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

Options:
A. In broad terms, the heart rate fell from 92 to 69, while MAP rose from 78 to 90. Systolic pressure was labile, ranging 110-135, with the lowest value around hour 27.6. SpO2 briefly dipped to 86 around hour 8.6 before recovering to 93, while respiratory rate peaked at 38 and later settled at 22. The associated labs and urine output showed that white count fell from 22.0 to 16.1, creatinine fell from 2.7 to 0.8, lactate rose from 2 to 222, and urine output fell from 205 to 140, with recorded outputs ranging 53-395.
B. In broad terms, the heart rate fell from 87 to 74, while MAP rose from 73 to 85. Systolic pressure was labile, ranging 108-170, with the lowest value around hour 25.0. SpO2 briefly dipped to 83 around hour 7.7 before recovering to 98, while respiratory rate peaked at 34 and later settled at 19. The associated labs and urine output showed that white count fell from 24.6 to 13.8, creatinine fell from 2.4 to 1, lactate rose from 2 to 187, and urine output fell from 240 to 105, with recorded outputs ranging 100-360.
C. In broad terms, the heart rate fell from 89 to 72, while MAP rose from 75 to 87. Systolic pressure was labile, ranging 106-155, with the lowest value around hour 26.1. SpO2 briefly dipped to 85 around hour 8.1 before recovering to 96, while respiratory rate peaked at 36 and later settled at 20. The associated labs and urine output showed that white count fell from 23.5 to 14.6, creatinine fell from 2.5 to 0.9, lactate rose from 2 to 202, and urine output fell from 225 to 120, with recorded outputs ranging 50-375.
D. In broad terms, the heart rate fell from 84 to 76, while MAP rose from 70 to 90. Systolic pressure was labile, ranging 110-185, with the lowest value around hour 23.9. SpO2 briefly dipped to 80 around hour 9.1 before recovering to 100, while respiratory rate peaked at 32 and later settled at 18. The associated labs and urine output showed that white count fell from 25.8 to 12.3, creatinine fell from 2.2 to 1.1, lactate rose from 2 to 172, and urine output fell from 255 to 70, with recorded outputs ranging 46-345.

Answer: C


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 78 to 84, diastolic pressure rose from 65 to 72, and heart rate fell from 86 to 75. The lowest MAP was about 75 around hour 24.6, and the lowest valid SpO2 was 88 around hour 7.1; respiratory rate rose as high as 39 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 34-34.7 C, white count fell from 25.0 to 13.1, creatinine fell from 2.7 to 1.0, lactate rose from 2 to 222, and urine output fell from 245 to 100.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 73 to 89, diastolic pressure was roughly stable (60 to 66), and heart rate fell from 91 to 70. The lowest MAP was about 75 around hour 27.1, and the lowest valid SpO2 was 83 around hour 8.5; respiratory rate rose as high as 34 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 39-40.0 C, white count fell from 22.4 to 15.7, creatinine fell from 2.4 to 0.8, lactate rose from 2 to 187, and urine output fell from 210 to 135.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 79 to 83, diastolic pressure rose from 66 to 73, and heart rate fell from 85 to 76. The lowest MAP was about 76 around hour 24.2, and the lowest valid SpO2 was 89 around hour 7.5; respiratory rate rose as high as 38 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33-34.0 C, white count fell from 25.4 to 12.7, creatinine fell from 2.8 to 1, lactate rose from 2 to 227, and urine output was roughly stable (250 to 170)
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 75 to 87, diastolic pressure rose from 62 to 69, and heart rate fell from 89 to 72. The lowest MAP was about 72 around hour 26.1, and the lowest valid SpO2 was 85 around hour 8.1; respiratory rate rose as high as 36 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 37-37.7 C, white count fell from 23.5 to 14.6, creatinine fell from 2.5 to 0.9, lactate rose from 2 to 202, and urine output fell from 225 to 120.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 75 to 87, diastolic pressure rose from 62 to 69, and heart rate fell from 89 to 72. The lowest MAP was about 72 around hour 26.1, and the lowest valid SpO2 was 85 around hour 8.1; respiratory rate rose as high as 36 but ended at 20. The lower-frequency data fit that summary: temperature ranged from 98.6 to 99.8, white count fell from 23.5 to 14.6, creatinine fell from 2.5 to 0.9, lactate rose from 2 to 202, and urine output fell from 225 to 120.


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

Options:
A. For handoff, the heart rate fell from 92 to 69, MAP rose from 78 to 90, and diastolic pressure moved from 59 to 72. Systolic pressure ranged 109-175 and ended at 136, and SpO2 recovered to 93 after a low of 88 around hour 9.1. Respiratory rate ended at 18; the available labs showed white count fell from 25.0 to 16.1, creatinine fell from 2.3 to 1.0, lactate rose from 2 to 182, and urine output fell from 245 to 140.
B. For handoff, the heart rate fell from 89 to 72, MAP rose from 75 to 87, and diastolic pressure moved from 62 to 69. Systolic pressure ranged 106-155 and ended at 140, and SpO2 recovered to 96 after a low of 85 around hour 8.1. Respiratory rate ended at 20; the available labs showed white count fell from 23.5 to 14.6, creatinine fell from 2.5 to 0.9, lactate rose from 2 to 202, and urine output fell from 225 to 120.
C. For handoff, the heart rate fell from 93 to 68, MAP rose from 79 to 91, and diastolic pressure moved from 58 to 73. Systolic pressure ranged 110-180 and ended at 165, and SpO2 recovered to 92 after a low of 84 around hour 8.7. Respiratory rate ended at 18; the available labs showed white count fell from 25.4 to 13.8, creatinine fell from 2.2 to 1.0, lactate rose from 2 to 177, and urine output fell from 275 to 145.
D. For handoff, the heart rate fell from 84 to 75, MAP rose from 70 to 82, and diastolic pressure moved from 66 to 66. Systolic pressure ranged 102-125 and ended at 110, and SpO2 recovered to 100 after a low of 80 around hour 7.3. Respiratory rate ended at 22; the available labs showed white count fell from 21.2 to 12.3, creatinine fell from 2.8 to 0.8, lactate rose from 2 to 232, and urine output fell from 195 to 90.

Answer: B


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

Options:
A. For handoff, the heart rate fell from 76 to 39, while MAP rose from 79 to 93. Systolic pressure was labile, ranging 91-144, with the lowest value around hour 7.2. SpO2 briefly dipped to 91 around hour 1.6 before recovering to 95, while respiratory rate peaked at 26 and later settled at 20. The associated labs and urine output showed that white count fell from 7.8 to 7.4, creatinine stayed around 0.8, lactate fell from 175 to 2.4, and urine output fell from 270 to 80, with recorded outputs ranging 33-330.
B. For handoff, the heart rate fell from 71 to 44, while MAP rose from 74 to 88. Systolic pressure was labile, ranging 96-179, with the lowest value around hour 6.3. SpO2 briefly dipped to 86 around hour 0.5 before recovering to 100, while respiratory rate peaked at 23 and later settled at 18. The associated labs and urine output showed that white count fell from 8.7 to 6.1, creatinine was roughly stable (0.6 to 0.8), lactate fell from 195 to 2.2, and urine output fell from 250 to 130, with recorded outputs ranging 80-350.
C. For handoff, the heart rate fell from 77 to 38, while MAP rose from 80 to 94. Systolic pressure was labile, ranging 98-139, with the lowest value around hour 7.3. SpO2 briefly dipped to 89 around hour 0.7 before recovering to 94, while respiratory rate peaked at 26 and later settled at 21. The associated labs and urine output showed that white count fell from 7.7 to 7.5, creatinine stayed around 0.8, lactate fell from 170 to 2.5, and urine output fell from 275 to 105, with recorded outputs ranging 34-325.
D. For handoff, the heart rate fell from 73 to 42, while MAP rose from 76 to 90. Systolic pressure was labile, ranging 94-164, with the lowest value around hour 6.7. SpO2 briefly dipped to 88 around hour 0.6 before recovering to 98, while respiratory rate peaked at 24 and later settled at 19. The associated labs and urine output showed that white count fell from 8.3 to 6.9, creatinine stayed around 0.7, lactate fell from 195 to 2.2, and urine output fell from 250 to 130, with recorded outputs ranging 30-350.

