 to 6.1, and urine output fell from 175 to 5.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 76 to 67, diastolic pressure stayed around 62, and heart rate rose from 106 to 164. The lowest MAP was about 59 around hour 18.9, and the lowest valid SpO2 was 85 around hour 16.9; respiratory rate rose as high as 43 but ended at 30. The lower-frequency data fit that summary: temperature ranged from 37 to 100.3, white count rose from 12.4 to 15.9, creatinine rose from 1.2 to 1.6, lactate stayed broadly stable from 1.5 to 6.1, and urine output fell from 175 to 5.


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 115 to 93, MAP fell from 76 to 67, and heart rate rose from 106 to 164. SpO2 started at 100, ended at 93, and fell as low as 85 around hour 16.9; respiratory rate ranged 17-43. For labs and output, white count rose from 12.4 to 15.9, creatinine rose from 1.2 to 1.6, lactate stayed broadly stable from 1.5 to 6.1, and urine output fell from 175 to 5.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 113 to 95, MAP fell from 74 to 65, and heart rate rose from 108 to 167. SpO2 started at 98, ended at 91, and fell as low as 83 around hour 18.0; respiratory rate ranged 16-45. For labs and output, white count rose from 13.5 to 15.1, creatinine rose from 1.0 to 1.8, lactate stayed broadly stable from 1.4 to 5.7, and urine output fell from 190 to 5.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 119 to 89, MAP fell from 80 to 70, and heart rate rose from 102 to 189. SpO2 started at 96, ended at 97, and fell as low as 84 around hour 15.0; respiratory rate ranged 19-39. For labs and output, white count rose from 10.5 to 17.8, creatinine rose from 1.4 to 1.6, lactate stayed broadly stable from 1.8 to 6.7, and urine output fell from 150 to 6.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 110 to 98, MAP fell from 72 to 62, and heart rate rose from 110 to 134. SpO2 started at 96, ended at 88, and fell as low as 80 around hour 19.1; respiratory rate ranged 15-48. For labs and output, white count rose from 14.7 to 16.2, creatinine rose from 0.9 to 1.7, lactate stayed broadly stable from 1.7 to 5.3, and urine output fell from 205 to 4.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate stayed around 75, while MAP rose from 57 to 79. Systolic pressure was labile, ranging 92-174, with the lowest value around hour 2.3. SpO2 briefly dipped to 82 around hour 3.6 before recovering to 99, while respiratory rate peaked at 26 and later settled at 24. The associated labs and urine output showed that white count was roughly stable (2.8 to 3.4), creatinine was roughly stable (0.7 to 0.7), lactate was checked once at 2, and urine output was roughly stable (125 to 100), with recorded outputs ranging 70-350.
B. Viewed chronologically, the heart rate stayed around 70, while MAP rose from 62 to 74. Systolic pressure was labile, ranging 87-139, with the lowest value around hour 2.0. SpO2 briefly dipped to 86 around hour 2.7 before recovering to 94, while respiratory rate peaked at 29 and later settled at 22. The associated labs and urine output showed that white count rose from 2.5 to 4.6, creatinine stayed around 0.5, lactate was checked once at 2, and urine output was roughly stable (140 to 98), with recorded outputs ranging 19-335.
C. Viewed chronologically, the heart rate stayed around 76, while MAP rose from 56 to 79. Systolic pressure was labile, ranging 93-179, with the lowest value around hour 2.4. SpO2 briefly dipped to 81 around hour 4.1 before recovering to 100, while respiratory rate peaked at 25 and later settled at 25. The associated labs and urine output showed that white count rose from 2.9 to 3.6, creatinine stayed around 0.7, lactate was checked once at 2, and urine output was roughly stable (100 to 50), with recorded outputs ranging 22-375.
D. Viewed chronologically, the heart rate stayed around 72, while MAP rose from 60 to 76. Systolic pressure was labile, ranging 89-154, with the lowest value around hour 2.1. SpO2 briefly dipped to 85 around hour 3.1 before recovering to 96, while respiratory rate peaked at 27 and later settled at 23. The associated labs and urine output showed that white count rose from 2.6 to 4.2, creatinine stayed around 0.6, lactate was checked once at 2, and urine output was roughly stable (125 to 100), with recorded outputs ranging 20-350.

Answer: D


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

Options:
A. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 60 to 76, diastolic pressure rose from 43 to 62, and heart rate stayed around 72. The lowest MAP was about 60 around hour 2.1, and the lowest valid SpO2 was 85 around hour 3.1; respiratory rate rose as high as 27 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 36.2-37.1 C, white count rose from 2.6 to 4.2, creatinine stayed around 0.6, lactate was checked once at 2, and urine output was roughly stable (125 to 100)
B. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 58 to 78, diastolic pressure rose from 41 to 60, and heart rate was roughly stable (74 to 75). The lowest MAP was about 60 around hour 2.1, and the lowest valid SpO2 was 85 around hour 2.1; respiratory rate rose as high as 27 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 36.2-37.1 C, white count rose from 2.6 to 4.2, creatinine stayed around 0.6, lactate was checked once at 2, and urine output was roughly stable (125 to 100)
C. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 64 to 72, diastolic pressure rose from 47 to 59, and heart rate stayed around 68. The lowest MAP was about 64 around hour 3.1, and the lowest valid SpO2 was 89 around hour 3.7; respiratory rate rose as high as 25 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 40.0-40.9 C, white count was roughly stable (3.4 to 4.8), creatinine stayed around 0.5, lactate was checked once at 2, and urine output was roughly stable (150 to 96)
D. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 56 to 80, diastolic pressure rose from 38 to 58, and heart rate stayed around 76. The lowest MAP was about 56 around hour 1.8, and the lowest valid SpO2 was 80 around hour 2.4; respiratory rate rose as high as 29 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 31.7-32.6 C, white count rose from 2.3 to 3.5, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 2, and urine output was roughly stable (125 to 150)

Answer: A

In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 60 to 76, diastolic pressure rose from 43 to 62, and heart rate stayed around 72. The lowest MAP was about 60 around hour 2.1, and the lowest valid SpO2 was 85 around hour 3.1; respiratory rate rose as high as 27 but ended at 23. The lower-frequency data fit that summary: temperature ranged from 97.1 to 98.7, white count rose from 2.6 to 4.2, creatinine stayed around 0.6, lactate was checked once at 2, and urine output was roughly stable (125 to 100)


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

Options:
A. Overall, the heart rate rose from 50 to 86, while MAP fell from 84 to 65. Systolic pressure was labile, ranging 92-165, with the lowest value around hour 19.4. SpO2 briefly dipped to 85 around hour 0.4 before recovering to 95, while respiratory rate peaked at 27 and later settled at 27. The associated labs and urine output showed that white count fell from 12.8 to 10.7, creatinine stayed around 0.6, lactate was not available, and urine output fell from 350 to 60, with recorded outputs ranging 15-350.
B. Overall, the heart rate rose from 48 to 89, while MAP fell from 82 to 63. Systolic pressure was labile, ranging 96-180, with the lowest value around hour 18.3. SpO2 briefly dipped to 83 around hour 0.3 before recovering to 97, while respiratory rate peaked at 29 and later settled at 26. The associated labs and urine output showed that white count fell from 13.9 to 9.6, creatinine stayed around 0.5, lactate was not available, and urine output fell from 365 to 58, with recorded outputs ranging 14-335.
C. Overall, the heart rate rose from 54 to 82, while MAP fell from 88 to 68. Systolic pressure was labile, ranging 88-140, with the lowest value around hour 21.3. SpO2 briefly dipped to 89 around hour 1.4 before recovering to 91, while respiratory rate peaked at 29 and later settled at 29. The associated labs and urine output showed that white count fell from 10.9 to 9.4, creatinine stayed around 0.7, lactate was not available, and urine output fell from 325 to 10, with recorded outputs ranging 10-375.
D. Overall, the heart rate rose from 46 to 90, while MAP fell from 80 to 60. Systolic pressure was labile, ranging 96-195, with the lowest value around hour 17.1. SpO2 briefly dipped to 80 around hour 0.2 before recovering to 100, while respiratory rate peaked at 25 and later settled at 25. The associated labs and urine output showed that white count fell from 15.1 to 9.9, creatinine was roughly stable (0.4 to 0.7), lactate was not available, and urine output fell from 350 to 60, with recorded outputs ranging 60-350.

Answer: A


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

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (147 to 101), MAP fell from 87 to 68, and heart rate rose from 47 to 89. SpO2 started at 82, ended at 98, and fell as low as 88 around hour 0.3; respiratory rate ranged 8-29. For labs and output, white count fell from 11.3 to 9.9, creatinine stayed around 0.7, lactate was not available, and urine output fell from 330 to 63.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (112 to 136), MAP fell from 87 to 63, and heart rate rose from 52 to 84. SpO2 started at 87, ended at 93, and fell as low as 83 around hour 0.5; respiratory rate ranged 8-28. For labs and output, white count fell from 13.9 to 9.6, creatinine was roughly stable (0.5 to 0.7), lactate was not available, and urine output fell from 350 to 60.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (127 to 121), MAP fell from 84 to 65, and heart rate rose from 50 to 86. SpO2 started at 85, ended at 95, and fell as low as 85 around hour 0.4; respiratory rate ranged 8-27. For labs and output, white count fell from 12.8 to 10.7, creatinine stayed around 0.6, lactate was not available, and urine output fell from 350 to 60.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 97 to 94, MAP fell from 80 to 68, and heart rate rose from 54 to 82. SpO2 started at 90, ended at 90, and fell as low as 84 around hour 0.6; respiratory rate ranged 7-29. For labs and output, white count fell from 15.1 to 8.4, creatinine stayed around 0.4, lactate was not available, and urine output fell from 380 to 56.

