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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 57 to 67, diastolic pressure rose from 47 to 58, and heart rate rose from 87 to 99. The lowest MAP was about 47 around hour 4.4, and the lowest valid SpO2 was 88 around hour 8.2; respiratory rate rose as high as 40 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 30.3-34 C, white count fell from 21.9 to 15.6, creatinine fell from 75 to 2.4, lactate was checked once at 2.6, and urine output rose from 22 to 140.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 52 to 72, diastolic pressure rose from 42 to 52, and heart rate rose from 92 to 94. The lowest MAP was about 47 around hour 5.9, and the lowest valid SpO2 was 83 around hour 9.6; respiratory rate rose as high as 35 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 35.5-39 C, white count fell from 19.3 to 18.2, creatinine fell from 70 to 2.1, lactate was checked once at 2.9, and urine output rose from 19 to 105.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 58 to 66, diastolic pressure rose from 48 to 59, and heart rate rose from 86 to 100. The lowest MAP was about 48 around hour 4.3, and the lowest valid SpO2 was 89 around hour 8.6; respiratory rate rose as high as 39 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 29.5-33 C, white count fell from 22.3 to 15.2, creatinine fell from 76 to 2.3, lactate was checked once at 2.5, and urine output rose from 22 to 170.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 54 to 70, diastolic pressure rose from 44 to 55, and heart rate rose from 90 to 96. The lowest MAP was about 44 around hour 4.9, and the lowest valid SpO2 was 85 around hour 9.2; respiratory rate rose as high as 37 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.3-37 C, white count fell from 20.4 to 17.1, creatinine fell from 72 to 2.2, lactate was checked once at 2.8, and urine output rose from 20 to 120.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 54 to 70, diastolic pressure rose from 44 to 55, and heart rate rose from 90 to 96. The lowest MAP was about 44 around hour 4.9, and the lowest valid SpO2 was 85 around hour 9.2; respiratory rate rose as high as 37 but ended at 24. The lower-frequency data fit that summary: temperature ranged from 91.9 to 98.6, white count fell from 20.4 to 17.1, creatinine fell from 72 to 2.2, lactate was checked once at 2.8, and urine output rose from 20 to 120.


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 94 to 112, MAP rose from 54 to 70, and heart rate rose from 90 to 96. SpO2 started at 91, ended at 92, and fell as low as 85 around hour 9.2; respiratory rate ranged 19-37. For labs and output, white count fell from 20.4 to 17.1, creatinine fell from 72 to 2.2, lactate was checked once at 2.8, and urine output rose from 20 to 120.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 92 to 114, MAP rose from 52 to 68, and heart rate rose from 92 to 99. SpO2 started at 93, ended at 90, and fell as low as 83 around hour 9.6; respiratory rate ranged 18-39. For labs and output, white count fell from 21.5 to 16.3, creatinine fell from 70 to 2.4, lactate was checked once at 2.6, and urine output rose from 19 to 135.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 98 to 108, MAP rose from 58 to 74, and heart rate rose from 86 to 100. SpO2 started at 87, ended at 96, and fell as low as 89 around hour 8.6; respiratory rate ranged 21-33. For labs and output, white count fell from 18.5 to 17.0, creatinine fell from 76 to 2.3, lactate was checked once at 3, and urine output rose from 22 to 95.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 90 to 108, MAP rose from 50 to 73, and heart rate rose from 94 to 97. SpO2 started at 96, ended at 88, and fell as low as 84 around hour 9.9; respiratory rate ranged 17-42. For labs and output, white count fell from 22.6 to 14.9, creatinine fell from 68 to 2.5, lactate was checked once at 2.5, and urine output rose from 18 to 150.

Answer: A


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

Options:
A. For handoff, the heart rate rose from 93 to 96, MAP rose from 57 to 73, and diastolic pressure moved from 41 to 58. Systolic pressure ranged 86-191 and ended at 108, and SpO2 recovered to 89 after a low of 88 around hour 10.2. Respiratory rate ended at 22; the available labs showed white count fell from 21.9 to 18.6, creatinine fell from 69 to 2.4, lactate was checked once at 3.0, and urine output rose from 18 to 140.
B. For handoff, the heart rate rose from 90 to 96, MAP rose from 54 to 70, and diastolic pressure moved from 44 to 55. Systolic pressure ranged 83-171 and ended at 112, and SpO2 recovered to 92 after a low of 85 around hour 9.2. Respiratory rate ended at 24; the available labs showed white count fell from 20.4 to 17.1, creatinine fell from 72 to 2.2, lactate was checked once at 2.8, and urine output rose from 20 to 120.
C. For handoff, the heart rate rose from 94 to 97, MAP rose from 58 to 74, and diastolic pressure moved from 40 to 59. Systolic pressure ranged 87-196 and ended at 116, and SpO2 recovered to 88 after a low of 84 around hour 9.8. Respiratory rate ended at 22; the available labs showed white count fell from 22.3 to 16.3, creatinine fell from 68 to 2.5, lactate was checked once at 3.0, and urine output was roughly stable (70 to 145)
D. For handoff, the heart rate rose from 86 to 99, MAP rose from 50 to 66, and diastolic pressure moved from 48 to 52. Systolic pressure ranged 78-141 and ended at 108, and SpO2 recovered to 96 after a low of 80 around hour 8.4. Respiratory rate ended at 26; the available labs showed white count fell from 18.1 to 14.9, creatinine fell from 76 to 1.9, lactate was checked once at 2.5, and urine output rose from 22 to 90.

Answer: B


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

Options:
A. For handoff, the heart rate fell from 115 to 78, while MAP fell from 76 to 69. Systolic pressure was labile, ranging 73-116, with the lowest value around hour 6.0. SpO2 briefly dipped to 88 around hour 0.2 before recovering to 97, while respiratory rate peaked at 24 and later settled at 22. The associated labs and urine output showed that white count fell from 8.8 to 5.1, creatinine fell from 4.9 to 1.2, lactate was checked once at 186, and urine output rose from 185 to 230, with recorded outputs ranging 80-355.
B. For handoff, the heart rate fell from 110 to 83, while MAP was roughly stable (71 to 69). Systolic pressure was labile, ranging 78-151, with the lowest value around hour 5.1. SpO2 briefly dipped to 83 around hour 1.1 before recovering to 98, while respiratory rate peaked at 21 and later settled at 19. The associated labs and urine output showed that white count fell from 11.4 to 5.5, creatinine fell from 4.0 to 1.2, lactate was checked once at 151, and urine output was roughly stable (150 to 200), with recorded outputs ranging 28-390.
C. For handoff, the heart rate fell from 116 to 77, while MAP fell from 77 to 70. Systolic pressure was labile, ranging 80-111, with the lowest value around hour 6.1. SpO2 briefly dipped to 89 around hour 0.2 before recovering to 96, while respiratory rate peaked at 24 and later settled at 22. The associated labs and urine output showed that white count fell from 8.4 to 6.5, creatinine fell from 5.0 to 0.9, lactate was checked once at 191, and urine output rose from 190 to 225, with recorded outputs ranging 34-350.
D. For handoff, the heart rate fell from 112 to 81, while MAP fell from 73 to 66. Systolic pressure was labile, ranging 76-136, with the lowest value around hour 5.5. SpO2 briefly dipped to 85 around hour 0.1 before recovering to 100, while respiratory rate peaked at 22 and later settled at 20. The associated labs and urine output showed that white count fell from 10.3 to 5.9, creatinine fell from 4.4 to 1.1, lactate was checked once at 166, and urine output rose from 165 to 250, with recorded outputs ranging 30-375.

Answer: D


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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 94 to 105, MAP fell from 76 to 69, and heart rate fell from 109 to 84. SpO2 started at 82, ended at 97, and fell as low as 88 around hour 0.0; respiratory rate ranged 12-24. For labs and output, white count fell from 8.8 to 5.1, creatinine fell from 4.9 to 0.9, lactate was checked once at 186, and urine output rose from 185 to 230.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 91 to 108, MAP fell from 73 to 66, and heart rate fell from 112 to 81. SpO2 started at 85, ended at 100, and fell as low as 85 around hour 0.1; respiratory rate ranged 10-22. For labs and output, white count fell from 10.3 to 5.9, creatinine fell from 4.4 to 1.1, lactate was checked once at 166, and urine output rose from 165 to 250.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 95 to 104, MAP was roughly stable (77 to 69), and heart rate fell from 108 to 85. SpO2 started at 81, ended at 96, and fell as low as 84 around hour 0.0; respiratory rate ranged 12-20. For labs and output, white count fell from 8.4 to 6.5, creatinine fell from 5.0 to 0.9, lactate was checked once at 191, and urine output rose from 190 to 225.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 86 to 112, MAP fell from 68 to 62, and heart rate fell from 116 to 76. SpO2 started at 90, ended at 96, and fell as low as 80 around hour 0.2; respiratory rate ranged 8-24. For labs and output, white count fell from 12.6 to 5.2, creatinine fell from 3.7 to 1.2, lactate was checked once at 166.2, and urine output rose from 135 to 280.

Answer: B


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

Options:
A. Across the recorded window, the heart rate fell from 115 to 78, MAP fell from 76 to 69, and diastolic pressure moved from 63 to 55. Systolic pressure ranged 79-156 and ended at 111, and SpO2 recovered to 97 after a low of 84 around hour 0.2. Respiratory rate ended at 18; the available labs showed white count fell from 11.8 to 5.1, creatinine fell from 3.9 to 1.3, lactate was checked once at 186, and urine output was roughly stable (215 to 270)
B. Across the recorded window, the heart rate fell from 110 to 84, MAP fell from 71 to 64, and diastolic pressure moved from 68 to 49. Systolic pressure ranged 74-121 and ended at 106, and SpO2 recovered to 98 after a low of 83 around hour 0.0. Respiratory rate ended at 21; the available labs showed white count fell from 9.2 to 5.5, creatinine fell from 4.8 to 1.0, lactate was checked once at 151, and urine output rose from 180 to 235.
C. Across the recorded window, the heart rate fell from 112 to 81, MAP fell from 73 to 66, and diastolic pressure moved from 66 to 52. Systolic pressure ranged 76-136 and ended at 108, and SpO2 recovered to 100 after a low of 85 around hour 0.1. Respiratory rate ended at 20; the available labs showed white count fell from 10.3 to 5.9, creatinine fell from 4.4 to 1.1, lactate was checked once at 166, and urine output rose from 165 to 250.
D. Across the recorded window, the heart rate fell from 108 to 86, MAP was roughly stable (68 to 69), and diastolic pressure moved from 70 to 48. Systolic pressure ranged 72-106 and ended at 104, and SpO2 recovered to 96 after a low of 80 around hour 1.1. Respiratory rate ended at 22; the available labs showed white count fell from 8.1 to 5.2, creatinine fell from 5.2 to 0.8, lactate was checked once at 136, and urine output rose from 195 to 220.

