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 (93 to 85), diastolic pressure fell from 85 to 69, and heart rate was roughly stable (64 to 75). The lowest MAP was about 59 around hour 5.0, and the lowest valid SpO2 was 80 around hour 0.5; respiratory rate rose as high as 37 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.5-34.1 C, white count rose from 7.0 to 10.1, creatinine was roughly stable (0.8 to 0.8), lactate was not available, and urine output fell from 400 to 90.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (88 to 90), diastolic pressure fell from 80 to 64, and heart rate rose from 69 to 75. The lowest MAP was about 54 around hour 5.9, and the lowest valid SpO2 was 75 around hour 0; respiratory rate rose as high as 33 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 38.8-39.4 C, white count rose from 6.1 to 12.7, creatinine stayed around 0.6, lactate was not available, and urine output fell from 385 to 42.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (94 to 84), diastolic pressure fell from 86 to 63, and heart rate was roughly stable (63 to 76). The lowest MAP was about 59 around hour 6.5, and the lowest valid SpO2 was 81 around hour 0.5; respiratory rate rose as high as 39 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 32.8-33.4 C, white count rose from 7.1 to 9.7, creatinine stayed around 0.8, lactate was not available, and urine output fell from 425 to 36.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (90 to 88), diastolic pressure fell from 82 to 66, and heart rate was roughly stable (67 to 72). The lowest MAP was about 56 around hour 5.5, and the lowest valid SpO2 was 77 around hour 0.6; respiratory rate rose as high as 35 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.5-37.1 C, white count rose from 6.5 to 11.6, creatinine stayed around 0.7, lactate was not available, and urine output fell from 400 to 40.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (90 to 88), diastolic pressure fell from 82 to 66, and heart rate was roughly stable (67 to 72). The lowest MAP was about 56 around hour 5.5, and the lowest valid SpO2 was 77 around hour 0.6; respiratory rate rose as high as 35 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 97.7 to 98.7, white count rose from 6.5 to 11.6, creatinine stayed around 0.7, lactate was not available, and urine output fell from 400 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 rose from 143 to 167, MAP was roughly stable (90 to 88), and heart rate was roughly stable (67 to 72). SpO2 started at 93, ended at 97, and fell as low as 77 around hour 0.6; respiratory rate ranged 12-35. For labs and output, white count rose from 6.5 to 11.6, creatinine stayed around 0.7, lactate was not available, and urine output fell from 400 to 40.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 128 to 163, MAP was roughly stable (88 to 91), and heart rate was roughly stable (69 to 70). SpO2 started at 95, ended at 95, and fell as low as 76 around hour 0.7; respiratory rate ranged 11-37. For labs and output, white count rose from 6.9 to 10.5, creatinine stayed around 0.6, lactate was not available, and urine output fell from 415 to 38.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 168 to 188, MAP was roughly stable (94 to 92), and heart rate rose from 63 to 75. SpO2 started at 89, ended at 100, and fell as low as 81 around hour 0.5; respiratory rate ranged 14-37. For labs and output, white count rose from 5.9 to 10.8, creatinine stayed around 0.8, lactate was not available, and urine output fell from 375 to 44.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 113 to 197, MAP was roughly stable (86 to 84), and heart rate was roughly stable (72 to 68). SpO2 started at 98, ended at 92, and fell as low as 72 around hour 0.8; respiratory rate ranged 10-40. For labs and output, white count rose from 7.2 to 9.3, creatinine was roughly stable (0.5 to 0.8), lactate was not available, and urine output fell from 400 to 40.

Answer: A


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

Options:
A. For handoff, the heart rate was roughly stable (70 to 69), MAP was roughly stable (93 to 91), and diastolic pressure moved from 79 to 69. Systolic pressure ranged 110-197 and ended at 187, and SpO2 recovered to 94 after a low of 76 around hour 0.7. Respiratory rate ended at 16; the available labs showed white count rose from 7.0 to 10.8, creatinine stayed around 0.6, lactate was not available, and urine output fell from 450 to 43.
B. For handoff, the heart rate was roughly stable (67 to 72), MAP was roughly stable (90 to 88), and diastolic pressure moved from 82 to 66. Systolic pressure ranged 107-177 and ended at 167, and SpO2 recovered to 97 after a low of 77 around hour 0.6. Respiratory rate ended at 17; the available labs showed white count rose from 6.5 to 11.6, creatinine stayed around 0.7, lactate was not available, and urine output fell from 400 to 40.
C. For handoff, the heart rate rose from 71 to 75, MAP was roughly stable (94 to 92), and diastolic pressure moved from 78 to 63. Systolic pressure ranged 111-202 and ended at 192, and SpO2 recovered to 93 after a low of 81 around hour 0.7. Respiratory rate ended at 15; the available labs showed white count rose from 7.1 to 13.5, creatinine stayed around 0.6, lactate was not available, and urine output fell from 425 to 44.
D. For handoff, the heart rate was roughly stable (62 to 76), MAP was roughly stable (86 to 91), and diastolic pressure moved from 86 to 62. Systolic pressure ranged 102-147 and ended at 163, and SpO2 recovered to 100 after a low of 72 around hour 1.6. Respiratory rate ended at 19; the available labs showed white count rose from 5.8 to 9.3, creatinine stayed around 0.8, lactate was not available, and urine output fell from 370 to 36.

Answer: B


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

Options:
A. Clinically, the heart rate fell from 104 to 86, MAP fell from 90 to 76, and diastolic pressure moved from 74 to 54. Systolic pressure ranged 91-165 and ended at 150, and SpO2 recovered to 91 after a low of 84 around hour 10.2. Respiratory rate ended at 20; the available labs showed white count fell from 17.0 to 6.6, creatinine stayed around 0.6, lactate was not available, and urine output fell from 240 to 113.
B. Clinically, the heart rate fell from 99 to 91, MAP fell from 85 to 76, and diastolic pressure moved from 79 to 49. Systolic pressure ranged 86-130 and ended at 126, and SpO2 recovered to 96 after a low of 83 around hour 10.7. Respiratory rate ended at 23; the available labs showed white count fell from 14.4 to 7.0, creatinine stayed around 0.8, lactate was not available, and urine output fell from 175 to 108.
C. Clinically, the heart rate fell from 105 to 92, MAP fell from 91 to 77, and diastolic pressure moved from 73 to 48. Systolic pressure ranged 92-170 and ended at 155, and SpO2 recovered to 90 after a low of 89 around hour 10.3. Respiratory rate ended at 20; the available labs showed white count fell from 17.4 to 8.0, creatinine stayed around 0.6, lactate was not available, and urine output fell from 215 to 114.
D. Clinically, the heart rate fell from 101 to 89, MAP fell from 87 to 73, and diastolic pressure moved from 77 to 51. Systolic pressure ranged 88-145 and ended at 130, and SpO2 recovered to 94 after a low of 85 around hour 9.7. Respiratory rate ended at 22; the available labs showed white count fell from 15.5 to 7.4, creatinine stayed around 0.7, lactate was not available, and urine output fell from 190 to 110.

Answer: D


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

Options:
A. Clinically, the heart rate fell from 143 to 82, while MAP fell from 82 to 70. Systolic pressure was labile, ranging 72-103, with the lowest value around hour 10.0. SpO2 briefly dipped to 88 around hour 2.5 before recovering to 92, while respiratory rate peaked at 33 and later settled at 22. The associated labs and urine output showed that white count rose from 1 to 6.5, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 180 to 320, with recorded outputs ranging 200-400.
B. Clinically, the heart rate fell from 123 to 85, while MAP fell from 79 to 67. Systolic pressure was labile, ranging 75-123, with the lowest value around hour 9.5. SpO2 briefly dipped to 85 around hour 2.3 before recovering to 95, while respiratory rate peaked at 30 and later settled at 21. The associated labs and urine output showed that white count rose from 1 to 7.3, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 200 to 300, with recorded outputs ranging 150-380.
C. Clinically, the heart rate fell from 148 to 81, while MAP fell from 83 to 71. Systolic pressure was labile, ranging 79-98, with the lowest value around hour 10.1. SpO2 briefly dipped to 86 around hour 2.5 before recovering to 91, while respiratory rate peaked at 32 and later settled at 23. The associated labs and urine output showed that white count rose from 1 to 7.9, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 175 to 325, with recorded outputs ranging 175-405.
D. Clinically, the heart rate fell from 93 to 90, while MAP fell from 74 to 70. Systolic pressure was labile, ranging 80-153, with the lowest value around hour 8.8. SpO2 briefly dipped to 80 around hour 3.3 before recovering to 100, while respiratory rate peaked at 26 and later settled at 19. The associated labs and urine output showed that white count rose from 1 to 6.5, creatinine was 0.4 on its only check, lactate was not available, and urine output was roughly stable (230 to 250), with recorded outputs ranging 120-350.