Answer: D


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

Options:
A. Across the recorded window, the heart rate fell from 76 to 45, MAP rose from 79 to 93, and diastolic pressure moved from 64 to 70. Systolic pressure ranged 97-184 and ended at 154, and SpO2 recovered to 95 after a low of 91 around hour 0.7. Respiratory rate ended at 18; the available labs showed white count fell from 8.8 to 7.4, creatinine stayed around 0.6, lactate fell from 215 to 2.4, and urine output fell from 230 to 150.
B. Across the recorded window, the heart rate fell from 71 to 44, MAP rose from 74 to 88, and diastolic pressure moved from 69 to 71. Systolic pressure ranged 92-149 and ended at 119, and SpO2 recovered to 100 after a low of 87 around hour 0.5. Respiratory rate ended at 20; the available labs showed white count fell from 7.9 to 6.1, creatinine stayed around 0.8, lactate fell from 180 to 2.1, and urine output fell from 300 to 115.
C. Across the recorded window, the heart rate fell from 73 to 42, MAP rose from 76 to 90, and diastolic pressure moved from 67 to 73. Systolic pressure ranged 94-164 and ended at 134, and SpO2 recovered to 98 after a low of 88 around hour 0.6. Respiratory rate ended at 19; the available labs showed white count fell from 8.3 to 6.9, creatinine stayed around 0.7, lactate fell from 195 to 2.2, and urine output fell from 250 to 130.
D. Across the recorded window, the heart rate fell from 68 to 46, MAP rose from 72 to 93, and diastolic pressure moved from 72 to 68. Systolic pressure ranged 90-134 and ended at 130, and SpO2 recovered to 100 after a low of 84 around hour 1.6. Respiratory rate ended at 21; the available labs showed white count fell from 7.6 to 6.2, creatinine stayed around 0.8, lactate fell from 165 to 1.9, and urine output fell from 280 to 100.

Answer: C


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

Options:
A. Over the available measurements, the heart rate was roughly stable (83 to 74), while MAP was roughly stable (79 to 74). Systolic pressure was labile, ranging 90-108, with the lowest value around hour 17.0. SpO2 briefly dipped to 86 around hour 3.6 before recovering to 92, while respiratory rate peaked at 31 and later settled at 14. The associated labs and urine output showed that white count fell from 12.1 to 9.6, creatinine rose from 0.8 to 0.9, lactate fell from 2.0 to 1.5, and urine output fell from 525 to 370, with recorded outputs ranging 12-565.
B. Over the available measurements, the heart rate was roughly stable (78 to 79), while MAP was roughly stable (74 to 69). Systolic pressure was labile, ranging 88-143, with the lowest value around hour 14.4. SpO2 briefly dipped to 83 around hour 2.7 before recovering to 97, while respiratory rate peaked at 28 and later settled at 12. The associated labs and urine output showed that white count fell from 14.7 to 8.3, creatinine rose from 0.6 to 1, lactate fell from 1.6 to 1.1, and urine output fell from 560 to 335, with recorded outputs ranging 60-530.
C. Over the available measurements, the heart rate was roughly stable (80 to 77), while MAP was roughly stable (76 to 71). Systolic pressure was labile, ranging 86-128, with the lowest value around hour 15.5. SpO2 briefly dipped to 85 around hour 3.1 before recovering to 95, while respiratory rate peaked at 29 and later settled at 13. The associated labs and urine output showed that white count fell from 13.6 to 9.1, creatinine rose from 0.7 to 0.9, lactate fell from 1.8 to 1.3, and urine output fell from 545 to 350, with recorded outputs ranging 10-545.
D. Over the available measurements, the heart rate was roughly stable (76 to 82), while MAP was roughly stable (72 to 74). Systolic pressure was labile, ranging 90-158, with the lowest value around hour 13.2. SpO2 briefly dipped to 80 around hour 4.1 before recovering to 100, while respiratory rate peaked at 27 and later settled at 11. The associated labs and urine output showed that white count fell from 15.8 to 8.3, creatinine rose from 0.5 to 1.1, lactate fell from 1.5 to 1.0, and urine output fell from 575 to 300, with recorded outputs ranging 8-515.

Answer: C


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

Options:
A. Viewed chronologically, the heart rate was roughly stable (83 to 74), MAP was roughly stable (79 to 74), and diastolic pressure moved from 57 to 61. Systolic pressure ranged 89-148 and ended at 95, and SpO2 recovered to 92 after a low of 88 around hour 4.1. Respiratory rate ended at 12; the available labs showed white count fell from 15.1 to 9.6, creatinine rose from 0.6 to 1.0, lactate fell from 2.0 to 1.1, and urine output fell from 565 to 370.
B. Viewed chronologically, the heart rate was roughly stable (80 to 77), MAP was roughly stable (76 to 71), and diastolic pressure moved from 60 to 58. Systolic pressure ranged 86-128 and ended at 99, and SpO2 recovered to 95 after a low of 85 around hour 3.1. Respiratory rate ended at 13; the available labs showed white count fell from 13.6 to 9.1, creatinine rose from 0.7 to 0.9, lactate fell from 1.8 to 1.3, and urine output fell from 545 to 350.
C. Viewed chronologically, the heart rate was roughly stable (84 to 73), MAP was roughly stable (80 to 75), and diastolic pressure moved from 56 to 62. Systolic pressure ranged 90-153 and ended at 100, and SpO2 recovered to 91 after a low of 84 around hour 3.7. Respiratory rate ended at 11; the available labs showed white count fell from 15.5 to 8.3, creatinine rose from 0.6 to 1.0, lactate fell from 2.0 to 1.1, and urine output fell from 595 to 375.
D. Viewed chronologically, the heart rate stayed around 76, MAP was roughly stable (76 to 71), and diastolic pressure moved from 60 to 55. Systolic pressure ranged 86-128 and ended at 99, and SpO2 recovered to 95 after a low of 85 around hour 3.1. Respiratory rate ended at 15; the available labs showed white count fell from 13.6 to 9.1, creatinine rose from 0.7 to 0.9, lactate fell from 1.8 to 1.3, and urine output fell from 545 to 350.