Answer: C


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

Options:
A. Across the recorded window, the heart rate fell from 89 to 44, while MAP fell from 58 to 34. Systolic pressure was labile, ranging 54-158, with the lowest value around hour 35.5. SpO2 briefly dipped to 88 around hour 2.5 before recovering to 99, while respiratory rate peaked at 34 and later settled at 28. The associated labs and urine output showed that white count rose from 4.8 to 18.3, creatinine was roughly stable (0.9 to 1), lactate fell from 532 to 3.4, and urine output fell from 250 to 7, with recorded outputs ranging 7-250.
B. Across the recorded window, the heart rate fell from 87 to 46, while MAP fell from 56 to 32. Systolic pressure was labile, ranging 56-173, with the lowest value around hour 33.2. SpO2 briefly dipped to 86 around hour 2.4 before recovering to 100, while respiratory rate peaked at 32 and later settled at 27. The associated labs and urine output showed that white count rose from 5.2 to 17.5, creatinine rose from 0.8 to 1.1, lactate fell from 517 to 3.0, and urine output fell from 265 to 7, with recorded outputs ranging 7-235.
C. Across the recorded window, the heart rate fell from 93 to 40, while MAP fell from 62 to 37. Systolic pressure was labile, ranging 50-133, with the lowest value around hour 39.2. SpO2 briefly dipped to 92 around hour 3.5 before recovering to 95, while respiratory rate peaked at 38 and later settled at 30. The associated labs and urine output showed that white count rose from 4.2 to 20.2, creatinine was roughly stable (1.0 to 1), lactate fell from 557 to 4.0, and urine output fell from 225 to 0, with recorded outputs ranging 0-275.
D. Across the recorded window, the heart rate fell from 84 to 48, while MAP fell from 54 to 30. Systolic pressure was labile, ranging 58-188, with the lowest value around hour 31.0. SpO2 briefly dipped to 89 around hour 2.2 before recovering to 100, while respiratory rate peaked at 36 and later settled at 26. The associated labs and urine output showed that white count rose from 5.5 to 16.1, creatinine stayed around 1, lactate fell from 532 to 3.4, and urine output fell from 250 to 7, with recorded outputs ranging 6-250.

Answer: A


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

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 83 to 51, MAP fell from 61 to 37, and heart rate fell from 86 to 47. SpO2 started at 96, ended at 100, and fell as low as 91 around hour 2.3; respiratory rate ranged 18-36. For labs and output, white count rose from 4.3 to 17.5, creatinine was roughly stable (1.0 to 1), lactate fell from 552 to 3.9, and urine output fell from 230 to 8.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 78 to 56, MAP fell from 56 to 32, and heart rate fell from 91 to 42. SpO2 started at 100, ended at 97, and fell as low as 86 around hour 2.6; respiratory rate ranged 16-36. For labs and output, white count rose from 5.2 to 17.2, creatinine rose from 0.8 to 1.1, lactate fell from 532.2 to 3.0, and urine output fell from 265 to 7.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 80 to 54, MAP fell from 58 to 34, and heart rate fell from 89 to 44. SpO2 started at 99, ended at 99, and fell as low as 88 around hour 2.5; respiratory rate ranged 17-34. For labs and output, white count rose from 4.8 to 18.3, creatinine was roughly stable (0.9 to 1), lactate fell from 532 to 3.4, and urine output fell from 250 to 7.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 76 to 50, MAP fell from 54 to 37, and heart rate fell from 94 to 40. SpO2 started at 100, ended at 94, and fell as low as 87 around hour 2.8; respiratory rate ranged 15-38. For labs and output, white count rose from 5.5 to 16.1, creatinine was roughly stable (0.8 to 1), lactate fell from 502 to 2.6, and urine output fell from 280 to 6.

Answer: C


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

Options:
A. Over the available measurements, the heart rate rose from 92 to 101, MAP rose from 73 to 79, and diastolic pressure moved from 64 to 68. Systolic pressure ranged 62-151 and ended at 115, and SpO2 recovered to 95 after a low of 85 around hour 0.1. Respiratory rate ended at 23; the available labs showed white count fell from 13.1 to 12, creatinine fell from 1.1 to 0.8, lactate fell from 211 to 0.8, and urine output fell from 300 to 30.
B. Over the available measurements, the heart rate rose from 90 to 104, MAP rose from 71 to 77, and diastolic pressure moved from 66 to 65. Systolic pressure ranged 60-136 and ended at 113, and SpO2 recovered to 97 after a low of 83 around hour 0.0. Respiratory rate ended at 24; the available labs showed white count fell from 12.0 to 11, creatinine fell from 1.2 to 0.7, lactate fell from 196 to 0.9, and urine output fell from 285 to 28.
C. Over the available measurements, the heart rate rose from 96 to 97, MAP rose from 77 to 83, and diastolic pressure moved from 60 to 72. Systolic pressure ranged 66-176 and ended at 119, and SpO2 recovered to 91 after a low of 84 around hour 0.2. Respiratory rate ended at 21; the available labs showed white count fell from 15.0 to 11.2, creatinine fell from 0.9 to 0.8, lactate fell from 236 to 0.7, and urine output fell from 350 to 34.
D. Over the available measurements, the heart rate rose from 88 to 106, MAP rose from 68 to 82, and diastolic pressure moved from 68 to 64. Systolic pressure ranged 58-121 and ended at 111, and SpO2 recovered to 100 after a low of 80 around hour 1.1. Respiratory rate ended at 25; the available labs showed white count fell from 10.8 to 10, creatinine fell from 1.4 to 0.7, lactate fell from 181 to 1.0, and urine output fell from 270 to 26.

Answer: A


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 115 to 100, diastolic pressure fell from 108 to 86, and heart rate fell from 114 to 97. The lowest MAP was about 73 around hour 35, and the lowest valid SpO2 was 91 around hour 10; respiratory rate rose as high as 37 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.4-34.6 C, white count was roughly stable (12.7 to 10.3), creatinine fell from 1.4 to 1.0, lactate fell from 3.8 to 2.8, and urine output rose from 760 to 1010.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 110 to 105, diastolic pressure fell from 103 to 87, and heart rate fell from 149 to 103. The lowest MAP was about 68 around hour 36, and the lowest valid SpO2 was 86 around hour 10; respiratory rate rose as high as 32 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 38.6-39.9 C, white count was roughly stable (10.1 to 12.9), creatinine fell from 1.0 to 0.8, lactate fell from 4.7 to 2.5, and urine output rose from 725 to 1150.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 116 to 99, diastolic pressure fell from 109 to 93, and heart rate fell from 109 to 96. The lowest MAP was about 74 around hour 30, and the lowest valid SpO2 was 92 around hour 9; respiratory rate rose as high as 36 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 32.6-33.9 C, white count was roughly stable (13.1 to 9.9), creatinine fell from 1.4 to 1, lactate fell from 3.7 to 2.9, and urine output rose from 765 to 1140.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 112 to 103, diastolic pressure fell from 105 to 89, and heart rate fell from 134 to 100. The lowest MAP was about 70 around hour 34, and the lowest valid SpO2 was 88 around hour 11; respiratory rate rose as high as 34 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 36.4-37.6 C, white count was roughly stable (11.2 to 11.8), creatinine fell from 1.2 to 0.9, lactate fell from 4.3 to 2.6, and urine output rose from 740 to 1090.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 112 to 103, diastolic pressure fell from 105 to 89, and heart rate fell from 134 to 100. The lowest MAP was about 70 around hour 34, and the lowest valid SpO2 was 88 around hour 11; respiratory rate rose as high as 34 but ended at 16. The lower-frequency data fit that summary: temperature ranged from 97.5 to 99.7, white count was roughly stable (11.2 to 11.8), creatinine fell from 1.2 to 0.9, lactate fell from 4.3 to 2.6, and urine output rose from 740 to 1090.


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 rose from 137 to 149, MAP fell from 112 to 103, and heart rate fell from 134 to 100. SpO2 started at 100, ended at 95, and fell as low as 88 around hour 11; respiratory rate ranged 6-34. For labs and output, white count was roughly stable (11.2 to 11.8), creatinine fell from 1.2 to 0.9, lactate fell from 4.3 to 2.6, and urine output rose from 740 to 1090.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 122 to 164, MAP fell from 110 to 101, and heart rate fell from 149 to 103. SpO2 started at 98, ended at 93, and fell as low as 86 around hour 12; respiratory rate ranged 6-36. For labs and output, white count was roughly stable (12.3 to 11), creatinine fell from 1.0 to 0.8, lactate fell from 3.9 to 2.5, and urine output rose from 755 to 1030.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 162 to 182, MAP fell from 116 to 107, and heart rate fell from 109 to 96. SpO2 started at 96, ended at 99, and fell as low as 92 around hour 9; respiratory rate ranged 7-30. For labs and output, white count was roughly stable (9.3 to 13.7), creatinine fell from 1.4 to 1, lactate fell from 4.5 to 2.9, and urine output rose from 715 to 1190.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 107 to 145, MAP fell from 108 to 106, and heart rate fell from 164 to 96. SpO2 started at 96, ended at 90, and fell as low as 87 around hour 13; respiratory rate ranged 5-38. For labs and output, white count was roughly stable (13.4 to 9.6), creatinine fell from 0.9 to 0.7, lactate fell from 3.5 to 2.3, and urine output rose from 770 to 970.