Answer: B


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

Options:
A. Over the available measurements, the heart rate fell from 123 to 85, MAP fell from 79 to 67, and diastolic pressure moved from 70 to 53. Systolic pressure ranged 75-123 and ended at 107, and SpO2 recovered to 95 after a low of 85 around hour 2.3. Respiratory rate ended at 21; the available labs showed white count rose from 1 to 7.3, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 200 to 300.
B. Over the available measurements, the heart rate fell from 108 to 87, MAP fell from 77 to 65, and diastolic pressure moved from 72 to 51. Systolic pressure ranged 73-108 and ended at 105, and SpO2 recovered to 97 after a low of 84 around hour 2.1. Respiratory rate ended at 22; the available labs showed white count rose from 1 to 6.5, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (250 to 285)
C. Over the available measurements, the heart rate fell from 148 to 88, MAP fell from 83 to 71, and diastolic pressure moved from 66 to 50. Systolic pressure ranged 79-148 and ended at 111, and SpO2 recovered to 91 after a low of 89 around hour 2.5. Respiratory rate ended at 19; the available labs showed white count rose from 1 to 7.9, creatinine was 0.5 on its only check, lactate was not available, and urine output rose from 225 to 325.
D. Over the available measurements, the heart rate fell from 93 to 90, MAP fell from 74 to 70, and diastolic pressure moved from 74 to 48. Systolic pressure ranged 70-93 and ended at 103, and SpO2 recovered to 100 after a low of 80 around hour 3.3. Respiratory rate ended at 23; the available labs showed white count rose from 1 to 6.5, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 170 to 270.

Answer: A


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

Options:
A. In broad terms, the heart rate fell from 94 to 73, while MAP stayed around 97. Systolic pressure was labile, ranging 90-155, with the lowest value around hour 17.8. SpO2 briefly dipped to 85 around hour 1.5 before recovering to 96, while respiratory rate peaked at 37 and later settled at 43. The associated labs and urine output showed that white count was 10.0 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output stayed around 150, with recorded outputs ranging 100-350.
B. In broad terms, the heart rate fell from 89 to 78, while MAP was roughly stable (98 to 103). Systolic pressure was labile, ranging 87-135, with the lowest value around hour 16.3. SpO2 briefly dipped to 88 around hour 2.3 before recovering to 93, while respiratory rate peaked at 38 and later settled at 40. The associated labs and urine output showed that white count was 9.5 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output stayed around 100, with recorded outputs ranging 98-365.
C. In broad terms, the heart rate fell from 91 to 76, while MAP stayed around 100. Systolic pressure was labile, ranging 87-135, with the lowest value around hour 16.3. SpO2 briefly dipped to 88 around hour 1.3 before recovering to 93, while respiratory rate peaked at 40 and later settled at 40. The associated labs and urine output showed that white count was 9.5 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (100 to 150), with recorded outputs ranging 100-350.
D. In broad terms, the heart rate fell from 86 to 80, while MAP stayed around 96. Systolic pressure was labile, ranging 91-105, with the lowest value around hour 14.1. SpO2 briefly dipped to 89 around hour 1.0 before recovering to 88, while respiratory rate peaked at 42 and later settled at 36. The associated labs and urine output showed that white count was 8.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (96 to 120), with recorded outputs ranging 96-380.

Answer: C


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 120 to 107, MAP stayed around 100, and heart rate fell from 91 to 76. SpO2 started at 98, ended at 93, and fell as low as 88 around hour 1.3; respiratory rate ranged 21-40. For labs and output, white count was 9.5 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (100 to 150)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 105 to 102, MAP stayed around 98, and heart rate fell from 89 to 79. SpO2 started at 96, ended at 95, and fell as low as 86 around hour 1.1; respiratory rate ranged 22-42. For labs and output, white count was 9.1 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (98 to 135)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 145 to 103, MAP stayed around 96, and heart rate fell from 95 to 79. SpO2 started at 100, ended at 89, and fell as low as 89 around hour 1.6; respiratory rate ranged 19-36. For labs and output, white count was 10.1 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output was roughly stable (96 to 175)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 90 to 87, MAP was roughly stable (96 to 103), and heart rate fell from 91 to 76. SpO2 started at 98, ended at 93, and fell as low as 87 around hour 1.3; respiratory rate ranged 21-40. For labs and output, white count was 9.5 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (100 to 150)

Answer: A


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

Options:
A. For handoff, the heart rate rose from 72 to 75, while MAP rose from 78 to 84. Systolic pressure was labile, ranging 80-160, with the lowest value around hour 16. SpO2 briefly dipped to 86 around hour 1.5 before recovering to 92, while respiratory rate peaked at 28 and later settled at 22. The associated labs and urine output showed that white count fell from 15.8 to 14.7, creatinine was roughly stable (0.9 to 0.6), lactate was checked once at 244, and urine output rose from 2 to 100, with recorded outputs ranging 2-430.
B. For handoff, the heart rate rose from 67 to 77, while MAP rose from 73 to 84. Systolic pressure was labile, ranging 78-195, with the lowest value around hour 14. SpO2 briefly dipped to 83 around hour 2.3 before recovering to 97, while respiratory rate peaked at 25 and later settled at 20. The associated labs and urine output showed that white count fell from 18.4 to 12.1, creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 209, and urine output was roughly stable (0 to 70), with recorded outputs ranging 0-465.
C. For handoff, the heart rate rose from 73 to 76, while MAP rose from 79 to 85. Systolic pressure was labile, ranging 72-155, with the lowest value around hour 17. SpO2 briefly dipped to 89 around hour 1.6 before recovering to 91, while respiratory rate peaked at 28 and later settled at 23. The associated labs and urine output showed that white count fell from 15.4 to 12.4, creatinine stayed around 0.9, lactate was checked once at 224, and urine output rose from 0 to 120, with recorded outputs ranging 0-450.
D. For handoff, the heart rate rose from 69 to 75, while MAP rose from 75 to 81. Systolic pressure was labile, ranging 76-180, with the lowest value around hour 15. SpO2 briefly dipped to 85 around hour 1.3 before recovering to 95, while respiratory rate peaked at 26 and later settled at 21. The associated labs and urine output showed that white count fell from 17.3 to 13.2, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 224, and urine output rose from 0 to 120, with recorded outputs ranging 0-450.

Answer: D


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

Options:
A. Across the recorded window, the heart rate rose from 72 to 75, MAP rose from 78 to 84, and diastolic pressure moved from 50 to 66. Systolic pressure ranged 79-200 and ended at 140, and SpO2 recovered to 92 after a low of 88 around hour 2.3. Respiratory rate ended at 20; the available labs showed white count fell from 18.8 to 14.7, creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 244, and urine output rose from 0 to 140.
B. Across the recorded window, the heart rate rose from 67 to 78, MAP rose from 73 to 79, and diastolic pressure moved from 55 to 60. Systolic pressure ranged 74-165 and ended at 129, and SpO2 recovered to 97 after a low of 83 around hour 1.1. Respiratory rate ended at 22; the available labs showed white count fell from 16.2 to 12.1, creatinine was roughly stable (0.9 to 0.6), lactate was checked once at 209, and urine output rose from 2 to 105.
C. Across the recorded window, the heart rate rose from 69 to 75, MAP rose from 75 to 81, and diastolic pressure moved from 53 to 63. Systolic pressure ranged 76-180 and ended at 144, and SpO2 recovered to 95 after a low of 85 around hour 1.3. Respiratory rate ended at 21; the available labs showed white count fell from 17.3 to 13.2, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 224, and urine output rose from 0 to 120.
D. Across the recorded window, the heart rate rose from 64 to 80, MAP rose from 70 to 76, and diastolic pressure moved from 58 to 58. Systolic pressure ranged 72-150 and ended at 114, and SpO2 recovered to 100 after a low of 84 around hour 1.0. Respiratory rate ended at 23; the available labs showed white count fell from 15.1 to 12.4, creatinine was roughly stable (1.0 to 0.5), lactate was checked once at 194, and urine output was roughly stable (50 to 90)

Answer: C


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

Options:
A. Across the recorded window, the heart rate was roughly stable (45 to 50), while MAP was roughly stable (100 to 101). Systolic pressure was labile, ranging 128-197, with the lowest value around hour 2.7. SpO2 briefly dipped to 85 around hour 0.1 before recovering to 88, while respiratory rate peaked at 28 and later settled at 27. The associated labs and urine output showed that white count was 8.5 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 250 to 900, with recorded outputs ranging 125-900.
B. Across the recorded window, the heart rate was roughly stable (43 to 52), while MAP was roughly stable (98 to 99). Systolic pressure was labile, ranging 132-212, with the lowest value around hour 2.6. SpO2 briefly dipped to 83 around hour 0.0 before recovering to 90, while respiratory rate peaked at 32 and later settled at 26. The associated labs and urine output showed that white count was 8.9 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output rose from 235 to 915, with recorded outputs ranging 110-915.
C. Across the recorded window, the heart rate was roughly stable (49 to 46), while MAP was roughly stable (96 to 104). Systolic pressure was labile, ranging 103-172, with the lowest value around hour 3.0. SpO2 briefly dipped to 89 around hour 1.1 before recovering to 84, while respiratory rate peaked at 30 and later settled at 29. The associated labs and urine output showed that white count was 7.9 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 275 to 850, with recorded outputs ranging 150-875.
D. Across the recorded window, the heart rate was roughly stable (40 to 54), while MAP was roughly stable (96 to 96). Systolic pressure was labile, ranging 158-227, with the lowest value around hour 2.4. SpO2 briefly dipped to 80 around hour 0.0 before recovering to 92, while respiratory rate peaked at 26 and later settled at 25. The associated labs and urine output showed that white count was 9.2 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output rose from 220 to 930, with recorded outputs ranging 175-930.