Answer: C


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

Options:
A. In broad terms, the heart rate rose from 85 to 94, MAP rose from 74 to 97, and diastolic pressure moved from 67 to 85. Systolic pressure ranged 68-156 and ended at 132, and SpO2 recovered to 91 after a low of 85 around hour 1.2. Respiratory rate ended at 26; the available labs showed white count fell from 20.1 to 6.7, creatinine fell from 1.2 to 0.9, lactate stayed broadly stable from 2.8 to 0.9, and urine output fell from 800 to 500.
B. In broad terms, the heart rate rose from 83 to 97, MAP rose from 72 to 95, and diastolic pressure moved from 69 to 82. Systolic pressure ranged 66-141 and ended at 117, and SpO2 recovered to 93 after a low of 83 around hour 1.0. Respiratory rate ended at 27; the available labs showed white count fell from 19.0 to 6.3, creatinine fell from 1.4 to 0.8, lactate stayed broadly stable from 2.6 to 1.0, and urine output fell from 785 to 485.
C. In broad terms, the heart rate rose from 89 to 90, MAP rose from 78 to 100, and diastolic pressure moved from 63 to 89. Systolic pressure ranged 72-181 and ended at 157, and SpO2 recovered to 87 after a low of 84 around hour 1.4. Respiratory rate ended at 24; the available labs showed white count fell from 22.0 to 5.9, creatinine fell from 0.9 to 0.7, lactate stayed broadly stable from 3.0 to 0.8, and urine output fell from 850 to 525.
D. In broad terms, the heart rate rose from 80 to 98, MAP rose from 70 to 100, and diastolic pressure moved from 72 to 80. Systolic pressure ranged 64-126 and ended at 128, and SpO2 recovered to 96 after a low of 80 around hour 2.2. Respiratory rate ended at 28; the available labs showed white count fell from 17.9 to 6.0, creatinine fell from 1.5 to 0.8, lactate stayed broadly stable from 2.5 to 1.1, and urine output fell from 770 to 470.

Answer: A


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 91 to 93, diastolic pressure rose from 73 to 82, and heart rate fell from 95 to 94. The lowest MAP was about 65 around hour 20, and the lowest valid SpO2 was 91 around hour 0.3; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.6-34.4 C, white count was 13.7 on its only check, creatinine was 1.1 on its only check, lactate was not available, and urine output was roughly stable (145 to 220)
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 86 to 98, diastolic pressure rose from 68 to 83, and heart rate was roughly stable (100 to 94). The lowest MAP was about 60 around hour 20, and the lowest valid SpO2 was 86 around hour 0; respiratory rate rose as high as 22 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 38.9-39.6 C, white count was 11.1 on its only check, creatinine was 1.5 on its only check, lactate was not available, and urine output was roughly stable (110 to 185)
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 92 to 95, diastolic pressure rose from 74 to 89, and heart rate fell from 94 to 91. The lowest MAP was about 66 around hour 17, and the lowest valid SpO2 was 92 around hour 0.3; respiratory rate rose as high as 25 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 32.9-33.6 C, white count was 14.1 on its only check, creatinine was 1.1 on its only check, lactate was not available, and urine output rose from 150 to 250.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 88 to 96, diastolic pressure rose from 70 to 85, and heart rate fell from 98 to 91. The lowest MAP was about 62 around hour 19, and the lowest valid SpO2 was 88 around hour 0.4; respiratory rate rose as high as 23 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 36.6-37.4 C, white count was 12.2 on its only check, creatinine was 1.3 on its only check, lactate was not available, and urine output was roughly stable (125 to 200)

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 88 to 96, diastolic pressure rose from 70 to 85, and heart rate fell from 98 to 91. The lowest MAP was about 62 around hour 19, and the lowest valid SpO2 was 88 around hour 0.4; respiratory rate rose as high as 23 but ended at 23. The lower-frequency data fit that summary: temperature ranged from 97.8 to 99.4, white count was 12.2 on its only check, creatinine was 1.3 on its only check, lactate was not available, and urine output was roughly stable (125 to 200)


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 143 to 134, MAP rose from 88 to 96, and heart rate fell from 98 to 91. SpO2 started at 96, ended at 96, and fell as low as 88 around hour 0.4; respiratory rate ranged 15-23. For labs and output, white count was 12.2 on its only check, creatinine was 1.3 on its only check, lactate was not available, and urine output was roughly stable (125 to 200)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 128 to 108, MAP rose from 86 to 94, and heart rate was roughly stable (100 to 94). SpO2 started at 98, ended at 94, and fell as low as 86 around hour 0.5; respiratory rate ranged 14-25. For labs and output, white count was 13.3 on its only check, creatinine was 1.1 on its only check, lactate was not available, and urine output was roughly stable (110 to 215)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 168 to 130, MAP rose from 92 to 99, and heart rate fell from 94 to 91. SpO2 started at 92, ended at 100, and fell as low as 87 around hour 0.3; respiratory rate ranged 17-21. For labs and output, white count was 10.3 on its only check, creatinine was 1.6 on its only check, lactate was not available, and urine output was roughly stable (150 to 175)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 113 to 93, MAP rose from 84 to 92, and heart rate fell from 100 to 86. SpO2 started at 100, ended at 92, and fell as low as 84 around hour 0.6; respiratory rate ranged 13-25. For labs and output, white count was 14.4 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output was roughly stable (95 to 230)

Answer: A


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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (141 to 114), MAP fell from 84 to 75, and heart rate fell from 86 to 63. SpO2 started at 96, ended at 88, and fell as low as 88 around hour 9.6; respiratory rate ranged 16-28. For labs and output, white count fell from 17.9 to 16.4, creatinine stayed around 0.9, lactate fell from 2.6 to 1.2, and urine output fell from 300 to 50.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (121 to 117), MAP fell from 81 to 72, and heart rate fell from 89 to 60. SpO2 started at 99, ended at 85, and fell as low as 85 around hour 11.1; respiratory rate ranged 14-29. For labs and output, white count fell from 19.4 to 17.9, creatinine was roughly stable (0.8 to 0.7), lactate fell from 2.4 to 1.2, and urine output fell from 300 to 50.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (146 to 113), MAP fell from 85 to 76, and heart rate fell from 85 to 63. SpO2 started at 95, ended at 89, and fell as low as 89 around hour 9.2; respiratory rate ranged 16-31. For labs and output, white count fell from 17.5 to 17.1, creatinine was roughly stable (0.9 to 0.6), lactate fell from 2.6 to 1.4, and urine output fell from 275 to 54.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 91 to 88, MAP fell from 76 to 75, and heart rate fell from 94 to 56. SpO2 started at 100, ended at 80, and fell as low as 84 around hour 13.3; respiratory rate ranged 12-31. For labs and output, white count fell from 21.6 to 15.6, creatinine was roughly stable (0.7 to 0.8), lactate fell from 2.1 to 0.9, and urine output fell from 330 to 46.

Answer: B


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

Options:
A. Across the recorded window, the heart rate rose from 60 to 79, while MAP fell from 75 to 69. Systolic pressure was labile, ranging 84-143, with the lowest value around hour 36.6. SpO2 briefly dipped to 85 around hour 3.9 before recovering to 95, while respiratory rate peaked at 29 and later settled at 28. The associated labs and urine output showed that white count fell from 15.9 to 12.7, creatinine was roughly stable (0.7 to 0.6), lactate fell from 2.5 to 1.4, and urine output fell from 495 to 30, with recorded outputs ranging 20-800.
B. Across the recorded window, the heart rate rose from 58 to 81, while MAP fell from 73 to 67. Systolic pressure was labile, ranging 88-158, with the lowest value around hour 34.4. SpO2 briefly dipped to 83 around hour 3.5 before recovering to 97, while respiratory rate peaked at 31 and later settled at 27. The associated labs and urine output showed that white count fell from 17.0 to 11.6, creatinine was roughly stable (0.6 to 0.7), lactate fell from 2.4 to 1.2, and urine output fell from 510 to 28, with recorded outputs ranging 19-785.
C. Across the recorded window, the heart rate rose from 64 to 75, while MAP was roughly stable (79 to 72). Systolic pressure was labile, ranging 80-118, with the lowest value around hour 40.4. SpO2 briefly dipped to 89 around hour 4.9 before recovering to 91, while respiratory rate peaked at 31 and later settled at 30. The associated labs and urine output showed that white count fell from 14.0 to 12.5, creatinine was roughly stable (0.8 to 0.5), lactate fell from 2.8 to 1.6, and urine output fell from 470 to 0, with recorded outputs ranging 0-825.
D. Across the recorded window, the heart rate rose from 56 to 84, while MAP fell from 70 to 64. Systolic pressure was labile, ranging 88-173, with the lowest value around hour 32.1. SpO2 briefly dipped to 80 around hour 3.1 before recovering to 100, while respiratory rate peaked at 27 and later settled at 26. The associated labs and urine output showed that white count fell from 18.1 to 11.9, creatinine stayed around 0.5, lactate fell from 2.5 to 1.4, and urine output fell from 495 to 30, with recorded outputs ranging 26-800.