Answer: A


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

Options:
A. Taken together, the heart rate rose from 68 to 74, while MAP was roughly stable (91 to 93). Systolic pressure was labile, ranging 92-130, with the lowest value around hour 17.9. SpO2 briefly dipped to 88 around hour 3 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 was roughly stable (8.6 to 10.2), creatinine stayed around 1.0, lactate was not available, and urine output fell from 380 to 200, with recorded outputs ranging 220-520.
B. Taken together, the heart rate rose from 65 to 77, while MAP was roughly stable (88 to 90). Systolic pressure was labile, ranging 95-150, with the lowest value around hour 16.4. SpO2 briefly dipped to 85 around hour 2 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 was roughly stable (9.1 to 9.7), creatinine stayed around 0.9, lactate was not available, and urine output fell from 400 to 250, with recorded outputs ranging 200-500.
C. Taken together, the heart rate rose from 69 to 73, while MAP was roughly stable (92 to 94). Systolic pressure was labile, ranging 91-125, with the lowest value around hour 18.3. SpO2 briefly dipped to 89 around hour 2 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 was roughly stable (8.5 to 8.9), creatinine was roughly stable (1.0 to 1), lactate was not available, and urine output fell from 400 to 250, with recorded outputs ranging 250-500.
D. Taken together, the heart rate rose from 60 to 82, while MAP was roughly stable (84 to 86). Systolic pressure was labile, ranging 99-180, with the lowest value around hour 14.1. SpO2 briefly dipped to 86 around hour 2 before recovering to 100, while respiratory rate peaked at 28 and later settled at 19. The associated labs and urine output showed that white count was roughly stable (9.8 to 8.9), creatinine stayed around 0.8, lactate was not available, and urine output fell from 430 to 220, with recorded outputs ranging 170-470.

Answer: B


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

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (142 to 115), MAP was roughly stable (91 to 93), and heart rate rose from 62 to 80. SpO2 started at 95, ended at 96, and fell as low as 88 around hour 2; respiratory rate ranged 14-24. For labs and output, white count was roughly stable (8.6 to 10.2), creatinine was roughly stable (1.0 to 1), lactate was not available, and urine output fell from 400 to 250.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (107 to 120), MAP was roughly stable (86 to 88), and heart rate rose from 67 to 80. SpO2 started at 100, ended at 93, and fell as low as 83 around hour 2; respiratory rate ranged 12-28. For labs and output, white count was roughly stable (9.5 to 8.9), creatinine stayed around 0.8, lactate was not available, and urine output fell from 415 to 235.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 147 to 114, MAP was roughly stable (92 to 93), and heart rate rose from 61 to 81. SpO2 started at 94, ended at 99, and fell as low as 84 around hour 2; respiratory rate ranged 15-24. For labs and output, white count was roughly stable (8.5 to 10.3), creatinine stayed around 1.0, lactate was not available, and urine output fell from 375 to 275.
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (122 to 118), MAP was roughly stable (88 to 90), and heart rate rose from 65 to 77. SpO2 started at 98, ended at 95, and fell as low as 85 around hour 2; respiratory rate ranged 13-26. For labs and output, white count was roughly stable (9.1 to 9.7), creatinine stayed around 0.9, lactate was not available, and urine output fell from 400 to 250.

Answer: D


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

Options:
A. In broad terms, the heart rate rose from 65 to 77, MAP was roughly stable (88 to 90), and diastolic pressure moved from 81 to 84. Systolic pressure ranged 95-150 and ended at 118, and SpO2 recovered to 95 after a low of 85 around hour 2. Respiratory rate ended at 21; the available labs showed white count was roughly stable (9.1 to 9.7), creatinine stayed around 0.9, lactate was not available, and urine output fell from 400 to 250.
B. In broad terms, the heart rate rose from 63 to 79, MAP was roughly stable (86 to 93), and diastolic pressure moved from 83 to 82. Systolic pressure ranged 93-135 and ended at 114, and SpO2 recovered to 97 after a low of 83 around hour 3. Respiratory rate ended at 22; the available labs showed white count was roughly stable (8.7 to 9.3), creatinine stayed around 1.0, lactate was not available, and urine output fell from 385 to 235.
C. In broad terms, the heart rate rose from 69 to 73, MAP was roughly stable (92 to 94), and diastolic pressure moved from 77 to 88. Systolic pressure ranged 99-175 and ended at 122, and SpO2 recovered to 91 after a low of 84 around hour 2. Respiratory rate ended at 19; the available labs showed white count was roughly stable (9.7 to 8.9), creatinine stayed around 0.8, lactate was not available, and urine output fell from 450 to 275.
D. In broad terms, the heart rate rose from 60 to 80, MAP was roughly stable (84 to 86), and diastolic pressure moved from 86 to 81. Systolic pressure ranged 90-120 and ended at 114, and SpO2 recovered to 100 after a low of 80 around hour 2. Respiratory rate ended at 23; the available labs showed white count was roughly stable (8.3 to 8.9), creatinine stayed around 1.1, lactate was not available, and urine output fell from 370 to 220.

Answer: A


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 (104 to 107), MAP stayed around 82, and heart rate fell from 94 to 67. SpO2 started at 100, ended at 99, and fell as low as 88 around hour 3.6; respiratory rate ranged 8-27. For labs and output, white count fell from 19.2 to 12.2, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 200 to 500.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (102 to 103), MAP was roughly stable (80 to 85), and heart rate fell from 94 to 67. SpO2 started at 100, ended at 99, and fell as low as 87 around hour 3.6; respiratory rate ranged 8-27. For labs and output, white count fell from 19.2 to 12.2, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 200 to 500.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (108 to 103), MAP stayed around 86, and heart rate fell from 98 to 63. SpO2 started at 96, ended at 95, and fell as low as 92 around hour 4.2; respiratory rate ranged 7-29. For labs and output, white count fell from 21.1 to 10.3, creatinine stayed around 0.6, lactate was not available, and urine output rose from 200 to 500.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (100 to 112), MAP stayed around 78, and heart rate fell from 90 to 70. SpO2 started at 96, ended at 100, and fell as low as 84 around hour 2.9; respiratory rate ranged 9-29. For labs and output, white count fell from 16.9 to 11.4, creatinine was roughly stable (0.3 to 0.2), lactate was not available, and urine output rose from 230 to 470.

Answer: A


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

Options:
A. For handoff, the heart rate fell from 97 to 64, MAP stayed around 85, and diastolic pressure moved from 69 to 68. Systolic pressure ranged 90-106 and ended at 104, and SpO2 recovered to 100 after a low of 87 around hour 4.1. Respiratory rate ended at 16; the available labs showed white count fell from 17.7 to 11.4, creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output was roughly stable (250 to 520)
B. For handoff, the heart rate fell from 94 to 67, MAP stayed around 82, and diastolic pressure moved from 66 to 71. Systolic pressure ranged 87-126 and ended at 107, and SpO2 recovered to 99 after a low of 88 around hour 3.6. Respiratory rate ended at 15; the available labs showed white count fell from 19.2 to 12.2, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 200 to 500.
C. For handoff, the heart rate fell from 98 to 70, MAP stayed around 86, and diastolic pressure moved from 70 to 68. Systolic pressure ranged 91-101 and ended at 103, and SpO2 recovered to 100 after a low of 84 around hour 4.2. Respiratory rate ended at 17; the available labs showed white count fell from 17.3 to 14.1, creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output rose from 225 to 525.
D. For handoff, the heart rate fell from 90 to 72, MAP was roughly stable (78 to 85), and diastolic pressure moved from 66 to 71. Systolic pressure ranged 87-126 and ended at 103, and SpO2 recovered to 99 after a low of 88 around hour 4.6. Respiratory rate ended at 15; the available labs showed white count fell from 19.2 to 12.2, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 200 to 500.

Answer: B


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

Options:
A. For handoff, the heart rate fell from 100 to 84, while MAP fell from 94 to 73. Systolic pressure was labile, ranging 91-135, with the lowest value around hour 28. SpO2 briefly dipped to 86 around hour 15.1 before recovering to 90, while respiratory rate peaked at 30 and later settled at 22. The associated labs and urine output showed that white count was roughly stable (9.6 to 12.4), creatinine stayed around 1.0, lactate was checked once at 254, and urine output was roughly stable (220 to 250), with recorded outputs ranging 130-330.
B. For handoff, the heart rate fell from 97 to 89, while MAP fell from 89 to 68. Systolic pressure was labile, ranging 98-170, with the lowest value around hour 25. SpO2 briefly dipped to 84 around hour 13.0 before recovering to 95, while respiratory rate peaked at 30 and later settled at 19. The associated labs and urine output showed that white count was roughly stable (12.2 to 9.8), creatinine stayed around 0.8, lactate was checked once at 289, and urine output rose from 185 to 285, with recorded outputs ranging 165-365.
C. For handoff, the heart rate fell from 100 to 83, while MAP fell from 95 to 74. Systolic pressure was labile, ranging 90-130, with the lowest value around hour 28. SpO2 briefly dipped to 87 around hour 16.0 before recovering to 89, while respiratory rate peaked at 30 and later settled at 22. The associated labs and urine output showed that white count was roughly stable (9.2 to 10.1), creatinine was roughly stable (1.0 to 1), lactate was checked once at 274, and urine output rose from 200 to 300, with recorded outputs ranging 200-350.
D. For handoff, the heart rate fell from 99 to 87, while MAP fell from 91 to 70. Systolic pressure was labile, ranging 94-155, with the lowest value around hour 26. SpO2 briefly dipped to 83 around hour 14.1 before recovering to 93, while respiratory rate peaked at 28 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (11.1 to 10.9), creatinine stayed around 0.9, lactate was checked once at 274, and urine output rose from 200 to 300, with recorded outputs ranging 150-350.