Answer: A


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (97 to 98), diastolic pressure fell from 82 to 66, and heart rate was roughly stable (42 to 53). The lowest MAP was about 79 around hour 19.3, and the lowest valid SpO2 was 88 around hour 0.0; respiratory rate rose as high as 30 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 33.7-34.7 C, white count was 9.0 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output rose from 270 to 950.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (100 to 101), diastolic pressure fell from 79 to 63, and heart rate was roughly stable (45 to 50). The lowest MAP was about 76 around hour 20.8, and the lowest valid SpO2 was 85 around hour 0.1; respiratory rate rose as high as 28 but ended at 27. The lower-frequency data fit that summary: temperature stayed around 36.7-37.7 C, white count was 8.5 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 250 to 900.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (96 to 97), diastolic pressure fell from 83 to 67, and heart rate rose from 41 to 53. The lowest MAP was about 80 around hour 18.9, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 30 but ended at 29. The lower-frequency data fit that summary: temperature stayed around 33.0-34.0 C, white count was 9.1 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output rose from 275 to 925.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (96 to 106), diastolic pressure fell from 74 to 60, and heart rate was roughly stable (50 to 46). The lowest MAP was about 79 around hour 21.8, and the lowest valid SpO2 was 80 around hour 0.2; respiratory rate rose as high as 26 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 41.2-42.2 C, white count was 7.8 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 220 to 870.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (100 to 101), diastolic pressure fell from 79 to 63, and heart rate was roughly stable (45 to 50). The lowest MAP was about 76 around hour 20.8, and the lowest valid SpO2 was 85 around hour 0.1; respiratory rate rose as high as 28 but ended at 27. The lower-frequency data fit that summary: temperature ranged from 98.1 to 99.8, white count was 8.5 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 250 to 900.


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 189 to 193, MAP was roughly stable (97 to 104), and heart rate was roughly stable (42 to 53). SpO2 started at 82, ended at 91, and fell as low as 84 around hour 0.0; respiratory rate ranged 16-26. For labs and output, white count was 8.0 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 270 to 880.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 154 to 212, MAP was roughly stable (98 to 99), and heart rate rose from 47 to 53. SpO2 started at 87, ended at 86, and fell as low as 83 around hour 0.2; respiratory rate ranged 14-30. For labs and output, white count was 8.9 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output rose from 235 to 915.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 169 to 197, MAP was roughly stable (100 to 101), and heart rate was roughly stable (45 to 50). SpO2 started at 85, ended at 88, and fell as low as 85 around hour 0.1; respiratory rate ranged 15-28. For labs and output, white count was 8.5 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 250 to 900.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 165 to 227, MAP was roughly stable (96 to 96), and heart rate was roughly stable (50 to 46). SpO2 started at 90, ended at 84, and fell as low as 80 around hour 0.2; respiratory rate ranged 13-29. For labs and output, white count was 9.2 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output rose from 220 to 930.

Answer: C


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

Options:
A. Clinically, the heart rate was roughly stable (48 to 47), MAP was roughly stable (97 to 104), and diastolic pressure moved from 76 to 66. Systolic pressure ranged 148-217 and ended at 217, and SpO2 recovered to 85 after a low of 84 around hour 0.2. Respiratory rate ended at 26; the available labs showed white count was 9.0 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 300 to 920.
B. Clinically, the heart rate was roughly stable (43 to 52), MAP was roughly stable (98 to 104), and diastolic pressure moved from 81 to 61. Systolic pressure ranged 113-182 and ended at 193, and SpO2 recovered to 90 after a low of 83 around hour 1.1. Respiratory rate ended at 28; the available labs showed white count was 8.1 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output rose from 265 to 885.
C. Clinically, the heart rate rose from 49 to 53, MAP was roughly stable (96 to 105), and diastolic pressure moved from 75 to 60. Systolic pressure ranged 153-222 and ended at 222, and SpO2 recovered to 84 after a low of 89 around hour 0.2. Respiratory rate ended at 25; the available labs showed white count was 9.1 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 225 to 925.
D. Clinically, the heart rate was roughly stable (45 to 50), MAP was roughly stable (100 to 101), and diastolic pressure moved from 79 to 63. Systolic pressure ranged 128-197 and ended at 197, and SpO2 recovered to 88 after a low of 85 around hour 0.1. Respiratory rate ended at 27; the available labs showed white count was 8.5 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 250 to 900.

Answer: D


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

Options:
A. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 109 to 112, MAP was roughly stable (86 to 84), and heart rate was roughly stable (58 to 63). SpO2 started at 94, ended at 97, and fell as low as 88 around hour 5.2; respiratory rate ranged 16-38. For labs and output, white count fell from 16.2 to 14.9, creatinine fell from 1.9 to 0.8, lactate was not available, and urine output was roughly stable (270 to 270)
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 106 to 121, MAP was roughly stable (83 to 81), and heart rate was roughly stable (61 to 60). SpO2 started at 97, ended at 94, and fell as low as 85 around hour 5.7; respiratory rate ranged 14-36. For labs and output, white count fell from 17.7 to 15.7, creatinine fell from 1.7 to 0.9, lactate was not available, and urine output was roughly stable (250 to 250)
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 110 to 117, MAP was roughly stable (87 to 84), and heart rate was roughly stable (57 to 64). SpO2 started at 93, ended at 98, and fell as low as 84 around hour 5.1; respiratory rate ranged 16-32. For labs and output, white count fell from 15.8 to 14.3, creatinine fell from 1.9 to 0.8, lactate was not available, and urine output was roughly stable (275 to 275)
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 102 to 151, MAP was roughly stable (78 to 76), and heart rate was roughly stable (66 to 56). SpO2 started at 100, ended at 90, and fell as low as 80 around hour 6.5; respiratory rate ranged 12-38. For labs and output, white count fell from 19.9 to 13.4, creatinine fell from 1.4 to 1, lactate was not available, and urine output was roughly stable (220 to 220)

Answer: B


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

Options:
A. Taken together, the heart rate fell from 83 to 68, while MAP fell from 86 to 80. Systolic pressure was labile, ranging 94-133, with the lowest value around hour 27.1. SpO2 briefly dipped to 86 around hour 0.4 before recovering to 91, while respiratory rate peaked at 31 and later settled at 20. The associated labs and urine output showed that white count was 6.6 on its only check, creatinine rose from 1.0 to 100, lactate was not available, and urine output was roughly stable (97 to 145), with recorded outputs ranging 33-340.
B. Taken together, the heart rate fell from 80 to 71, while MAP fell from 83 to 77. Systolic pressure was labile, ranging 90-153, with the lowest value around hour 25.6. SpO2 briefly dipped to 85 around hour 0.3 before recovering to 94, while respiratory rate peaked at 29 and later settled at 19. The associated labs and urine output showed that white count was 7.1 on its only check, creatinine rose from 0.9 to 99, lactate was not available, and urine output was roughly stable (100 to 125), with recorded outputs ranging 30-320.
C. Taken together, the heart rate fell from 84 to 67, while MAP fell from 87 to 81. Systolic pressure was labile, ranging 86-128, with the lowest value around hour 27.5. SpO2 briefly dipped to 89 around hour 0.4 before recovering to 90, while respiratory rate peaked at 31 and later settled at 21. The associated labs and urine output showed that white count was 6.5 on its only check, creatinine rose from 1.0 to 99.1, lactate was not available, and urine output was roughly stable (96 to 150), with recorded outputs ranging 80-345.
D. Taken together, the heart rate fell from 76 to 73, while MAP was roughly stable (78 to 80). Systolic pressure was labile, ranging 94-183, with the lowest value around hour 23.4. SpO2 briefly dipped to 80 around hour 1.3 before recovering to 98, while respiratory rate peaked at 27 and later settled at 17. The associated labs and urine output showed that white count was 7.8 on its only check, creatinine rose from 0.8 to 94, lactate was not available, and urine output was roughly stable (96 to 75), with recorded outputs ranging 26-290.