Answer: B


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

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 151 to 77, diastolic pressure fell from 100 to 89, and heart rate stayed around 42. The lowest MAP was about 83 around hour 18.4, and the lowest valid SpO2 was 91 around hour 2; respiratory rate rose as high as 24 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 39.8-40.4 C, white count was 11.9 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 72 to 345.
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 131 to 80, diastolic pressure fell from 97 to 86, and heart rate stayed around 45. The lowest MAP was about 80 around hour 17.4, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 26 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 36.8-37.4 C, white count was 10.4 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 75 to 325.
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 156 to 76, diastolic pressure fell from 100 to 90, and heart rate stayed around 41. The lowest MAP was about 84 around hour 19.3, and the lowest valid SpO2 was 92 around hour 2; respiratory rate rose as high as 28 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 40.5-41.1 C, white count was 12.3 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 71 to 375.
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 101 to 84, diastolic pressure fell from 92 to 82, and heart rate was roughly stable (50 to 48). The lowest MAP was about 80 around hour 17.4, and the lowest valid SpO2 was 87 around hour 0; respiratory rate rose as high as 26 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 36.8-37.4 C, white count was 10.4 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 75 to 325.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 131 to 80, diastolic pressure fell from 97 to 86, and heart rate stayed around 45. The lowest MAP was about 80 around hour 17.4, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 26 but ended at 16. The lower-frequency data fit that summary: temperature ranged from 98.2 to 99.3, white count was 10.4 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 75 to 325.


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 fell from 225 to 126, MAP fell from 151 to 83, and heart rate stayed around 42. SpO2 started at 91, ended at 85, and fell as low as 87 around hour 2; respiratory rate ranged 10-28. For labs and output, white count was 11.9 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 78 to 345.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 190 to 142, MAP fell from 116 to 83, and heart rate stayed around 47. SpO2 started at 86, ended at 90, and fell as low as 87 around hour 0; respiratory rate ranged 12-27. 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 rose from 73 to 310.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 205 to 146, MAP fell from 131 to 80, and heart rate stayed around 45. SpO2 started at 88, ended at 88, and fell as low as 88 around hour 0; respiratory rate ranged 11-26. For labs and output, white count was 10.4 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 75 to 325.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 175 to 155, MAP fell from 101 to 76, and heart rate was roughly stable (50 to 48). SpO2 started at 92, ended at 84, and fell as low as 88 around hour 0; respiratory rate ranged 11-28. For labs and output, white count was 10.4 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 75 to 325.

Answer: C


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

Options:
A. For handoff, the heart rate rose from 64 to 95, while MAP rose from 60 to 79. Systolic pressure was labile, ranging 72-139, with the lowest value around hour 5.3. SpO2 briefly dipped to 88 around hour 5.4 before recovering to 97, while respiratory rate peaked at 24 and later settled at 16. The associated labs and urine output showed that white count fell from 6.6 to 6.4, creatinine fell from 4.4 to 3.0, lactate stayed broadly stable from 1.3 to 1, and urine output fell from 380 to 250, with recorded outputs ranging 220-420.
B. For handoff, the heart rate rose from 59 to 100, while MAP rose from 55 to 74. Systolic pressure was labile, ranging 79-174, with the lowest value around hour 4.4. SpO2 briefly dipped to 86 around hour 4.0 before recovering to 98, while respiratory rate peaked at 25 and later settled at 14. The associated labs and urine output showed that white count fell from 7.5 to 5.5, creatinine fell from 3.5 to 3.0, lactate stayed broadly stable from 1.0 to 1, and urine output fell from 415 to 285, with recorded outputs ranging 185-385.
C. For handoff, the heart rate rose from 65 to 94, while MAP rose from 61 to 80. Systolic pressure was labile, ranging 71-134, with the lowest value around hour 5.4. SpO2 briefly dipped to 89 around hour 5.0 before recovering to 96, while respiratory rate peaked at 25 and later settled at 17. The associated labs and urine output showed that white count fell from 6.5 to 5.1, creatinine fell from 4.5 to 3.6, lactate stayed broadly stable from 1.4 to 1, and urine output fell from 375 to 325, with recorded outputs ranging 250-425.
D. For handoff, the heart rate rose from 61 to 98, while MAP rose from 57 to 76. Systolic pressure was labile, ranging 75-159, with the lowest value around hour 4.8. SpO2 briefly dipped to 85 around hour 4.4 before recovering to 100, while respiratory rate peaked at 23 and later settled at 15. The associated labs and urine output showed that white count fell from 7.1 to 5.9, creatinine fell from 3.9 to 3.5, lactate stayed broadly stable from 1.1 to 1, and urine output fell from 400 to 300, with recorded outputs ranging 200-400.

Answer: D


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

Options:
A. Across the recorded window, the heart rate rose from 64 to 95, MAP rose from 60 to 79, and diastolic pressure moved from 39 to 55. Systolic pressure ranged 78-179 and ended at 154, and SpO2 recovered to 97 after a low of 84 around hour 4.9. Respiratory rate ended at 14; the available labs showed white count fell from 7.6 to 5.1, creatinine fell from 3.4 to 2.9, lactate stayed broadly stable from 1.3 to 1, and urine output fell from 450 to 320.
B. Across the recorded window, the heart rate rose from 59 to 100, MAP rose from 55 to 79, and diastolic pressure moved from 44 to 50. Systolic pressure ranged 73-144 and ended at 130, and SpO2 recovered to 98 after a low of 83 around hour 5.4. Respiratory rate ended at 16; the available labs showed white count fell from 6.7 to 5.5, creatinine fell from 4.3 to 3.1, lactate stayed broadly stable from 1.0 to 1, and urine output fell from 385 to 285.
C. Across the recorded window, the heart rate rose from 61 to 98, MAP rose from 57 to 76, and diastolic pressure moved from 42 to 52. Systolic pressure ranged 75-159 and ended at 134, and SpO2 recovered to 100 after a low of 85 around hour 4.4. Respiratory rate ended at 15; the available labs showed white count fell from 7.1 to 5.9, creatinine fell from 3.9 to 3.5, lactate stayed broadly stable from 1.1 to 1, and urine output fell from 400 to 300.
D. Across the recorded window, the heart rate rose from 56 to 101, MAP rose from 52 to 72, and diastolic pressure moved from 46 to 49. Systolic pressure ranged 70-129 and ended at 104, and SpO2 recovered to 96 after a low of 80 around hour 3.7. Respiratory rate ended at 17; the available labs showed white count fell from 6.3 to 5.2, creatinine fell from 4.7 to 2.8, lactate stayed broadly stable from 0.8 to 1, and urine output fell from 370 to 270.