Answer: D


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

Options:
A. Across the recorded window, the heart rate fell from 100 to 84, MAP fell from 94 to 73, and diastolic pressure moved from 76 to 57. Systolic pressure ranged 97-175 and ended at 122, and SpO2 recovered to 90 after a low of 82 around hour 15.6. Respiratory rate ended at 18; the available labs showed white count was roughly stable (12.6 to 10.1), creatinine stayed around 0.8, lactate was checked once at 294, and urine output was roughly stable (250 to 280)
B. Across the recorded window, the heart rate fell from 97 to 90, MAP fell from 89 to 68, and diastolic pressure moved from 81 to 51. Systolic pressure ranged 92-140 and ended at 117, and SpO2 recovered to 95 after a low of 81 around hour 13.0. Respiratory rate ended at 21; the available labs showed white count was roughly stable (10.0 to 9.8), creatinine stayed around 1.0, lactate was checked once at 259, and urine output rose from 185 to 315.
C. Across the recorded window, the heart rate fell from 99 to 87, MAP fell from 91 to 70, and diastolic pressure moved from 79 to 54. Systolic pressure ranged 94-155 and ended at 119, and SpO2 recovered to 93 after a low of 83 around hour 14.1. Respiratory rate ended at 20; the available labs showed white count was roughly stable (11.1 to 10.9), creatinine stayed around 0.9, lactate was checked once at 274, and urine output rose from 200 to 300.
D. Across the recorded window, the heart rate fell from 94 to 92, MAP fell from 86 to 73, and diastolic pressure moved from 84 to 50. Systolic pressure ranged 90-125 and ended at 115, and SpO2 recovered to 98 after a low of 78 around hour 15.1. Respiratory rate ended at 22; the available labs showed white count was roughly stable (8.8 to 8.7), creatinine stayed around 1.1, lactate was checked once at 244, and urine output rose from 170 to 330.

Answer: C


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

Options:
A. Over the available measurements, the heart rate rose from 96 to 110, MAP rose from 51 to 74, and diastolic pressure moved from 43 to 50. Systolic pressure ranged 74-188 and ended at 141, and SpO2 recovered to 96 after a low of 85 around hour 2.1. Respiratory rate ended at 27; the available labs showed white count rose from 25 to 362, creatinine fell from 1.8 to 0.8, lactate rose from 1.6 to 288, and urine output rose from 20 to 100.
B. Over the available measurements, the heart rate rose from 94 to 112, MAP rose from 49 to 77, and diastolic pressure moved from 45 to 48. Systolic pressure ranged 72-173 and ended at 137, and SpO2 recovered to 98 after a low of 83 around hour 3.1. Respiratory rate ended at 28; the available labs showed white count rose from 24 to 347, creatinine fell from 2.0 to 0.7, lactate rose from 1.5 to 303, and urine output rose from 19 to 98.
C. Over the available measurements, the heart rate rose from 100 to 106, MAP rose from 55 to 78, and diastolic pressure moved from 39 to 54. Systolic pressure ranged 78-213 and ended at 166, and SpO2 recovered to 92 after a low of 84 around hour 2.4. Respiratory rate ended at 25; the available labs showed white count rose from 27 to 361.2, creatinine fell from 1.6 to 0.9, lactate rose from 1.9 to 263, and urine output was roughly stable (70 to 96)
D. Over the available measurements, the heart rate rose from 92 to 113, MAP rose from 46 to 70, and diastolic pressure moved from 48 to 47. Systolic pressure ranged 70-158 and ended at 111, and SpO2 recovered to 100 after a low of 80 around hour 1.8. Respiratory rate ended at 29; the available labs showed white count rose from 23 to 332, creatinine fell from 2.1 to 0.7, lactate rose from 1.3 to 318, and urine output rose from 18 to 96.

Answer: A


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

Options:
A. Over the available measurements, the heart rate stayed around 63, while MAP was roughly stable (69 to 75). Systolic pressure was labile, ranging 90-91, with the lowest value around hour 4.4. SpO2 briefly dipped to 93 around hour 238.4 before recovering to 98, while respiratory rate peaked at 14 and later settled at 16. The associated labs and urine output showed that white count rose from 6 to 9, creatinine was roughly stable (2.1 to 1.4), lactate rose from 2.4 to 490, and urine output was not recorded.
B. Over the available measurements, the heart rate was roughly stable (58 to 63), while MAP stayed around 72. Systolic pressure was labile, ranging 90-91, with the lowest value around hour 4.4. SpO2 briefly dipped to 93 around hour 237.4 before recovering to 98, while respiratory rate peaked at 17 and later settled at 16. The associated labs and urine output showed that white count rose from 6 to 8.2, creatinine was roughly stable (2.1 to 1.5), lactate rose from 2.4 to 490, and urine output was not recorded.
C. Over the available measurements, the heart rate stayed around 60, while MAP stayed around 72. Systolic pressure was labile, ranging 90-91, with the lowest value around hour 4.4. SpO2 briefly dipped to 93 around hour 237.4 before recovering to 98, while respiratory rate peaked at 16 and later settled at 16. The associated labs and urine output showed that white count rose from 6 to 9, creatinine was roughly stable (2.1 to 1.4), lactate rose from 2.4 to 490, and urine output was not recorded.
D. Over the available measurements, the heart rate stayed around 56, while MAP stayed around 76. Systolic pressure was labile, ranging 86-94, with the lowest value around hour 5.2. SpO2 briefly dipped to 94 around hour 267.4 before recovering to 94, while respiratory rate peaked at 18 and later settled at 18. The associated labs and urine output showed that white count rose from 5 to 8, creatinine was roughly stable (2.4 to 1.1), lactate rose from 2.1 to 520, and urine output was not recorded.

Answer: C


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (90 to 91), MAP stayed around 72, and heart rate stayed around 60. SpO2 started at 99, ended at 98, and fell as low as 93 around hour 237.4; respiratory rate ranged 16-16. For labs and output, white count rose from 6 to 9, creatinine was roughly stable (2.1 to 1.4), lactate rose from 2.4 to 490, and urine output was not recorded.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (88 to 93), MAP was roughly stable (75 to 72), and heart rate stayed around 60. SpO2 started at 99, ended at 98, and fell as low as 93 around hour 237.4; respiratory rate ranged 16-18. For labs and output, white count rose from 6 to 9, creatinine was roughly stable (2.1 to 1.5), lactate rose from 2.6 to 490, and urine output was not recorded.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (94 to 87), MAP was roughly stable (76 to 75), and heart rate stayed around 60. SpO2 started at 99, ended at 98, and fell as low as 92 around hour 237.4; respiratory rate ranged 16-18. For labs and output, white count rose from 6 to 9, creatinine was roughly stable (2.1 to 1.4), lactate rose from 2.4 to 490, and urine output was not recorded.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (86 to 96), MAP stayed around 68, and heart rate was roughly stable (56 to 63). SpO2 started at 99, ended at 98, and fell as low as 93 around hour 237.4; respiratory rate ranged 16-18. For labs and output, white count rose from 6 to 8.2, creatinine was roughly stable (2.1 to 1.4), lactate rose from 2.4 to 490, and urine output was not recorded.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate stayed around 63, MAP stayed around 69, and diastolic pressure moved from 70 to 57. Systolic pressure ranged 87-88 and ended at 94, and SpO2 recovered to 100 after a low of 92 around hour 217.4. Respiratory rate ended at 18; the available labs showed white count rose from 6 to 8.2, creatinine was roughly stable (2.3 to 1.6), lactate rose from 2.2 to 510, and urine output was not recorded.
B. Viewed chronologically, the heart rate stayed around 60, MAP stayed around 72, and diastolic pressure moved from 67 to 54. Systolic pressure ranged 90-91 and ended at 91, and SpO2 recovered to 98 after a low of 93 around hour 237.4. Respiratory rate ended at 16; the available labs showed white count rose from 6 to 9, creatinine was roughly stable (2.1 to 1.4), lactate rose from 2.4 to 490, and urine output was not recorded.
C. Viewed chronologically, the heart rate stayed around 64, MAP was roughly stable (68 to 75), and diastolic pressure moved from 67 to 54. Systolic pressure ranged 87-91 and ended at 87, and SpO2 recovered to 98 after a low of 93 around hour 238.4. Respiratory rate ended at 16; the available labs showed white count rose from 6 to 9, creatinine was roughly stable (2.1 to 1.4), lactate rose from 2.4 to 490, and urine output was not recorded.
D. Viewed chronologically, the heart rate was roughly stable (56 to 63), MAP stayed around 72, and diastolic pressure moved from 67 to 51. Systolic pressure ranged 90-91 and ended at 91, and SpO2 recovered to 98 after a low of 93 around hour 237.4. Respiratory rate ended at 16; the available labs showed white count rose from 6 to 9, creatinine was roughly stable (2.1 to 1.4), lactate rose from 2.4 to 490, and urine output was not recorded.

Answer: B


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 143 to 154, MAP rose from 94 to 104, 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 9-33. For labs and output, white count was roughly stable (18.2 to 17.8), creatinine was roughly stable (0.7 to 0.6), lactate was not available, and urine output fell from 5090 to 1.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 128 to 158, MAP rose from 92 to 102, and heart rate stayed around 52. SpO2 started at 86, ended at 90, and fell as low as 86 around hour 0.0; respiratory rate ranged 9-35. For labs and output, white count was roughly stable (17.1 to 18.9), creatinine stayed around 0.6, lactate was not available, and urine output fell from 5090 to 1.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 168 to 188, MAP rose from 98 to 107, 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 8-29. For labs and output, white count was roughly stable (20.1 to 15.9), creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output fell from 4990 to 1.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 113 to 184, MAP rose from 90 to 100, and heart rate was roughly stable (54 to 53). SpO2 started at 92, ended at 84, and fell as low as 88 around hour 0.1; respiratory rate ranged 9-35. For labs and output, white count fell from 18.2 to 17, creatinine was roughly stable (0.7 to 0.6), lactate was not available, and urine output fell from 5090 to 1.