Answer: B


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

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 74, diastolic pressure was roughly stable (74 to 71), and heart rate fell from 77 to 74. The lowest MAP was about 67 around hour 24.1, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 30 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.8-33.8 C, white count was 7.6 on its only check, creatinine rose from 0.8 to 100, lactate was not available, and urine output was roughly stable (97 to 105)
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 81 to 79, diastolic pressure fell from 69 to 65, and heart rate fell from 82 to 69. The lowest MAP was about 67 around hour 26.6, and the lowest valid SpO2 was 83 around hour 0.4; respiratory rate rose as high as 28 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 38.0-39.0 C, white count was 6.7 on its only check, creatinine rose from 1.0 to 97, lactate was not available, and urine output was roughly stable (98 to 140)
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 83 to 77, diastolic pressure was roughly stable (71 to 68), and heart rate fell from 80 to 71. The lowest MAP was about 64 around hour 25.6, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 29 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 35.8-36.8 C, white count was 7.1 on its only check, creatinine rose from 0.9 to 99, lactate was not available, and urine output was roughly stable (100 to 125)
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 78 to 75, diastolic pressure was roughly stable (66 to 64), and heart rate fell from 84 to 66. The lowest MAP was about 60 around hour 27.9, and the lowest valid SpO2 was 80 around hour 0.5; respiratory rate rose as high as 31 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 40.3-41.3 C, white count was 6.3 on its only check, creatinine rose from 1.1 to 99.1, lactate was not available, and urine output was roughly stable (96 to 175)

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 83 to 77, diastolic pressure was roughly stable (71 to 68), and heart rate fell from 80 to 71. The lowest MAP was about 64 around hour 25.6, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 29 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 96.4 to 98.2, white count was 7.1 on its only check, creatinine rose from 0.9 to 99, lactate was not available, and urine output was roughly stable (100 to 125)


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

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 154 to 109, MAP fell from 86 to 80, and heart rate fell from 77 to 74. SpO2 started at 90, ended at 97, and fell as low as 88 around hour 0.2; respiratory rate ranged 18-31. For labs and output, white count was 6.6 on its only check, creatinine rose from 1.0 to 100, lactate was not available, and urine output was roughly stable (97 to 145)
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 119 to 108, MAP was roughly stable (81 to 80), and heart rate fell from 82 to 69. SpO2 started at 95, ended at 92, and fell as low as 84 around hour 0.4; respiratory rate ranged 15-30. For labs and output, white count was 7.5 on its only check, creatinine rose from 0.8 to 97, lactate was not available, and urine output was roughly stable (98 to 110)
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 159 to 108, MAP fell from 87 to 81, and heart rate fell from 76 to 75. SpO2 started at 89, ended at 98, and fell as low as 89 around hour 0.2; respiratory rate ranged 18-27. For labs and output, white count was 6.5 on its only check, creatinine rose from 1.0 to 99.1, lactate was not available, and urine output was roughly stable (96 to 150)
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 134 to 112, MAP fell from 83 to 77, and heart rate fell from 80 to 71. SpO2 started at 93, ended at 94, and fell as low as 85 around hour 0.3; respiratory rate ranged 16-29. For labs and output, white count was 7.1 on its only check, creatinine rose from 0.9 to 99, lactate was not available, and urine output was roughly stable (100 to 125)

Answer: D


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 148 to 127, MAP fell from 84 to 76, and heart rate rose from 43 to 102. SpO2 started at 100, ended at 95, and fell as low as 85 around hour 18; respiratory rate ranged 11-35. For labs and output, white count rose from 3 to 8.3, creatinine fell from 1.2 to 1, lactate stayed broadly stable from 1.4 to 1.4, and urine output fell from 400 to 45.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 133 to 113, MAP fell from 82 to 74, and heart rate rose from 45 to 100. SpO2 started at 98, ended at 93, and fell as low as 83 around hour 19; respiratory rate ranged 10-37. For labs and output, white count rose from 3 to 7.9, creatinine was roughly stable (1.0 to 1.1), lactate fell from 1.6 to 1.2, and urine output fell from 415 to 43.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 173 to 102, MAP fell from 88 to 80, and heart rate rose from 39 to 105. SpO2 started at 96, ended at 99, and fell as low as 89 around hour 16; respiratory rate ranged 13-37. For labs and output, white count rose from 2 to 7.5, creatinine fell from 1.4 to 1, lactate stayed broadly stable from 1.6 to 1.6, and urine output fell from 375 to 49.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 118 to 98, MAP was roughly stable (80 to 79), and heart rate rose from 48 to 98. SpO2 started at 96, ended at 90, and fell as low as 84 around hour 20; respiratory rate ranged 9-40. For labs and output, white count rose from 4 to 7.6, creatinine fell from 0.9 to 0.7, lactate stayed broadly stable from 1.1 to 1.1, and urine output fell from 430 to 40.

Answer: A


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

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (106 to 102), diastolic pressure was roughly stable (94 to 88), and heart rate fell from 79 to 72. The lowest MAP was about 72 around hour 16.9, and the lowest valid SpO2 was 88 around hour 0.1; respiratory rate rose as high as 48 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 36.1-37.2 C, white count was roughly stable (12.4 to 13.4), creatinine fell from 1 to 0.8, lactate was not available, and urine output was roughly stable (375 to 450)
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (103 to 105), diastolic pressure stayed around 91, and heart rate fell from 79 to 69. The lowest MAP was about 69 around hour 15.9, and the lowest valid SpO2 was 88 around hour 0.1; respiratory rate rose as high as 48 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 36.1-37.2 C, white count was roughly stable (12.4 to 13.4), creatinine fell from 1 to 0.8, lactate was not available, and urine output was roughly stable (375 to 450)
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (107 to 101), diastolic pressure stayed around 95, and heart rate fell from 83 to 72. The lowest MAP was about 73 around hour 17.8, and the lowest valid SpO2 was 92 around hour 0; respiratory rate rose as high as 44 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 39.9-41.0 C, white count was roughly stable (14.3 to 15.3), creatinine fell from 1 to 0.9, lactate was not available, and urine output was roughly stable (400 to 425)
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (98 to 110), diastolic pressure stayed around 86, and heart rate fell from 74 to 71. The lowest MAP was about 64 around hour 13.7, and the lowest valid SpO2 was 84 around hour 0.0; respiratory rate rose as high as 50 but ended at 10. The lower-frequency data fit that summary: temperature stayed around 31.6-32.7 C, white count was roughly stable (10.2 to 11.2), creatinine was roughly stable (1 to 0.9), lactate was not available, and urine output rose from 345 to 500.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (103 to 105), diastolic pressure stayed around 91, and heart rate fell from 79 to 69. The lowest MAP was about 69 around hour 15.9, and the lowest valid SpO2 was 88 around hour 0.1; respiratory rate rose as high as 48 but ended at 12. The lower-frequency data fit that summary: temperature ranged from 97 to 99, white count was roughly stable (12.4 to 13.4), creatinine fell from 1 to 0.8, lactate was not available, and urine output was roughly stable (375 to 450)


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

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 159 to 179, MAP was roughly stable (106 to 108), and heart rate fell from 76 to 72. SpO2 started at 96, ended at 97, and fell as low as 91 around hour 0.0; respiratory rate ranged 8-50. For labs and output, white count was roughly stable (10.9 to 12.6), creatinine fell from 1 to 0.7, lactate was not available, and urine output was roughly stable (395 to 470)
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 124 to 164, MAP was roughly stable (101 to 103), and heart rate fell from 81 to 67. SpO2 started at 100, ended at 98, and fell as low as 86 around hour 0.2; respiratory rate ranged 8-50. For labs and output, white count was roughly stable (13.5 to 12.3), creatinine stayed around 1, lactate was not available, and urine output was roughly stable (375 to 450)
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 139 to 149, MAP was roughly stable (103 to 105), and heart rate fell from 79 to 69. SpO2 started at 99, ended at 100, and fell as low as 88 around hour 0.1; respiratory rate ranged 8-48. For labs and output, white count was roughly stable (12.4 to 13.4), creatinine fell from 1 to 0.8, lactate was not available, and urine output was roughly stable (375 to 450)
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (109 to 145), MAP was roughly stable (98 to 108), and heart rate fell from 84 to 64. SpO2 started at 100, ended at 96, and fell as low as 87 around hour 0.2; respiratory rate ranged 7-52. For labs and output, white count was roughly stable (14.7 to 11.2), creatinine fell from 1 to 0.8, lactate was not available, and urine output was roughly stable (345 to 420)

Answer: C


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 88 to 74, diastolic pressure fell from 65 to 57, and heart rate fell from 79 to 75. The lowest MAP was about 67 around hour 7.1, and the lowest valid SpO2 was 88 around hour 2.4; respiratory rate rose as high as 24 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.6-33.6 C, white count was 7.3 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (320 to 320)
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 83 to 79, diastolic pressure fell from 60 to 51, and heart rate fell from 84 to 70. The lowest MAP was about 67 around hour 8.6, and the lowest valid SpO2 was 83 around hour 3.8; respiratory rate rose as high as 21 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 37.9-38.9 C, white count was 6.4 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (285 to 285)
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 89 to 73, diastolic pressure fell from 66 to 58, and heart rate fell from 78 to 76. The lowest MAP was about 68 around hour 7.0, and the lowest valid SpO2 was 89 around hour 2.8; respiratory rate rose as high as 24 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 31.9-32.9 C, white count was 7.4 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (325 to 350)
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 85 to 77, diastolic pressure fell from 62 to 54, and heart rate fell from 82 to 72. The lowest MAP was about 64 around hour 7.6, and the lowest valid SpO2 was 85 around hour 3.4; respiratory rate rose as high as 22 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 35.6-36.6 C, white count was 6.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (300 to 300)

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 85 to 77, diastolic pressure fell from 62 to 54, and heart rate fell from 82 to 72. The lowest MAP was about 64 around hour 7.6, and the lowest valid SpO2 was 85 around hour 3.4; respiratory rate rose as high as 22 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 96 to 97.8, white count was 6.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (300 to 300)


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (151 to 150), MAP fell from 85 to 77, and heart rate fell from 82 to 72. SpO2 started at 85, ended at 98, and fell as low as 85 around hour 3.4; respiratory rate ranged 12-22. For labs and output, white count was 6.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (300 to 300)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (136 to 165), MAP fell from 83 to 75, and heart rate fell from 84 to 75. SpO2 started at 87, ended at 96, and fell as low as 83 around hour 3.8; respiratory rate ranged 11-24. For labs and output, white count was 7.2 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (285 to 315)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (176 to 146), MAP was roughly stable (89 to 80), and heart rate fell from 78 to 76. SpO2 started at 81, ended at 100, and fell as low as 84 around hour 2.8; respiratory rate ranged 14-20. For labs and output, white count was 6.2 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (325 to 275)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (155 to 180), MAP fell from 80 to 72, and heart rate fell from 86 to 68. SpO2 started at 90, ended at 94, and fell as low as 80 around hour 4.2; respiratory rate ranged 10-24. For labs and output, white count was 7.5 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (270 to 330)