Answer: C


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 80, diastolic pressure rose from 58 to 67, and heart rate rose from 47 to 91. The lowest MAP was about 53 around hour 33.9, and the lowest valid SpO2 was 91 around hour 0; respiratory rate rose as high as 28 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.7-35.3 C, white count fell from 8.9 to 6.6, creatinine fell from 0.9 to 0.7, lactate was checked once at 2.4, and urine output rose from 53 to 195.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 69 to 83, diastolic pressure rose from 55 to 64, and heart rate rose from 50 to 88. The lowest MAP was about 50 around hour 36.9, and the lowest valid SpO2 was 88 around hour 0.9; respiratory rate rose as high as 26 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.7-38.3 C, white count fell from 8.4 to 7.1, creatinine fell from 0.8 to 0.6, lactate was checked once at 2.6, and urine output rose from 50 to 175.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 73 to 79, diastolic pressure rose from 59 to 68, and heart rate rose from 46 to 92. The lowest MAP was about 54 around hour 33.1, and the lowest valid SpO2 was 92 around hour 0.8; respiratory rate rose as high as 28 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 33.0-34.5 C, white count fell from 9.0 to 6.5, creatinine was roughly stable (0.9 to 0.7), lactate was checked once at 2.4, and urine output rose from 54 to 225.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 64 to 88, diastolic pressure rose from 50 to 61, and heart rate rose from 54 to 84. The lowest MAP was about 53 around hour 37.9, and the lowest valid SpO2 was 84 around hour 1.1; respiratory rate rose as high as 24 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 41.2-42.8 C, white count fell from 7.7 to 7.2, creatinine fell from 0.7 to 0.4, lactate was checked once at 2.9, and urine output rose from 46 to 145.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 69 to 83, diastolic pressure rose from 55 to 64, and heart rate rose from 50 to 88. The lowest MAP was about 50 around hour 36.9, and the lowest valid SpO2 was 88 around hour 0.9; respiratory rate rose as high as 26 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 98.1 to 100.9, white count fell from 8.4 to 7.1, creatinine fell from 0.8 to 0.6, lactate was checked once at 2.6, and urine output rose from 50 to 175.


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 75 to 80, diastolic pressure rose from 70 to 77, and heart rate rose from 93 to 126. The lowest MAP was about 51 around hour 2.5, and the lowest valid SpO2 was 88 around hour 23.7; respiratory rate rose as high as 34 but ended at 33. The lower-frequency data fit that summary: temperature stayed around 33.1-33.9 C, white count was roughly stable (12.2 to 9.4), creatinine was roughly stable (2.5 to 1), lactate stayed broadly stable from 1.1 to 1.3, and urine output was roughly stable (520 to 430)
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 70 to 85, diastolic pressure was roughly stable (65 to 71), and heart rate rose from 98 to 108. The lowest MAP was about 51 around hour 3.7, and the lowest valid SpO2 was 83 around hour 25.8; respiratory rate rose as high as 29 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 38.4-39.1 C, white count was roughly stable (9.6 to 10.3), creatinine was roughly stable (2.1 to 1), lactate stayed broadly stable from 1.5 to 1.0, and urine output was roughly stable (485 to 465)
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 76 to 79, diastolic pressure rose from 71 to 78, and heart rate rose from 92 to 148. The lowest MAP was about 52 around hour 2.5, and the lowest valid SpO2 was 89 around hour 22.8; respiratory rate rose as high as 33 but ended at 34. The lower-frequency data fit that summary: temperature stayed around 32.4-33.1 C, white count was roughly stable (12.6 to 9.3), creatinine was roughly stable (2.5 to 1.1), lactate stayed broadly stable from 1.1 to 1.4, and urine output was roughly stable (525 to 500)
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 83, diastolic pressure rose from 67 to 74, and heart rate rose from 96 to 123. The lowest MAP was about 48 around hour 2.7, and the lowest valid SpO2 was 85 around hour 24.7; respiratory rate rose as high as 31 but ended at 30. The lower-frequency data fit that summary: temperature stayed around 36.1-36.9 C, white count was roughly stable (10.7 to 9.9), creatinine was roughly stable (2.3 to 1), lactate stayed broadly stable from 1.3 to 1.1, and urine output was roughly stable (500 to 450)

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 83, diastolic pressure rose from 67 to 74, and heart rate rose from 96 to 123. The lowest MAP was about 48 around hour 2.7, and the lowest valid SpO2 was 85 around hour 24.7; respiratory rate rose as high as 31 but ended at 30. The lower-frequency data fit that summary: temperature ranged from 97 to 98.4, white count was roughly stable (10.7 to 9.9), creatinine was roughly stable (2.3 to 1), lactate stayed broadly stable from 1.3 to 1.1, and urine output was roughly stable (500 to 450)


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

Options:
A. Across the recorded window, the heart rate was roughly stable (87 to 79), MAP fell from 110 to 91, and diastolic pressure moved from 72 to 73. Systolic pressure ranged 26-189 and ended at 146, and SpO2 recovered to 93 after a low of 88 around hour 1.9. Respiratory rate ended at 22; the available labs showed white count stayed around 14.0, creatinine rose from 1.3 to 1.5, lactate was checked once at 2.5, and urine output rose from 255 to 380.
B. Across the recorded window, the heart rate fell from 82 to 78, MAP fell from 105 to 91, and diastolic pressure moved from 77 to 74. Systolic pressure ranged 24-154 and ended at 122, and SpO2 recovered to 98 after a low of 83 around hour 2.7. Respiratory rate ended at 24; the available labs showed white count stayed around 11.4, creatinine rose from 1.0 to 1.5, lactate was checked once at 2.1, and urine output rose from 220 to 415.
C. Across the recorded window, the heart rate fell from 84 to 76, MAP fell from 107 to 88, and diastolic pressure moved from 75 to 76. Systolic pressure ranged 25-169 and ended at 126, and SpO2 recovered to 96 after a low of 85 around hour 1.7. Respiratory rate ended at 23; the available labs showed white count stayed around 12.5, creatinine rose from 1.1 to 1.3, lactate was checked once at 2.3, and urine output rose from 235 to 400.
D. Across the recorded window, the heart rate fell from 80 to 77, MAP fell from 102 to 84, and diastolic pressure moved from 80 to 72. Systolic pressure ranged 23-139 and ended at 96, and SpO2 recovered to 100 after a low of 84 around hour 1.4. Respiratory rate ended at 25; the available labs showed white count was roughly stable (10.2 to 11.7), creatinine rose from 1.1 to 1.3, lactate was checked once at 2.3, and urine output rose from 285 to 400.

Answer: C


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (97 to 94), diastolic pressure was roughly stable (88 to 91), and heart rate rose from 47 to 60. The lowest MAP was about 88 around hour 3.7, and the lowest valid SpO2 was 91 around hour 0; respiratory rate rose as high as 24 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.4-33.9 C, white count was roughly stable (5.0 to 3.8), creatinine stayed around 1.0, lactate was checked once at 206, and urine output was not recorded.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (100 to 97), diastolic pressure was roughly stable (85 to 88), and heart rate rose from 50 to 57. The lowest MAP was about 85 around hour 4.2, and the lowest valid SpO2 was 88 around hour 0.2; respiratory rate rose as high as 22 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 36.4-36.9 C, white count was roughly stable (4.5 to 4.3), creatinine stayed around 0.9, lactate was checked once at 186, and urine output was not recorded.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (96 to 93), diastolic pressure was roughly stable (89 to 92), and heart rate rose from 46 to 61. The lowest MAP was about 89 around hour 3.6, and the lowest valid SpO2 was 92 around hour 0.1; respiratory rate rose as high as 24 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.6-33.1 C, white count was roughly stable (5.1 to 3.7), creatinine was roughly stable (1.0 to 1), lactate was checked once at 186, and urine output was not recorded.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (96 to 100), diastolic pressure stayed around 80, and heart rate rose from 50 to 57. The lowest MAP was about 88 around hour 5.2, and the lowest valid SpO2 was 88 around hour 0.2; respiratory rate rose as high as 22 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 36.4-36.9 C, white count was roughly stable (4.5 to 4.3), creatinine stayed around 0.9, lactate was checked once at 186, and urine output was not recorded.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (100 to 97), diastolic pressure was roughly stable (85 to 88), and heart rate rose from 50 to 57. The lowest MAP was about 85 around hour 4.2, and the lowest valid SpO2 was 88 around hour 0.2; respiratory rate rose as high as 22 but ended at 20. The lower-frequency data fit that summary: temperature ranged from 97.6 to 98.5, white count was roughly stable (4.5 to 4.3), creatinine stayed around 0.9, lactate was checked once at 186, and urine output was not recorded.