Answer: A


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 39 to 104, MAP was roughly stable (79 to 82), and heart rate fell from 81 to 72. SpO2 started at 97, ended at 100, and fell as low as 88 around hour 6.2; respiratory rate ranged 12-29. For labs and output, white count fell from 12.8 to 9.9, creatinine rose from 0.9 to 1, lactate was checked once at 2, and urine output fell from 1250 to 180.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 34 to 120, MAP rose from 74 to 82, and heart rate fell from 86 to 67. SpO2 started at 98, ended at 95, and fell as low as 84 around hour 7.1; respiratory rate ranged 9-28. For labs and output, white count fell from 15.4 to 9.6, creatinine rose from 0.7 to 1, lactate was checked once at 2, and urine output fell from 1110 to 215.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 40 to 99, MAP was roughly stable (80 to 83), and heart rate fell from 80 to 73. SpO2 started at 96, ended at 100, and fell as low as 89 around hour 6.1; respiratory rate ranged 12-25. For labs and output, white count fell from 12.4 to 10.9, creatinine rose from 0.9 to 1.1, lactate was checked once at 2.2, and urine output fell from 1270 to 175.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 36 to 124, MAP was roughly stable (76 to 79), and heart rate fell from 84 to 69. SpO2 started at 100, ended at 97, and fell as low as 85 around hour 6.7; respiratory rate ranged 10-27. For labs and output, white count fell from 14.3 to 10.7, creatinine rose from 0.8 to 1, lactate was checked once at 2, and urine output fell from 1170 to 200.

Answer: D


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

Options:
A. Over the available measurements, the heart rate fell from 84 to 69, MAP was roughly stable (76 to 79), and diastolic pressure moved from 20 to 71. Systolic pressure ranged 22-138 and ended at 124, and SpO2 recovered to 97 after a low of 85 around hour 6.7. Respiratory rate ended at 25; the available labs showed white count fell from 14.3 to 10.7, creatinine rose from 0.8 to 1, lactate was checked once at 2, and urine output fell from 1170 to 200.
B. Over the available measurements, the heart rate fell from 82 to 71, MAP was roughly stable (74 to 77), and diastolic pressure moved from 21 to 69. Systolic pressure ranged 21-123 and ended at 109, and SpO2 recovered to 99 after a low of 84 around hour 6.3. Respiratory rate ended at 26; the available labs showed white count fell from 13.2 to 9.9, creatinine rose from 0.9 to 1, lactate was checked once at 2, and urine output fell from 1220 to 185.
C. Over the available measurements, the heart rate fell from 88 to 72, MAP was roughly stable (80 to 83), and diastolic pressure moved from 18 to 68. Systolic pressure ranged 24-163 and ended at 149, and SpO2 recovered to 93 after a low of 89 around hour 7.3. Respiratory rate ended at 23; the available labs showed white count fell from 16.2 to 12.6, creatinine rose from 0.7 to 1, lactate was checked once at 2, and urine output fell from 1070 to 225.
D. Over the available measurements, the heart rate fell from 80 to 74, MAP rose from 72 to 82, and diastolic pressure moved from 22 to 66. Systolic pressure ranged 20-108 and ended at 120, and SpO2 recovered to 100 after a low of 80 around hour 7.7. Respiratory rate ended at 27; the available labs showed white count fell from 12.1 to 8.4, creatinine rose from 1.0 to 1.2, lactate was checked once at 2, and urine output fell from 1290 to 170.

Answer: A


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

Options:
A. Over the available measurements, the heart rate rose from 61 to 78, while MAP fell from 110 to 92. Systolic pressure was labile, ranging 102-136, with the lowest value around hour 14.2. SpO2 briefly dipped to 86 around hour 44.7 before recovering to 96, while respiratory rate peaked at 25 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (17.0 to 19.9), creatinine stayed around 0.8, lactate was not available, and urine output was roughly stable (655 to 720), with recorded outputs ranging 140-1480.
B. Over the available measurements, the heart rate rose from 56 to 83, while MAP fell from 105 to 92. Systolic pressure was labile, ranging 100-171, with the lowest value around hour 11.6. SpO2 briefly dipped to 83 around hour 42.7 before recovering to 100, while respiratory rate peaked at 22 and later settled at 17. The associated labs and urine output showed that white count was roughly stable (19.6 to 17.3), creatinine stayed around 0.6, lactate was not available, and urine output was roughly stable (690 to 650), with recorded outputs ranging 105-1340.
C. Over the available measurements, the heart rate rose from 58 to 81, while MAP fell from 107 to 89. Systolic pressure was labile, ranging 98-156, with the lowest value around hour 12.7. SpO2 briefly dipped to 85 around hour 41.7 before recovering to 99, while respiratory rate peaked at 23 and later settled at 18. The associated labs and urine output showed that white count was roughly stable (18.5 to 18.4), creatinine stayed around 0.7, lactate was not available, and urine output was roughly stable (675 to 700), with recorded outputs ranging 120-1400.
D. Over the available measurements, the heart rate rose from 54 to 86, while MAP fell from 102 to 84. Systolic pressure was labile, ranging 100-186, with the lowest value around hour 10.4. SpO2 briefly dipped to 80 around hour 37.2 before recovering to 100, while respiratory rate peaked at 21 and later settled at 16. The associated labs and urine output showed that white count was roughly stable (20.8 to 17.6), creatinine was roughly stable (0.5 to 0.8), lactate was not available, and urine output was roughly stable (675 to 700), with recorded outputs ranging 170-1400.

Answer: C


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 110 to 86, diastolic pressure was roughly stable (84 to 89), and heart rate rose from 55 to 84. The lowest MAP was about 82 around hour 9.2, and the lowest valid SpO2 was 88 around hour 38.7; respiratory rate rose as high as 25 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.7-34.7 C, white count was roughly stable (20.0 to 16.9), creatinine was roughly stable (0.8 to 0.8), lactate was not available, and urine output was roughly stable (675 to 750)
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 105 to 91, diastolic pressure was roughly stable (79 to 83), and heart rate rose from 60 to 79. The lowest MAP was about 82 around hour 11.7, and the lowest valid SpO2 was 83 around hour 44.0; respiratory rate rose as high as 22 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 39.0-40.0 C, white count was roughly stable (17.4 to 19.5), creatinine stayed around 0.6, lactate was not available, and urine output was roughly stable (660 to 715)
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 111 to 85, diastolic pressure was roughly stable (85 to 90), and heart rate rose from 54 to 84. The lowest MAP was about 83 around hour 8.8, and the lowest valid SpO2 was 89 around hour 40.7; respiratory rate rose as high as 25 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.0-34.0 C, white count was roughly stable (20.4 to 16.5), creatinine stayed around 0.8, lactate was not available, and urine output was roughly stable (700 to 675)
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 107 to 89, diastolic pressure was roughly stable (81 to 86), and heart rate rose from 58 to 81. The lowest MAP was about 79 around hour 10.7, and the lowest valid SpO2 was 85 around hour 41.7; respiratory rate rose as high as 23 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 36.7-37.7 C, white count was roughly stable (18.5 to 18.4), creatinine stayed around 0.7, lactate was not available, and urine output was roughly stable (675 to 700)

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 107 to 89, diastolic pressure was roughly stable (81 to 86), and heart rate rose from 58 to 81. The lowest MAP was about 79 around hour 10.7, and the lowest valid SpO2 was 85 around hour 41.7; respiratory rate rose as high as 23 but ended at 18. The lower-frequency data fit that summary: temperature ranged from 98 to 99.8, white count was roughly stable (18.5 to 18.4), creatinine stayed around 0.7, lactate was not available, and urine output was roughly stable (675 to 700)


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (147 to 144), MAP fell from 107 to 89, and heart rate rose from 58 to 81. SpO2 started at 96, ended at 99, and fell as low as 85 around hour 41.7; respiratory rate ranged 13-23. For labs and output, white count was roughly stable (18.5 to 18.4), creatinine stayed around 0.7, lactate was not available, and urine output was roughly stable (675 to 700)
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (132 to 159), MAP fell from 105 to 87, and heart rate rose from 60 to 79. SpO2 started at 98, ended at 97, and fell as low as 83 around hour 44.0; respiratory rate ranged 12-24. For labs and output, white count was roughly stable (19.6 to 17.3), creatinine was roughly stable (0.6 to 0.8), lactate was not available, and urine output was roughly stable (675 to 700)
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (172 to 119), MAP fell from 111 to 93, and heart rate rose from 54 to 84. SpO2 started at 92, ended at 100, and fell as low as 89 around hour 38.0; respiratory rate ranged 15-25. For labs and output, white count was roughly stable (16.6 to 17.6), creatinine stayed around 0.8, lactate was not available, and urine output was roughly stable (650 to 725)
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 117 to 97, MAP fell from 102 to 92, and heart rate rose from 62 to 76. SpO2 started at 100, ended at 94, and fell as low as 84 around hour 46.2; respiratory rate ranged 11-25. For labs and output, white count was roughly stable (20.8 to 16.1), creatinine stayed around 0.5, lactate was not available, and urine output was roughly stable (705 to 670)

