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

Options:
A. Taken together, the heart rate was roughly stable (75 to 67), while MAP was roughly stable (71 to 64). Systolic pressure was labile, ranging 80-105, with the lowest value around hour 20. SpO2 briefly dipped to 88 around hour 8.9 before recovering to 90, while respiratory rate peaked at 28 and later settled at 20. The associated labs and urine output showed that white count fell from 8 to 7.7, creatinine fell from 1.5 to 0.9, lactate was not available, and urine output fell from 200 to 0, with recorded outputs ranging 0-920.
B. Taken together, the heart rate was roughly stable (72 to 70), while MAP fell from 68 to 61. Systolic pressure was labile, ranging 83-125, with the lowest value around hour 18. SpO2 briefly dipped to 85 around hour 7.9 before recovering to 93, while respiratory rate peaked at 26 and later settled at 18. The associated labs and urine output showed that white count fell from 9 to 7.2, creatinine fell from 1.3 to 1.1, lactate was not available, and urine output fell from 180 to 30, with recorded outputs ranging 0-1000.
C. Taken together, the heart rate was roughly stable (76 to 66), while MAP fell from 72 to 65. Systolic pressure was labile, ranging 87-100, with the lowest value around hour 20. SpO2 briefly dipped to 86 around hour 8.5 before recovering to 89, while respiratory rate peaked at 28 and later settled at 20. The associated labs and urine output showed that white count fell from 8 to 7.8, creatinine fell from 1.6 to 0.9, lactate was not available, and urine output fell from 205 to 34, with recorded outputs ranging 0-900.
D. Taken together, the heart rate was roughly stable (68 to 74), while MAP fell from 64 to 56. Systolic pressure was labile, ranging 88-155, with the lowest value around hour 16. SpO2 briefly dipped to 80 around hour 7.2 before recovering to 98, while respiratory rate peaked at 24 and later settled at 16. The associated labs and urine output showed that white count fell from 10 to 6.4, creatinine was roughly stable (1.0 to 1.2), lactate was not available, and urine output fell from 150 to 26, with recorded outputs ranging 30-1120.

Answer: B


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

Options:
A. In broad terms, the heart rate was roughly stable (89 to 88), while MAP fell from 114 to 99. Systolic pressure was labile, ranging 103-170, with the lowest value around hour 16.0. SpO2 briefly dipped to 88 around hour 12.6 before recovering to 95, while respiratory rate peaked at 22 and later settled at 16. The associated labs and urine output showed that white count was not available, creatinine was not available, lactate was not available, and urine output fell from 1220 to 430, with recorded outputs ranging 400-1780.
B. In broad terms, the heart rate was roughly stable (84 to 93), while MAP fell from 109 to 94. Systolic pressure was labile, ranging 127-189, with the lowest value around hour 13.4. SpO2 briefly dipped to 86 around hour 10.0 before recovering to 100, while respiratory rate peaked at 22 and later settled at 14. The associated labs and urine output showed that white count was not available, creatinine was not available, lactate was not available, and urine output fell from 1360 to 365, with recorded outputs ranging 365-1640.
C. In broad terms, the heart rate was roughly stable (86 to 91), while MAP fell from 111 to 96. Systolic pressure was labile, ranging 123-174, with the lowest value around hour 14.5. SpO2 briefly dipped to 85 around hour 11.1 before recovering to 98, while respiratory rate peaked at 20 and later settled at 15. The associated labs and urine output showed that white count was not available, creatinine was not available, lactate was not available, and urine output fell from 1300 to 380, with recorded outputs ranging 380-1700.
D. In broad terms, the heart rate was roughly stable (82 to 96), while MAP fell from 106 to 99. Systolic pressure was labile, ranging 153-204, with the lowest value around hour 12.2. SpO2 briefly dipped to 80 around hour 12.1 before recovering to 100, while respiratory rate peaked at 18 and later settled at 13. The associated labs and urine output showed that white count was not available, creatinine was not available, lactate was not available, and urine output fell from 1420 to 330, with recorded outputs ranging 330-1580.

Answer: C


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 169 to 140, MAP fell from 111 to 96, and heart rate was roughly stable (86 to 91). SpO2 started at 100, ended at 98, and fell as low as 85 around hour 11.1; respiratory rate ranged 11-20. For labs and output, white count was not available, creatinine was not available, lactate was not available, and urine output fell from 1300 to 380.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 154 to 136, MAP fell from 109 to 94, and heart rate rose from 88 to 94. SpO2 started at 98, ended at 96, and fell as low as 83 around hour 12.2; respiratory rate ranged 10-22. For labs and output, white count was not available, creatinine was not available, lactate was not available, and urine output fell from 1360 to 365.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 194 to 136, MAP fell from 115 to 99, and heart rate was roughly stable (82 to 95). SpO2 started at 96, ended at 100, and fell as low as 84 around hour 9.2; respiratory rate ranged 13-18. For labs and output, white count was not available, creatinine was not available, lactate was not available, and urine output fell from 1200 to 405.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 139 to 136, MAP fell from 106 to 92, and heart rate was roughly stable (90 to 86). SpO2 started at 96, ended at 94, and fell as low as 80 around hour 13.3; respiratory rate ranged 9-22. For labs and output, white count was not available, creatinine was not available, lactate was not available, and urine output fell from 1420 to 350.

Answer: A


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

Options:
A. For handoff, the heart rate was roughly stable (88 to 87), while MAP fell from 158 to 92. Systolic pressure was labile, ranging 114-174, with the lowest value around hour 21.2. SpO2 briefly dipped to 83 around hour 10.7 before recovering to 89, while respiratory rate peaked at 35 and later settled at 20. The associated labs and urine output showed that white count was 9.3 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 420 to 275, with recorded outputs ranging 170-530.
B. For handoff, the heart rate was roughly stable (83 to 92), while MAP fell from 123 to 87. Systolic pressure was labile, ranging 119-209, with the lowest value around hour 18.6. SpO2 briefly dipped to 78 around hour 9.3 before recovering to 94, while respiratory rate peaked at 30 and later settled at 17. The associated labs and urine output showed that white count was 11.9 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (385 to 340), with recorded outputs ranging 200-565.
C. For handoff, the heart rate was roughly stable (89 to 86), while MAP fell from 163 to 93. Systolic pressure was labile, ranging 121-169, with the lowest value around hour 21.6. SpO2 briefly dipped to 81 around hour 10.3 before recovering to 88, while respiratory rate peaked at 34 and later settled at 20. The associated labs and urine output showed that white count was 8.9 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (425 to 300), with recorded outputs ranging 175-525.
D. For handoff, the heart rate was roughly stable (85 to 90), while MAP fell from 138 to 89. Systolic pressure was labile, ranging 117-194, with the lowest value around hour 19.7. SpO2 briefly dipped to 80 around hour 9.7 before recovering to 92, while respiratory rate peaked at 32 and later settled at 18. The associated labs and urine output showed that white count was 10.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (400 to 325), with recorded outputs ranging 150-550.

Answer: D


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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 170 to 110, MAP fell from 158 to 92, and heart rate was roughly stable (82 to 93). SpO2 started at 83, ended at 95, and fell as low as 79 around hour 9.2; respiratory rate ranged 16-29. For labs and output, white count was 9.3 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (420 to 305)
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 150 to 130, MAP fell from 138 to 89, and heart rate was roughly stable (85 to 90). SpO2 started at 86, ended at 92, and fell as low as 80 around hour 9.7; respiratory rate ranged 14-32. For labs and output, white count was 10.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (400 to 325)
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 175 to 105, MAP fell from 163 to 93, and heart rate rose from 81 to 93. SpO2 started at 82, ended at 96, and fell as low as 84 around hour 9.1; respiratory rate ranged 16-34. For labs and output, white count was 8.9 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (425 to 300)
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 120 to 100, MAP fell from 108 to 92, and heart rate was roughly stable (90 to 86). SpO2 started at 90, ended at 88, and fell as low as 79 around hour 10.4; respiratory rate ranged 12-36. For labs and output, white count was 13.1 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (370 to 355)

Answer: B


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

Options:
A. Across the recorded window, the heart rate rose from 60 to 115, while MAP rose from 72 to 81. Systolic pressure was labile, ranging 93-122, with the lowest value around hour 6.8. SpO2 briefly dipped to 85 around hour 0.4 before recovering to 97, while respiratory rate peaked at 26 and later settled at 23. The associated labs and urine output showed that white count rose from 2 to 10.4, creatinine was 0.5 on its only check, lactate was checked once at 1114, and urine output stayed around 400, with recorded outputs ranging 300-400.
B. Across the recorded window, the heart rate rose from 58 to 117, while MAP rose from 70 to 84. Systolic pressure was labile, ranging 95-137, with the lowest value around hour 6.4. SpO2 briefly dipped to 83 around hour 1.4 before recovering to 99, while respiratory rate peaked at 25 and later settled at 22. The associated labs and urine output showed that white count rose from 2 to 9.3, creatinine was 0.4 on its only check, lactate was checked once at 1174, and urine output was roughly stable (385 to 350), with recorded outputs ranging 300-400.
C. Across the recorded window, the heart rate rose from 64 to 111, while MAP rose from 76 to 85. Systolic pressure was labile, ranging 97-100, with the lowest value around hour 7.4. SpO2 briefly dipped to 89 around hour 0.5 before recovering to 93, while respiratory rate peaked at 28 and later settled at 25. The associated labs and urine output showed that white count rose from 2 to 12.3, creatinine was 0.6 on its only check, lactate was checked once at 1114.2, and urine output stayed around 425, with recorded outputs ranging 325-425.
D. Across the recorded window, the heart rate rose from 56 to 120, while MAP rose from 68 to 76. Systolic pressure was labile, ranging 98-152, with the lowest value around hour 6.0. SpO2 briefly dipped to 80 around hour 0.2 before recovering to 100, while respiratory rate peaked at 24 and later settled at 21. The associated labs and urine output showed that white count rose from 2 to 9.6, creatinine was 0.3 on its only check, lactate was checked once at 1234, and urine output stayed around 370, with recorded outputs ranging 350-370.