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

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 77 to 82, diastolic pressure rose from 64 to 72, and heart rate rose from 70 to 89. The lowest MAP was about 63 around hour 8.2, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 28 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 33.2-35.1 C, white count was roughly stable (17.3 to 14.2), creatinine stayed around 1.3, lactate fell from 234 to 2.1, and urine output fell from 320 to 140.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 87, diastolic pressure was roughly stable (59 to 66), and heart rate rose from 75 to 84. The lowest MAP was about 63 around hour 9.7, and the lowest valid SpO2 was 83 around hour 0.4; respiratory rate rose as high as 25 but ended at 10. The lower-frequency data fit that summary: temperature stayed around 38.5-40.4 C, white count was roughly stable (14.7 to 16.8), creatinine stayed around 1.0, lactate fell from 199 to 2.4, and urine output fell from 285 to 105.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 74 to 85, diastolic pressure rose from 61 to 69, and heart rate rose from 73 to 86. The lowest MAP was about 60 around hour 8.7, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 26 but ended at 11. The lower-frequency data fit that summary: temperature stayed around 36.2-38.1 C, white count was roughly stable (15.8 to 15.7), creatinine stayed around 1.1, lactate fell from 214 to 2.3, and urine output fell from 300 to 120.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 70 to 90, diastolic pressure rose from 56 to 64, and heart rate rose from 78 to 82. The lowest MAP was about 56 around hour 9.4, and the lowest valid SpO2 was 80 around hour 0.5; respiratory rate rose as high as 28 but ended at 9. The lower-frequency data fit that summary: temperature stayed around 40.7-42.6 C, white count was roughly stable (13.6 to 17.9), creatinine was roughly stable (0.8 to 1.2), lactate fell from 214 to 2.3, and urine output fell from 300 to 170.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 74 to 85, diastolic pressure rose from 61 to 69, and heart rate rose from 73 to 86. The lowest MAP was about 60 around hour 8.7, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 26 but ended at 11. The lower-frequency data fit that summary: temperature ranged from 97.2 to 100.6, white count was roughly stable (15.8 to 15.7), creatinine stayed around 1.1, lactate fell from 214 to 2.3, and urine output fell from 300 to 120.


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

Options:
A. For handoff, the heart rate was roughly stable (108 to 97), while MAP fell from 115 to 82. Systolic pressure was labile, ranging 74-133, with the lowest value around hour 14.1. SpO2 briefly dipped to 89 around hour 4.4 before recovering to 92, while respiratory rate peaked at 24 and later settled at 24. The associated labs and urine output showed that white count fell from 6 to 5.6, creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output rose from 83 to 420, with recorded outputs ranging 77-480.
B. For handoff, the heart rate was roughly stable (103 to 98), while MAP fell from 110 to 82. Systolic pressure was labile, ranging 72-168, with the lowest value around hour 11.5. SpO2 briefly dipped to 86 around hour 4.9 before recovering to 97, while respiratory rate peaked at 21 and later settled at 21. The associated labs and urine output showed that white count fell from 7 to 4.7, creatinine was roughly stable (0.4 to 0.5), lactate was not available, and urine output rose from 78 to 350, with recorded outputs ranging 82-515.
C. For handoff, the heart rate was roughly stable (109 to 96), while MAP fell from 116 to 83. Systolic pressure was labile, ranging 66-128, with the lowest value around hour 14.5. SpO2 briefly dipped to 92 around hour 4.5 before recovering to 91, while respiratory rate peaked at 24 and later settled at 24. The associated labs and urine output showed that white count fell from 6 to 4.3, creatinine stayed around 0.6, lactate was not available, and urine output rose from 80 to 400, with recorded outputs ranging 80-500.
D. For handoff, the heart rate was roughly stable (105 to 100), while MAP fell from 112 to 79. Systolic pressure was labile, ranging 70-153, with the lowest value around hour 12.6. SpO2 briefly dipped to 88 around hour 3.9 before recovering to 95, while respiratory rate peaked at 22 and later settled at 22. The associated labs and urine output showed that white count fell from 7 to 5.1, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 80 to 400, with recorded outputs ranging 80-500.

Answer: D


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

Options:
A. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 112 to 79, diastolic pressure fell from 84 to 64, and heart rate was roughly stable (105 to 100). The lowest MAP was about 48 around hour 12.6, and the lowest valid SpO2 was 88 around hour 3.9; respiratory rate rose as high as 22 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 34.7-37.1 C, white count fell from 7 to 5.1, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 80 to 400.
B. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 110 to 81, diastolic pressure fell from 82 to 62, and heart rate was roughly stable (107 to 103). The lowest MAP was about 46 around hour 13.7, and the lowest valid SpO2 was 86 around hour 2.9; respiratory rate rose as high as 21 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 37.0-39.4 C, white count fell from 7 to 5.5, creatinine was roughly stable (0.4 to 0.3), lactate was not available, and urine output rose from 82 to 385.
C. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 116 to 75, diastolic pressure fell from 88 to 68, and heart rate was roughly stable (101 to 96). The lowest MAP was about 52 around hour 10.7, and the lowest valid SpO2 was 92 around hour 3.3; respiratory rate rose as high as 24 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 31.0-33.4 C, white count fell from 8 to 4.5, creatinine stayed around 0.6, lactate was not available, and urine output rose from 80 to 450.
D. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 108 to 84, diastolic pressure fell from 80 to 61, and heart rate was roughly stable (110 to 96). The lowest MAP was about 51 around hour 13.6, and the lowest valid SpO2 was 84 around hour 4.7; respiratory rate rose as high as 20 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 39.2-41.6 C, white count fell from 6 to 5.8, creatinine was roughly stable (0.3 to 0.2), lactate was not available, and urine output rose from 84 to 370.

Answer: A

Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 112 to 79, diastolic pressure fell from 84 to 64, and heart rate was roughly stable (105 to 100). The lowest MAP was about 48 around hour 12.6, and the lowest valid SpO2 was 88 around hour 3.9; respiratory rate rose as high as 22 but ended at 22. The lower-frequency data fit that summary: temperature ranged from 94.5 to 98.8, white count fell from 7 to 5.1, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output rose from 80 to 400.