Answer: A


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

Options:
A. For handoff, the heart rate fell from 118 to 97, while MAP rose from 84 to 117. Systolic pressure was labile, ranging 123-176, with the lowest value around hour 4. SpO2 briefly dipped to 86 around hour 0.6 before recovering to 94, while respiratory rate peaked at 39 and later settled at 14. The associated labs and urine output showed that white count rose from 1 to 7.6, creatinine fell from 2 to 0.8, lactate stayed broadly stable from 2.0 to 2, and urine output fell from 580 to 320, with recorded outputs ranging 170-795.
B. For handoff, the heart rate fell from 113 to 98, while MAP rose from 79 to 117. Systolic pressure was labile, ranging 121-211, with the lowest value around hour 4. SpO2 briefly dipped to 83 around hour 1.5 before recovering to 99, while respiratory rate peaked at 35 and later settled at 11. The associated labs and urine output showed that white count rose from 1 to 6.7, creatinine fell from 2 to 1.0, lactate stayed broadly stable from 1.6 to 2, and urine output fell from 615 to 250, with recorded outputs ranging 135-760.
C. For handoff, the heart rate fell from 119 to 96, while MAP rose from 85 to 118. Systolic pressure was labile, ranging 115-171, with the lowest value around hour 5. SpO2 briefly dipped to 89 around hour 0.6 before recovering to 93, while respiratory rate peaked at 41 and later settled at 14. The associated labs and urine output showed that white count rose from 1 to 6.3, creatinine fell from 2 to 1, lactate stayed broadly stable from 2.0 to 2, and urine output fell from 575 to 325, with recorded outputs ranging 200-800.
D. For handoff, the heart rate fell from 115 to 100, while MAP rose from 81 to 114. Systolic pressure was labile, ranging 119-196, with the lowest value around hour 4. SpO2 briefly dipped to 85 around hour 0.5 before recovering to 97, while respiratory rate peaked at 37 and later settled at 12. The associated labs and urine output showed that white count rose from 1 to 7.1, creatinine fell from 2 to 0.9, lactate stayed broadly stable from 1.8 to 2, and urine output fell from 600 to 300, with recorded outputs ranging 150-775.

Answer: D


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

Options:
A. Across the recorded window, the heart rate fell from 118 to 97, MAP rose from 84 to 117, and diastolic pressure moved from 74 to 105. Systolic pressure ranged 122-216 and ended at 189, and SpO2 recovered to 94 after a low of 84 around hour 0.6. Respiratory rate ended at 10; the available labs showed white count rose from 1 to 6.3, creatinine fell from 2 to 1.0, lactate stayed broadly stable from 2.0 to 2, and urine output fell from 650 to 320.
B. Across the recorded window, the heart rate fell from 113 to 103, MAP rose from 79 to 112, and diastolic pressure moved from 79 to 99. Systolic pressure ranged 117-181 and ended at 154, and SpO2 recovered to 99 after a low of 83 around hour 0.4. Respiratory rate ended at 13; the available labs showed white count rose from 1 to 6.7, creatinine fell from 2 to 0.8, lactate stayed broadly stable from 1.6 to 2, and urine output fell from 585 to 285.
C. Across the recorded window, the heart rate fell from 115 to 100, MAP rose from 81 to 114, and diastolic pressure moved from 77 to 102. Systolic pressure ranged 119-196 and ended at 169, and SpO2 recovered to 97 after a low of 85 around hour 0.5. Respiratory rate ended at 12; the available labs showed white count rose from 1 to 7.1, creatinine fell from 2 to 0.9, lactate stayed broadly stable from 1.8 to 2, and urine output fell from 600 to 300.
D. Across the recorded window, the heart rate fell from 110 to 96, MAP rose from 76 to 117, and diastolic pressure moved from 82 to 98. Systolic pressure ranged 114-166 and ended at 165, and SpO2 recovered to 100 after a low of 80 around hour 1.5. Respiratory rate ended at 14; the available labs showed white count rose from 1 to 6.3, creatinine fell from 2 to 0.8, lactate stayed broadly stable from 1.5 to 2, and urine output fell from 570 to 270.

Answer: C


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 68 to 54, diastolic pressure fell from 55 to 41, and heart rate rose from 64 to 75. The lowest MAP was about 59 around hour 31.7, and the lowest valid SpO2 was 88 around hour 5.4; respiratory rate rose as high as 24 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 33.6-35.6 C, white count rose from 4 to 8.8, creatinine rose from 5.4 to 6.6, lactate was not available, and urine output was roughly stable (105 to 97)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 65 to 57, diastolic pressure fell from 52 to 38, and heart rate was roughly stable (67 to 72). The lowest MAP was about 56 around hour 34.7, and the lowest valid SpO2 was 85 around hour 6.4; respiratory rate rose as high as 23 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 36.6-38.6 C, white count rose from 4 to 9.3, creatinine rose from 4.9 to 6.1, lactate was not available, and urine output was roughly stable (125 to 100)
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 69 to 53, diastolic pressure fell from 56 to 35, and heart rate was roughly stable (63 to 76). The lowest MAP was about 57 around hour 35.7, and the lowest valid SpO2 was 89 around hour 5.8; respiratory rate rose as high as 25 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 32.9-34.9 C, white count rose from 5 to 8.7, creatinine rose from 5.5 to 6.7, lactate was not available, and urine output was roughly stable (100 to 96)
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 60 to 57, diastolic pressure fell from 48 to 34, and heart rate was roughly stable (72 to 68). The lowest MAP was about 52 around hour 39.2, and the lowest valid SpO2 was 80 around hour 7.2; respiratory rate rose as high as 25 but ended at 10. The lower-frequency data fit that summary: temperature stayed around 41.1-43.1 C, white count rose from 3 to 10.1, creatinine rose from 4.2 to 6.2, lactate was not available, and urine output was roughly stable (155 to 150)

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 65 to 57, diastolic pressure fell from 52 to 38, and heart rate was roughly stable (67 to 72). The lowest MAP was about 56 around hour 34.7, and the lowest valid SpO2 was 85 around hour 6.4; respiratory rate rose as high as 23 but ended at 12. The lower-frequency data fit that summary: temperature ranged from 97.8 to 101.5, white count rose from 4 to 9.3, creatinine rose from 4.9 to 6.1, lactate was not available, and urine output was roughly stable (125 to 100)


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

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 105 to 114, MAP fell from 68 to 60, and heart rate was roughly stable (64 to 75). SpO2 started at 97, ended at 100, and fell as low as 88 around hour 5.9; respiratory rate ranged 12-22. For labs and output, white count rose from 4 to 9.8, creatinine rose from 5.4 to 6.2, lactate was not available, and urine output was roughly stable (145 to 97)
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 99 to 113, MAP was roughly stable (63 to 60), and heart rate was roughly stable (69 to 70). SpO2 started at 98, ended at 97, and fell as low as 84 around hour 6.8; respiratory rate ranged 9-24. For labs and output, white count rose from 4 to 8.9, creatinine rose from 4.5 to 6.5, lactate was not available, and urine output was roughly stable (110 to 98)
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 101 to 117, MAP fell from 65 to 57, and heart rate was roughly stable (67 to 72). SpO2 started at 100, ended at 99, and fell as low as 85 around hour 6.4; respiratory rate ranged 10-23. For labs and output, white count rose from 4 to 9.3, creatinine rose from 4.9 to 6.1, lactate was not available, and urine output was roughly stable (125 to 100)
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 96 to 122, MAP fell from 60 to 52, and heart rate rose from 72 to 75. SpO2 started at 96, ended at 94, and fell as low as 80 around hour 7.2; respiratory rate ranged 8-25. For labs and output, white count rose from 5 to 8.5, creatinine rose from 4.2 to 6.8, lactate was not available, and urine output was roughly stable (95 to 96)

Answer: C


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

Options:
A. Clinically, the heart rate was roughly stable (70 to 69), MAP was roughly stable (68 to 60), and diastolic pressure moved from 49 to 41. Systolic pressure ranged 99-196 and ended at 113, and SpO2 recovered to 96 after a low of 88 around hour 7.4. Respiratory rate ended at 10; the available labs showed white count rose from 4 to 9.8, creatinine rose from 4.4 to 6.6, lactate was not available, and urine output was roughly stable (145 to 97)
B. Clinically, the heart rate was roughly stable (65 to 74), MAP fell from 63 to 55, and diastolic pressure moved from 54 to 36. Systolic pressure ranged 94-161 and ended at 115, and SpO2 recovered to 100 after a low of 84 around hour 6.0. Respiratory rate ended at 13; the available labs showed white count rose from 4 to 8.5, creatinine rose from 5.3 to 5.7, lactate was not available, and urine output was roughly stable (175 to 98)
C. Clinically, the heart rate rose from 71 to 75, MAP fell from 69 to 61, and diastolic pressure moved from 48 to 35. Systolic pressure ranged 100-201 and ended at 121, and SpO2 recovered to 95 after a low of 89 around hour 7.0. Respiratory rate ended at 10; the available labs showed white count rose from 5 to 9.9, creatinine rose from 4.3 to 6.7, lactate was not available, and urine output was roughly stable (150 to 96)
D. Clinically, the heart rate was roughly stable (67 to 72), MAP fell from 65 to 57, and diastolic pressure moved from 52 to 38. Systolic pressure ranged 96-176 and ended at 117, and SpO2 recovered to 99 after a low of 85 around hour 6.4. Respiratory rate ended at 12; the available labs showed white count rose from 4 to 9.3, creatinine rose from 4.9 to 6.1, lactate was not available, and urine output was roughly stable (125 to 100)

Answer: D


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

Options:
A. Clinically, the heart rate rose from 83 to 89, while MAP fell from 82 to 72. Systolic pressure was labile, ranging 104-136, with the lowest value around hour 4.2. SpO2 briefly dipped to 86 around hour 1.9 before recovering to 93, while respiratory rate peaked at 43 and later settled at 20. The associated labs and urine output showed that white count rose from 12 to 19.3, creatinine rose from 0.8 to 0.9, lactate fell from 2 to 1.7, and urine output was roughly stable (280 to 370), with recorded outputs ranging 33-770.
B. Clinically, the heart rate rose from 80 to 92, while MAP fell from 79 to 69. Systolic pressure was labile, ranging 100-156, with the lowest value around hour 3.7. SpO2 briefly dipped to 85 around hour 1.7 before recovering to 96, while respiratory rate peaked at 41 and later settled at 18. The associated labs and urine output showed that white count rose from 14 to 17.8, creatinine rose from 0.7 to 0.9, lactate fell from 2 to 1.5, and urine output was roughly stable (300 to 350), with recorded outputs ranging 30-750.
C. Clinically, the heart rate rose from 84 to 88, while MAP fell from 83 to 73. Systolic pressure was labile, ranging 96-131, with the lowest value around hour 4.3. SpO2 briefly dipped to 89 around hour 1.9 before recovering to 92, while respiratory rate peaked at 45 and later settled at 20. The associated labs and urine output showed that white count rose from 12 to 17, creatinine rose from 0.8 to 1, lactate fell from 2 to 1.8, and urine output was roughly stable (275 to 375), with recorded outputs ranging 80-775.
D. Clinically, the heart rate rose from 76 to 96, while MAP fell from 74 to 72. Systolic pressure was labile, ranging 96-186, with the lowest value around hour 3.0. SpO2 briefly dipped to 80 around hour 2.7 before recovering to 100, while respiratory rate peaked at 36 and later settled at 16. The associated labs and urine output showed that white count rose from 16 to 17.5, creatinine rose from 0.5 to 1.1, lactate fell from 2 to 1.2, and urine output stayed around 330, with recorded outputs ranging 30-750.