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 rose from 75 to 78, diastolic pressure rose from 62 to 69, and heart rate rose from 57 to 118. The lowest MAP was about 69 around hour 7.8, and the lowest valid SpO2 was 88 around hour 0.3; respiratory rate rose as high as 28 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.4-34.3 C, white count rose from 2 to 8.9, creatinine was 0.6 on its only check, lactate was checked once at 1194, and urine output was roughly stable (380 to 420)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 81, diastolic pressure rose from 59 to 72, and heart rate rose from 60 to 115. The lowest MAP was about 66 around hour 6.8, and the lowest valid SpO2 was 85 around hour 0.4; respiratory rate rose as high as 26 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 36.4-37.3 C, white count rose from 2 to 10.4, creatinine was 0.5 on its only check, lactate was checked once at 1114, and urine output was roughly stable (400 to 400)
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 76 to 77, diastolic pressure rose from 63 to 76, and heart rate rose from 56 to 118. The lowest MAP was about 70 around hour 6.2, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 28 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 32.6-33.5 C, white count rose from 2 to 8.5, creatinine was 0.6 on its only check, lactate was checked once at 1214, and urine output was roughly stable (375 to 425)
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 86, diastolic pressure rose from 54 to 68, and heart rate rose from 64 to 110. The lowest MAP was about 62 around hour 7.5, and the lowest valid SpO2 was 80 around hour 0.6; respiratory rate rose as high as 28 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 40.9-41.8 C, white count rose from 2 to 12.7, creatinine was 0.3 on its only check, lactate was checked once at 994, and urine output was roughly stable (430 to 450)

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 81, diastolic pressure rose from 59 to 72, and heart rate rose from 60 to 115. The lowest MAP was about 66 around hour 6.8, and the lowest valid SpO2 was 85 around hour 0.4; respiratory rate rose as high as 26 but ended at 23. The lower-frequency data fit that summary: temperature ranged from 97.5 to 99.2, white count rose from 2 to 10.4, creatinine was 0.5 on its only check, lactate was checked once at 1114, and urine output was roughly stable (400 to 400)


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

Options:
A. Clinically, the heart rate rose from 63 to 112, MAP rose from 75 to 84, and diastolic pressure moved from 56 to 75. Systolic pressure ranged 96-142 and ended at 115, and SpO2 recovered to 94 after a low of 84 around hour 0.5. Respiratory rate ended at 22; the available labs showed white count rose from 2 to 9.6, creatinine was 0.4 on its only check, lactate was checked once at 1194, and urine output was roughly stable (450 to 380)
B. Clinically, the heart rate rose from 58 to 118, MAP rose from 70 to 79, and diastolic pressure moved from 61 to 69. Systolic pressure ranged 91-107 and ended at 110, and SpO2 recovered to 99 after a low of 83 around hour 0.3. Respiratory rate ended at 24; the available labs showed white count rose from 2 to 9.3, creatinine was 0.6 on its only check, lactate was checked once at 1054, and urine output was roughly stable (385 to 415)
C. Clinically, the heart rate rose from 64 to 111, MAP rose from 76 to 84, and diastolic pressure moved from 55 to 76. Systolic pressure ranged 97-147 and ended at 108, and SpO2 recovered to 93 after a low of 89 around hour 1.4. Respiratory rate ended at 21; the available labs showed white count rose from 2 to 12.3, creatinine was 0.4 on its only check, lactate was checked once at 1214, and urine output was roughly stable (425 to 375)
D. Clinically, the heart rate rose from 60 to 115, MAP rose from 72 to 81, and diastolic pressure moved from 59 to 72. Systolic pressure ranged 93-122 and ended at 112, and SpO2 recovered to 97 after a low of 85 around hour 0.4. Respiratory rate ended at 23; the available labs showed white count rose from 2 to 10.4, creatinine was 0.5 on its only check, lactate was checked once at 1114, and urine output was roughly stable (400 to 400)

Answer: D


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

Options:
A. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (77 to 74), diastolic pressure fell from 67 to 59, and heart rate was roughly stable (73 to 70). The lowest MAP was about 55 around hour 9.8, and the lowest valid SpO2 was 85 around hour 57.8; respiratory rate rose as high as 34 but ended at 34. The lower-frequency data fit that summary: temperature stayed around 36.2-37.1 C, white count fell from 20.8 to 10.5, creatinine was roughly stable (2.2 to 1.6), lactate rose from 1.3 to 456, and urine output rose from 50 to 400.
B. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (75 to 76), diastolic pressure fell from 65 to 56, and heart rate was roughly stable (75 to 68). The lowest MAP was about 58 around hour 10.8, and the lowest valid SpO2 was 83 around hour 60.0; respiratory rate rose as high as 32 but ended at 32. The lower-frequency data fit that summary: temperature stayed around 38.5-39.4 C, white count fell from 19.7 to 11.6, creatinine was roughly stable (2.1 to 1.5), lactate rose from 1.5 to 441, and urine output rose from 48 to 415.
C. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (81 to 70), diastolic pressure fell from 71 to 63, and heart rate stayed around 69. The lowest MAP was about 55 around hour 9.8, and the lowest valid SpO2 was 85 around hour 56.8; respiratory rate rose as high as 34 but ended at 38. The lower-frequency data fit that summary: temperature stayed around 36.2-37.1 C, white count fell from 20.8 to 10.5, creatinine was roughly stable (2.2 to 1.6), lactate rose from 1.3 to 456, and urine output rose from 50 to 400.
D. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (72 to 78), diastolic pressure fell from 62 to 54, and heart rate was roughly stable (78 to 66). The lowest MAP was about 50 around hour 10.6, and the lowest valid SpO2 was 80 around hour 62.3; respiratory rate rose as high as 36 but ended at 30. The lower-frequency data fit that summary: temperature stayed around 40.7-41.6 C, white count fell from 18.6 to 12.8, creatinine was roughly stable (1.9 to 1.7), lactate rose from 1.6 to 426, and urine output rose from 46 to 450.

Answer: A

In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (77 to 74), diastolic pressure fell from 67 to 59, and heart rate was roughly stable (73 to 70). The lowest MAP was about 55 around hour 9.8, and the lowest valid SpO2 was 85 around hour 57.8; respiratory rate rose as high as 34 but ended at 34. The lower-frequency data fit that summary: temperature ranged from 97.1 to 98.8, white count fell from 20.8 to 10.5, creatinine was roughly stable (2.2 to 1.6), lactate rose from 1.3 to 456, and urine output rose from 50 to 400.


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

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (75 to 68), diastolic pressure rose from 57 to 65, and heart rate rose from 8 to 97. The lowest MAP was about 44 around hour 8, and the lowest valid SpO2 was 75 around hour 22; respiratory rate rose as high as 32 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.3-33.8 C, white count fell from 16.2 to 9.3, creatinine stayed around 1.1, lactate was not available, and urine output fell from 220 to 65.
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (72 to 71), diastolic pressure rose from 54 to 62, and heart rate rose from 8 to 100. The lowest MAP was about 41 around hour 8, and the lowest valid SpO2 was 72 around hour 24; respiratory rate rose as high as 30 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 36.3-36.8 C, white count fell from 14.7 to 10.8, creatinine stayed around 1, lactate was not available, and urine output fell from 200 to 15.
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (76 to 67), diastolic pressure was roughly stable (58 to 59), and heart rate rose from 7 to 96. The lowest MAP was about 44 around hour 9, and the lowest valid SpO2 was 76 around hour 22; respiratory rate rose as high as 34 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.5-33.0 C, white count fell from 16.6 to 8.9, creatinine stayed around 1, lactate was not available, and urine output fell from 225 to 13.
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (68 to 76), diastolic pressure rose from 50 to 58, and heart rate rose from 9 to 103. The lowest MAP was about 36 around hour 9, and the lowest valid SpO2 was 68 around hour 23; respiratory rate rose as high as 26 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 40.8-41.3 C, white count fell from 12.4 to 10.9, creatinine stayed around 1, lactate was not available, and urine output fell from 170 to 17.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (72 to 71), diastolic pressure rose from 54 to 62, and heart rate rose from 8 to 100. The lowest MAP was about 41 around hour 8, and the lowest valid SpO2 was 72 around hour 24; respiratory rate rose as high as 30 but ended at 20. The lower-frequency data fit that summary: temperature ranged from 97.4 to 98.3, white count fell from 14.7 to 10.8, creatinine stayed around 1, lactate was not available, and urine output fell from 200 to 15.


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

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 108, MAP was roughly stable (69 to 74), and heart rate rose from 8 to 97. SpO2 started at 97, ended at 95, and fell as low as 75 around hour 26; respiratory rate ranged 8-27. For labs and output, white count fell from 16.2 to 9.3, creatinine rose from 0.9 to 1.1, lactate was not available, and urine output fell from 200 to 15.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (103 to 101), MAP was roughly stable (72 to 74), and heart rate rose from 8 to 100. SpO2 started at 100, ended at 98, and fell as low as 71 around hour 24; respiratory rate ranged 10-30. For labs and output, white count fell from 14.7 to 10.8, creatinine stayed around 1, lactate was not available, and urine output fell from 200 to 15.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 105, MAP was roughly stable (72 to 71), and heart rate rose from 8 to 100. SpO2 started at 100, ended at 98, and fell as low as 72 around hour 24; respiratory rate ranged 10-30. For labs and output, white count fell from 14.7 to 10.8, creatinine stayed around 1, lactate was not available, and urine output fell from 200 to 15.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 100, MAP was roughly stable (76 to 66), and heart rate rose from 7 to 103. SpO2 started at 96, ended at 100, and fell as low as 68 around hour 22; respiratory rate ranged 12-32. For labs and output, white count fell from 12.4 to 10, creatinine stayed around 1, lactate was not available, and urine output fell from 170 to 17.