Answer: A


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

Options:
A. Viewed chronologically, the heart rate fell from 100 to 78, while MAP fell from 97 to 84. Systolic pressure was labile, ranging 87-114, with the lowest value around hour 36.6. SpO2 briefly dipped to 86 around hour 12.1 before recovering to 94, while respiratory rate peaked at 24 and later settled at 18. The associated labs and urine output showed that white count rose from 9.9 to 14.8, creatinine rose from 0.8 to 0.9, lactate was checked once at 1542, and urine output fell from 720 to 280, with recorded outputs ranging 97-680.
B. Viewed chronologically, the heart rate fell from 95 to 83, while MAP fell from 92 to 84. Systolic pressure was labile, ranging 85-149, with the lowest value around hour 31.4. SpO2 briefly dipped to 83 around hour 11.6 before recovering to 99, while respiratory rate peaked at 21 and later settled at 15. The associated labs and urine output showed that white count rose from 12.5 to 14.0, creatinine rose from 0.6 to 1.0, lactate was checked once at 1402, and urine output fell from 685 to 250, with recorded outputs ranging 98-715.
C. Viewed chronologically, the heart rate fell from 100 to 77, while MAP fell from 98 to 85. Systolic pressure was labile, ranging 79-109, with the lowest value around hour 37.4. SpO2 briefly dipped to 89 around hour 12.5 before recovering to 93, while respiratory rate peaked at 24 and later settled at 18. The associated labs and urine output showed that white count rose from 9.5 to 12.5, creatinine rose from 0.8 to 1, lactate was checked once at 1562, and urine output fell from 725 to 275, with recorded outputs ranging 150-675.
D. Viewed chronologically, the heart rate fell from 97 to 81, while MAP fell from 94 to 81. Systolic pressure was labile, ranging 83-134, with the lowest value around hour 33.6. SpO2 briefly dipped to 85 around hour 10.6 before recovering to 97, while respiratory rate peaked at 22 and later settled at 16. The associated labs and urine output showed that white count rose from 11.4 to 13.3, creatinine rose from 0.7 to 0.9, lactate was checked once at 1462, and urine output fell from 700 to 300, with recorded outputs ranging 100-700.

Answer: D


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

Options:
A. Overall, the heart rate fell from 100 to 84, MAP fell from 97 to 84, and diastolic pressure moved from 77 to 69. Systolic pressure ranged 86-154 and ended at 98, and SpO2 recovered to 94 after a low of 88 around hour 12.1. Respiratory rate ended at 14; the available labs showed white count rose from 12.9 to 14.8, creatinine rose from 0.6 to 1.0, lactate was checked once at 1542, and urine output fell from 680 to 320.
B. Overall, the heart rate fell from 95 to 83, MAP fell from 92 to 84, and diastolic pressure moved from 82 to 70. Systolic pressure ranged 81-119 and ended at 91, and SpO2 recovered to 99 after a low of 83 around hour 11.6. Respiratory rate ended at 17; the available labs showed white count rose from 10.3 to 12.2, creatinine rose from 0.8 to 0.9, lactate was checked once at 1402, and urine output fell from 715 to 285.
C. Overall, the heart rate fell from 97 to 81, MAP fell from 94 to 81, and diastolic pressure moved from 80 to 72. Systolic pressure ranged 83-134 and ended at 95, and SpO2 recovered to 97 after a low of 85 around hour 10.6. Respiratory rate ended at 16; the available labs showed white count rose from 11.4 to 13.3, creatinine rose from 0.7 to 0.9, lactate was checked once at 1462, and urine output fell from 700 to 300.
D. Overall, the heart rate fell from 92 to 86, MAP fell from 90 to 76, and diastolic pressure moved from 84 to 68. Systolic pressure ranged 78-104 and ended at 90, and SpO2 recovered to 100 after a low of 84 around hour 8.3. Respiratory rate ended at 18; the available labs showed white count rose from 9.2 to 12.5, creatinine rose from 0.8 to 0.9, lactate was checked once at 1342, and urine output fell from 750 to 270.

Answer: C


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

Options:
A. Overall, the heart rate rose from 50 to 95, while MAP fell from 102 to 84. Systolic pressure was labile, ranging 88-168, with the lowest value around hour 31.4. SpO2 briefly dipped to 85 around hour 3.4 before recovering to 93, while respiratory rate peaked at 34 and later settled at 24. The associated labs and urine output showed that white count was roughly stable (7.2 to 7.5), creatinine stayed around 0.5, lactate was not available, and urine output rose from 400 to 700, with recorded outputs ranging 100-700.
B. Overall, the heart rate rose from 48 to 97, while MAP fell from 100 to 82. Systolic pressure was labile, ranging 92-183, with the lowest value around hour 29.1. SpO2 briefly dipped to 83 around hour 3.0 before recovering to 95, while respiratory rate peaked at 36 and later settled at 23. The associated labs and urine output showed that white count was roughly stable (7.6 to 7.1), creatinine stayed around 0.4, lactate was not available, and urine output rose from 415 to 685, with recorded outputs ranging 98-685.
C. Overall, the heart rate rose from 54 to 91, while MAP fell from 106 to 88. Systolic pressure was labile, ranging 84-143, with the lowest value around hour 35.1. SpO2 briefly dipped to 89 around hour 4.0 before recovering to 89, while respiratory rate peaked at 38 and later settled at 26. The associated labs and urine output showed that white count was roughly stable (6.6 to 6.7), creatinine was roughly stable (0.6 to 0.6), lactate was not available, and urine output rose from 400 to 700, with recorded outputs ranging 150-700.
D. Overall, the heart rate rose from 46 to 100, while MAP fell from 98 to 87. Systolic pressure was labile, ranging 92-198, with the lowest value around hour 26.9. SpO2 briefly dipped to 80 around hour 4.4 before recovering to 98, while respiratory rate peaked at 30 and later settled at 22. The associated labs and urine output showed that white count was roughly stable (8.0 to 6.8), creatinine stayed around 0.3, lactate was not available, and urine output rose from 430 to 650, with recorded outputs ranging 96-670.

Answer: A


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

Options:
A. In broad terms, the heart rate fell from 76 to 70, MAP rose from 75 to 90, and diastolic pressure moved from 51 to 70. Systolic pressure ranged 98-159 and ended at 149, and SpO2 recovered to 98 after a low of 85 around hour 77.7. Respiratory rate ended at 16; the available labs showed white count fell from 9.1 to 7, creatinine fell from 0.7 to 0.5, lactate was not available, and urine output was roughly stable (350 to 400)
B. In broad terms, the heart rate fell from 74 to 72, MAP rose from 73 to 88, and diastolic pressure moved from 53 to 68. Systolic pressure ranged 96-144 and ended at 134, and SpO2 recovered to 100 after a low of 84 around hour 75.5. Respiratory rate ended at 17; the available labs showed white count fell from 8.7 to 6.2, creatinine fell from 0.8 to 0.4, lactate was not available, and urine output was roughly stable (400 to 415)
C. In broad terms, the heart rate fell from 80 to 66, MAP rose from 79 to 93, and diastolic pressure moved from 47 to 74. Systolic pressure ranged 100-184 and ended at 145, and SpO2 recovered to 94 after a low of 89 around hour 78.7. Respiratory rate ended at 14; the available labs showed white count fell from 9.7 to 8, creatinine fell from 0.6 to 0.5, lactate was not available, and urine output was roughly stable (375 to 375)
D. In broad terms, the heart rate was roughly stable (72 to 73), MAP rose from 70 to 86, and diastolic pressure moved from 56 to 67. Systolic pressure ranged 94-129 and ended at 119, and SpO2 recovered to 100 after a low of 80 around hour 73.2. Respiratory rate ended at 18; the available labs showed white count fell from 8.3 to 6, creatinine fell from 0.8 to 0.3, lactate was not available, and urine output was roughly stable (320 to 430)

Answer: A


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (80 to 75), diastolic pressure was roughly stable (65 to 60), and heart rate rose from 72 to 84. The lowest MAP was about 61 around hour 16.5, and the lowest valid SpO2 was 88 around hour 2; respiratory rate rose as high as 36 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 33.6-34.5 C, white count was roughly stable (16.4 to 13.2), creatinine was roughly stable (1 to 1.0), lactate was checked once at 1.7, and urine output fell from 320 to 43.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (75 to 80), diastolic pressure was roughly stable (60 to 61), and heart rate rose from 77 to 84. The lowest MAP was about 56 around hour 16.6, and the lowest valid SpO2 was 83 around hour 2; respiratory rate rose as high as 31 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 38.9-39.8 C, white count was roughly stable (13.8 to 15.8), creatinine was roughly stable (1 to 0.8), lactate was checked once at 2.0, and urine output fell from 285 to 38.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (81 to 74), diastolic pressure was roughly stable (66 to 67), and heart rate rose from 71 to 85. The lowest MAP was about 62 around hour 13.6, and the lowest valid SpO2 was 89 around hour 2; respiratory rate rose as high as 35 but ended at 27. The lower-frequency data fit that summary: temperature stayed around 32.9-33.8 C, white count was roughly stable (16.8 to 12.8), creatinine stayed around 1, lactate was checked once at 1.9, and urine output fell from 300 to 90.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (77 to 78), diastolic pressure was roughly stable (62 to 63), and heart rate rose from 75 to 81. The lowest MAP was about 58 around hour 15.5, and the lowest valid SpO2 was 85 around hour 3; respiratory rate rose as high as 33 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 36.6-37.5 C, white count was roughly stable (14.9 to 14.7), creatinine was roughly stable (1 to 0.9), lactate was checked once at 1.9, and urine output fell from 300 to 40.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (77 to 78), diastolic pressure was roughly stable (62 to 63), and heart rate rose from 75 to 81. The lowest MAP was about 58 around hour 15.5, and the lowest valid SpO2 was 85 around hour 3; respiratory rate rose as high as 33 but ended at 25. The lower-frequency data fit that summary: temperature ranged from 97.9 to 99.5, white count was roughly stable (14.9 to 14.7), creatinine was roughly stable (1 to 0.9), lactate was checked once at 1.9, and urine output fell from 300 to 40.