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 146 to 111, MAP fell from 82 to 72, and heart rate rose from 77 to 95. SpO2 started at 96, ended at 99, and fell as low as 88 around hour 1.5; respiratory rate ranged 10-38. For labs and output, white count rose from 12 to 19.3, creatinine rose from 0.8 to 1, lactate fell from 2.2 to 1.7, and urine output was roughly stable (280 to 370)
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 111 to 108, MAP fell from 77 to 67, and heart rate rose from 82 to 95. SpO2 started at 100, ended at 94, and fell as low as 83 around hour 1.9; respiratory rate ranged 9-43. For labs and output, white count rose from 15 to 17, creatinine rose from 0.6 to 1.0, lactate fell from 2 to 1.4, and urine output was roughly stable (315 to 335)
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 151 to 110, MAP fell from 83 to 72, and heart rate rose from 76 to 96. SpO2 started at 95, ended at 100, and fell as low as 84 around hour 1.4; respiratory rate ranged 10-37. For labs and output, white count rose from 12 to 19.7, creatinine rose from 0.8 to 0.9, lactate fell from 2 to 1.8, and urine output was roughly stable (275 to 375)
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 126 to 114, MAP fell from 79 to 69, and heart rate rose from 80 to 92. SpO2 started at 99, ended at 96, and fell as low as 85 around hour 1.7; respiratory rate ranged 9-41. For labs and output, white count rose from 14 to 17.8, creatinine rose from 0.7 to 0.9, lactate fell from 2 to 1.5, and urine output was roughly stable (300 to 350)

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 rose from 53 to 83, while MAP rose from 80 to 94. Systolic pressure was labile, ranging 86-106, with the lowest value around hour 8.6. SpO2 briefly dipped to 91 around hour 0.8 before recovering to 94, while respiratory rate peaked at 36 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (12.3 to 14.6), creatinine was roughly stable (1.7 to 1), lactate stayed broadly stable from 1.6 to 1.9, and urine output fell from 180 to 63, with recorded outputs ranging 33-275.
B. Over the available measurements, the heart rate rose from 48 to 88, while MAP rose from 75 to 89. Systolic pressure was labile, ranging 84-141, with the lowest value around hour 7.7. SpO2 briefly dipped to 86 around hour 0.6 before recovering to 99, while respiratory rate peaked at 32 and later settled at 18. The associated labs and urine output showed that white count fell from 14.9 to 12.3, creatinine was roughly stable (1.4 to 1.1), lactate stayed broadly stable from 1.2 to 1.5, and urine output fell from 215 to 58, with recorded outputs ranging 60-310.
C. Over the available measurements, the heart rate rose from 50 to 86, while MAP rose from 77 to 91. Systolic pressure was labile, ranging 82-126, with the lowest value around hour 8.1. SpO2 briefly dipped to 88 around hour 0.7 before recovering to 97, while respiratory rate peaked at 34 and later settled at 19. The associated labs and urine output showed that white count was roughly stable (13.8 to 13.1), creatinine was roughly stable (1.5 to 1), lactate stayed broadly stable from 1.4 to 1.7, and urine output fell from 200 to 60, with recorded outputs ranging 30-325.
D. Over the available measurements, the heart rate rose from 46 to 90, while MAP rose from 72 to 94. Systolic pressure was labile, ranging 86-156, with the lowest value around hour 7.3. SpO2 briefly dipped to 84 around hour 1.7 before recovering to 100, while respiratory rate peaked at 30 and later settled at 17. The associated labs and urine output showed that white count was roughly stable (16.1 to 10.8), creatinine was roughly stable (1.2 to 1), lactate stayed broadly stable from 1.1 to 1.4, and urine output fell from 230 to 10, with recorded outputs ranging 10-295.

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 rose from 100 to 126, MAP rose from 77 to 91, and heart rate rose from 50 to 86. SpO2 started at 88, ended at 97, and fell as low as 88 around hour 0.7; respiratory rate ranged 8-34. For labs and output, white count was roughly stable (13.8 to 13.1), creatinine was roughly stable (1.5 to 1), lactate stayed broadly stable from 1.4 to 1.7, and urine output fell from 200 to 60.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 98 to 141, MAP rose from 75 to 89, and heart rate rose from 52 to 84. SpO2 started at 90, ended at 95, and fell as low as 86 around hour 0.8; respiratory rate ranged 8-36. For labs and output, white count was roughly stable (14.9 to 12.0), creatinine was roughly stable (1.6 to 1.1), lactate stayed broadly stable from 1.6 to 1.5, and urine output fell from 215 to 58.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 96 to 122, MAP rose from 81 to 94, and heart rate rose from 46 to 90. SpO2 started at 84, ended at 100, and fell as low as 87 around hour 0.6; respiratory rate ranged 9-30. For labs and output, white count was roughly stable (11.9 to 15.0), creatinine was roughly stable (1.8 to 1), lactate stayed broadly stable from 1.6 to 1.9, and urine output fell from 175 to 64.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 96 to 156, MAP rose from 72 to 86, and heart rate rose from 54 to 89. SpO2 started at 92, ended at 92, and fell as low as 84 around hour 0.8; respiratory rate ranged 7-36. For labs and output, white count fell from 16.1 to 12.3, creatinine was roughly stable (1.2 to 1), lactate stayed broadly stable from 1.1 to 1.4, and urine output fell from 230 to 56.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate fell from 106 to 74, while MAP rose from 69 to 79. Systolic pressure was labile, ranging 77-111, with the lowest value around hour 28.6. SpO2 briefly dipped to 91 around hour 3.2 before recovering to 96, while respiratory rate peaked at 30 and later settled at 26. The associated labs and urine output showed that white count fell from 12.6 to 10, creatinine was roughly stable (0.8 to 0.5), lactate fell from 2476 to 2059, and urine output fell from 130 to 0, with recorded outputs ranging 0-420.
B. Viewed chronologically, the heart rate fell from 101 to 79, while MAP rose from 64 to 74. Systolic pressure was labile, ranging 82-146, with the lowest value around hour 26.0. SpO2 briefly dipped to 87 around hour 2.1 before recovering to 100, while respiratory rate peaked at 28 and later settled at 23. The associated labs and urine output showed that white count fell from 15.2 to 8.2, creatinine stayed around 0.6, lactate fell from 2396 to 1979, and urine output fell from 150 to 50, with recorded outputs ranging 48-400.
C. Viewed chronologically, the heart rate fell from 107 to 73, while MAP rose from 70 to 80. Systolic pressure was labile, ranging 84-106, with the lowest value around hour 29.0. SpO2 briefly dipped to 89 around hour 2.5 before recovering to 95, while respiratory rate peaked at 31 and later settled at 26. The associated labs and urine output showed that white count fell from 12.2 to 10, creatinine was roughly stable (0.8 to 0.5), lactate fell from 2496 to 2079, and urine output fell from 125 to 54, with recorded outputs ranging 54-425.
D. Viewed chronologically, the heart rate fell from 103 to 77, while MAP rose from 66 to 76. Systolic pressure was labile, ranging 80-131, with the lowest value around hour 27.1. SpO2 briefly dipped to 88 around hour 2.2 before recovering to 99, while respiratory rate peaked at 29 and later settled at 24. The associated labs and urine output showed that white count fell from 14.1 to 9, creatinine was roughly stable (0.7 to 0.6), lactate fell from 2396 to 1979, and urine output fell from 150 to 50, with recorded outputs ranging 50-400.

Answer: D


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

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 166 to 186, MAP stayed around 108, and heart rate fell from 141 to 89. SpO2 started at 96, ended at 92, and fell as low as 88 around hour 39.3; respiratory rate ranged 8-28. For labs and output, white count fell from 19.9 to 12, creatinine fell from 1.5 to 1.1, lactate fell from 2.1 to 1.6, and urine output fell from 1380 to 180.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 131 to 175, MAP stayed around 103, and heart rate fell from 106 to 95. SpO2 started at 91, ended at 97, and fell as low as 83 around hour 34.0; respiratory rate ranged 11-31. For labs and output, white count fell from 17.3 to 12.2, creatinine fell from 1.1 to 1, lactate fell from 2.0 to 1.2, and urine output fell from 1240 to 215.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 171 to 191, MAP was roughly stable (109 to 108), and heart rate fell from 121 to 92. SpO2 started at 93, ended at 95, and fell as low as 84 around hour 36.3; respiratory rate ranged 10-29. For labs and output, white count fell from 18.4 to 13, creatinine fell from 1.3 to 1, lactate fell from 1.9 to 1.4, and urine output fell from 1300 to 200.
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 146 to 160, MAP stayed around 105, and heart rate fell from 121 to 92. SpO2 started at 93, ended at 95, and fell as low as 85 around hour 36.3; respiratory rate ranged 10-29. For labs and output, white count fell from 18.4 to 13, creatinine fell from 1.3 to 1, lactate fell from 1.9 to 1.4, and urine output fell from 1300 to 200.