Answer: C


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

Options:
A. Taken together, the heart rate rose from 8 to 97, MAP was roughly stable (75 to 74), and diastolic pressure moved from 51 to 65. Systolic pressure ranged 85-150 and ended at 108, and SpO2 recovered to 95 after a low of 71 around hour 26. Respiratory rate ended at 18; the available labs showed white count fell from 16.2 to 10, creatinine stayed around 1, lactate was not available, and urine output fell from 250 to 16.
B. Taken together, the heart rate rose from 8 to 103, MAP was roughly stable (70 to 69), and diastolic pressure moved from 56 to 59. Systolic pressure ranged 80-115 and ended at 103, and SpO2 recovered to 100 after a low of 70 around hour 23. Respiratory rate ended at 21; the available labs showed white count fell from 13.6 to 9.7, creatinine stayed around 1, lactate was not available, and urine output fell from 185 to 14.
C. Taken together, the heart rate rose from 9 to 96, MAP was roughly stable (76 to 74), and diastolic pressure moved from 50 to 66. Systolic pressure ranged 86-155 and ended at 101, and SpO2 recovered to 94 after a low of 76 around hour 25. Respiratory rate ended at 18; the available labs showed white count fell from 16.6 to 12.7, creatinine stayed around 1, lactate was not available, and urine output fell from 225 to 17.
D. Taken together, the heart rate rose from 8 to 100, MAP was roughly stable (72 to 71), and diastolic pressure moved from 54 to 62. Systolic pressure ranged 82-130 and ended at 105, and SpO2 recovered to 98 after a low of 72 around hour 24. Respiratory rate ended at 20; the available labs showed white count fell from 14.7 to 10.8, creatinine stayed around 1, lactate was not available, and urine output fell from 200 to 15.

Answer: D


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

Options:
A. Taken together, the heart rate was roughly stable (81 to 78), while MAP rose from 59 to 113. Systolic pressure was labile, ranging 92-149, with the lowest value around hour 1.6. SpO2 briefly dipped to 88 around hour 1.7 before recovering to 94, while respiratory rate peaked at 43 and later settled at 24. The associated labs and urine output showed that white count fell from 10.0 to 9.7, creatinine stayed around 0.6, lactate was not available, and urine output rose from 145 to 250, with recorded outputs ranging 75-650.
B. Taken together, the heart rate was roughly stable (78 to 81), while MAP rose from 56 to 110. Systolic pressure was labile, ranging 95-169, with the lowest value around hour 1.4. SpO2 briefly dipped to 85 around hour 1.5 before recovering to 97, while respiratory rate peaked at 40 and later settled at 23. The associated labs and urine output showed that white count was roughly stable (11.5 to 10.5), creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 145 to 250, with recorded outputs ranging 25-650.
C. Taken together, the heart rate was roughly stable (82 to 77), while MAP rose from 60 to 114. Systolic pressure was labile, ranging 91-144, with the lowest value around hour 1.6. SpO2 briefly dipped to 86 around hour 1.8 before recovering to 93, while respiratory rate peaked at 42 and later settled at 25. The associated labs and urine output showed that white count was roughly stable (9.6 to 12.4), creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output rose from 95 to 275, with recorded outputs ranging 23-625.
D. Taken together, the heart rate was roughly stable (74 to 86), while MAP rose from 52 to 113. Systolic pressure was labile, ranging 100-199, with the lowest value around hour 1.1. SpO2 briefly dipped to 80 around hour 2.5 before recovering to 100, while respiratory rate peaked at 36 and later settled at 21. The associated labs and urine output showed that white count was roughly stable (13.8 to 8.2), creatinine was roughly stable (0.3 to 0.6), lactate was not available, and urine output was roughly stable (115 to 200), with recorded outputs ranging 27-680.

Answer: B


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

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 98 to 131, MAP rose from 59 to 113, and heart rate was roughly stable (75 to 84). SpO2 started at 90, ended at 100, and fell as low as 84 around hour 1.3; respiratory rate ranged 16-37. For labs and output, white count was roughly stable (10.0 to 12.0), creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output rose from 165 to 270.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 93 to 150, MAP rose from 54 to 108, and heart rate was roughly stable (80 to 79). SpO2 started at 95, ended at 95, and fell as low as 83 around hour 1.6; respiratory rate ranged 13-42. For labs and output, white count was roughly stable (12.6 to 9.4), creatinine stayed around 0.4, lactate was not available, and urine output rose from 145 to 250.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 99 to 110, MAP rose from 60 to 114, and heart rate rose from 74 to 84. SpO2 started at 89, ended at 100, and fell as low as 89 around hour 1.2; respiratory rate ranged 16-42. For labs and output, white count fell from 9.6 to 9.1, creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output rose from 170 to 275.
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 95 to 135, MAP rose from 56 to 110, and heart rate was roughly stable (78 to 81). SpO2 started at 93, ended at 97, and fell as low as 85 around hour 1.5; respiratory rate ranged 14-40. For labs and output, white count was roughly stable (11.5 to 10.5), creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 145 to 250.

Answer: D


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 97 to 75, diastolic pressure fell from 83 to 65, and heart rate was roughly stable (75 to 79). The lowest MAP was about 81 around hour 48.2, and the lowest valid SpO2 was 91 around hour 5.4; respiratory rate rose as high as 24 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 33.4-33.8 C, white count was 10.1 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 670 to 550.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 98 to 80, diastolic pressure fell from 78 to 60, and heart rate was roughly stable (80 to 79). The lowest MAP was about 76 around hour 53.5, and the lowest valid SpO2 was 86 around hour 4.9; respiratory rate rose as high as 21 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 38.6-39.0 C, white count was 9.2 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 635 to 485.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 96 to 74, diastolic pressure fell from 84 to 59, and heart rate was roughly stable (74 to 80). The lowest MAP was about 82 around hour 51, and the lowest valid SpO2 was 92 around hour 5.3; respiratory rate rose as high as 24 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 32.6-33.0 C, white count was 10.2 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 675 to 525.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 78, diastolic pressure fell from 80 to 62, and heart rate was roughly stable (78 to 76). The lowest MAP was about 78 around hour 51.2, and the lowest valid SpO2 was 88 around hour 5.9; respiratory rate rose as high as 22 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 36.4-36.8 C, white count was 9.6 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 650 to 500.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 78, diastolic pressure fell from 80 to 62, and heart rate was roughly stable (78 to 76). The lowest MAP was about 78 around hour 51.2, and the lowest valid SpO2 was 88 around hour 5.9; respiratory rate rose as high as 22 but ended at 15. The lower-frequency data fit that summary: temperature ranged from 0 to 98.3, white count was 9.6 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 650 to 500.


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

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 26 to 109, MAP rose from 68 to 72, and heart rate fell from 69 to 65. SpO2 started at 97, ended at 100, and fell as low as 84 around hour 3.2; respiratory rate ranged 12-22. For labs and output, white count was roughly stable (7.8 to 9.3), creatinine stayed around 0.9, lactate fell from 1.4 to 0.9, and urine output fell from 355 to 200.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 24 to 115, MAP was roughly stable (63 to 67), and heart rate fell from 74 to 60. SpO2 started at 98, ended at 97, and fell as low as 83 around hour 4.1; respiratory rate ranged 9-24. For labs and output, white count was roughly stable (8.7 to 8.4), creatinine was roughly stable (0.7 to 0.9), lactate fell from 1.8 to 0.8, and urine output fell from 335 to 220.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 25 to 113, MAP was roughly stable (65 to 69), and heart rate fell from 72 to 62. SpO2 started at 100, ended at 99, and fell as low as 85 around hour 3.7; respiratory rate ranged 10-23. For labs and output, white count was roughly stable (8.3 to 8.8), creatinine stayed around 0.8, lactate fell from 1.6 to 0.8, and urine output fell from 335 to 220.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 23 to 118, MAP was roughly stable (60 to 64), and heart rate fell from 76 to 65. SpO2 started at 96, ended at 94, and fell as low as 80 around hour 4.5; respiratory rate ranged 8-25. For labs and output, white count was roughly stable (9.1 to 8), creatinine stayed around 0.7, lactate fell from 1.9 to 0.7, and urine output fell from 305 to 250.

Answer: C


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

Options:
A. Clinically, the heart rate rose from 81 to 84, while MAP was roughly stable (90 to 83). Systolic pressure was labile, ranging 86-114, with the lowest value around hour 7.9. SpO2 briefly dipped to 97 around hour 27.4 before recovering to 92, while respiratory rate peaked at 34 and later settled at 20. The associated labs and urine output showed that white count fell from 17.2 to 15.7, creatinine rose from 0.8 to 0.9, lactate rose from 2 to 2.7, and urine output fell from 480 to 0, with recorded outputs ranging 0-545.
B. Clinically, the heart rate rose from 78 to 87, while MAP fell from 87 to 80. Systolic pressure was labile, ranging 89-134, with the lowest value around hour 7.4. SpO2 briefly dipped to 94 around hour 26.4 before recovering to 95, while respiratory rate peaked at 31 and later settled at 18. The associated labs and urine output showed that white count fell from 18.7 to 17.5, creatinine rose from 0.7 to 0.9, lactate rose from 2 to 2.5, and urine output fell from 500 to 30, with recorded outputs ranging 25-525.
C. Clinically, the heart rate rose from 82 to 83, while MAP fell from 91 to 84. Systolic pressure was labile, ranging 93-109, with the lowest value around hour 8.0. SpO2 briefly dipped to 95 around hour 28.3 before recovering to 91, while respiratory rate peaked at 33 and later settled at 20. The associated labs and urine output showed that white count fell from 16.8 to 15.3, creatinine rose from 0.8 to 0.9, lactate rose from 2 to 2.8, and urine output fell from 475 to 34, with recorded outputs ranging 27-550.
D. Clinically, the heart rate rose from 74 to 92, while MAP fell from 82 to 76. Systolic pressure was labile, ranging 94-164, with the lowest value around hour 6.7. SpO2 briefly dipped to 90 around hour 24.1 before recovering to 100, while respiratory rate peaked at 26 and later settled at 16. The associated labs and urine output showed that white count fell from 20.9 to 16.7, creatinine rose from 0.5 to 1, lactate rose from 2 to 2.2, and urine output fell from 530 to 26, with recorded outputs ranging 30-495.