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (110 to 111), MAP was roughly stable (77 to 78), and heart rate rose from 75 to 81. SpO2 started at 99, ended at 94, and fell as low as 85 around hour 3; respiratory rate ranged 8-33. For labs and output, white count was roughly stable (14.9 to 14.7), creatinine was roughly stable (1 to 0.9), lactate was checked once at 1.9, and urine output fell from 300 to 40.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (108 to 107), MAP was roughly stable (75 to 81), and heart rate rose from 77 to 79. SpO2 started at 100, ended at 92, and fell as low as 84 around hour 3; respiratory rate ranged 8-35. For labs and output, white count was roughly stable (16.0 to 13.6), creatinine was roughly stable (1 to 1.0), lactate was checked once at 1.8, and urine output fell from 285 to 42.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (114 to 107), MAP was roughly stable (81 to 82), and heart rate rose from 71 to 84. SpO2 started at 95, ended at 98, and fell as low as 89 around hour 2; respiratory rate ranged 9-35. For labs and output, white count was roughly stable (13.0 to 13.9), creatinine was roughly stable (1 to 0.8), lactate was checked once at 2.1, and urine output fell from 325 to 36.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (106 to 116), MAP was roughly stable (72 to 74), and heart rate rose from 80 to 83. SpO2 started at 100, ended at 90, and fell as low as 80 around hour 4; respiratory rate ranged 7-35. For labs and output, white count was roughly stable (17.1 to 12.4), creatinine stayed around 1, lactate was checked once at 2.1, and urine output fell from 300 to 40.

Answer: A


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

Options:
A. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (74 to 71), diastolic pressure was roughly stable (64 to 62), and heart rate was roughly stable (100 to 98). The lowest MAP was about 57 around hour 72.5, and the lowest valid SpO2 was 85 around hour 0.7; respiratory rate rose as high as 25 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 36.4-38.2 C, white count rose from 9.1 to 10.6, creatinine was roughly stable (0.9 to 1), lactate stayed broadly stable from 497 to 510, and urine output fell from 200 to 120.
B. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (72 to 73), diastolic pressure was roughly stable (62 to 59), and heart rate was roughly stable (98 to 96). The lowest MAP was about 60 around hour 73.5, and the lowest valid SpO2 was 83 around hour 0.8; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 38.6-40.5 C, white count rose from 8.7 to 11.7, creatinine was roughly stable (0.8 to 1), lactate stayed broadly stable from 512 to 495, and urine output fell from 185 to 135.
C. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (78 to 67), diastolic pressure was roughly stable (68 to 66), and heart rate was roughly stable (96 to 100). The lowest MAP was about 61 around hour 68.8, and the lowest valid SpO2 was 89 around hour 0.6; respiratory rate rose as high as 27 but ended at 27. The lower-frequency data fit that summary: temperature stayed around 32.6-34.5 C, white count rose from 9.7 to 10.2, creatinine rose from 1.0 to 1.1, lactate stayed broadly stable from 472 to 535, and urine output was roughly stable (225 to 170)
D. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (70 to 76), diastolic pressure was roughly stable (60 to 58), and heart rate was roughly stable (96 to 101). The lowest MAP was about 52 around hour 77.0, and the lowest valid SpO2 was 80 around hour 0; respiratory rate rose as high as 23 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 40.9-42.7 C, white count rose from 8.3 to 12.8, creatinine was roughly stable (0.8 to 1), lactate stayed broadly stable from 527 to 480, and urine output fell from 170 to 150.

Answer: A

Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (74 to 71), diastolic pressure was roughly stable (64 to 62), and heart rate was roughly stable (100 to 98). The lowest MAP was about 57 around hour 72.5, and the lowest valid SpO2 was 85 around hour 0.7; respiratory rate rose as high as 25 but ended at 25. The lower-frequency data fit that summary: temperature ranged from 97.6 to 100.8, white count rose from 9.1 to 10.6, creatinine was roughly stable (0.9 to 1), lactate stayed broadly stable from 497 to 510, and urine output fell from 200 to 120.


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

Options:
A. Across the recorded window, the heart rate rose from 63 to 71, while MAP rose from 75 to 98. Systolic pressure was labile, ranging 83-173, with the lowest value around hour 44.8. SpO2 briefly dipped to 85 around hour 50.8 before recovering to 97, while respiratory rate peaked at 34 and later settled at 11. The associated labs and urine output showed that white count was roughly stable (6.1 to 5.7), creatinine stayed around 0.9, lactate fell from 240 to 1, and urine output rose from 150 to 500, with recorded outputs ranging 25-700.
B. Across the recorded window, the heart rate rose from 61 to 73, while MAP rose from 73 to 96. Systolic pressure was labile, ranging 87-188, with the lowest value around hour 42.5. SpO2 briefly dipped to 86 around hour 48.5 before recovering to 99, while respiratory rate peaked at 36 and later settled at 10. The associated labs and urine output showed that white count was roughly stable (6.5 to 5.3), creatinine stayed around 0.8, lactate fell from 255 to 1, and urine output rose from 135 to 515, with recorded outputs ranging 24-715.
C. Across the recorded window, the heart rate rose from 67 to 70, while MAP rose from 79 to 100. Systolic pressure was labile, ranging 79-148, with the lowest value around hour 48.5. SpO2 briefly dipped to 89 around hour 54.5 before recovering to 93, while respiratory rate peaked at 38 and later settled at 13. The associated labs and urine output showed that white count fell from 5.5 to 4.9, creatinine was roughly stable (1.0 to 1), lactate fell from 240 to 1, and urine output rose from 150 to 500, with recorded outputs ranging 75-700.
D. Across the recorded window, the heart rate rose from 58 to 76, while MAP rose from 70 to 101. Systolic pressure was labile, ranging 88-203, with the lowest value around hour 40.3. SpO2 briefly dipped to 80 around hour 51.8 before recovering to 100, while respiratory rate peaked at 30 and later settled at 9. The associated labs and urine output showed that white count was roughly stable (6.8 to 5.0), creatinine stayed around 0.8, lactate fell from 270 to 1, and urine output rose from 120 to 450, with recorded outputs ranging 23-730.

Answer: A


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 162 to 115, MAP was roughly stable (94 to 95), and heart rate fell from 87 to 62. SpO2 started at 97, ended at 93, and fell as low as 91 around hour 0.7; respiratory rate ranged 18-29. For labs and output, white count fell from 8.6 to 5.7, creatinine fell from 1.5 to 1, lactate was checked once at 1.7, and urine output rose from 43 to 330.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 127 to 114, MAP was roughly stable (89 to 95), and heart rate fell from 92 to 57. SpO2 started at 98, ended at 88, and fell as low as 87 around hour 0.9; respiratory rate ranged 15-28. For labs and output, white count fell from 9.5 to 6.1, creatinine fell from 1.1 to 1, lactate was checked once at 1.4, and urine output rose from 38 to 365.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 167 to 114, MAP was roughly stable (95 to 96), and heart rate fell from 86 to 63. SpO2 started at 96, ended at 94, and fell as low as 92 around hour 0.7; respiratory rate ranged 18-25. For labs and output, white count fell from 8.5 to 7.1, creatinine fell from 1.6 to 1.1, lactate was checked once at 1.7, and urine output rose from 44 to 325.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 142 to 118, MAP was roughly stable (91 to 92), and heart rate fell from 90 to 59. SpO2 started at 100, ended at 90, and fell as low as 88 around hour 0.8; respiratory rate ranged 16-27. For labs and output, white count fell from 9.1 to 6.5, creatinine fell from 1.3 to 1, lactate was checked once at 1.5, and urine output rose from 40 to 350.

Answer: D


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

Options:
A. Over the available measurements, the heart rate fell from 90 to 59, MAP was roughly stable (91 to 92), and diastolic pressure moved from 75 to 83. Systolic pressure ranged 92-142 and ended at 118, and SpO2 recovered to 90 after a low of 88 around hour 0.8. Respiratory rate ended at 16; the available labs showed white count fell from 9.1 to 6.5, creatinine fell from 1.3 to 1, lactate was checked once at 1.5, and urine output rose from 40 to 350.
B. Over the available measurements, the heart rate fell from 88 to 61, MAP was roughly stable (89 to 90), and diastolic pressure moved from 77 to 81. Systolic pressure ranged 90-127 and ended at 116, and SpO2 recovered to 92 after a low of 87 around hour 0.7. Respiratory rate ended at 17; the available labs showed white count fell from 8.7 to 5.7, creatinine fell from 1.5 to 1, lactate was checked once at 1.4, and urine output rose from 90 to 335.
C. Over the available measurements, the heart rate fell from 94 to 62, MAP was roughly stable (95 to 96), and diastolic pressure moved from 71 to 80. Systolic pressure ranged 96-167 and ended at 122, and SpO2 recovered to 86 after a low of 92 around hour 0.9. Respiratory rate ended at 14; the available labs showed white count fell from 9.7 to 7.1, creatinine fell from 1.1 to 1, lactate was checked once at 1.8, and urine output rose from 36 to 375.
D. Over the available measurements, the heart rate fell from 86 to 64, MAP was roughly stable (86 to 95), and diastolic pressure moved from 80 to 78. Systolic pressure ranged 88-112 and ended at 114, and SpO2 recovered to 94 after a low of 84 around hour 1.8. Respiratory rate ended at 18; the available labs showed white count fell from 8.3 to 5.8, creatinine fell from 1.6 to 1, lactate was checked once at 1.2, and urine output rose from 44 to 320.