Answer: D


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

Options:
A. For handoff, the heart rate rose from 83 to 102, while MAP fell from 114 to 107. Systolic pressure was labile, ranging 124-154, with the lowest value around hour 9.0. SpO2 briefly dipped to 86 around hour 0.6 before recovering to 92, while respiratory rate peaked at 21 and later settled at 16. The associated labs and urine output showed that white count was 6.0 on its only check, creatinine was 1.4 on its only check, lactate was not available, and urine output fell from 620 to 330, with recorded outputs ranging 370-580.
B. For handoff, the heart rate rose from 78 to 107, while MAP was roughly stable (109 to 107). Systolic pressure was labile, ranging 135-189, with the lowest value around hour 8.1. SpO2 briefly dipped to 83 around hour 1.5 before recovering to 97, while respiratory rate peaked at 18 and later settled at 14. The associated labs and urine output showed that white count was 6.9 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output fell from 585 to 300, with recorded outputs ranging 300-615.
C. For handoff, the heart rate rose from 84 to 108, while MAP fell from 115 to 108. Systolic pressure was labile, ranging 95-178, with the lowest value around hour 9.1. SpO2 briefly dipped to 89 around hour 0.6 before recovering to 91, while respiratory rate peaked at 21 and later settled at 17. The associated labs and urine output showed that white count was 5.9 on its only check, creatinine was 1.4 on its only check, lactate was not available, and urine output fell from 625 to 300, with recorded outputs ranging 300-575.
D. For handoff, the heart rate rose from 80 to 105, while MAP fell from 111 to 104. Systolic pressure was labile, ranging 120-174, with the lowest value around hour 8.5. SpO2 briefly dipped to 85 around hour 0.5 before recovering to 95, while respiratory rate peaked at 19 and later settled at 15. The associated labs and urine output showed that white count was 6.5 on its only check, creatinine was 1.2 on its only check, lactate was not available, and urine output fell from 600 to 350, with recorded outputs ranging 350-600.

Answer: D


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

Options:
A. Across the recorded window, the heart rate rose from 83 to 102, MAP was roughly stable (114 to 107), and diastolic pressure moved from 95 to 95. Systolic pressure ranged 140-194 and ended at 144, and SpO2 recovered to 92 after a low of 88 around hour 1.5. Respiratory rate ended at 14; the available labs showed white count was 7.0 on its only check, creatinine was 1.4 on its only check, lactate was not available, and urine output fell from 580 to 370.
B. Across the recorded window, the heart rate rose from 78 to 108, MAP fell from 109 to 102, and diastolic pressure moved from 100 to 89. Systolic pressure ranged 105-159 and ended at 133, and SpO2 recovered to 97 after a low of 83 around hour 0.4. Respiratory rate ended at 16; the available labs showed white count was 6.1 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output fell from 615 to 335.
C. Across the recorded window, the heart rate rose from 80 to 105, MAP fell from 111 to 104, and diastolic pressure moved from 98 to 92. Systolic pressure ranged 120-174 and ended at 148, and SpO2 recovered to 95 after a low of 85 around hour 0.5. Respiratory rate ended at 15; the available labs showed white count was 6.5 on its only check, creatinine was 1.2 on its only check, lactate was not available, and urine output fell from 600 to 350.
D. Across the recorded window, the heart rate rose from 76 to 110, MAP fell from 106 to 100, and diastolic pressure moved from 100 to 88. Systolic pressure ranged 90-144 and ended at 118, and SpO2 recovered to 100 after a low of 84 around hour 0.3. Respiratory rate ended at 17; the available labs showed white count was 5.8 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 650 to 320.

Answer: C


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

Options:
A. Across the recorded window, the heart rate rose from 50 to 68, while MAP was roughly stable (75 to 74). Systolic pressure was labile, ranging 116-157, with the lowest value around hour 18.9. SpO2 briefly dipped to 85 around hour 0 before recovering to 99, while respiratory rate peaked at 22 and later settled at 22. The associated labs and urine output showed that white count was roughly stable (9.1 to 8.8), creatinine stayed around 1.3, lactate was not available, and urine output rose from 0 to 950, with recorded outputs ranging 0-950.
B. Across the recorded window, the heart rate rose from 53 to 70, while MAP was roughly stable (73 to 72). Systolic pressure was labile, ranging 118-172, with the lowest value around hour 17.8. SpO2 briefly dipped to 83 around hour 0 before recovering to 100, while respiratory rate peaked at 21 and later settled at 21. The associated labs and urine output showed that white count fell from 9.5 to 8, creatinine was roughly stable (1.1 to 1.4), lactate was not available, and urine output rose from 0 to 950, with recorded outputs ranging 0-950.
C. Across the recorded window, the heart rate rose from 54 to 64, while MAP was roughly stable (79 to 78). Systolic pressure was labile, ranging 120-132, with the lowest value around hour 20.8. SpO2 briefly dipped to 89 around hour 2 before recovering to 95, while respiratory rate peaked at 24 and later settled at 24. The associated labs and urine output showed that white count was roughly stable (8.5 to 9.4), creatinine stayed around 1.6, lactate was not available, and urine output rose from 0 to 975, with recorded outputs ranging 2-975.
D. Across the recorded window, the heart rate rose from 46 to 72, while MAP was roughly stable (70 to 77). Systolic pressure was labile, ranging 120-187, with the lowest value around hour 16.6. SpO2 briefly dipped to 80 around hour 1 before recovering to 100, while respiratory rate peaked at 20 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (9.8 to 8.1), creatinine stayed around 1.0, lactate was not available, and urine output rose from 3 to 900, with recorded outputs ranging 0-920.

Answer: A


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (78 to 71), diastolic pressure was roughly stable (51 to 46), and heart rate rose from 47 to 71. The lowest MAP was about 66 around hour 13.3, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 32.1-33.8 C, white count was roughly stable (9.6 to 8.3), creatinine stayed around 1.5, lactate was not available, and urine output rose from 2 to 930.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (75 to 74), diastolic pressure was roughly stable (48 to 49), and heart rate rose from 50 to 68. The lowest MAP was about 63 around hour 12.3, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 22 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 35.1-36.8 C, white count was roughly stable (9.1 to 8.8), creatinine stayed around 1.3, lactate was not available, and urine output rose from 0 to 950.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (79 to 70), diastolic pressure was roughly stable (52 to 53), and heart rate rose from 46 to 72. The lowest MAP was about 67 around hour 10.4, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 31.4-33.0 C, white count was roughly stable (9.7 to 8.2), creatinine was roughly stable (1.6 to 1.4), lactate was not available, and urine output rose from 0 to 1000.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (70 to 78), diastolic pressure was roughly stable (44 to 44), and heart rate rose from 54 to 71. The lowest MAP was about 58 around hour 14.6, and the lowest valid SpO2 was 80 around hour 3; respiratory rate rose as high as 20 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 39.6-41.3 C, white count was roughly stable (8.3 to 9.6), creatinine stayed around 1.0, lactate was not available, and urine output rose from 0 to 980.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (75 to 74), diastolic pressure was roughly stable (48 to 49), and heart rate rose from 50 to 68. The lowest MAP was about 63 around hour 12.3, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 22 but ended at 22. The lower-frequency data fit that summary: temperature ranged from 95.1 to 98.2, white count was roughly stable (9.1 to 8.8), creatinine stayed around 1.3, lactate was not available, and urine output rose from 0 to 950.


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

Options:
A. Clinically, the heart rate rose from 53 to 65, MAP was roughly stable (78 to 77), and diastolic pressure moved from 45 to 52. Systolic pressure ranged 119-177 and ended at 172, and SpO2 recovered to 96 after a low of 84 around hour 2. Respiratory rate ended at 20; the available labs showed white count fell from 9.6 to 8, creatinine stayed around 1.1, lactate was not available, and urine output rose from 50 to 970.
B. Clinically, the heart rate rose from 48 to 70, MAP was roughly stable (73 to 77), and diastolic pressure moved from 50 to 47. Systolic pressure ranged 114-142 and ended at 148, and SpO2 recovered to 100 after a low of 83 around hour 1. Respiratory rate ended at 23; the available labs showed white count was roughly stable (8.7 to 8.4), creatinine stayed around 1.5, lactate was not available, and urine output rose from 0 to 935.
C. Clinically, the heart rate rose from 54 to 71, MAP was roughly stable (79 to 78), and diastolic pressure moved from 44 to 46. Systolic pressure ranged 120-182 and ended at 177, and SpO2 recovered to 95 after a low of 89 around hour 2. Respiratory rate ended at 20; the available labs showed white count was roughly stable (9.7 to 9.4), creatinine stayed around 1.1, lactate was not available, and urine output rose from 2 to 975.
D. Clinically, the heart rate rose from 50 to 68, MAP was roughly stable (75 to 74), and diastolic pressure moved from 48 to 49. Systolic pressure ranged 116-157 and ended at 152, and SpO2 recovered to 99 after a low of 85 around hour 0. Respiratory rate ended at 22; the available labs showed white count was roughly stable (9.1 to 8.8), creatinine stayed around 1.3, lactate was not available, and urine output rose from 0 to 950.

Answer: D


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

Options:
A. Over the available measurements, the heart rate rose from 69 to 95, MAP fell from 75 to 66, and diastolic pressure moved from 53 to 54. Systolic pressure ranged 90-142 and ended at 109, and SpO2 recovered to 97 after a low of 85 around hour 0.9. Respiratory rate ended at 20; the available labs showed white count fell from 18.2 to 10.3, creatinine stayed around 0.7, lactate was not available, and urine output fell from 555 to 300.
B. Over the available measurements, the heart rate rose from 67 to 97, MAP fell from 73 to 69, and diastolic pressure moved from 55 to 52. Systolic pressure ranged 88-127 and ended at 105, and SpO2 recovered to 99 after a low of 83 around hour 1.9. Respiratory rate ended at 21; the available labs showed white count fell from 17.1 to 9.2, creatinine stayed around 0.8, lactate was not available, and urine output fell from 540 to 285.
C. Over the available measurements, the heart rate rose from 73 to 91, MAP fell from 79 to 70, and diastolic pressure moved from 49 to 58. Systolic pressure ranged 94-167 and ended at 113, and SpO2 recovered to 93 after a low of 84 around hour 1.0. Respiratory rate ended at 18; the available labs showed white count fell from 20.1 to 9.5, creatinine stayed around 0.6, lactate was not available, and urine output fell from 605 to 325.
D. Over the available measurements, the heart rate rose from 64 to 98, MAP fell from 70 to 62, and diastolic pressure moved from 58 to 51. Systolic pressure ranged 86-112 and ended at 104, and SpO2 recovered to 100 after a low of 80 around hour 0.8. Respiratory rate ended at 22; the available labs showed white count fell from 15.9 to 8.1, creatinine stayed around 0.8, lactate was not available, and urine output fell from 525 to 270.