Answer: B


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

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 77, diastolic pressure was roughly stable (75 to 76), and heart rate rose from 75 to 90. The lowest MAP was about 66 around hour 6.9, and the lowest valid SpO2 was 97 around hour 25.4; respiratory rate rose as high as 34 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.6-34.7 C, white count fell from 20.2 to 16.0, creatinine rose from 0.8 to 1.0, lactate rose from 2 to 2.7, and urine output fell from 520 to 27.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 85 to 82, diastolic pressure was roughly stable (70 to 70), and heart rate rose from 80 to 85. The lowest MAP was about 66 around hour 8.4, and the lowest valid SpO2 was 92 around hour 27.5; respiratory rate rose as high as 29 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 38.9-40.0 C, white count fell from 17.6 to 16.1, creatinine rose from 0.6 to 0.8, lactate rose from 2 to 2.4, and urine output fell from 485 to 32.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 87 to 80, diastolic pressure was roughly stable (72 to 73), and heart rate rose from 78 to 87. The lowest MAP was about 63 around hour 7.4, and the lowest valid SpO2 was 94 around hour 26.4; respiratory rate rose as high as 31 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 36.6-37.7 C, white count fell from 18.7 to 17.5, creatinine rose from 0.7 to 0.9, lactate rose from 2 to 2.5, and urine output fell from 500 to 30.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 82 to 79, diastolic pressure was roughly stable (68 to 68), and heart rate rose from 82 to 85. The lowest MAP was about 58 around hour 8.2, and the lowest valid SpO2 was 90 around hour 28.6; respiratory rate rose as high as 33 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 41.1-42.2 C, white count fell from 16.4 to 14.9, creatinine rose from 0.5 to 1, lactate rose from 2 to 2.2, and urine output fell from 470 to 80.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 87 to 80, diastolic pressure was roughly stable (72 to 73), and heart rate rose from 78 to 87. The lowest MAP was about 63 around hour 7.4, and the lowest valid SpO2 was 94 around hour 26.4; respiratory rate rose as high as 31 but ended at 18. The lower-frequency data fit that summary: temperature ranged from 97.9 to 99.8, white count fell from 18.7 to 17.5, creatinine rose from 0.7 to 0.9, lactate rose from 2 to 2.5, and urine output fell from 500 to 30.


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

Options:
A. Viewed chronologically, the heart rate rose from 81 to 82, while MAP rose from 83 to 90. Systolic pressure was labile, ranging 91-126, with the lowest value around hour 0.7. SpO2 briefly dipped to 88 around hour 9.7 before recovering to 95, while respiratory rate peaked at 30 and later settled at 24. The associated labs and urine output showed that white count was roughly stable (7.8 to 9.8), creatinine fell from 1 to 0.7, lactate was not available, and urine output fell from 320 to 75, with recorded outputs ranging 47-280.
B. Viewed chronologically, the heart rate rose from 76 to 87, while MAP rose from 78 to 85. Systolic pressure was labile, ranging 98-161, with the lowest value around hour 0.5. SpO2 briefly dipped to 86 around hour 8.3 before recovering to 100, while respiratory rate peaked at 30 and later settled at 21. The associated labs and urine output showed that white count was roughly stable (8.7 to 8.9), creatinine fell from 1 to 0.9, lactate was not available, and urine output fell from 285 to 110, with recorded outputs ranging 52-315.
C. Viewed chronologically, the heart rate rose from 82 to 85, while MAP rose from 84 to 91. Systolic pressure was labile, ranging 90-121, with the lowest value around hour 0.7. SpO2 briefly dipped to 89 around hour 9.3 before recovering to 94, while respiratory rate peaked at 30 and later settled at 24. The associated labs and urine output showed that white count was roughly stable (7.7 to 8.5), creatinine was roughly stable (1 to 0.9), lactate was not available, and urine output fell from 325 to 150, with recorded outputs ranging 100-275.
D. Viewed chronologically, the heart rate rose from 78 to 85, while MAP rose from 80 to 87. Systolic pressure was labile, ranging 94-146, with the lowest value around hour 0.6. SpO2 briefly dipped to 85 around hour 8.7 before recovering to 98, while respiratory rate peaked at 28 and later settled at 22. The associated labs and urine output showed that white count was roughly stable (8.3 to 9.3), creatinine fell from 1 to 0.8, lactate was not available, and urine output fell from 300 to 125, with recorded outputs ranging 50-300.

Answer: D


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

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 76 to 82, diastolic pressure rose from 68 to 77, and heart rate was roughly stable (80 to 83). The lowest MAP was about 61 around hour 18.8, and the lowest valid SpO2 was 88 around hour 9.2; respiratory rate rose as high as 29 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.3-34.1 C, white count was 4.2 on its only check, creatinine rose from 0.4 to 0.7, lactate was checked once at 196, and urine output was roughly stable (180 to 250)
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 73 to 85, diastolic pressure rose from 65 to 74, and heart rate was roughly stable (83 to 80). The lowest MAP was about 58 around hour 20.3, and the lowest valid SpO2 was 85 around hour 9.7; respiratory rate rose as high as 27 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.3-37.1 C, white count was 3.7 on its only check, creatinine was roughly stable (0.5 to 0.6), lactate was checked once at 176, and urine output was roughly stable (200 to 200)
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 77 to 81, diastolic pressure rose from 69 to 71, and heart rate was roughly stable (79 to 84). The lowest MAP was about 61 around hour 21.3, and the lowest valid SpO2 was 89 around hour 9.1; respiratory rate rose as high as 29 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 32.5-33.4 C, white count was 4.3 on its only check, creatinine was roughly stable (0.4 to 0.7), lactate was checked once at 201, and urine output was roughly stable (175 to 225)
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 90, diastolic pressure rose from 60 to 70, and heart rate stayed around 88. The lowest MAP was about 58 around hour 20.3, and the lowest valid SpO2 was 85 around hour 8.7; respiratory rate rose as high as 27 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.3-37.1 C, white count was 3.7 on its only check, creatinine was roughly stable (0.5 to 0.6), lactate was checked once at 176, and urine output was roughly stable (200 to 230)

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 73 to 85, diastolic pressure rose from 65 to 74, and heart rate was roughly stable (83 to 80). The lowest MAP was about 58 around hour 20.3, and the lowest valid SpO2 was 85 around hour 9.7; respiratory rate rose as high as 27 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 97.4 to 98.7, white count was 3.7 on its only check, creatinine was roughly stable (0.5 to 0.6), lactate was checked once at 176, and urine output was roughly stable (200 to 200)


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

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 66 to 76, diastolic pressure was roughly stable (56 to 59), and heart rate fell from 84 to 73. The lowest MAP was about 61 around hour 0.0, and the lowest valid SpO2 was 88 around hour 2.8; respiratory rate rose as high as 42 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.9-34.1 C, white count was roughly stable (13.4 to 10.0), creatinine was roughly stable (0.8 to 0.6), lactate was checked once at 2.6, and urine output fell from 770 to 300.
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 61 to 81, diastolic pressure stayed around 51, and heart rate fell from 87 to 70. The lowest MAP was about 61 around hour 1.1, and the lowest valid SpO2 was 85 around hour 3.3; respiratory rate rose as high as 40 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 35.9-37.1 C, white count was roughly stable (11.9 to 11.5), creatinine fell from 0.7 to 0.5, lactate was checked once at 2.8, and urine output fell from 750 to 250.
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 63 to 79, diastolic pressure was roughly stable (53 to 56), and heart rate fell from 87 to 70. The lowest MAP was about 58 around hour 0.1, and the lowest valid SpO2 was 85 around hour 3.3; respiratory rate rose as high as 40 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 35.9-37.1 C, white count was roughly stable (11.9 to 11.5), creatinine fell from 0.7 to 0.5, lactate was checked once at 2.8, and urine output fell from 750 to 250.
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 58 to 84, diastolic pressure was roughly stable (48 to 52), and heart rate fell from 92 to 73. The lowest MAP was about 54 around hour 0.2, and the lowest valid SpO2 was 80 around hour 2.3; respiratory rate rose as high as 36 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 40.4-41.6 C, white count was roughly stable (9.7 to 13.8), creatinine fell from 0.5 to 0.3, lactate was checked once at 3.1, and urine output fell from 720 to 220.

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 63 to 79, diastolic pressure was roughly stable (53 to 56), and heart rate fell from 87 to 70. The lowest MAP was about 58 around hour 0.1, and the lowest valid SpO2 was 85 around hour 3.3; respiratory rate rose as high as 40 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 37 to 98.7, white count was roughly stable (11.9 to 11.5), creatinine fell from 0.7 to 0.5, lactate was checked once at 2.8, and urine output fell from 750 to 250.