Answer: A


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (120 to 121), MAP rose from 72 to 85, and heart rate was roughly stable (109 to 106). SpO2 started at 94, ended at 97, and fell as low as 85 around hour 0.1; respiratory rate ranged 12-40. For labs and output, white count fell from 19.6 to 11.1, creatinine fell from 0.8 to 0.5, lactate was checked once at 170, and urine output fell from 1500 to 85.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (105 to 136), MAP rose from 70 to 83, and heart rate was roughly stable (111 to 104). SpO2 started at 96, ended at 95, and fell as low as 83 around hour 0.2; respiratory rate ranged 11-42. For labs and output, white count fell from 20.7 to 10.0, creatinine fell from 0.7 to 0.6, lactate was checked once at 170.2, and urine output fell from 1440 to 87.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (145 to 96), MAP rose from 76 to 89, and heart rate stayed around 105. SpO2 started at 94, ended at 97, and fell as low as 85 around hour 0.1; respiratory rate ranged 12-42. For labs and output, white count fell from 19.6 to 10.3, creatinine fell from 0.8 to 0.5, lactate was checked once at 170, and urine output fell from 1500 to 85.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (90 to 117), MAP rose from 68 to 88, and heart rate was roughly stable (114 to 102). SpO2 started at 98, ended at 92, and fell as low as 84 around hour 0.2; respiratory rate ranged 10-44. For labs and output, white count fell from 21.9 to 8.8, creatinine fell from 0.7 to 0.6, lactate was checked once at 140, and urine output fell from 1380 to 90.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate stayed around 112, MAP rose from 72 to 85, and diastolic pressure moved from 57 to 69. Systolic pressure ranged 97-173 and ended at 121, and SpO2 recovered to 97 after a low of 85 around hour 0.1. Respiratory rate ended at 20; the available labs showed white count fell from 19.6 to 11.1, creatinine fell from 0.8 to 0.5, lactate was checked once at 170, and urine output fell from 1500 to 85.
B. Viewed chronologically, the heart rate was roughly stable (109 to 106), MAP rose from 72 to 85, and diastolic pressure moved from 57 to 72. Systolic pressure ranged 97-173 and ended at 121, and SpO2 recovered to 97 after a low of 85 around hour 0.1. Respiratory rate ended at 18; the available labs showed white count fell from 19.6 to 11.1, creatinine fell from 0.8 to 0.5, lactate was checked once at 170, and urine output fell from 1500 to 85.
C. Viewed chronologically, the heart rate was roughly stable (113 to 102), MAP rose from 76 to 88, and diastolic pressure moved from 53 to 76. Systolic pressure ranged 100-198 and ended at 117, and SpO2 recovered to 93 after a low of 89 around hour 1.1. Respiratory rate ended at 16; the available labs showed white count fell from 21.5 to 13.0, creatinine fell from 0.7 to 0.6, lactate was checked once at 195, and urine output fell from 1400 to 89.
D. Viewed chronologically, the heart rate was roughly stable (104 to 110), MAP rose from 68 to 80, and diastolic pressure moved from 62 to 68. Systolic pressure ranged 92-143 and ended at 91, and SpO2 recovered to 100 after a low of 84 around hour 0.0. Respiratory rate ended at 20; the available labs showed white count fell from 17.4 to 10.3, creatinine fell from 1.0 to 0.3, lactate was checked once at 140, and urine output fell from 1550 to 80.

Answer: B


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

Options:
A. Viewed chronologically, the heart rate rose from 69 to 93, while MAP was roughly stable (86 to 84). Systolic pressure was labile, ranging 26-100, with the lowest value around hour 2.3. SpO2 briefly dipped to 88 around hour 3.0 before recovering to 99, while respiratory rate peaked at 30 and later settled at 30. The associated labs and urine output showed that white count fell from 12.4 to 10.2, creatinine rose from 0.9 to 1, lactate stayed broadly stable from 2.9 to 2.9, and urine output was roughly stable (24 to 53), with recorded outputs ranging 26-540.
B. Viewed chronologically, the heart rate rose from 64 to 98, while MAP was roughly stable (81 to 84). Systolic pressure was labile, ranging 28-135, with the lowest value around hour 2.0. SpO2 briefly dipped to 83 around hour 3.8 before recovering to 100, while respiratory rate peaked at 28 and later settled at 28. The associated labs and urine output showed that white count fell from 15.0 to 10, creatinine was roughly stable (0.7 to 1.0), lactate stayed broadly stable from 2.6 to 2.6, and urine output was roughly stable (26 to 0), with recorded outputs ranging 0-505.
C. Viewed chronologically, the heart rate rose from 70 to 92, while MAP was roughly stable (87 to 85). Systolic pressure was labile, ranging 25-95, with the lowest value around hour 2.4. SpO2 briefly dipped to 86 around hour 3.0 before recovering to 94, while respiratory rate peaked at 31 and later settled at 31. The associated labs and urine output showed that white count fell from 12.0 to 10, creatinine was roughly stable (0.9 to 0.8), lactate stayed broadly stable from 3.0 to 3.0, and urine output was roughly stable (23 to 100), with recorded outputs ranging 27-545.
D. Viewed chronologically, the heart rate rose from 66 to 96, while MAP was roughly stable (83 to 81). Systolic pressure was labile, ranging 27-120, with the lowest value around hour 2.1. SpO2 briefly dipped to 85 around hour 2.8 before recovering to 98, while respiratory rate peaked at 29 and later settled at 29. The associated labs and urine output showed that white count fell from 13.9 to 11, creatinine was roughly stable (0.8 to 0.9), lactate stayed broadly stable from 2.7 to 2.7, and urine output was roughly stable (25 to 50), with recorded outputs ranging 25-520.

Answer: D


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

Options:
A. Overall, the heart rate fell from 101 to 64, while MAP rose from 62 to 76. Systolic pressure was labile, ranging 26-166, with the lowest value around hour 0.1. SpO2 briefly dipped to 85 around hour 0.3 before recovering to 98, while respiratory rate peaked at 27 and later settled at 11. The associated labs and urine output showed that white count fell from 11.7 to 10.3, creatinine was roughly stable (5.6 to 2.2), lactate stayed broadly stable from 1.8 to 1, and urine output fell from 175 to 55, with recorded outputs ranging 25-300.
B. Overall, the heart rate fell from 99 to 66, while MAP rose from 60 to 74. Systolic pressure was labile, ranging 27-181, with the lowest value around hour 0.0. SpO2 briefly dipped to 83 around hour 0.2 before recovering to 100, while respiratory rate peaked at 26 and later settled at 10. The associated labs and urine output showed that white count fell from 12.8 to 9.5, creatinine was roughly stable (5.2 to 2.3), lactate stayed broadly stable from 1.6 to 1, and urine output fell from 190 to 53, with recorded outputs ranging 55-285.
C. Overall, the heart rate fell from 105 to 60, while MAP rose from 66 to 80. Systolic pressure was labile, ranging 30-141, with the lowest value around hour 0.2. SpO2 briefly dipped to 86 around hour 0.4 before recovering to 94, while respiratory rate peaked at 29 and later settled at 13. The associated labs and urine output showed that white count fell from 9.8 to 8.3, creatinine was roughly stable (6.2 to 2.0), lactate stayed broadly stable from 2.0 to 1, and urine output fell from 150 to 59, with recorded outputs ranging 27-325.
D. Overall, the heart rate fell from 96 to 68, while MAP rose from 58 to 79. Systolic pressure was labile, ranging 28-196, with the lowest value around hour 0.0. SpO2 briefly dipped to 80 around hour 1.3 before recovering to 100, while respiratory rate peaked at 25 and later settled at 9. The associated labs and urine output showed that white count fell from 13.9 to 8.1, creatinine was roughly stable (4.8 to 2.5), lactate stayed broadly stable from 1.5 to 1, and urine output fell from 205 to 5, with recorded outputs ranging 5-270.

Answer: A


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

Options:
A. In broad terms, the heart rate was roughly stable (83 to 75), while MAP rose from 68 to 116. Systolic pressure was labile, ranging 72-113, with the lowest value around hour 0.2. SpO2 briefly dipped to 91 around hour 0.4 before recovering to 91, while respiratory rate peaked at 30 and later settled at 18. The associated labs and urine output showed that white count fell from 15.7 to 9.6, creatinine fell from 46 to 0.9, lactate was checked once at 1.7, and urine output rose from 53 to 180, with recorded outputs ranging 53-780.
B. In broad terms, the heart rate was roughly stable (78 to 80), while MAP rose from 63 to 111. Systolic pressure was labile, ranging 77-148, with the lowest value around hour 0.0. SpO2 briefly dipped to 89 around hour 0.2 before recovering to 96, while respiratory rate peaked at 30 and later settled at 16. The associated labs and urine output showed that white count fell from 18.3 to 9.3, creatinine fell from 41 to 0.9, lactate was checked once at 1.7, and urine output rose from 48 to 215, with recorded outputs ranging 48-815.
C. In broad terms, the heart rate was roughly stable (80 to 78), while MAP rose from 65 to 113. Systolic pressure was labile, ranging 75-133, with the lowest value around hour 0.1. SpO2 briefly dipped to 88 around hour 0.3 before recovering to 94, while respiratory rate peaked at 28 and later settled at 17. The associated labs and urine output showed that white count fell from 17.2 to 10.4, creatinine fell from 43 to 0.8, lactate was checked once at 1.5, and urine output rose from 50 to 200, with recorded outputs ranging 50-800.
D. In broad terms, the heart rate was roughly stable (76 to 82), while MAP rose from 60 to 116. Systolic pressure was labile, ranging 80-163, with the lowest value around hour 0.0. SpO2 briefly dipped to 84 around hour 1.3 before recovering to 98, while respiratory rate peaked at 26 and later settled at 15. The associated labs and urine output showed that white count fell from 19.4 to 8.2, creatinine fell from 38 to 1.0, lactate was checked once at 1.2, and urine output rose from 46 to 150, with recorded outputs ranging 46-830.