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 rose from 74 to 80, diastolic pressure rose from 55 to 61, and heart rate stayed around 47. The lowest MAP was about 66 around hour 26.6, and the lowest valid SpO2 was 86 around hour 17.2; respiratory rate rose as high as 28 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 38.9-40.1 C, white count fell from 12 to 7.1, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 280 to 83.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 69 to 85, diastolic pressure rose from 50 to 62, and heart rate was roughly stable (52 to 53). The lowest MAP was about 63 around hour 25.6, and the lowest valid SpO2 was 83 around hour 14.7; respiratory rate rose as high as 29 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 35.9-37.1 C, white count fell from 10 to 6.6, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 260 to 80.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 71 to 83, diastolic pressure rose from 52 to 64, and heart rate stayed around 50. The lowest MAP was about 63 around hour 25.6, and the lowest valid SpO2 was 83 around hour 15.7; respiratory rate rose as high as 29 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 35.9-37.1 C, white count fell from 10 to 6.6, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 260 to 80.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 66 to 88, diastolic pressure rose from 48 to 60, and heart rate stayed around 54. The lowest MAP was about 58 around hour 23.4, and the lowest valid SpO2 was 78 around hour 13.4; respiratory rate rose as high as 31 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 31.4-32.6 C, white count fell from 8 to 5.8, creatinine was 1.1 on its only check, lactate was not available, and urine output fell from 230 to 130.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 71 to 83, diastolic pressure rose from 52 to 64, and heart rate stayed around 50. The lowest MAP was about 63 around hour 25.6, and the lowest valid SpO2 was 83 around hour 15.7; respiratory rate rose as high as 29 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 96.7 to 98.7, white count fell from 10 to 6.6, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 260 to 80.


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 143 to 163, MAP rose from 74 to 86, and heart rate stayed around 47. SpO2 started at 88, ended at 82, and fell as low as 82 around hour 17.2; respiratory rate ranged 12-28. For labs and output, white count fell from 12 to 6.1, creatinine was 1.0 on its only check, lactate was not available, and urine output fell from 280 to 77.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 108 to 156, MAP rose from 69 to 81, and heart rate was roughly stable (52 to 53). SpO2 started at 87, ended at 85, and fell as low as 83 around hour 15.7; respiratory rate ranged 13-31. For labs and output, white count fell from 10 to 5.8, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 260 to 80.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 148 to 168, MAP rose from 75 to 87, and heart rate stayed around 46. SpO2 started at 89, ended at 81, and fell as low as 87 around hour 17.6; respiratory rate ranged 11-27. For labs and output, white count fell from 12 to 6.0, creatinine was 1.0 on its only check, lactate was not available, and urine output fell from 285 to 76.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 123 to 141, MAP rose from 71 to 83, and heart rate stayed around 50. SpO2 started at 85, ended at 85, and fell as low as 83 around hour 15.7; respiratory rate ranged 13-29. For labs and output, white count fell from 10 to 6.6, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 260 to 80.

Answer: D


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

Options:
A. Over the available measurements, the heart rate stayed around 50, MAP rose from 71 to 83, and diastolic pressure moved from 52 to 64. Systolic pressure ranged 105-148 and ended at 141, and SpO2 recovered to 85 after a low of 83 around hour 15.7. Respiratory rate ended at 19; the available labs showed white count fell from 10 to 6.6, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 260 to 80.
B. Over the available measurements, the heart rate stayed around 48, MAP rose from 73 to 81, and diastolic pressure moved from 50 to 66. Systolic pressure ranged 103-163 and ended at 156, and SpO2 recovered to 83 after a low of 82 around hour 14.6. Respiratory rate ended at 18; the available labs showed white count fell from 11 to 5.8, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 310 to 78.
C. Over the available measurements, the heart rate was roughly stable (54 to 53), MAP rose from 71 to 83, and diastolic pressure moved from 52 to 61. Systolic pressure ranged 105-148 and ended at 141, and SpO2 recovered to 85 after a low of 83 around hour 15.7. Respiratory rate ended at 19; the available labs showed white count fell from 10 to 6.6, creatinine was 0.9 on its only check, lactate was not available, and urine output fell from 260 to 80.
D. Over the available measurements, the heart rate stayed around 46, MAP rose from 76 to 86, and diastolic pressure moved from 48 to 68. Systolic pressure ranged 100-178 and ended at 137, and SpO2 recovered to 80 after a low of 88 around hour 16.6. Respiratory rate ended at 17; the available labs showed white count fell from 12 to 5.8, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 290 to 76.

Answer: A


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 82 to 85, diastolic pressure rose from 18 to 76, and heart rate rose from 81 to 93. The lowest MAP was about 61 around hour 6, and the lowest valid SpO2 was 88 around hour 9.4; respiratory rate rose as high as 26 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.1-35.3 C, white count was roughly stable (17.2 to 13.4), creatinine was roughly stable (1.0 to 0.9), lactate was checked once at 1.5, and urine output rose from 113 to 300.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 77 to 87, diastolic pressure rose from 15 to 70, and heart rate rose from 86 to 88. The lowest MAP was about 61 around hour 7, and the lowest valid SpO2 was 83 around hour 11.5; respiratory rate rose as high as 24 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 38.4-40.5 C, white count was roughly stable (14.6 to 16.0), creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 1.9, and urine output rose from 108 to 265.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 83 to 86, diastolic pressure rose from 18 to 77, and heart rate rose from 80 to 94. The lowest MAP was about 62 around hour 5, and the lowest valid SpO2 was 89 around hour 8.5; respiratory rate rose as high as 27 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 32.4-34.5 C, white count was roughly stable (17.6 to 13.0), creatinine stayed around 1.0, lactate was checked once at 1.7, and urine output rose from 110 to 330.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 79 to 85, diastolic pressure rose from 16 to 73, and heart rate rose from 84 to 90. The lowest MAP was about 58 around hour 6, and the lowest valid SpO2 was 85 around hour 10.4; respiratory rate rose as high as 25 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 36.1-38.3 C, white count was roughly stable (15.7 to 14.9), creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 1.7, and urine output rose from 110 to 280.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 79 to 85, diastolic pressure rose from 16 to 73, and heart rate rose from 84 to 90. The lowest MAP was about 58 around hour 6, and the lowest valid SpO2 was 85 around hour 10.4; respiratory rate rose as high as 25 but ended at 16. The lower-frequency data fit that summary: temperature ranged from 36.1 to 101, white count was roughly stable (15.7 to 14.9), creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 1.7, and urine output rose from 110 to 280.