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 stayed around 81, diastolic pressure was roughly stable (58 to 56), and heart rate fell from 83 to 56. The lowest MAP was about 51 around hour 9.9, and the lowest valid SpO2 was 88 around hour 9.3; respiratory rate rose as high as 28 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 39.1-39.6 C, white count fell from 13.6 to 8.7, creatinine was roughly stable (1.1 to 1.4), lactate rose from 1.9 to 2.7, and urine output fell from 815 to 43.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 76, diastolic pressure was roughly stable (63 to 57), and heart rate fell from 78 to 61. The lowest MAP was about 46 around hour 8.5, and the lowest valid SpO2 was 83 around hour 8.4; respiratory rate rose as high as 31 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 33.9-34.4 C, white count fell from 11.0 to 7.8, creatinine stayed around 1.5, lactate rose from 1.7 to 2.9, and urine output fell from 795 to 90.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 82, diastolic pressure was roughly stable (57 to 63), and heart rate fell from 84 to 62. The lowest MAP was about 52 around hour 9.5, and the lowest valid SpO2 was 89 around hour 7.8; respiratory rate rose as high as 27 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 39.9-40.4 C, white count fell from 14.0 to 8.8, creatinine was roughly stable (1.1 to 1.4), lactate rose from 1.9 to 2.6, and urine output fell from 820 to 44.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 78, diastolic pressure was roughly stable (61 to 59), and heart rate fell from 80 to 59. The lowest MAP was about 48 around hour 8.9, and the lowest valid SpO2 was 85 around hour 8.8; respiratory rate rose as high as 29 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 36.1-36.6 C, white count fell from 12.1 to 8.2, creatinine was roughly stable (1.3 to 1.2), lactate rose from 1.7 to 2.9, and urine output fell from 795 to 40.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 78, diastolic pressure was roughly stable (61 to 59), and heart rate fell from 80 to 59. The lowest MAP was about 48 around hour 8.9, and the lowest valid SpO2 was 85 around hour 8.8; respiratory rate rose as high as 29 but ended at 22. The lower-frequency data fit that summary: temperature ranged from 97 to 97.8, white count fell from 12.1 to 8.2, creatinine was roughly stable (1.3 to 1.2), lactate rose from 1.7 to 2.9, and urine output fell from 795 to 40.


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

Options:
A. For handoff, the heart rate fell from 83 to 56, MAP was roughly stable (81 to 81), and diastolic pressure moved from 61 to 59. Systolic pressure ranged 85-147 and ended at 136, and SpO2 recovered to 99 after a low of 85 around hour 9.8. Respiratory rate ended at 22; the available labs showed white count fell from 12.1 to 8.2, creatinine was roughly stable (1.3 to 1.2), lactate rose from 1.7 to 2.9, and urine output fell from 795 to 40.
B. For handoff, the heart rate fell from 80 to 59, MAP stayed around 78, and diastolic pressure moved from 61 to 59. Systolic pressure ranged 85-147 and ended at 140, and SpO2 recovered to 99 after a low of 85 around hour 8.8. Respiratory rate ended at 22; the available labs showed white count fell from 12.1 to 8.2, creatinine was roughly stable (1.3 to 1.2), lactate rose from 1.7 to 2.9, and urine output fell from 795 to 40.
C. For handoff, the heart rate fell from 84 to 62, MAP stayed around 82, and diastolic pressure moved from 65 to 56. Systolic pressure ranged 89-122 and ended at 115, and SpO2 recovered to 100 after a low of 81 around hour 9.4. Respiratory rate ended at 24; the available labs showed white count fell from 10.2 to 8.8, creatinine was roughly stable (1.6 to 0.9), lactate rose from 1.9 to 3.1, and urine output fell from 770 to 44.
D. For handoff, the heart rate fell from 76 to 64, MAP stayed around 74, and diastolic pressure moved from 56 to 64. Systolic pressure ranged 80-177 and ended at 170, and SpO2 recovered to 94 after a low of 84 around hour 8.1. Respiratory rate ended at 20; the available labs showed white count fell from 14.3 to 7.4, creatinine was roughly stable (1.0 to 1.5), lactate rose from 1.4 to 2.6, and urine output fell from 845 to 36.

Answer: B


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

Options:
A. For handoff, the heart rate rose from 53 to 92, while MAP fell from 85 to 68. Systolic pressure was labile, ranging 71-129, with the lowest value around hour 2.7. SpO2 briefly dipped to 91 around hour 1 before recovering to 94, while respiratory rate peaked at 30 and later settled at 30. The associated labs and urine output showed that white count rose from 2.5 to 9.3, creatinine was roughly stable (0.5 to 0.4), lactate fell from 3.1 to 2, and urine output was roughly stable (18 to 55), with recorded outputs ranging 16-305.
B. For handoff, the heart rate rose from 48 to 97, while MAP fell from 80 to 62. Systolic pressure was labile, ranging 78-164, with the lowest value around hour 2.4. SpO2 briefly dipped to 86 around hour 0 before recovering to 99, while respiratory rate peaked at 30 and later settled at 27. The associated labs and urine output showed that white count rose from 2.9 to 8.4, creatinine was roughly stable (0.3 to 0.6), lactate fell from 2.8 to 2, and urine output rose from 21 to 103, with recorded outputs ranging 14-270.
C. For handoff, the heart rate rose from 54 to 91, while MAP fell from 86 to 69. Systolic pressure was labile, ranging 70-124, with the lowest value around hour 2.8. SpO2 briefly dipped to 92 around hour 2 before recovering to 93, while respiratory rate peaked at 30 and later settled at 30. The associated labs and urine output showed that white count rose from 2.5 to 8, creatinine rose from 0.5 to 0.6, lactate fell from 3.1 to 2, and urine output rose from 18 to 109, with recorded outputs ranging 20-310.
D. For handoff, the heart rate rose from 50 to 95, while MAP fell from 82 to 65. Systolic pressure was labile, ranging 74-149, with the lowest value around hour 2.5. SpO2 briefly dipped to 88 around hour 0 before recovering to 97, while respiratory rate peaked at 28 and later settled at 28. The associated labs and urine output showed that white count rose from 2.7 to 8.8, creatinine was roughly stable (0.4 to 0.5), lactate fell from 2.9 to 2, and urine output rose from 20 to 105, with recorded outputs ranging 15-285.

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 fell from 146 to 107, MAP fell from 85 to 68, and heart rate rose from 47 to 98. SpO2 started at 85, ended at 100, and fell as low as 91 around hour 0; respiratory rate ranged 12-26. For labs and output, white count rose from 2.5 to 9.3, creatinine rose from 0.5 to 0.6, lactate fell from 3.1 to 2, and urine output rose from 18 to 108.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 126 to 110, MAP fell from 82 to 65, and heart rate rose from 50 to 95. SpO2 started at 88, ended at 97, and fell as low as 88 around hour 0; respiratory rate ranged 11-28. For labs and output, white count rose from 2.7 to 8.8, creatinine was roughly stable (0.4 to 0.5), lactate fell from 2.9 to 2, and urine output rose from 20 to 105.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 151 to 106, MAP fell from 86 to 68, and heart rate rose from 46 to 99. SpO2 started at 84, ended at 100, and fell as low as 87 around hour 0; respiratory rate ranged 13-26. For labs and output, white count rose from 2.5 to 9.4, creatinine was roughly stable (0.5 to 0.4), lactate fell from 3.1 to 2, and urine output rose from 18 to 109.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 96 to 93, MAP fell from 78 to 60, and heart rate rose from 54 to 98. SpO2 started at 92, ended at 92, and fell as low as 84 around hour 3; respiratory rate ranged 9-30. For labs and output, white count rose from 3.0 to 8, creatinine was roughly stable (0.2 to 0.7), lactate fell from 2.6 to 2, and urine output rose from 22 to 100.

Answer: B


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

Options:
A. Across the recorded window, the heart rate rose from 53 to 92, MAP fell from 85 to 68, and diastolic pressure moved from 61 to 49. Systolic pressure ranged 77-169 and ended at 106, and SpO2 recovered to 94 after a low of 91 around hour 1. Respiratory rate ended at 26; the available labs showed white count rose from 2.9 to 9.3, creatinine was roughly stable (0.3 to 0.6), lactate fell from 3.1 to 2, and urine output rose from 22 to 108.
B. Across the recorded window, the heart rate rose from 48 to 98, MAP fell from 80 to 63, and diastolic pressure moved from 66 to 43. Systolic pressure ranged 72-134 and ended at 108, and SpO2 recovered to 99 after a low of 86 around hour 0. Respiratory rate ended at 29; the available labs showed white count rose from 2.6 to 8.4, creatinine was roughly stable (0.5 to 0.4), lactate fell from 2.8 to 2, and urine output rose from 19 to 103.
C. Across the recorded window, the heart rate rose from 50 to 95, MAP fell from 82 to 65, and diastolic pressure moved from 64 to 46. Systolic pressure ranged 74-149 and ended at 110, and SpO2 recovered to 97 after a low of 88 around hour 0. Respiratory rate ended at 28; the available labs showed white count rose from 2.7 to 8.8, creatinine was roughly stable (0.4 to 0.5), lactate fell from 2.9 to 2, and urine output rose from 20 to 105.
D. Across the recorded window, the heart rate rose from 46 to 100, MAP fell from 78 to 60, and diastolic pressure moved from 68 to 42. Systolic pressure ranged 70-119 and ended at 106, and SpO2 recovered to 100 after a low of 87 around hour 0. Respiratory rate ended at 30; the available labs showed white count rose from 2.4 to 8, creatinine was roughly stable (0.6 to 0.3), lactate fell from 2.6 to 2, and urine output was roughly stable (70 to 100)

Answer: C


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

Options:
A. Clinically, the heart rate was roughly stable (87 to 80), while MAP fell from 110 to 95. Systolic pressure was labile, ranging 104-130, with the lowest value around hour 15.3. SpO2 briefly dipped to 88 around hour 12.2 before recovering to 93, while respiratory rate peaked at 33 and later settled at 16. The associated labs and urine output showed that white count was roughly stable (3.7 to 3.2), creatinine was roughly stable (0.7 to 0.7), lactate was checked once at 270, and urine output rose from 250 to 350, with recorded outputs ranging 120-350.
B. Clinically, the heart rate was roughly stable (84 to 83), while MAP fell from 107 to 92. Systolic pressure was labile, ranging 107-150, with the lowest value around hour 13.8. SpO2 briefly dipped to 85 around hour 10.7 before recovering to 96, while respiratory rate peaked at 30 and later settled at 14. The associated labs and urine output showed that white count was roughly stable (4.2 to 4), creatinine stayed around 0.6, lactate was checked once at 270, and urine output rose from 250 to 350, with recorded outputs ranging 70-350.
C. Clinically, the heart rate was roughly stable (88 to 79), while MAP fell from 111 to 95. Systolic pressure was labile, ranging 103-125, with the lowest value around hour 15.7. SpO2 briefly dipped to 89 around hour 11.7 before recovering to 92, while respiratory rate peaked at 34 and later settled at 16. The associated labs and urine output showed that white count was roughly stable (3.6 to 5), creatinine stayed around 0.7, lactate was checked once at 245, and urine output was roughly stable (275 to 300), with recorded outputs ranging 66-325.
D. Clinically, the heart rate was roughly stable (80 to 88), while MAP fell from 102 to 88. Systolic pressure was labile, ranging 111-180, with the lowest value around hour 11.6. SpO2 briefly dipped to 86 around hour 8.4 before recovering to 100, while respiratory rate peaked at 32 and later settled at 12. The associated labs and urine output showed that white count was roughly stable (5.0 to 3), creatinine stayed around 0.4, lactate was checked once at 300, and urine output rose from 220 to 320, with recorded outputs ranging 74-380.