Answer: C


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

Options:
A. For handoff, the heart rate fell from 97 to 81, while MAP fell from 148 to 76. Systolic pressure was labile, ranging 113-167, with the lowest value around hour 29.0. SpO2 briefly dipped to 88 around hour 22 before recovering to 97, while respiratory rate peaked at 24 and later settled at 18. The associated labs and urine output showed that white count was 26.3 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 2430 to 180, with recorded outputs ranging 80-2270.
B. For handoff, the heart rate fell from 92 to 86, while MAP fell from 113 to 71. Systolic pressure was labile, ranging 118-202, with the lowest value around hour 26.4. SpO2 briefly dipped to 86 around hour 20 before recovering to 98, while respiratory rate peaked at 25 and later settled at 16. The associated labs and urine output showed that white count was 28.9 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 2300 to 215, with recorded outputs ranging 28-2410.
C. For handoff, the heart rate fell from 98 to 80, while MAP fell from 153 to 76. Systolic pressure was labile, ranging 112-162, with the lowest value around hour 29.4. SpO2 briefly dipped to 89 around hour 22 before recovering to 96, while respiratory rate peaked at 25 and later settled at 19. The associated labs and urine output showed that white count was 25.9 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 2450 to 150, with recorded outputs ranging 34-2250.
D. For handoff, the heart rate fell from 94 to 84, while MAP fell from 128 to 73. Systolic pressure was labile, ranging 116-187, with the lowest value around hour 27.5. SpO2 briefly dipped to 85 around hour 21 before recovering to 100, while respiratory rate peaked at 23 and later settled at 17. The associated labs and urine output showed that white count was 27.8 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 2350 to 200, with recorded outputs ranging 30-2350.

Answer: D


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

Options:
A. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 128 to 73, diastolic pressure fell from 98 to 60, and heart rate fell from 94 to 84. The lowest MAP was about 73 around hour 29.1, and the lowest valid SpO2 was 85 around hour 21; respiratory rate rose as high as 23 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.9-37.1 C, white count was 27.8 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 2350 to 200.
B. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 113 to 75, diastolic pressure fell from 96 to 58, and heart rate fell from 96 to 82. The lowest MAP was about 71 around hour 30.2, and the lowest valid SpO2 was 83 around hour 22; respiratory rate rose as high as 25 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 39.1-39.4 C, white count was 26.7 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 2290 to 250.
C. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 153 to 69, diastolic pressure fell from 100 to 64, and heart rate fell from 90 to 87. The lowest MAP was about 77 around hour 27.2, and the lowest valid SpO2 was 89 around hour 20; respiratory rate rose as high as 25 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 33.1-33.4 C, white count was 29.7 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 2450 to 225.
D. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 98 to 78, diastolic pressure fell from 94 to 57, and heart rate fell from 98 to 80. The lowest MAP was about 68 around hour 29, and the lowest valid SpO2 was 80 around hour 23; respiratory rate rose as high as 21 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 41.4-41.6 C, white count was 25.6 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 2230 to 250.

Answer: A

Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 128 to 73, diastolic pressure fell from 98 to 60, and heart rate fell from 94 to 84. The lowest MAP was about 73 around hour 29.1, and the lowest valid SpO2 was 85 around hour 21; respiratory rate rose as high as 23 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 98.4 to 98.8, white count was 27.8 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 2350 to 200.


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

Options:
A. Across the recorded window, the heart rate rose from 88 to 97, while MAP rose from 81 to 88. Systolic pressure was labile, ranging 115-152, with the lowest value around hour 0.1. SpO2 briefly dipped to 85 around hour 0.2 before recovering to 94, while respiratory rate peaked at 27 and later settled at 26. The associated labs and urine output showed that white count fell from 17.5 to 9.3, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 100, and urine output stayed around 350, with recorded outputs ranging 300-450.
B. Across the recorded window, the heart rate rose from 86 to 99, while MAP rose from 79 to 86. Systolic pressure was labile, ranging 117-167, with the lowest value around hour 0.0. SpO2 briefly dipped to 83 around hour 0.1 before recovering to 96, while respiratory rate peaked at 26 and later settled at 25. The associated labs and urine output showed that white count fell from 18.6 to 8.5, creatinine stayed around 0.7, lactate was checked once at 100, and urine output stayed around 350, with recorded outputs ranging 335-450.
C. Across the recorded window, the heart rate rose from 92 to 93, while MAP rose from 85 to 92. Systolic pressure was labile, ranging 111-127, with the lowest value around hour 0.2. SpO2 briefly dipped to 86 around hour 0.3 before recovering to 90, while respiratory rate peaked at 29 and later settled at 28. The associated labs and urine output showed that white count fell from 15.6 to 10.1, creatinine was roughly stable (0.9 to 0.6), lactate was checked once at 96, and urine output stayed around 375, with recorded outputs ranging 275-425.
D. Across the recorded window, the heart rate rose from 84 to 100, while MAP rose from 76 to 91. Systolic pressure was labile, ranging 120-182, with the lowest value around hour 0.0. SpO2 briefly dipped to 80 around hour 1.2 before recovering to 98, while respiratory rate peaked at 25 and later settled at 24. The associated labs and urine output showed that white count fell from 19.8 to 8.6, creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 96, and urine output was roughly stable (320 to 330), with recorded outputs ranging 300-450.

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 rose from 84 to 85, diastolic pressure was roughly stable (74 to 78), and heart rate rose from 85 to 100. The lowest MAP was about 75 around hour 21.8, and the lowest valid SpO2 was 88 around hour 0.1; respiratory rate rose as high as 29 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 33.7-35.2 C, white count fell from 19.0 to 8.8, creatinine stayed around 0.9, lactate was checked once at 100, and urine output was roughly stable (350 to 400)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 81 to 88, diastolic pressure was roughly stable (71 to 75), and heart rate rose from 88 to 97. The lowest MAP was about 72 around hour 23.3, and the lowest valid SpO2 was 85 around hour 0.2; respiratory rate rose as high as 27 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 36.7-38.2 C, white count fell from 17.5 to 9.3, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 100, and urine output was roughly stable (350 to 350)
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 85 to 88, diastolic pressure was roughly stable (75 to 72), and heart rate rose from 84 to 100. The lowest MAP was about 75 around hour 24.3, and the lowest valid SpO2 was 89 around hour 0.1; respiratory rate rose as high as 29 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 33.0-34.5 C, white count fell from 19.4 to 8.7, creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 96, and urine output was roughly stable (375 to 375)
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 76 to 92, diastolic pressure was roughly stable (66 to 70), and heart rate rose from 92 to 100. The lowest MAP was about 68 around hour 25.6, and the lowest valid SpO2 was 80 around hour 0; respiratory rate rose as high as 25 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 41.2-42.7 C, white count fell from 15.2 to 10.1, creatinine was roughly stable (0.7 to 0.5), lactate was checked once at 96, and urine output was roughly stable (320 to 320)

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 81 to 88, diastolic pressure was roughly stable (71 to 75), and heart rate rose from 88 to 97. The lowest MAP was about 72 around hour 23.3, and the lowest valid SpO2 was 85 around hour 0.2; respiratory rate rose as high as 27 but ended at 26. The lower-frequency data fit that summary: temperature ranged from 98 to 100.8, white count fell from 17.5 to 9.3, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 100, and urine output was roughly stable (350 to 350)


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 rose from 118 to 123, MAP rose from 84 to 91, and heart rate rose from 85 to 100. SpO2 started at 93, ended at 97, and fell as low as 88 around hour 0.1; respiratory rate ranged 16-29. For labs and output, white count fell from 16.0 to 9.8, creatinine stayed around 0.9, lactate was checked once at 100.2, and urine output was roughly stable (350 to 370)
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 113 to 158, MAP rose from 79 to 86, and heart rate rose from 90 to 100. SpO2 started at 98, ended at 92, and fell as low as 83 around hour 0.3; respiratory rate ranged 13-29. For labs and output, white count fell from 18.6 to 8.5, creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 98, and urine output was roughly stable (335 to 365)
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 115 to 143, MAP rose from 81 to 88, and heart rate rose from 88 to 97. SpO2 started at 96, ended at 94, and fell as low as 85 around hour 0.2; respiratory rate ranged 14-27. For labs and output, white count fell from 17.5 to 9.3, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 100, and urine output was roughly stable (350 to 350)
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 110 to 139, MAP rose from 76 to 91, and heart rate rose from 92 to 95. SpO2 started at 100, ended at 90, and fell as low as 84 around hour 0.4; respiratory rate ranged 12-29. For labs and output, white count fell from 19.8 to 8.6, creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 96, and urine output was roughly stable (320 to 380)