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

Options:
A. Taken together, the heart rate rose from 80 to 94, while MAP fell from 97 to 76. Systolic pressure was labile, ranging 51-128, with the lowest value around hour 9.4. SpO2 briefly dipped to 88 around hour 1.4 before recovering to 92, while respiratory rate peaked at 20 and later settled at 16. The associated labs and urine output showed that white count rose from 9.3 to 12.8, creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 0.8, and urine output fell from 140 to 0, with recorded outputs ranging 0-680.
B. Taken together, the heart rate rose from 77 to 97, while MAP fell from 94 to 73. Systolic pressure was labile, ranging 54-148, with the lowest value around hour 8.9. SpO2 briefly dipped to 85 around hour 0.4 before recovering to 95, while respiratory rate peaked at 18 and later settled at 14. The associated labs and urine output showed that white count rose from 9.8 to 11.3, creatinine was roughly stable (0.8 to 0.9), lactate was checked once at 0.7, and urine output was roughly stable (120 to 45), with recorded outputs ranging 40-700.
C. Taken together, the heart rate rose from 81 to 93, while MAP fell from 98 to 77. Systolic pressure was labile, ranging 50-123, with the lowest value around hour 9.5. SpO2 briefly dipped to 89 around hour 0.5 before recovering to 91, while respiratory rate peaked at 20 and later settled at 16. The associated labs and urine output showed that white count was roughly stable (9.2 to 10.5), creatinine rose from 0.9 to 1, lactate was checked once at 0.8, and urine output was roughly stable (145 to 41), with recorded outputs ranging 45-675.
D. Taken together, the heart rate rose from 72 to 100, while MAP fell from 90 to 68. Systolic pressure was labile, ranging 58-178, with the lowest value around hour 8.2. SpO2 briefly dipped to 86 around hour 0.2 before recovering to 100, while respiratory rate peaked at 20 and later settled at 12. The associated labs and urine output showed that white count rose from 10.6 to 12.1, creatinine was roughly stable (0.7 to 1.1), lactate was checked once at 0.5, and urine output was roughly stable (90 to 50), with recorded outputs ranging 36-730.

Answer: B


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 50 to 77, diastolic pressure rose from 37 to 61, and heart rate was roughly stable (77 to 79). The lowest MAP was about 47 around hour 9.7, and the lowest valid SpO2 was 88 around hour 2; respiratory rate rose as high as 30 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 32.6-34.4 C, white count rose from 3.8 to 7.0, creatinine rose from 0.8 to 1.0, lactate fell from 1.4 to 0.9, and urine output fell from 520 to 77.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 45 to 82, diastolic pressure rose from 32 to 62, and heart rate was roughly stable (82 to 74). The lowest MAP was about 43 around hour 9.1, and the lowest valid SpO2 was 83 around hour 2; respiratory rate rose as high as 30 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 37.9-39.6 C, white count rose from 2.9 to 7.9, creatinine rose from 0.6 to 1, lactate fell from 1.8 to 0.7, and urine output fell from 485 to 130.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 51 to 76, diastolic pressure rose from 38 to 68, and heart rate was roughly stable (76 to 79). The lowest MAP was about 49 around hour 8.1, and the lowest valid SpO2 was 89 around hour 1; respiratory rate rose as high as 30 but ended at 27. The lower-frequency data fit that summary: temperature stayed around 31.9-33.6 C, white count rose from 3.9 to 6.9, creatinine rose from 0.8 to 1.0, lactate fell from 1.4 to 0.9, and urine output fell from 525 to 76.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 47 to 80, diastolic pressure rose from 34 to 64, and heart rate was roughly stable (80 to 76). The lowest MAP was about 45 around hour 8.7, and the lowest valid SpO2 was 85 around hour 2; respiratory rate rose as high as 28 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 35.6-37.4 C, white count rose from 3.3 to 7.5, creatinine rose from 0.7 to 0.9, lactate fell from 1.6 to 0.8, and urine output fell from 500 to 80.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 47 to 80, diastolic pressure rose from 34 to 64, and heart rate was roughly stable (80 to 76). The lowest MAP was about 45 around hour 8.7, and the lowest valid SpO2 was 85 around hour 2; respiratory rate rose as high as 28 but ended at 25. The lower-frequency data fit that summary: temperature ranged from 96 to 99.3, white count rose from 3.3 to 7.5, creatinine rose from 0.7 to 0.9, lactate fell from 1.6 to 0.8, and urine output fell from 500 to 80.


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 80 to 89, diastolic pressure rose from 68 to 75, and heart rate fell from 93 to 75. The lowest MAP was about 73 around hour 1.2, and the lowest valid SpO2 was 88 around hour 0.1; respiratory rate rose as high as 23 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 32.5-34.7 C, white count fell from 24.8 to 14.2, creatinine fell from 2.5 to 1.4, lactate was checked once at 1.2, and urine output was roughly stable (170 to 185)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 77 to 92, diastolic pressure rose from 65 to 72, and heart rate fell from 96 to 72. The lowest MAP was about 70 around hour 1.4, and the lowest valid SpO2 was 85 around hour 0.2; respiratory rate rose as high as 21 but ended at 11. The lower-frequency data fit that summary: temperature stayed around 35.5-37.7 C, white count fell from 23.3 to 15.7, creatinine fell from 2.3 to 1.3, lactate was checked once at 1.4, and urine output was roughly stable (150 to 135)
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 81 to 88, diastolic pressure was roughly stable (69 to 69), and heart rate fell from 92 to 76. The lowest MAP was about 73 around hour 2.4, and the lowest valid SpO2 was 89 around hour 0.1; respiratory rate rose as high as 23 but ended at 13. The lower-frequency data fit that summary: temperature stayed around 31.8-34.0 C, white count fell from 25.2 to 13.8, creatinine fell from 2.5 to 1.6, lactate was checked once at 1.1, and urine output was roughly stable (175 to 160)
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 96, diastolic pressure rose from 60 to 68, and heart rate fell from 100 to 75. The lowest MAP was about 66 around hour 1.7, and the lowest valid SpO2 was 80 around hour 0; respiratory rate rose as high as 19 but ended at 9. The lower-frequency data fit that summary: temperature stayed around 40.0-42.2 C, white count fell from 21.1 to 17.9, creatinine fell from 2.0 to 1.0, lactate was checked once at 1.7, and urine output was roughly stable (120 to 105)

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 77 to 92, diastolic pressure rose from 65 to 72, and heart rate fell from 96 to 72. The lowest MAP was about 70 around hour 1.4, and the lowest valid SpO2 was 85 around hour 0.2; respiratory rate rose as high as 21 but ended at 11. The lower-frequency data fit that summary: temperature ranged from 35.5 to 99.9, white count fell from 23.3 to 15.7, creatinine fell from 2.3 to 1.3, lactate was checked once at 1.4, and urine output was roughly stable (150 to 135)


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

Options:
A. Clinically, the heart rate fell from 99 to 69, MAP rose from 80 to 95, and diastolic pressure moved from 62 to 75. Systolic pressure ranged 113-186 and ended at 170, and SpO2 recovered to 97 after a low of 84 around hour 0.3. Respiratory rate ended at 10; the available labs showed white count fell from 24.8 to 14.9, creatinine fell from 2.1 to 1.5, lactate was checked once at 1.6, and urine output was roughly stable (200 to 155)
B. Clinically, the heart rate fell from 94 to 74, MAP rose from 75 to 95, and diastolic pressure moved from 67 to 70. Systolic pressure ranged 108-151 and ended at 146, and SpO2 recovered to 98 after a low of 83 around hour 1.2. Respiratory rate ended at 12; the available labs showed white count fell from 22.2 to 14.6, creatinine fell from 2.4 to 1.1, lactate was checked once at 1.2, and urine output was roughly stable (165 to 120)
C. Clinically, the heart rate fell from 100 to 75, MAP rose from 81 to 96, and diastolic pressure moved from 61 to 69. Systolic pressure ranged 114-191 and ended at 175, and SpO2 recovered to 96 after a low of 89 around hour 0.3. Respiratory rate ended at 9; the available labs showed white count fell from 25.2 to 17.6, creatinine fell from 2.0 to 1.6, lactate was checked once at 1.6, and urine output was roughly stable (125 to 160)
D. Clinically, the heart rate fell from 96 to 72, MAP rose from 77 to 92, and diastolic pressure moved from 65 to 72. Systolic pressure ranged 110-166 and ended at 150, and SpO2 recovered to 100 after a low of 85 around hour 0.2. Respiratory rate ended at 11; the available labs showed white count fell from 23.3 to 15.7, creatinine fell from 2.3 to 1.3, lactate was checked once at 1.4, and urine output was roughly stable (150 to 135)