Answer: A


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

Options:
A. For handoff, the heart rate fell from 85 to 75, MAP fell from 88 to 80, and diastolic pressure moved from 59 to 51. Systolic pressure ranged 94-183 and ended at 170, and SpO2 recovered to 95 after a low of 88 around hour 3.9. Respiratory rate ended at 20; the available labs showed white count was 7.3 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (280 to 320)
B. For handoff, the heart rate fell from 82 to 72, MAP fell from 85 to 77, and diastolic pressure moved from 62 to 54. Systolic pressure ranged 91-163 and ended at 150, and SpO2 recovered to 98 after a low of 85 around hour 3.4. Respiratory rate ended at 21; the available labs showed white count was 6.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (300 to 300)
C. For handoff, the heart rate fell from 86 to 68, MAP fell from 89 to 81, and diastolic pressure moved from 58 to 58. Systolic pressure ranged 95-188 and ended at 175, and SpO2 recovered to 94 after a low of 84 around hour 4.0. Respiratory rate ended at 19; the available labs showed white count was 7.4 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (350 to 325)
D. For handoff, the heart rate fell from 78 to 76, MAP was roughly stable (80 to 80), and diastolic pressure moved from 66 to 50. Systolic pressure ranged 86-133 and ended at 146, and SpO2 recovered to 100 after a low of 80 around hour 4.4. Respiratory rate ended at 23; the available labs showed white count was 6.0 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (330 to 270)

Answer: B


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

Options:
A. For handoff, the heart rate fell from 92 to 78, while MAP was roughly stable (85 to 87). Systolic pressure was labile, ranging 16-137, with the lowest value around hour 7.4. SpO2 briefly dipped to 88 around hour 3.9 before recovering to 91, while respiratory rate peaked at 24 and later settled at 16. The associated labs and urine output showed that white count fell from 9.2 to 8.1, creatinine rose from 1 to 1.3, lactate fell from 2.1 to 1, and urine output was roughly stable (57 to 97), with recorded outputs ranging 60-320.
B. For handoff, the heart rate fell from 87 to 83, while MAP was roughly stable (80 to 87). Systolic pressure was labile, ranging 19-172, with the lowest value around hour 6.5. SpO2 briefly dipped to 83 around hour 4.4 before recovering to 96, while respiratory rate peaked at 21 and later settled at 14. The associated labs and urine output showed that white count fell from 11.8 to 8.5, creatinine rose from 1 to 1.4, lactate fell from 1.8 to 1, and urine output was roughly stable (62 to 50), with recorded outputs ranging 38-285.
C. For handoff, the heart rate fell from 93 to 77, while MAP was roughly stable (86 to 88). Systolic pressure was labile, ranging 22-132, with the lowest value around hour 7.5. SpO2 briefly dipped to 86 around hour 4.0 before recovering to 90, while respiratory rate peaked at 24 and later settled at 17. The associated labs and urine output showed that white count fell from 8.8 to 8.3, creatinine rose from 1 to 1.2, lactate fell from 2.1 to 1, and urine output was roughly stable (56 to 96), with recorded outputs ranging 44-325.
D. For handoff, the heart rate fell from 89 to 81, while MAP was roughly stable (82 to 84). Systolic pressure was labile, ranging 18-157, with the lowest value around hour 6.9. SpO2 briefly dipped to 85 around hour 3.4 before recovering to 94, while respiratory rate peaked at 22 and later settled at 15. The associated labs and urine output showed that white count fell from 10.7 to 8.9, creatinine rose from 1 to 1.2, lactate fell from 1.9 to 1, and urine output was roughly stable (60 to 100), with recorded outputs ranging 40-300.

Answer: D


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

Options:
A. Across the recorded window, the heart rate was roughly stable (69 to 73), while MAP rose from 97 to 104. Systolic pressure was labile, ranging 124-186, with the lowest value around hour 6.5. SpO2 briefly dipped to 88 around hour 1.5 before recovering to 91, while respiratory rate peaked at 28 and later settled at 17. The associated labs and urine output showed that white count fell from 9.1 to 7.8, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output fell from 300 to 200, with recorded outputs ranging 100-300.
B. Across the recorded window, the heart rate was roughly stable (67 to 75), while MAP rose from 95 to 102. Systolic pressure was labile, ranging 139-201, with the lowest value around hour 6.1. SpO2 briefly dipped to 86 around hour 1.4 before recovering to 93, while respiratory rate peaked at 27 and later settled at 16. The associated labs and urine output showed that white count fell from 9.5 to 7, creatinine rose from 0.6 to 0.9, lactate was not available, and urine output fell from 285 to 185, with recorded outputs ranging 150-315.
C. Across the recorded window, the heart rate was roughly stable (73 to 69), while MAP rose from 100 to 107. Systolic pressure was labile, ranging 99-161, with the lowest value around hour 7.1. SpO2 briefly dipped to 92 around hour 2.5 before recovering to 87, while respiratory rate peaked at 30 and later settled at 19. The associated labs and urine output showed that white count fell from 8.5 to 8.4, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output fell from 325 to 150, with recorded outputs ranging 96-275.
D. Across the recorded window, the heart rate was roughly stable (64 to 78), while MAP rose from 92 to 100. Systolic pressure was labile, ranging 128-216, with the lowest value around hour 5.8. SpO2 briefly dipped to 89 around hour 1.2 before recovering to 96, while respiratory rate peaked at 30 and later settled at 15. The associated labs and urine output showed that white count fell from 9.8 to 7.0, creatinine was roughly stable (0.5 to 1.0), lactate was not available, and urine output fell from 270 to 170, with recorded outputs ranging 96-330.

Answer: A


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 100 to 101, diastolic pressure rose from 74 to 89, and heart rate was roughly stable (66 to 76). The lowest MAP was about 80 around hour 14.0, and the lowest valid SpO2 was 91 around hour 1.3; respiratory rate rose as high as 30 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.5-34.1 C, white count fell from 9.6 to 7.3, creatinine rose from 0.8 to 0.9, lactate was not available, and urine output was roughly stable (280 to 250)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 97 to 104, diastolic pressure rose from 71 to 86, and heart rate was roughly stable (69 to 73). The lowest MAP was about 77 around hour 15.5, and the lowest valid SpO2 was 88 around hour 1.5; respiratory rate rose as high as 28 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.5-37.1 C, white count fell from 9.1 to 7.8, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output fell from 300 to 200.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 100 to 103, diastolic pressure rose from 75 to 90, and heart rate rose from 65 to 76. The lowest MAP was about 81 around hour 13.6, and the lowest valid SpO2 was 92 around hour 0.5; respiratory rate rose as high as 30 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 32.8-33.4 C, white count fell from 9.7 to 7.2, creatinine was roughly stable (0.8 to 0.9), lactate was not available, and urine output fell from 275 to 225.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 92 to 108, diastolic pressure rose from 66 to 83, and heart rate was roughly stable (74 to 68). The lowest MAP was about 80 around hour 16.5, and the lowest valid SpO2 was 84 around hour 1.8; respiratory rate rose as high as 26 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 41.0-41.6 C, white count fell from 8.3 to 7.8, creatinine was roughly stable (0.5 to 0.7), lactate was not available, and urine output fell from 330 to 170.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 97 to 104, diastolic pressure rose from 71 to 86, and heart rate was roughly stable (69 to 73). The lowest MAP was about 77 around hour 15.5, and the lowest valid SpO2 was 88 around hour 1.5; respiratory rate rose as high as 28 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 97.7 to 98.7, white count fell from 9.1 to 7.8, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output fell from 300 to 200.


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

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (174 to 130), MAP rose from 100 to 107, and heart rate was roughly stable (66 to 76). SpO2 started at 97, ended at 92, and fell as low as 91 around hour 1.3; respiratory rate ranged 6-26. For labs and output, white count fell from 8.6 to 8.3, creatinine rose from 0.8 to 0.9, lactate was not available, and urine output fell from 320 to 220.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (139 to 165), MAP rose from 95 to 102, and heart rate rose from 71 to 76. SpO2 started at 98, ended at 89, and fell as low as 86 around hour 1.6; respiratory rate ranged 5-30. For labs and output, white count fell from 9.5 to 7, creatinine was roughly stable (0.6 to 0.9), lactate was not available, and urine output fell from 285 to 185.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (154 to 150), MAP rose from 97 to 104, and heart rate was roughly stable (69 to 73). SpO2 started at 100, ended at 91, and fell as low as 88 around hour 1.5; respiratory rate ranged 5-28. For labs and output, white count fell from 9.1 to 7.8, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output fell from 300 to 200.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 124 to 104, MAP rose from 92 to 107, and heart rate was roughly stable (74 to 68). SpO2 started at 96, ended at 86, and fell as low as 87 around hour 1.8; respiratory rate ranged 4-30. For labs and output, white count fell from 9.8 to 7.0, creatinine was roughly stable (0.5 to 1.0), lactate was not available, and urine output fell from 270 to 170.