Answer: A


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

Options:
A. Over the available measurements, the heart rate was roughly stable (87 to 82), while MAP fell from 169 to 94. Systolic pressure was labile, ranging 77-107, with the lowest value around hour 14.1. SpO2 briefly dipped to 88 around hour 0.9 before recovering to 96, while respiratory rate peaked at 28 and later settled at 16. The associated labs and urine output showed that white count rose from 4.0 to 5.8, creatinine stayed around 0.9, lactate was not available, and urine output rose from 1000 to 1100, with recorded outputs ranging 900-1700.
B. Over the available measurements, the heart rate was roughly stable (82 to 87), while MAP fell from 134 to 89. Systolic pressure was labile, ranging 84-142, with the lowest value around hour 11.5. SpO2 briefly dipped to 86 around hour 0.7 before recovering to 100, while respiratory rate peaked at 29 and later settled at 14. The associated labs and urine output showed that white count rose from 4.9 to 6.2, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output rose from 940 to 1040, with recorded outputs ranging 865-1760.
C. Over the available measurements, the heart rate was roughly stable (84 to 85), while MAP fell from 149 to 91. Systolic pressure was labile, ranging 80-127, with the lowest value around hour 12.6. SpO2 briefly dipped to 85 around hour 0.8 before recovering to 99, while respiratory rate peaked at 27 and later settled at 15. The associated labs and urine output showed that white count rose from 4.5 to 6.6, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output rose from 1000 to 1100, with recorded outputs ranging 850-1700.
D. Over the available measurements, the heart rate was roughly stable (80 to 90), while MAP fell from 119 to 94. Systolic pressure was labile, ranging 84-157, with the lowest value around hour 10.3. SpO2 briefly dipped to 80 around hour 1.8 before recovering to 100, while respiratory rate peaked at 25 and later settled at 13. The associated labs and urine output showed that white count rose from 5.2 to 5.8, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output was roughly stable (880 to 1050), with recorded outputs ranging 880-1820.

Answer: C


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 169 to 88, diastolic pressure fell from 75 to 56, and heart rate was roughly stable (81 to 88). The lowest MAP was about 61 around hour 13.6, and the lowest valid SpO2 was 88 around hour 0.7; respiratory rate rose as high as 28 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 32.7-33.7 C, white count rose from 5.0 to 6.1, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 920 to 1180.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 134 to 93, diastolic pressure fell from 70 to 57, and heart rate was roughly stable (86 to 83). The lowest MAP was about 56 around hour 13.7, and the lowest valid SpO2 was 83 around hour 0.9; respiratory rate rose as high as 29 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 38.0-39.0 C, white count rose from 4.1 to 7.0, creatinine stayed around 0.7, lactate was not available, and urine output rose from 1000 to 1150.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 174 to 87, diastolic pressure fell from 76 to 63, and heart rate was roughly stable (80 to 88). The lowest MAP was about 62 around hour 10.7, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 29 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 32.0-33.0 C, white count rose from 5.1 to 6.0, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 900 to 1200.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 149 to 91, diastolic pressure fell from 72 to 59, and heart rate was roughly stable (84 to 85). The lowest MAP was about 58 around hour 12.6, and the lowest valid SpO2 was 85 around hour 0.8; respiratory rate rose as high as 27 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 35.7-36.7 C, white count rose from 4.5 to 6.6, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output rose from 1000 to 1100.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 149 to 91, diastolic pressure fell from 72 to 59, and heart rate was roughly stable (84 to 85). The lowest MAP was about 58 around hour 12.6, and the lowest valid SpO2 was 85 around hour 0.8; respiratory rate rose as high as 27 but ended at 15. The lower-frequency data fit that summary: temperature ranged from 96.3 to 98, white count rose from 4.5 to 6.6, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output rose from 1000 to 1100.


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 127 to 101, MAP fell from 149 to 91, and heart rate was roughly stable (84 to 85). SpO2 started at 99, ended at 99, and fell as low as 85 around hour 0.8; respiratory rate ranged 8-27. For labs and output, white count rose from 4.5 to 6.6, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output rose from 1000 to 1100.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 112 to 97, MAP fell from 134 to 94, and heart rate was roughly stable (86 to 83). SpO2 started at 100, ended at 97, and fell as low as 84 around hour 0.9; respiratory rate ranged 8-28. For labs and output, white count rose from 4.9 to 6.2, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output rose from 940 to 1040.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 152 to 97, MAP fell from 174 to 95, and heart rate was roughly stable (80 to 89). SpO2 started at 95, ended at 100, and fell as low as 89 around hour 0.7; respiratory rate ranged 6-25. For labs and output, white count rose from 3.9 to 7.2, creatinine stayed around 0.9, lactate was not available, and urine output was roughly stable (1000 to 1050)
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 97 to 94, MAP fell from 119 to 86, and heart rate was roughly stable (88 to 88). SpO2 started at 100, ended at 94, and fell as low as 80 around hour 1.0; respiratory rate ranged 7-29. For labs and output, white count rose from 5.2 to 5.8, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output rose from 880 to 980.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate was roughly stable (87 to 82), MAP fell from 169 to 94, and diastolic pressure moved from 69 to 62. Systolic pressure ranged 83-147 and ended at 104, and SpO2 recovered to 96 after a low of 84 around hour 0.9. Respiratory rate ended at 14; the available labs showed white count rose from 5.0 to 5.8, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output was roughly stable (1050 to 1020)
B. Viewed chronologically, the heart rate was roughly stable (84 to 85), MAP fell from 149 to 91, and diastolic pressure moved from 72 to 59. Systolic pressure ranged 80-127 and ended at 101, and SpO2 recovered to 99 after a low of 85 around hour 0.8. Respiratory rate ended at 15; the available labs showed white count rose from 4.5 to 6.6, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output rose from 1000 to 1100.
C. Viewed chronologically, the heart rate was roughly stable (88 to 81), MAP fell from 174 to 94, and diastolic pressure moved from 68 to 63. Systolic pressure ranged 84-152 and ended at 97, and SpO2 recovered to 95 after a low of 89 around hour 1.8. Respiratory rate ended at 13; the available labs showed white count rose from 5.1 to 7.2, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output rose from 1100 to 1180.
D. Viewed chronologically, the heart rate was roughly stable (80 to 88), MAP fell from 119 to 86, and diastolic pressure moved from 76 to 56. Systolic pressure ranged 76-97 and ended at 96, and SpO2 recovered to 100 after a low of 80 around hour 0.7. Respiratory rate ended at 17; the available labs showed white count rose from 3.8 to 5.8, creatinine was roughly stable (1.0 to 0.5), lactate was not available, and urine output rose from 880 to 1220.

Answer: B


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 67 to 70, diastolic pressure rose from 53 to 69, and heart rate rose from 65 to 82. The lowest MAP was about 54 around hour 1.9, and the lowest valid SpO2 was 88 around hour 0.2; respiratory rate rose as high as 28 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.2-34.2 C, white count fell from 20.6 to 12.8, creatinine was roughly stable (2.5 to 2.4), lactate rose from 1.6 to 202, and urine output fell from 1000 to 250.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 62 to 75, diastolic pressure rose from 48 to 64, and heart rate rose from 70 to 82. The lowest MAP was about 49 around hour 2.2, and the lowest valid SpO2 was 83 around hour 0; respiratory rate rose as high as 25 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 38.5-39.5 C, white count fell from 18.0 to 15.4, creatinine stayed around 2.1, lactate rose from 1.5 to 217, and urine output fell from 940 to 185.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 69, diastolic pressure rose from 54 to 63, and heart rate rose from 64 to 83. The lowest MAP was about 54 around hour 3.1, and the lowest valid SpO2 was 89 around hour 0.2; respiratory rate rose as high as 28 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 32.5-33.5 C, white count fell from 21.0 to 12.4, creatinine stayed around 2.5, lactate rose from 1.9 to 177, and urine output fell from 1100 to 225.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 64 to 73, diastolic pressure rose from 50 to 66, and heart rate rose from 68 to 79. The lowest MAP was about 51 around hour 2.1, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 26 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.2-37.2 C, white count fell from 19.1 to 14.3, creatinine stayed around 2.3, lactate rose from 1.6 to 202, and urine output fell from 1000 to 200.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 64 to 73, diastolic pressure rose from 50 to 66, and heart rate rose from 68 to 79. The lowest MAP was about 51 around hour 2.1, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 26 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 97.1 to 98.9, white count fell from 19.1 to 14.3, creatinine stayed around 2.3, lactate rose from 1.6 to 202, and urine output fell from 1000 to 200.


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 rose from 111 to 146, MAP rose from 64 to 73, and heart rate rose from 68 to 79. SpO2 started at 96, ended at 93, and fell as low as 85 around hour 0.3; respiratory rate ranged 14-26. For labs and output, white count fell from 19.1 to 14.3, creatinine stayed around 2.3, lactate rose from 1.6 to 202, and urine output fell from 1000 to 200.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 109 to 161, MAP rose from 62 to 71, and heart rate rose from 70 to 77. SpO2 started at 98, ended at 91, and fell as low as 83 around hour 0.4; respiratory rate ranged 13-27. For labs and output, white count fell from 20.2 to 13.2, creatinine was roughly stable (2.1 to 2.4), lactate rose from 1.8 to 202, and urine output fell from 1000 to 200.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 115 to 142, MAP rose from 68 to 76, and heart rate rose from 64 to 83. SpO2 started at 92, ended at 97, and fell as low as 84 around hour 0.2; respiratory rate ranged 16-24. For labs and output, white count fell from 17.2 to 16.2, creatinine stayed around 2.5, lactate rose from 1.4 to 227, and urine output fell from 1100 to 175.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 106 to 176, MAP rose from 60 to 68, and heart rate rose from 72 to 82. SpO2 started at 100, ended at 88, and fell as low as 80 around hour 0.5; respiratory rate ranged 12-28. For labs and output, white count fell from 21.4 to 13.5, creatinine stayed around 2.0, lactate rose from 1.9 to 172, and urine output fell from 880 to 230.

Answer: A