Answer: B


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (144 to 128), MAP fell from 110 to 95, and heart rate was roughly stable (81 to 86). SpO2 started at 93, ended at 99, and fell as low as 84 around hour 9.2; respiratory rate ranged 12-27. For labs and output, white count was roughly stable (3.7 to 4), creatinine stayed around 0.7, lactate was checked once at 250, and urine output rose from 270 to 370.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 109 to 147, MAP fell from 105 to 90, and heart rate was roughly stable (86 to 81). SpO2 started at 98, ended at 94, and fell as low as 83 around hour 11.8; respiratory rate ranged 10-32. For labs and output, white count was roughly stable (4.6 to 4), creatinine was roughly stable (0.5 to 0.7), lactate was checked once at 270.2, and urine output rose from 250 to 350.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 149 to 169, MAP fell from 111 to 96, and heart rate was roughly stable (80 to 86). SpO2 started at 92, ended at 100, and fell as low as 89 around hour 8.8; respiratory rate ranged 13-32. For labs and output, white count was roughly stable (3.6 to 3.2), creatinine stayed around 0.7, lactate was checked once at 245, and urine output rose from 275 to 375.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 124 to 132, MAP fell from 107 to 92, and heart rate was roughly stable (84 to 83). SpO2 started at 96, ended at 96, and fell as low as 85 around hour 10.7; respiratory rate ranged 11-30. For labs and output, white count was roughly stable (4.2 to 4), creatinine stayed around 0.6, lactate was checked once at 270, and urine output rose from 250 to 350.

Answer: D


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

Options:
A. Taken together, the heart rate rose from 93 to 105, MAP rose from 76 to 89, and diastolic pressure moved from 55 to 81. Systolic pressure ranged 87-172 and ended at 115, and SpO2 recovered to 96 after a low of 88 around hour 5.2. Respiratory rate ended at 24; the available labs showed white count rose from 6 to 8.8, creatinine was roughly stable (0.5 to 0.8), lactate fell from 2.4 to 1.2, and urine output fell from 530 to 220.
B. Taken together, the heart rate rose from 88 to 110, MAP rose from 71 to 84, and diastolic pressure moved from 60 to 76. Systolic pressure ranged 82-137 and ended at 117, and SpO2 recovered to 100 after a low of 84 around hour 3.8. Respiratory rate ended at 26; the available labs showed white count rose from 6 to 7.5, creatinine was roughly stable (0.7 to 0.6), lactate fell from 2.1 to 1.5, and urine output fell from 560 to 185.
C. Taken together, the heart rate rose from 94 to 111, MAP rose from 77 to 90, and diastolic pressure moved from 54 to 75. Systolic pressure ranged 88-177 and ended at 123, and SpO2 recovered to 95 after a low of 89 around hour 4.8. Respiratory rate ended at 23; the available labs showed white count rose from 7 to 8.9, creatinine was roughly stable (0.5 to 0.8), lactate fell from 2.5 to 1.1, and urine output fell from 535 to 225.
D. Taken together, the heart rate rose from 90 to 108, MAP rose from 73 to 86, and diastolic pressure moved from 58 to 78. Systolic pressure ranged 84-152 and ended at 119, and SpO2 recovered to 99 after a low of 85 around hour 4.2. Respiratory rate ended at 25; the available labs showed white count rose from 6 to 8.3, creatinine was roughly stable (0.6 to 0.7), lactate fell from 2.2 to 1.4, and urine output fell from 510 to 200.

Answer: D


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (93 to 92), diastolic pressure rose from 81 to 91, and heart rate fell from 93 to 58. The lowest MAP was about 70 around hour 9.7, and the lowest valid SpO2 was 84 around hour 10; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.7-34.4 C, white count was 9.1 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 370 to 670.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (90 to 95), diastolic pressure rose from 78 to 88, and heart rate fell from 96 to 55. The lowest MAP was about 67 around hour 11.2, and the lowest valid SpO2 was 85 around hour 11; respiratory rate rose as high as 22 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 36.7-37.4 C, white count was 8.6 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output rose from 350 to 650.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (94 to 91), diastolic pressure rose from 82 to 85, and heart rate fell from 92 to 59. The lowest MAP was about 70 around hour 12.2, and the lowest valid SpO2 was 89 around hour 9; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.0-33.6 C, white count was 9.2 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 375 to 675.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (86 to 100), diastolic pressure rose from 74 to 84, and heart rate fell from 100 to 50. The lowest MAP was about 62 around hour 13.4, and the lowest valid SpO2 was 80 around hour 13; respiratory rate rose as high as 24 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 41.2-41.9 C, white count was 7.8 on its only check, creatinine was 1.1 on its only check, lactate was not available, and urine output rose from 320 to 700.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (90 to 95), diastolic pressure rose from 78 to 88, and heart rate fell from 96 to 55. The lowest MAP was about 67 around hour 11.2, and the lowest valid SpO2 was 85 around hour 11; respiratory rate rose as high as 22 but ended at 22. The lower-frequency data fit that summary: temperature ranged from 98.1 to 99.3, white count was 8.6 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output rose from 350 to 650.


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

Options:
A. Clinically, the heart rate fell from 99 to 58, MAP was roughly stable (93 to 98), and diastolic pressure moved from 75 to 85. Systolic pressure ranged 118-162 and ended at 118, and SpO2 recovered to 82 after a low of 88 around hour 12. Respiratory rate ended at 20; the available labs showed white count was 9.1 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output rose from 330 to 670.
B. Clinically, the heart rate fell from 94 to 57, MAP was roughly stable (88 to 93), and diastolic pressure moved from 80 to 86. Systolic pressure ranged 113-127 and ended at 113, and SpO2 recovered to 87 after a low of 84 around hour 10. Respiratory rate ended at 23; the available labs showed white count was 8.2 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 400 to 635.
C. Clinically, the heart rate fell from 100 to 51, MAP rose from 94 to 98, and diastolic pressure moved from 74 to 92. Systolic pressure ranged 111-167 and ended at 111, and SpO2 recovered to 81 after a low of 89 around hour 12. Respiratory rate ended at 20; the available labs showed white count was 9.2 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output rose from 325 to 675.
D. Clinically, the heart rate fell from 96 to 55, MAP was roughly stable (90 to 95), and diastolic pressure moved from 78 to 88. Systolic pressure ranged 115-142 and ended at 115, and SpO2 recovered to 85 after a low of 85 around hour 11. Respiratory rate ended at 22; the available labs showed white count was 8.6 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output rose from 350 to 650.

Answer: D


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

Options:
A. Clinically, the heart rate rose from 53 to 77, while MAP fell from 86 to 79. Systolic pressure was labile, ranging 80-105, with the lowest value around hour 18.9. SpO2 briefly dipped to 86 around hour 12.9 before recovering to 92, while respiratory rate peaked at 25 and later settled at 24. The associated labs and urine output showed that white count rose from 1 to 9.6, creatinine fell from 1.7 to 1.0, lactate was checked once at 220, and urine output fell from 470 to 280, with recorded outputs ranging 320-880.
B. Clinically, the heart rate rose from 50 to 80, while MAP fell from 83 to 76. Systolic pressure was labile, ranging 76-108, with the lowest value around hour 17.4. SpO2 briefly dipped to 85 around hour 11.4 before recovering to 95, while respiratory rate peaked at 23 and later settled at 23. The associated labs and urine output showed that white count rose from 1 to 9.1, creatinine fell from 1.5 to 1.2, lactate was checked once at 200, and urine output fell from 450 to 300, with recorded outputs ranging 300-900.
C. Clinically, the heart rate rose from 54 to 76, while MAP was roughly stable (87 to 79). Systolic pressure was labile, ranging 72-104, with the lowest value around hour 19.3. SpO2 briefly dipped to 89 around hour 12.4 before recovering to 91, while respiratory rate peaked at 25 and later settled at 25. The associated labs and urine output showed that white count rose from 1 to 9.7, creatinine fell from 1.8 to 0.9, lactate was checked once at 225, and urine output fell from 475 to 250, with recorded outputs ranging 250-875.
D. Clinically, the heart rate rose from 46 to 83, while MAP fell from 78 to 72. Systolic pressure was labile, ranging 80-112, with the lowest value around hour 15.1. SpO2 briefly dipped to 80 around hour 9.2 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 rose from 1 to 8.3, creatinine fell from 1.2 to 1.0, lactate was checked once at 170, and urine output fell from 420 to 330, with recorded outputs ranging 270-930.