Answer: C


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

Options:
A. Clinically, the heart rate was roughly stable (72 to 70), MAP rose from 100 to 107, and diastolic pressure moved from 68 to 89. Systolic pressure ranged 144-206 and ended at 146, and SpO2 recovered to 88 after a low of 91 around hour 2.5. Respiratory rate ended at 16; the available labs showed white count fell from 9.6 to 8.3, creatinine was roughly stable (0.6 to 0.9), lactate was not available, and urine output fell from 320 to 180.
B. Clinically, the heart rate rose from 67 to 76, MAP rose from 95 to 102, and diastolic pressure moved from 73 to 83. Systolic pressure ranged 109-171 and ended at 135, and SpO2 recovered to 93 after a low of 86 around hour 1.4. Respiratory rate ended at 18; the available labs showed white count fell from 8.7 to 7.4, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output fell from 285 to 215.
C. Clinically, the heart rate was roughly stable (73 to 69), MAP rose from 100 to 108, and diastolic pressure moved from 67 to 90. Systolic pressure ranged 149-211 and ended at 175, and SpO2 recovered to 87 after a low of 87 around hour 1.8. Respiratory rate ended at 15; the available labs showed white count fell from 9.7 to 7, creatinine was roughly stable (0.6 to 0.9), lactate was not available, and urine output fell from 350 to 175.
D. Clinically, the heart rate was roughly stable (69 to 73), MAP rose from 97 to 104, and diastolic pressure moved from 71 to 86. Systolic pressure ranged 124-186 and ended at 150, and SpO2 recovered to 91 after a low of 88 around hour 1.5. Respiratory rate ended at 17; the available labs showed white count fell from 9.1 to 7.8, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output fell from 300 to 200.

Answer: D


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

Options:
A. Viewed chronologically, the heart rate was roughly stable (94 to 92), while MAP fell from 84 to 56. Systolic pressure was labile, ranging 61-119, with the lowest value around hour 58.5. SpO2 briefly dipped to 88 around hour 16.5 before recovering to 93, while respiratory rate peaked at 42 and later settled at 26. The associated labs and urine output showed that white count was roughly stable (5.4 to 5.6), creatinine fell from 0.9 to 0.5, lactate was not available, and urine output rose from 170 to 300, with recorded outputs ranging 24-530.
B. Viewed chronologically, the heart rate was roughly stable (89 to 97), while MAP fell from 79 to 51. Systolic pressure was labile, ranging 66-154, with the lowest value around hour 53.2. SpO2 briefly dipped to 83 around hour 14.4 before recovering to 98, while respiratory rate peaked at 37 and later settled at 23. The associated labs and urine output showed that white count fell from 6.3 to 4.3, creatinine was roughly stable (0.7 to 0.7), lactate was not available, and urine output rose from 135 to 335, with recorded outputs ranging 75-565.
C. Viewed chronologically, the heart rate was roughly stable (95 to 91), while MAP fell from 85 to 57. Systolic pressure was labile, ranging 68-114, with the lowest value around hour 59.2. SpO2 briefly dipped to 86 around hour 17.4 before recovering to 92, while respiratory rate peaked at 41 and later settled at 26. The associated labs and urine output showed that white count was roughly stable (5.3 to 5.7), creatinine fell from 0.9 to 0.5, lactate was not available, and urine output rose from 175 to 375, with recorded outputs ranging 23-525.
D. Viewed chronologically, the heart rate was roughly stable (91 to 95), while MAP fell from 81 to 53. Systolic pressure was labile, ranging 64-139, with the lowest value around hour 55.5. SpO2 briefly dipped to 85 around hour 15.5 before recovering to 96, while respiratory rate peaked at 39 and later settled at 24. The associated labs and urine output showed that white count was roughly stable (5.9 to 5.1), creatinine fell from 0.8 to 0.6, lactate was not available, and urine output rose from 150 to 350, with recorded outputs ranging 25-550.

Answer: D


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 rose from 108 to 112, MAP was roughly stable (73 to 69), and heart rate rose from 70 to 88. SpO2 started at 97, ended at 100, and fell as low as 88 around hour 3.2; respiratory rate ranged 8-24. For labs and output, white count fell from 12.2 to 10.7, creatinine fell from 1 to 0.7, lactate stayed broadly stable from 1.9 to 1.9, and urine output fell from 330 to 83.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 103 to 117, MAP was roughly stable (68 to 64), and heart rate rose from 75 to 83. SpO2 started at 98, ended at 95, and fell as low as 83 around hour 4.1; respiratory rate ranged 8-23. For labs and output, white count was roughly stable (14.8 to 12.1), creatinine was roughly stable (1 to 0.9), lactate stayed broadly stable from 1.9 to 1.5, and urine output fell from 365 to 78.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 105 to 115, MAP was roughly stable (70 to 66), and heart rate rose from 73 to 85. SpO2 started at 100, ended at 97, and fell as low as 85 around hour 3.7; respiratory rate ranged 8-22. For labs and output, white count was roughly stable (13.7 to 13.2), creatinine fell from 1 to 0.8, lactate stayed broadly stable from 1.7 to 1.7, and urine output fell from 350 to 80.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (100 to 111), MAP was roughly stable (66 to 69), and heart rate rose from 78 to 80. SpO2 started at 96, ended at 92, and fell as low as 84 around hour 4.5; respiratory rate ranged 7-24. For labs and output, white count was roughly stable (15.9 to 10.9), creatinine fell from 1 to 0.8, lactate stayed broadly stable from 1.4 to 1.4, and urine output fell from 380 to 76.

Answer: C


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

Options:
A. Taken together, the heart rate rose from 76 to 82, MAP was roughly stable (73 to 69), and diastolic pressure moved from 50 to 56. Systolic pressure ranged 28-122 and ended at 111, and SpO2 recovered to 94 after a low of 88 around hour 4.7. Respiratory rate ended at 16; the available labs showed white count was roughly stable (15.2 to 14.7), creatinine fell from 1 to 0.9, lactate stayed broadly stable from 1.9 to 1.5, and urine output fell from 370 to 83.
B. Taken together, the heart rate rose from 71 to 87, MAP was roughly stable (68 to 64), and diastolic pressure moved from 55 to 51. Systolic pressure ranged 26-117 and ended at 113, and SpO2 recovered to 99 after a low of 84 around hour 3.3. Respiratory rate ended at 18; the available labs showed white count fell from 12.6 to 12.4, creatinine fell from 1 to 0.7, lactate stayed broadly stable from 1.5 to 1.9, and urine output fell from 400 to 78.
C. Taken together, the heart rate rose from 77 to 88, MAP was roughly stable (74 to 70), and diastolic pressure moved from 49 to 50. Systolic pressure ranged 29-123 and ended at 119, and SpO2 recovered to 93 after a low of 89 around hour 4.3. Respiratory rate ended at 15; the available labs showed white count was roughly stable (15.6 to 15.1), creatinine fell from 1 to 0.9, lactate stayed broadly stable from 1.9 to 1.4, and urine output fell from 375 to 84.
D. Taken together, the heart rate rose from 73 to 85, MAP was roughly stable (70 to 66), and diastolic pressure moved from 53 to 53. Systolic pressure ranged 27-119 and ended at 115, and SpO2 recovered to 97 after a low of 85 around hour 3.7. Respiratory rate ended at 17; the available labs showed white count was roughly stable (13.7 to 13.2), creatinine fell from 1 to 0.8, lactate stayed broadly stable from 1.7 to 1.7, and urine output fell from 350 to 80.

Answer: D


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

Options:
A. Taken together, the heart rate rose from 63 to 70, while MAP rose from 90 to 98. Systolic pressure was labile, ranging 80-115, with the lowest value around hour 17.2. SpO2 briefly dipped to 91 around hour 1.1 before recovering to 96, while respiratory rate peaked at 33 and later settled at 16. The associated labs and urine output showed that white count was 16 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (97 to 150), with recorded outputs ranging 26-530.
B. Taken together, the heart rate rose from 60 to 73, while MAP rose from 87 to 95. Systolic pressure was labile, ranging 83-135, with the lowest value around hour 15.7. SpO2 briefly dipped to 88 around hour 0.1 before recovering to 99, while respiratory rate peaked at 30 and later settled at 14. The associated labs and urine output showed that white count was 18 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output rose from 100 to 200, with recorded outputs ranging 25-550.
C. Taken together, the heart rate rose from 64 to 69, while MAP rose from 91 to 99. Systolic pressure was labile, ranging 87-110, with the lowest value around hour 17.6. SpO2 briefly dipped to 92 around hour 0.2 before recovering to 95, while respiratory rate peaked at 32 and later settled at 16. The associated labs and urine output showed that white count was 16 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 96 to 250, with recorded outputs ranging 27-525.
D. Taken together, the heart rate rose from 56 to 78, while MAP rose from 82 to 90. Systolic pressure was labile, ranging 88-165, with the lowest value around hour 13.4. SpO2 briefly dipped to 84 around hour 0.0 before recovering to 100, while respiratory rate peaked at 26 and later settled at 12. The associated labs and urine output showed that white count was 20 on its only check, creatinine was 0.3 on its only check, lactate was not available, and urine output rose from 96 to 230, with recorded outputs ranging 75-580.