Answer: C


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (122 to 113), diastolic pressure rose from 97 to 109, and heart rate rose from 47 to 94. The lowest MAP was about 68 around hour 27.4, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 28 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33-34.1 C, white count rose from 10.0 to 11.8, creatinine fell from 1.5 to 1.3, lactate was not available, and urine output rose from 115 to 420.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (117 to 118), diastolic pressure rose from 98 to 104, and heart rate rose from 52 to 89. The lowest MAP was about 63 around hour 32.6, and the lowest valid SpO2 was 83 around hour 0.5; respiratory rate rose as high as 28 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 38-39.4 C, white count rose from 9.1 to 14.4, creatinine was roughly stable (1.1 to 1.2), lactate was not available, and urine output rose from 150 to 450.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (123 to 112), diastolic pressure was roughly stable (96 to 103), and heart rate rose from 46 to 95. The lowest MAP was about 68 around hour 31.4, and the lowest valid SpO2 was 89 around hour 0.3; respiratory rate rose as high as 28 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 32-33.4 C, white count rose from 10.1 to 11.4, creatinine fell from 1.6 to 1.4, lactate was not available, and urine output rose from 110 to 425.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (119 to 116), diastolic pressure rose from 100 to 106, and heart rate rose from 50 to 91. The lowest MAP was about 65 around hour 30.4, and the lowest valid SpO2 was 85 around hour 0.4; respiratory rate rose as high as 26 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 36-37.1 C, white count rose from 9.5 to 13.3, creatinine fell from 1.3 to 1.1, lactate was not available, and urine output rose from 135 to 400.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (119 to 116), diastolic pressure rose from 100 to 106, and heart rate rose from 50 to 91. The lowest MAP was about 65 around hour 30.4, and the lowest valid SpO2 was 85 around hour 0.4; respiratory rate rose as high as 26 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 96.8 to 98.7, white count rose from 9.5 to 13.3, creatinine fell from 1.3 to 1.1, lactate was not available, and urine output rose from 135 to 400.


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 158 to 151, MAP was roughly stable (119 to 116), and heart rate rose from 50 to 91. SpO2 started at 85, ended at 95, and fell as low as 85 around hour 0.4; respiratory rate ranged 12-26. For labs and output, white count rose from 9.5 to 13.3, creatinine fell from 1.3 to 1.1, lactate was not available, and urine output rose from 135 to 400.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 143 to 123, MAP was roughly stable (117 to 114), and heart rate rose from 52 to 94. SpO2 started at 87, ended at 93, and fell as low as 83 around hour 0.5; respiratory rate ranged 11-28. For labs and output, white count rose from 9.9 to 12.5, creatinine fell from 1.1 to 0.9, lactate was not available, and urine output rose from 120 to 385.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 183 to 147, MAP stayed around 123, and heart rate rose from 50 to 91. SpO2 started at 85, ended at 95, and fell as low as 84 around hour 0.4; respiratory rate ranged 12-26. For labs and output, white count rose from 9.5 to 13.3, creatinine fell from 1.3 to 1.1, lactate was not available, and urine output rose from 135 to 400.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 128 to 108, MAP was roughly stable (114 to 112), and heart rate rose from 54 to 86. SpO2 started at 90, ended at 90, and fell as low as 80 around hour 0.6; respiratory rate ranged 10-28. For labs and output, white count rose from 10.2 to 11.1, creatinine was roughly stable (1.0 to 1.2), lactate was not available, and urine output rose from 105 to 370.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate rose from 53 to 60, while MAP rose from 71 to 77. Systolic pressure was labile, ranging 80-146, with the lowest value around hour 2.8. SpO2 briefly dipped to 88 around hour 44.6 before recovering to 96, while respiratory rate peaked at 26 and later settled at 20. The associated labs and urine output showed that white count fell from 7.7 to 5.8, creatinine stayed around 1.0, lactate was checked once at 0.9, and urine output was roughly stable (200 to 225), with recorded outputs ranging 100-350.
B. Viewed chronologically, the heart rate rose from 48 to 65, while MAP rose from 66 to 77. Systolic pressure was labile, ranging 85-181, with the lowest value around hour 2.5. SpO2 briefly dipped to 83 around hour 42.6 before recovering to 100, while respiratory rate peaked at 24 and later settled at 17. The associated labs and urine output showed that white count fell from 8.6 to 6.2, creatinine was roughly stable (0.8 to 0.9), lactate was checked once at 0.8, and urine output was roughly stable (185 to 175), with recorded outputs ranging 48-365.
C. Viewed chronologically, the heart rate rose from 54 to 59, while MAP rose from 72 to 78. Systolic pressure was labile, ranging 87-141, with the lowest value around hour 2.9. SpO2 briefly dipped to 86 around hour 45.4 before recovering to 95, while respiratory rate peaked at 27 and later settled at 20. The associated labs and urine output showed that white count fell from 7.6 to 7.2, creatinine was roughly stable (1.0 to 0.7), lactate was checked once at 1.0, and urine output was roughly stable (225 to 200), with recorded outputs ranging 54-325.
D. Viewed chronologically, the heart rate rose from 50 to 63, while MAP rose from 68 to 74. Systolic pressure was labile, ranging 83-166, with the lowest value around hour 2.6. SpO2 briefly dipped to 85 around hour 41.6 before recovering to 99, while respiratory rate peaked at 25 and later settled at 18. The associated labs and urine output showed that white count fell from 8.2 to 6.6, creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 0.9, and urine output was roughly stable (200 to 225), with recorded outputs ranging 50-350.

Answer: D


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

Options:
A. In broad terms, the heart rate fell from 133 to 50, MAP rose from 71 to 79, and diastolic pressure moved from 67 to 54. Systolic pressure ranged 82-259 and ended at 156, and SpO2 recovered to 85 after a low of 77 around hour 1.9. Respiratory rate ended at 25; the available labs showed white count rose from 7 to 16.1, creatinine was roughly stable (1.2 to 1.4), lactate stayed broadly stable from 7.3 to 1.2, and urine output rose from 0 to 125.
B. In broad terms, the heart rate fell from 118 to 52, MAP rose from 69 to 77, and diastolic pressure moved from 69 to 52. Systolic pressure ranged 80-244 and ended at 141, and SpO2 recovered to 87 after a low of 76 around hour 1.8. Respiratory rate ended at 26; the available labs showed white count rose from 7 to 15.3, creatinine was roughly stable (1.4 to 1.2), lactate stayed broadly stable from 6.9 to 1.4, and urine output was roughly stable (50 to 110)
C. In broad terms, the heart rate fell from 158 to 53, MAP rose from 75 to 83, and diastolic pressure moved from 63 to 51. Systolic pressure ranged 86-284 and ended at 181, and SpO2 recovered to 81 after a low of 81 around hour 2.1. Respiratory rate ended at 23; the available labs showed white count rose from 8 to 18.0, creatinine was roughly stable (0.9 to 1.6), lactate stayed broadly stable from 7.9 to 0.9, and urine output rose from 2 to 150.
D. In broad terms, the heart rate fell from 103 to 54, MAP rose from 66 to 82, and diastolic pressure moved from 72 to 50. Systolic pressure ranged 78-229 and ended at 152, and SpO2 recovered to 90 after a low of 72 around hour 2.9. Respiratory rate ended at 27; the available labs showed white count rose from 6 to 13.9, creatinine was roughly stable (1.5 to 1.1), lactate stayed broadly stable from 6.5 to 1.5, and urine output rose from 0 to 95.

Answer: A


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

Options:
A. In broad terms, the heart rate rose from 93 to 96, while MAP rose from 57 to 73. Systolic pressure was labile, ranging 80-151, with the lowest value around hour 4.7. SpO2 briefly dipped to 88 around hour 9.7 before recovering to 89, while respiratory rate peaked at 40 and later settled at 26. The associated labs and urine output showed that white count fell from 18.9 to 16.3, creatinine fell from 75 to 2.3, lactate was checked once at 3.0, and urine output rose from 22 to 100, with recorded outputs ranging 20-1020.
B. In broad terms, the heart rate rose from 88 to 98, while MAP rose from 52 to 73. Systolic pressure was labile, ranging 85-186, with the lowest value around hour 3.8. SpO2 briefly dipped to 83 around hour 10.2 before recovering to 94, while respiratory rate peaked at 35 and later settled at 23. The associated labs and urine output showed that white count fell from 21.5 to 16.0, creatinine fell from 70 to 2.4, lactate was checked once at 2.6, and urine output was roughly stable (19 to 70), with recorded outputs ranging 0-1160.
C. In broad terms, the heart rate rose from 90 to 96, while MAP rose from 54 to 70. Systolic pressure was labile, ranging 83-171, with the lowest value around hour 4.2. SpO2 briefly dipped to 85 around hour 9.2 before recovering to 92, while respiratory rate peaked at 37 and later settled at 24. The associated labs and urine output showed that white count fell from 20.4 to 17.1, creatinine fell from 72 to 2.2, lactate was checked once at 2.8, and urine output rose from 20 to 120, with recorded outputs ranging 0-1100.
D. In broad terms, the heart rate rose from 86 to 100, while MAP rose from 50 to 66. Systolic pressure was labile, ranging 87-201, with the lowest value around hour 3.5. SpO2 briefly dipped to 86 around hour 8.4 before recovering to 96, while respiratory rate peaked at 39 and later settled at 22. The associated labs and urine output showed that white count fell from 22.6 to 14.9, creatinine fell from 68 to 2.5, lactate was checked once at 2.5, and urine output rose from 18 to 150, with recorded outputs ranging 0-1220.

Answer: C