Answer: B


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

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 73, diastolic pressure fell from 76 to 65, and heart rate rose from 47 to 83. The lowest MAP was about 62 around hour 18.4, and the lowest valid SpO2 was 88 around hour 9.9; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.4-33.6 C, white count rose from 1 to 8.6, creatinine fell from 1.7 to 1.4, lactate was checked once at 180, and urine output fell from 470 to 320.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 81 to 78, diastolic pressure was roughly stable (71 to 66), and heart rate rose from 52 to 78. The lowest MAP was about 57 around hour 18.5, and the lowest valid SpO2 was 83 around hour 12.5; respiratory rate rose as high as 25 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 38.6-38.9 C, white count rose from 1 to 9.5, creatinine fell from 1.4 to 1.3, lactate was checked once at 215, and urine output fell from 435 to 350.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 83 to 76, diastolic pressure was roughly stable (73 to 68), and heart rate rose from 50 to 80. The lowest MAP was about 59 around hour 17.4, and the lowest valid SpO2 was 85 around hour 11.4; respiratory rate rose as high as 23 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 36.4-36.6 C, white count rose from 1 to 9.1, creatinine fell from 1.5 to 1.2, lactate was checked once at 200, and urine output fell from 450 to 300.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 78 to 75, diastolic pressure was roughly stable (68 to 64), and heart rate rose from 54 to 83. The lowest MAP was about 54 around hour 19.6, and the lowest valid SpO2 was 80 around hour 10.4; respiratory rate rose as high as 21 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 40.9-41.1 C, white count rose from 1 to 9.8, creatinine fell from 1.2 to 0.9, lactate was checked once at 230, and urine output fell from 420 to 270.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 83 to 76, diastolic pressure was roughly stable (73 to 68), and heart rate rose from 50 to 80. The lowest MAP was about 59 around hour 17.4, and the lowest valid SpO2 was 85 around hour 11.4; respiratory rate rose as high as 23 but ended at 23. The lower-frequency data fit that summary: temperature ranged from 97.5 to 97.8, white count rose from 1 to 9.1, creatinine fell from 1.5 to 1.2, lactate was checked once at 200, and urine output fell from 450 to 300.


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

Options:
A. Viewed chronologically, the heart rate rose from 53 to 65, while MAP rose from 61 to 68. Systolic pressure was labile, ranging 85-100, with the lowest value around hour 10.3. SpO2 briefly dipped to 91 around hour 0.3 before recovering to 94, while respiratory rate peaked at 26 and later settled at 12. The associated labs and urine output showed that white count fell from 20.6 to 8.0, creatinine fell from 1.4 to 0.8, lactate rose from 3.6 to 177, and urine output fell from 755 to 520, with recorded outputs ranging 495-920.
B. Viewed chronologically, the heart rate rose from 48 to 70, while MAP rose from 56 to 68. Systolic pressure was labile, ranging 83-135, with the lowest value around hour 9.4. SpO2 briefly dipped to 86 around hour 1.2 before recovering to 99, while respiratory rate peaked at 23 and later settled at 9. The associated labs and urine output showed that white count fell from 23.2 to 7.1, creatinine fell from 1.0 to 0.8, lactate rose from 2.7 to 142, and urine output fell from 790 to 450, with recorded outputs ranging 450-885.
C. Viewed chronologically, the heart rate rose from 54 to 64, while MAP rose from 62 to 69. Systolic pressure was labile, ranging 77-95, with the lowest value around hour 10.4. SpO2 briefly dipped to 92 around hour 0.3 before recovering to 93, while respiratory rate peaked at 26 and later settled at 12. The associated labs and urine output showed that white count fell from 20.2 to 6.7, creatinine fell from 1.4 to 1, lactate rose from 3.7 to 182, and urine output fell from 750 to 525, with recorded outputs ranging 500-925.
D. Viewed chronologically, the heart rate rose from 50 to 68, while MAP rose from 58 to 65. Systolic pressure was labile, ranging 81-120, with the lowest value around hour 9.8. SpO2 briefly dipped to 88 around hour 0.2 before recovering to 97, while respiratory rate peaked at 24 and later settled at 10. The associated labs and urine output showed that white count fell from 22.1 to 7.5, creatinine fell from 1.2 to 0.9, lactate rose from 3.1 to 157, and urine output fell from 775 to 500, with recorded outputs ranging 475-900.

Answer: D


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

Options:
A. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 58 to 65, diastolic pressure rose from 47 to 55, and heart rate rose from 50 to 68. The lowest MAP was about 52 around hour 1.8, and the lowest valid SpO2 was 88 around hour 0.2; respiratory rate rose as high as 24 but ended at 10. The lower-frequency data fit that summary: temperature stayed around 36.4-36.9 C, white count fell from 22.1 to 7.5, creatinine fell from 1.2 to 0.9, lactate rose from 3.1 to 157, and urine output fell from 775 to 500.
B. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 56 to 67, diastolic pressure rose from 45 to 53, and heart rate rose from 52 to 66. The lowest MAP was about 50 around hour 2.0, and the lowest valid SpO2 was 86 around hour 0.3; respiratory rate rose as high as 26 but ended at 9. The lower-frequency data fit that summary: temperature stayed around 38.6-39.1 C, white count fell from 21.0 to 7.9, creatinine fell from 1.0 to 0.8, lactate rose from 3.5 to 142, and urine output fell from 760 to 550.
C. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 62 to 65, diastolic pressure rose from 51 to 59, and heart rate rose from 46 to 71. The lowest MAP was about 56 around hour 1.6, and the lowest valid SpO2 was 92 around hour 0; respiratory rate rose as high as 26 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 32.6-33.1 C, white count fell from 24.0 to 6.9, creatinine fell from 1.4 to 1.0, lactate rose from 2.5 to 182, and urine output fell from 800 to 475.
D. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 54 to 70, diastolic pressure was roughly stable (42 to 52), and heart rate rose from 54 to 64. The lowest MAP was about 55 around hour 2.8, and the lowest valid SpO2 was 84 around hour 0.4; respiratory rate rose as high as 22 but ended at 8. The lower-frequency data fit that summary: temperature stayed around 40.9-41.4 C, white count fell from 19.9 to 8.2, creatinine fell from 0.9 to 0.8, lactate rose from 3.9 to 127, and urine output fell from 745 to 530.

Answer: A

In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 58 to 65, diastolic pressure rose from 47 to 55, and heart rate rose from 50 to 68. The lowest MAP was about 52 around hour 1.8, and the lowest valid SpO2 was 88 around hour 0.2; respiratory rate rose as high as 24 but ended at 10. The lower-frequency data fit that summary: temperature ranged from 97.5 to 98.5, white count fell from 22.1 to 7.5, creatinine fell from 1.2 to 0.9, lactate rose from 3.1 to 157, and urine output fell from 775 to 500.


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

Options:
A. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 97, MAP rose from 55 to 68, and heart rate rose from 53 to 65. SpO2 started at 91, ended at 94, and fell as low as 91 around hour 0.3; respiratory rate ranged 8-22. For labs and output, white count fell from 23.6 to 7.0, creatinine fell from 1.4 to 1, lactate rose from 3.3 to 177, and urine output fell from 795 to 480.
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 94, MAP rose from 58 to 65, and heart rate rose from 50 to 68. SpO2 started at 88, ended at 97, and fell as low as 88 around hour 0.2; respiratory rate ranged 9-24. For labs and output, white count fell from 22.1 to 7.5, creatinine fell from 1.2 to 0.9, lactate rose from 3.1 to 157, and urine output fell from 775 to 500.
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (98 to 90), MAP rose from 58 to 68, and heart rate rose from 50 to 68. SpO2 started at 88, ended at 97, and fell as low as 87 around hour 0.2; respiratory rate ranged 9-24. For labs and output, white count fell from 22.1 to 7.5, creatinine fell from 1.2 to 0.9, lactate rose from 3.1 to 157, and urine output fell from 775 to 500.
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 90, MAP rose from 62 to 65, and heart rate rose from 46 to 71. SpO2 started at 84, ended at 100, and fell as low as 84 around hour 0.0; respiratory rate ranged 10-26. For labs and output, white count fell from 19.9 to 6.7, creatinine fell from 0.9 to 0.8, lactate rose from 3.9 to 127, and urine output fell from 745 to 530.

Answer: B


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

Options:
A. Overall, the heart rate rose from 53 to 65, MAP rose from 61 to 68, and diastolic pressure moved from 44 to 58. Systolic pressure ranged 84-140 and ended at 90, and SpO2 recovered to 94 after a low of 91 around hour 1.2. Respiratory rate ended at 8; the available labs showed white count fell from 23.6 to 8.0, creatinine fell from 1.0 to 0.8, lactate rose from 3.6 to 137, and urine output fell from 795 to 520.
B. Overall, the heart rate rose from 48 to 70, MAP rose from 56 to 63, and diastolic pressure moved from 49 to 53. Systolic pressure ranged 79-105 and ended at 92, and SpO2 recovered to 99 after a low of 87 around hour 0.1. Respiratory rate ended at 11; the available labs showed white count fell from 21.0 to 6.7, creatinine fell from 1.4 to 0.8, lactate rose from 2.7 to 172, and urine output fell from 825 to 485.
C. Overall, the heart rate rose from 50 to 68, MAP rose from 58 to 65, and diastolic pressure moved from 47 to 55. Systolic pressure ranged 81-120 and ended at 94, and SpO2 recovered to 97 after a low of 88 around hour 0.2. Respiratory rate ended at 10; the available labs showed white count fell from 22.1 to 7.5, creatinine fell from 1.2 to 0.9, lactate rose from 3.1 to 157, and urine output fell from 775 to 500.
D. Overall, the heart rate rose from 46 to 71, MAP rose from 54 to 60, and diastolic pressure moved from 52 to 52. Systolic pressure ranged 76-90 and ended at 90, and SpO2 recovered to 100 after a low of 84 around hour 0.0. Respiratory rate ended at 12; the available labs showed white count fell from 19.9 to 6.8, creatinine fell from 1.5 to 0.8, lactate rose from 2.4 to 187, and urine output fell from 745 to 470.