Answer: B


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

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 148 to 119, MAP rose from 90 to 98, and heart rate rose from 57 to 76. SpO2 started at 85, ended at 100, and fell as low as 87 around hour 0.0; respiratory rate ranged 14-27. For labs and output, white count was 16 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 97 to 180.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (113 to 138), MAP rose from 85 to 93, and heart rate rose from 62 to 76. SpO2 started at 90, ended at 97, and fell as low as 86 around hour 0.2; respiratory rate ranged 11-32. For labs and output, white count was 19 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output rose from 98 to 215.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (153 to 98), MAP rose from 91 to 99, and heart rate rose from 56 to 77. SpO2 started at 84, ended at 100, and fell as low as 92 around hour 0.0; respiratory rate ranged 14-26. For labs and output, white count was 16 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (150 to 175)
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (128 to 123), MAP rose from 87 to 95, and heart rate rose from 60 to 73. SpO2 started at 88, ended at 99, and fell as low as 88 around hour 0.1; respiratory rate ranged 12-30. For labs and output, white count was 18 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output rose from 100 to 200.

Answer: D


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

Options:
A. In broad terms, the heart rate was roughly stable (65 to 58), while MAP was roughly stable (105 to 100). Systolic pressure was labile, ranging 124-147, with the lowest value around hour 44.1. SpO2 briefly dipped to 86 around hour 0.4 before recovering to 91, while respiratory rate peaked at 37 and later settled at 22. The associated labs and urine output showed that white count fell from 9.1 to 6.2, creatinine stayed around 1, lactate was checked once at 1.1, and urine output fell from 240 to 38, with recorded outputs ranging 32-200.
B. In broad terms, the heart rate was roughly stable (60 to 63), while MAP was roughly stable (100 to 101). Systolic pressure was labile, ranging 135-182, with the lowest value around hour 38.9. SpO2 briefly dipped to 83 around hour 1.3 before recovering to 96, while respiratory rate peaked at 33 and later settled at 19. The associated labs and urine output showed that white count fell from 10.0 to 5.3, creatinine stayed around 1, lactate was checked once at 1.5, and urine output fell from 205 to 0, with recorded outputs ranging 0-235.
C. In broad terms, the heart rate was roughly stable (62 to 61), while MAP was roughly stable (102 to 98). Systolic pressure was labile, ranging 120-167, with the lowest value around hour 41.1. SpO2 briefly dipped to 85 around hour 0.3 before recovering to 94, while respiratory rate peaked at 35 and later settled at 20. The associated labs and urine output showed that white count fell from 9.6 to 5.7, creatinine stayed around 1, lactate was checked once at 1.3, and urine output fell from 220 to 35, with recorded outputs ranging 35-220.
D. In broad terms, the heart rate was roughly stable (58 to 66), while MAP was roughly stable (98 to 94). Systolic pressure was labile, ranging 150-197, with the lowest value around hour 36.6. SpO2 briefly dipped to 80 around hour 0.1 before recovering to 98, while respiratory rate peaked at 30 and later settled at 18. The associated labs and urine output showed that white count fell from 10.3 to 4.9, creatinine stayed around 1.1, lactate was checked once at 1.6, and urine output fell from 190 to 30, with recorded outputs ranging 40-250.

Answer: C


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 was roughly stable (105 to 95), diastolic pressure was roughly stable (85 to 80), and heart rate was roughly stable (59 to 64). The lowest MAP was about 72 around hour 25.6, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 38 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.9-34.3 C, white count fell from 10.1 to 5.2, creatinine stayed around 1, lactate was checked once at 1.5, and urine output fell from 200 to 38.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (100 to 100), diastolic pressure was roughly stable (80 to 75), and heart rate was roughly stable (64 to 59). The lowest MAP was about 67 around hour 28.2, and the lowest valid SpO2 was 83 around hour 0.4; respiratory rate rose as high as 37 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 38.1-39.5 C, white count fell from 9.2 to 6.1, creatinine stayed around 1.1, lactate was checked once at 1.1, and urine output fell from 235 to 85.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (106 to 94), diastolic pressure fell from 86 to 74, and heart rate was roughly stable (58 to 65). The lowest MAP was about 72 around hour 28.1, and the lowest valid SpO2 was 89 around hour 0.2; respiratory rate rose as high as 39 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.1-33.5 C, white count fell from 10.2 to 5.1, creatinine stayed around 1, lactate was checked once at 1.6, and urine output fell from 195 to 39.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (102 to 98), diastolic pressure was roughly stable (82 to 77), and heart rate was roughly stable (62 to 61). The lowest MAP was about 69 around hour 27.1, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 35 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 35.9-37.3 C, white count fell from 9.6 to 5.7, creatinine stayed around 1, lactate was checked once at 1.3, and urine output fell from 220 to 35.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (102 to 98), diastolic pressure was roughly stable (82 to 77), and heart rate was roughly stable (62 to 61). The lowest MAP was about 69 around hour 27.1, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 35 but ended at 20. The lower-frequency data fit that summary: temperature ranged from 96.7 to 99.2, white count fell from 9.6 to 5.7, creatinine stayed around 1, lactate was checked once at 1.3, and urine output fell from 220 to 35.


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

Options:
A. For handoff, the heart rate was roughly stable (80 to 72), while MAP fell from 157 to 77. Systolic pressure was labile, ranging 72-130, with the lowest value around hour 4. SpO2 briefly dipped to 93 around hour 0.8 before recovering to 94, while respiratory rate peaked at 22 and later settled at 18. The associated labs and urine output showed that white count stayed around 10.2, creatinine was roughly stable (0.6 to 0.7), lactate stayed broadly stable from 0.6 to 0.9, and urine output fell from 395 to 230, with recorded outputs ranging 125-355.
B. For handoff, the heart rate was roughly stable (75 to 77), while MAP fell from 122 to 77. Systolic pressure was labile, ranging 77-165, with the lowest value around hour 3. SpO2 briefly dipped to 88 around hour 1.6 before recovering to 99, while respiratory rate peaked at 20 and later settled at 16. The associated labs and urine output showed that white count was roughly stable (11 to 10), creatinine stayed around 0.5, lactate stayed broadly stable from 0.8 to 0.7, and urine output fell from 360 to 200, with recorded outputs ranging 73-390.
C. For handoff, the heart rate was roughly stable (81 to 71), while MAP fell from 162 to 78. Systolic pressure was labile, ranging 79-125, with the lowest value around hour 4. SpO2 briefly dipped to 91 around hour 0.8 before recovering to 93, while respiratory rate peaked at 23 and later settled at 19. The associated labs and urine output showed that white count was roughly stable (8 to 13), creatinine stayed around 0.7, lactate stayed broadly stable from 0.6 to 0.9, and urine output fell from 400 to 225, with recorded outputs ranging 79-350.
D. For handoff, the heart rate was roughly stable (77 to 75), while MAP fell from 137 to 74. Systolic pressure was labile, ranging 75-150, with the lowest value around hour 3. SpO2 briefly dipped to 90 around hour 0.7 before recovering to 97, while respiratory rate peaked at 21 and later settled at 17. The associated labs and urine output showed that white count was roughly stable (10 to 11), creatinine stayed around 0.6, lactate stayed broadly stable from 0.7 to 0.8, and urine output fell from 375 to 250, with recorded outputs ranging 75-375.

Answer: D


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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 170 to 108, MAP fell from 157 to 77, and heart rate was roughly stable (74 to 78). SpO2 started at 95, ended at 100, and fell as low as 93 around hour 0.6; respiratory rate ranged 14-23. For labs and output, white count stayed around 10.2, creatinine stayed around 0.6, lactate stayed broadly stable from 0.7 to 0.8, and urine output fell from 375 to 250.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 150 to 111, MAP fell from 137 to 74, and heart rate was roughly stable (77 to 75). SpO2 started at 98, ended at 97, and fell as low as 90 around hour 0.7; respiratory rate ranged 13-21. For labs and output, white count was roughly stable (10 to 11), creatinine stayed around 0.6, lactate stayed broadly stable from 0.7 to 0.8, and urine output fell from 375 to 250.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 175 to 107, MAP fell from 162 to 78, and heart rate was roughly stable (73 to 79). SpO2 started at 94, ended at 100, and fell as low as 94 around hour 0.6; respiratory rate ranged 15-19. For labs and output, white count was roughly stable (8 to 13), creatinine was roughly stable (0.7 to 0.6), lactate stayed broadly stable from 0.9 to 0.8, and urine output fell from 375 to 250.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 120 to 107, MAP fell from 107 to 77, and heart rate was roughly stable (82 to 70). SpO2 started at 100, ended at 92, and fell as low as 89 around hour 0.8; respiratory rate ranged 11-23. For labs and output, white count was roughly stable (12 to 9), creatinine stayed around 0.4, lactate stayed broadly stable from 0.8 to 0.7, and urine output fell from 345 to 280.

Answer: B


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 fell from 157 to 113, MAP fell from 100 to 83, and heart rate rose from 60 to 83. SpO2 started at 97, ended at 100, and fell as low as 88 around hour 47.2; respiratory rate ranged 12-26. For labs and output, white count fell from 8 to 3.8, creatinine was roughly stable (0.6 to 0.6), lactate fell from 2.4 to 1.8, and urine output fell from 1300 to 380.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 122 to 112, MAP fell from 97 to 83, and heart rate rose from 65 to 78. SpO2 started at 98, ended at 96, and fell as low as 84 around hour 52.5; respiratory rate ranged 9-28. For labs and output, white count fell from 8 to 2.9, creatinine stayed around 0.4, lactate fell from 2.4 to 1.6, and urine output fell from 1240 to 395.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 162 to 112, MAP fell from 100 to 84, and heart rate rose from 59 to 83. SpO2 started at 96, ended at 100, and fell as low as 89 around hour 46.5; respiratory rate ranged 12-29. For labs and output, white count fell from 7 to 2.5, creatinine stayed around 0.6, lactate fell from 2.0 to 1.8, and urine output fell from 1400 to 355.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 137 to 116, MAP fell from 99 to 80, and heart rate rose from 63 to 80. SpO2 started at 100, ended at 98, and fell as low as 85 around hour 50.2; respiratory rate ranged 10-27. For labs and output, white count fell from 8 to 3.3, creatinine stayed around 0.5, lactate fell from 2.2 to 1.8, and urine output fell from 1300 to 380.

Answer: D


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

Options:
A. Over the available measurements, the heart rate stayed around 53, while MAP fell from 101 to 91. Systolic pressure was labile, ranging 103-158, with the lowest value around hour 16.9. SpO2 briefly dipped to 85 around hour 0.2 before recovering to 91, while respiratory rate peaked at 25 and later settled at 16. The associated labs and urine output showed that white count rose from 7.6 to 8.3, creatinine stayed around 1, lactate was not available, and urine output was not recorded.
B. Over the available measurements, the heart rate stayed around 48, while MAP fell from 106 to 91. Systolic pressure was labile, ranging 97-123, with the lowest value around hour 14.3. SpO2 briefly dipped to 90 around hour 1.1 before recovering to 86, while respiratory rate peaked at 24 and later settled at 13. The associated labs and urine output showed that white count was roughly stable (6.7 to 7.9), creatinine stayed around 1, lactate was not available, and urine output was not recorded.
C. Over the available measurements, the heart rate stayed around 50, while MAP fell from 104 to 88. Systolic pressure was labile, ranging 99-138, with the lowest value around hour 15.4. SpO2 briefly dipped to 88 around hour 0.1 before recovering to 88, while respiratory rate peaked at 23 and later settled at 14. The associated labs and urine output showed that white count was roughly stable (7.1 to 7.5), creatinine stayed around 1, lactate was not available, and urine output was not recorded.
D. Over the available measurements, the heart rate was roughly stable (47 to 50), while MAP fell from 104 to 88. Systolic pressure was labile, ranging 99-138, with the lowest value around hour 15.4. SpO2 briefly dipped to 88 around hour 0.1 before recovering to 88, while respiratory rate peaked at 23 and later settled at 14. The associated labs and urine output showed that white count was roughly stable (7.1 to 6.7), creatinine stayed around 1.1, lactate was not available, and urine output was not recorded.

Answer: C


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 fell from 138 to 118, MAP fell from 104 to 88, and heart rate stayed around 50. SpO2 started at 88, ended at 88, and fell as low as 88 around hour 0.1; respiratory rate ranged 9-23. For labs and output, white count was roughly stable (7.1 to 7.5), creatinine stayed around 1, lactate was not available, and urine output was not recorded.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 123 to 120, MAP fell from 102 to 86, and heart rate was roughly stable (52 to 53). SpO2 started at 90, ended at 86, and fell as low as 88 around hour 0.1; respiratory rate ranged 9-25. For labs and output, white count was roughly stable (7.1 to 6.7), creatinine stayed around 1, lactate was not available, and urine output was not recorded.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 163 to 114, MAP fell from 108 to 91, and heart rate stayed around 46. SpO2 started at 92, ended at 84, and fell as low as 87 around hour 0.2; respiratory rate ranged 8-21. For labs and output, white count was roughly stable (7.7 to 6.9), creatinine stayed around 1, lactate was not available, and urine output was not recorded.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 108 to 88, MAP fell from 100 to 84, and heart rate stayed around 54. SpO2 started at 84, ended at 92, and fell as low as 84 around hour 0.0; respiratory rate ranged 10-21. For labs and output, white count was roughly stable (6.3 to 8.2), creatinine stayed around 1.1, lactate was not available, and urine output was not recorded.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate rose from 63 to 88, while MAP rose from 75 to 96. Systolic pressure was labile, ranging 104-167, with the lowest value around hour 12.1. SpO2 briefly dipped to 88 around hour 1 before recovering to 94, while respiratory rate peaked at 28 and later settled at 16. The associated labs and urine output showed that white count fell from 14 to 12.5, creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output rose from 97 to 400, with recorded outputs ranging 27-430.
B. Viewed chronologically, the heart rate rose from 58 to 93, while MAP rose from 70 to 91. Systolic pressure was labile, ranging 109-202, with the lowest value around hour 9.5. SpO2 briefly dipped to 83 around hour 0 before recovering to 99, while respiratory rate peaked at 25 and later settled at 14. The associated labs and urine output showed that white count fell from 17 to 11.8, creatinine stayed around 0.4, lactate was not available, and urine output rose from 100 to 450, with recorded outputs ranging 80-450.
C. Viewed chronologically, the heart rate rose from 64 to 87, while MAP rose from 76 to 97. Systolic pressure was labile, ranging 111-162, with the lowest value around hour 12.5. SpO2 briefly dipped to 89 around hour 2 before recovering to 93, while respiratory rate peaked at 28 and later settled at 17. The associated labs and urine output showed that white count fell from 14 to 12.5, creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output rose from 96 to 475, with recorded outputs ranging 80-425.
D. Viewed chronologically, the heart rate rose from 60 to 91, while MAP rose from 72 to 93. Systolic pressure was labile, ranging 107-187, with the lowest value around hour 10.6. SpO2 briefly dipped to 85 around hour 0 before recovering to 97, while respiratory rate peaked at 26 and later settled at 15. The associated labs and urine output showed that white count fell from 16 to 12.6, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 100 to 450, with recorded outputs ranging 30-450.

Answer: D


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

Options:
A. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 93, diastolic pressure rose from 63 to 83, and heart rate rose from 60 to 91. The lowest MAP was about 63 around hour 2.6, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 26 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 36.2-37.7 C, white count fell from 16 to 12.6, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 100 to 450.
B. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 70 to 95, diastolic pressure rose from 61 to 81, and heart rate rose from 62 to 89. The lowest MAP was about 61 around hour 2.8, and the lowest valid SpO2 was 83 around hour 2; respiratory rate rose as high as 28 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 38.5-40.0 C, white count fell from 15 to 13.7, creatinine stayed around 0.4, lactate was not available, and urine output rose from 100 to 500.
C. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 76 to 89, diastolic pressure rose from 67 to 80, and heart rate rose from 56 to 95. The lowest MAP was about 66 around hour 3.6, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 28 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 32.5-34.0 C, white count fell from 18 to 10.7, creatinine was roughly stable (0.6 to 0.5), lactate was not available, and urine output rose from 96 to 475.
D. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 98, diastolic pressure rose from 58 to 78, and heart rate rose from 64 to 94. The lowest MAP was about 58 around hour 2.9, and the lowest valid SpO2 was 80 around hour 3; respiratory rate rose as high as 24 but ended at 13. The lower-frequency data fit that summary: temperature stayed around 40.7-42.2 C, white count fell from 14 to 12.5, creatinine was roughly stable (0.3 to 0.2), lactate was not available, and urine output rose from 96 to 420.

Answer: A

In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 93, diastolic pressure rose from 63 to 83, and heart rate rose from 60 to 91. The lowest MAP was about 63 around hour 2.6, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 26 but ended at 15. The lower-frequency data fit that summary: temperature ranged from 97.1 to 99.9, white count fell from 16 to 12.6, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 100 to 450.


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

Options:
A. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 114 to 117, MAP rose from 75 to 96, and heart rate rose from 57 to 94. SpO2 started at 82, ended at 100, and fell as low as 88 around hour 0; respiratory rate ranged 10-24. For labs and output, white count fell from 14 to 12.5, creatinine was roughly stable (0.4 to 0.5), lactate was not available, and urine output rose from 97 to 470.
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 111 to 123, MAP rose from 72 to 93, and heart rate rose from 60 to 91. SpO2 started at 85, ended at 97, and fell as low as 85 around hour 0; respiratory rate ranged 9-26. For labs and output, white count fell from 16 to 12.6, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 100 to 450.
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 115 to 119, MAP rose from 76 to 96, and heart rate rose from 56 to 95. SpO2 started at 81, ended at 100, and fell as low as 84 around hour 0; respiratory rate ranged 10-24. For labs and output, white count fell from 14 to 12.5, creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output rose from 96 to 475.
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 106 to 153, MAP rose from 68 to 88, and heart rate rose from 64 to 94. SpO2 started at 90, ended at 92, and fell as low as 80 around hour 3; respiratory rate ranged 8-28. For labs and output, white count fell from 18 to 11.8, creatinine was roughly stable (0.3 to 0.6), lactate was not available, and urine output rose from 96 to 420.

Answer: B