Answer: C


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

Options:
A. Across the recorded window, the heart rate fell from 94 to 73, MAP was roughly stable (76 to 78), and diastolic pressure moved from 52 to 64. Systolic pressure ranged 84-194 and ended at 142, and SpO2 recovered to 94 after a low of 84 around hour 36. Respiratory rate ended at 4; the available labs showed white count fell from 8.6 to 6, creatinine fell from 0.9 to 0.7, lactate was checked once at 2, and urine output fell from 250 to 97.
B. Across the recorded window, the heart rate fell from 89 to 78, MAP was roughly stable (71 to 78), and diastolic pressure moved from 57 to 59. Systolic pressure ranged 79-159 and ended at 118, and SpO2 recovered to 99 after a low of 83 around hour 34. Respiratory rate ended at 5; the available labs showed white count fell from 7.7 to 6.4, creatinine fell from 1.2 to 0.8, lactate was checked once at 2, and urine output fell from 215 to 98.
C. Across the recorded window, the heart rate fell from 91 to 76, MAP was roughly stable (73 to 75), and diastolic pressure moved from 55 to 61. Systolic pressure ranged 81-174 and ended at 122, and SpO2 recovered to 97 after a low of 85 around hour 33. Respiratory rate ended at 5; the available labs showed white count fell from 8.1 to 6.8, creatinine fell from 1.1 to 0.9, lactate was checked once at 2, and urine output fell from 200 to 100.
D. Across the recorded window, the heart rate fell from 86 to 79, MAP was roughly stable (68 to 70), and diastolic pressure moved from 60 to 58. Systolic pressure ranged 76-144 and ended at 92, and SpO2 recovered to 100 after a low of 80 around hour 28. Respiratory rate ended at 6; the available labs showed white count fell from 7.3 to 6.0, creatinine fell from 1.4 to 0.8, lactate was checked once at 2, and urine output fell from 230 to 96.

Answer: C


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

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 55 to 64, diastolic pressure rose from 43 to 54, and heart rate rose from 47 to 94. The lowest MAP was about 55 around hour 1.2, and the lowest valid SpO2 was 88 around hour 2.8; respiratory rate rose as high as 30 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.8-36.2 C, white count fell from 15.3 to 10.7, creatinine was roughly stable (0.5 to 0.6), lactate fell from 285 to 0.8, and urine output was roughly stable (97 to 107)
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 50 to 69, diastolic pressure rose from 38 to 55, and heart rate rose from 52 to 89. The lowest MAP was about 50 around hour 0.3, and the lowest valid SpO2 was 83 around hour 3.7; respiratory rate rose as high as 31 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 38.0-41.5 C, white count fell from 12.7 to 11.2, creatinine rose from 0.3 to 0.6, lactate fell from 320 to 0.6, and urine output was roughly stable (98 to 160)
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 52 to 67, diastolic pressure rose from 40 to 57, and heart rate rose from 50 to 91. The lowest MAP was about 52 around hour 0.2, and the lowest valid SpO2 was 85 around hour 3.3; respiratory rate rose as high as 29 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 35.8-39.2 C, white count fell from 13.8 to 12.2, creatinine was roughly stable (0.4 to 0.5), lactate fell from 305 to 0.7, and urine output was roughly stable (100 to 110)
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 48 to 72, diastolic pressure rose from 36 to 52, and heart rate rose from 54 to 94. The lowest MAP was about 48 around hour 0.4, and the lowest valid SpO2 was 80 around hour 2.3; respiratory rate rose as high as 27 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 40.3-43.7 C, white count fell from 11.6 to 10.1, creatinine was roughly stable (0.2 to 0.3), lactate fell from 335 to 0.5, and urine output was roughly stable (96 to 114)

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 52 to 67, diastolic pressure rose from 40 to 57, and heart rate rose from 50 to 91. The lowest MAP was about 52 around hour 0.2, and the lowest valid SpO2 was 85 around hour 3.3; respiratory rate rose as high as 29 but ended at 18. The lower-frequency data fit that summary: temperature ranged from 96.4 to 102.6, white count fell from 13.8 to 12.2, creatinine was roughly stable (0.4 to 0.5), lactate fell from 305 to 0.7, and urine output was roughly stable (100 to 110)


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 94 to 103, MAP rose from 55 to 70, and heart rate rose from 47 to 94. SpO2 started at 87, ended at 100, and fell as low as 88 around hour 2.8; respiratory rate ranged 16-31. For labs and output, white count fell from 12.3 to 11.4, creatinine was roughly stable (0.5 to 0.4), lactate fell from 325 to 0.8, and urine output was roughly stable (97 to 113)
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 89 to 102, MAP rose from 50 to 70, and heart rate rose from 52 to 89. SpO2 started at 92, ended at 95, and fell as low as 84 around hour 3.7; respiratory rate ranged 13-30. For labs and output, white count fell from 14.9 to 11.1, creatinine was roughly stable (0.3 to 0.6), lactate fell from 290 to 0.6, and urine output was roughly stable (98 to 108)
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 95 to 102, MAP rose from 56 to 71, and heart rate rose from 46 to 95. SpO2 started at 86, ended at 100, and fell as low as 89 around hour 2.7; respiratory rate ranged 16-27. For labs and output, white count fell from 11.9 to 10.4, creatinine rose from 0.5 to 0.6, lactate fell from 305.2 to 0.8, and urine output was roughly stable (96 to 114)
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 91 to 106, MAP rose from 52 to 67, and heart rate rose from 50 to 91. SpO2 started at 90, ended at 97, and fell as low as 85 around hour 3.3; respiratory rate ranged 14-29. For labs and output, white count fell from 13.8 to 12.2, creatinine was roughly stable (0.4 to 0.5), lactate fell from 305 to 0.7, and urine output was roughly stable (100 to 110)

Answer: D


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

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 85, diastolic pressure fell from 88 to 77, and heart rate rose from 57 to 149. The lowest MAP was about 69 around hour 41.1, and the lowest valid SpO2 was 88 around hour 1.6; respiratory rate rose as high as 30 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.4-34 C, white count fell from 15.0 to 9.3, creatinine rose from 1.0 to 1.3, lactate fell from 132 to 1.6, and urine output fell from 420 to 130.
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 99 to 88, diastolic pressure was roughly stable (85 to 80), and heart rate rose from 60 to 129. The lowest MAP was about 66 around hour 40.1, and the lowest valid SpO2 was 85 around hour 1.8; respiratory rate rose as high as 29 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.4-37 C, white count fell from 13.5 to 10.8, creatinine rose from 0.9 to 1.1, lactate fell from 152 to 1.4, and urine output fell from 400 to 150.
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 84, diastolic pressure was roughly stable (89 to 84), and heart rate rose from 56 to 154. The lowest MAP was about 70 around hour 36.4, and the lowest valid SpO2 was 89 around hour 1.6; respiratory rate rose as high as 31 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 32.6-33 C, white count fell from 15.4 to 8.9, creatinine rose from 1.0 to 1.2, lactate fell from 127 to 1.6, and urine output fell from 425 to 200.
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 92, diastolic pressure was roughly stable (80 to 76), and heart rate rose from 64 to 132. The lowest MAP was about 62 around hour 44.6, and the lowest valid SpO2 was 80 around hour 0.8; respiratory rate rose as high as 27 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 40.9-42 C, white count fell from 11.2 to 9.7, creatinine rose from 0.8 to 0.9, lactate fell from 182 to 1.1, and urine output fell from 370 to 180.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 99 to 88, diastolic pressure was roughly stable (85 to 80), and heart rate rose from 60 to 129. The lowest MAP was about 66 around hour 40.1, and the lowest valid SpO2 was 85 around hour 1.8; respiratory rate rose as high as 29 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 97.5 to 98.6, white count fell from 13.5 to 10.8, creatinine rose from 0.9 to 1.1, lactate fell from 152 to 1.4, and urine output fell from 400 to 150.


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

Options:
A. Taken together, the heart rate rose from 63 to 109, MAP fell from 100 to 91, and diastolic pressure moved from 82 to 83. Systolic pressure ranged 97-170 and ended at 109, and SpO2 recovered to 93 after a low of 88 around hour 2.8. Respiratory rate ended at 20; the available labs showed white count fell from 15.0 to 12.3, creatinine rose from 0.8 to 1.3, lactate fell from 172 to 1.2, and urine output fell from 420 to 170.
B. Taken together, the heart rate rose from 58 to 132, MAP fell from 97 to 86, and diastolic pressure moved from 87 to 77. Systolic pressure ranged 98-135 and ended at 111, and SpO2 recovered to 98 after a low of 83 around hour 1.6. Respiratory rate ended at 22; the available labs showed white count fell from 12.4 to 9.7, creatinine rose from 1.0 to 1.2, lactate fell from 137 to 1.5, and urine output fell from 385 to 135.
C. Taken together, the heart rate rose from 64 to 104, MAP fell from 100 to 92, and diastolic pressure moved from 81 to 84. Systolic pressure ranged 96-175 and ended at 117, and SpO2 recovered to 92 after a low of 84 around hour 2.0. Respiratory rate ended at 19; the available labs showed white count fell from 15.4 to 10, creatinine rose from 0.8 to 1.4, lactate fell from 177 to 1.1, and urine output fell from 450 to 175.
D. Taken together, the heart rate rose from 60 to 129, MAP fell from 99 to 88, and diastolic pressure moved from 85 to 80. Systolic pressure ranged 100-150 and ended at 113, and SpO2 recovered to 96 after a low of 85 around hour 1.8. Respiratory rate ended at 21; the available labs showed white count fell from 13.5 to 10.8, creatinine rose from 0.9 to 1.1, lactate fell from 152 to 1.4, and urine output fell from 400 to 150.

Answer: D