Answer: D


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 194 to 146, MAP fell from 119 to 97, and heart rate rose from 97 to 114. SpO2 started at 97, ended at 97, and fell as low as 84 around hour 11.7; respiratory rate ranged 12-18. For labs and output, white count fell from 25.7 to 14.7, creatinine was roughly stable (0.9 to 0.6), lactate fell from 1.7 to 0.8, and urine output fell from 180 to 78.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 159 to 139, MAP fell from 114 to 92, and heart rate rose from 98 to 109. SpO2 started at 98, ended at 92, and fell as low as 83 around hour 14.3; respiratory rate ranged 10-20. For labs and output, white count fell from 28.3 to 12.1, creatinine stayed around 0.7, lactate fell from 1.7 to 0.7, and urine output fell from 200 to 75.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 199 to 125, MAP fell from 120 to 98, and heart rate rose from 96 to 114. SpO2 started at 96, ended at 98, and fell as low as 89 around hour 11.3; respiratory rate ranged 13-21. For labs and output, white count fell from 25.3 to 12.4, creatinine was roughly stable (0.9 to 0.6), lactate fell from 1.8 to 0.8, and urine output fell from 175 to 79.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 174 to 150, MAP fell from 116 to 94, and heart rate rose from 100 to 111. SpO2 started at 100, ended at 94, and fell as low as 85 around hour 13.2; respiratory rate ranged 11-19. For labs and output, white count fell from 27.2 to 13.2, creatinine was roughly stable (0.8 to 0.7), lactate fell from 1.5 to 0.7, and urine output fell from 200 to 75.

Answer: D


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 48 to 66, diastolic pressure rose from 28 to 54, and heart rate rose from 65 to 77. The lowest MAP was about 44 around hour 10.7, and the lowest valid SpO2 was 69 around hour 9.2; respiratory rate rose as high as 30 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.9-33.6 C, white count was 4.2 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output rose from 2 to 320.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 43 to 71, diastolic pressure rose from 25 to 55, and heart rate rose from 70 to 72. The lowest MAP was about 39 around hour 10.1, and the lowest valid SpO2 was 64 around hour 10.1; respiratory rate rose as high as 30 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 38.1-38.9 C, white count was 3.3 on its only check, creatinine was 1.4 on its only check, lactate was not available, and urine output rose from 0 to 350.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 49 to 65, diastolic pressure rose from 28 to 61, and heart rate rose from 64 to 77. The lowest MAP was about 45 around hour 9.1, and the lowest valid SpO2 was 70 around hour 8.7; respiratory rate rose as high as 30 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 32.1-32.9 C, white count was 4.3 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output rose from 2 to 325.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 45 to 69, diastolic pressure rose from 26 to 57, and heart rate rose from 68 to 74. The lowest MAP was about 41 around hour 9.7, and the lowest valid SpO2 was 66 around hour 9.7; respiratory rate rose as high as 28 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 35.9-36.6 C, white count was 3.7 on its only check, creatinine was 1.2 on its only check, lactate was not available, and urine output rose from 0 to 300.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 45 to 69, diastolic pressure rose from 26 to 57, and heart rate rose from 68 to 74. The lowest MAP was about 41 around hour 9.7, and the lowest valid SpO2 was 66 around hour 9.7; respiratory rate rose as high as 28 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 96.7 to 97.8, white count was 3.7 on its only check, creatinine was 1.2 on its only check, lactate was not available, and urine output rose from 0 to 300.


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 101 to 112, MAP rose from 45 to 69, and heart rate rose from 68 to 74. SpO2 started at 100, ended at 98, and fell as low as 66 around hour 9.7; respiratory rate ranged 18-28. For labs and output, white count was 3.7 on its only check, creatinine was 1.2 on its only check, lactate was not available, and urine output rose from 0 to 300.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 99 to 114, MAP rose from 43 to 67, and heart rate rose from 70 to 72. SpO2 started at 99, ended at 96, and fell as low as 64 around hour 10.1; respiratory rate ranged 17-29. For labs and output, white count was 4.1 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output rose from 0 to 315.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 105 to 108, MAP rose from 49 to 73, and heart rate rose from 64 to 77. SpO2 started at 96, ended at 100, and fell as low as 70 around hour 9.1; respiratory rate ranged 20-30. For labs and output, white count was 3.1 on its only check, creatinine was 1.4 on its only check, lactate was not available, and urine output rose from 2 to 275.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 96 to 108, MAP rose from 40 to 72, and heart rate rose from 72 to 75. SpO2 started at 96, ended at 94, and fell as low as 65 around hour 10.4; respiratory rate ranged 16-30. For labs and output, white count was 4.5 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output rose from 0 to 330.

Answer: A


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

Options:
A. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 80, diastolic pressure rose from 56 to 71, and heart rate rose from 77 to 91. The lowest MAP was about 57 around hour 13.1, and the lowest valid SpO2 was 85 around hour 6.5; respiratory rate rose as high as 33 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 36.4-37.3 C, white count fell from 24.9 to 20.8, creatinine fell from 1 to 0.8, lactate fell from 2.5 to 1, and urine output rose from 225 to 375.
B. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 70 to 82, diastolic pressure rose from 54 to 69, and heart rate rose from 79 to 89. The lowest MAP was about 55 around hour 14.2, and the lowest valid SpO2 was 83 around hour 6.9; respiratory rate rose as high as 35 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 38.6-39.5 C, white count fell from 23.8 to 21.9, creatinine was roughly stable (1 to 0.9), lactate fell from 2.6 to 1, and urine output rose from 210 to 425.
C. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 76 to 79, diastolic pressure rose from 60 to 75, and heart rate rose from 73 to 94. The lowest MAP was about 61 around hour 11.2, and the lowest valid SpO2 was 89 around hour 5.5; respiratory rate rose as high as 37 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 32.6-33.5 C, white count fell from 26.8 to 18.9, creatinine fell from 1 to 0.9, lactate fell from 2.2 to 1, and urine output rose from 250 to 350.
D. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 84, diastolic pressure rose from 52 to 68, and heart rate rose from 82 to 86. The lowest MAP was about 60 around hour 14.1, and the lowest valid SpO2 was 80 around hour 7.2; respiratory rate rose as high as 28 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 40.9-41.8 C, white count fell from 22.6 to 21.1, creatinine fell from 1 to 0.7, lactate fell from 2.8 to 1, and urine output rose from 195 to 405.

Answer: A

In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 72 to 80, diastolic pressure rose from 56 to 71, and heart rate rose from 77 to 91. The lowest MAP was about 57 around hour 13.1, and the lowest valid SpO2 was 85 around hour 6.5; respiratory rate rose as high as 33 but ended at 22. The lower-frequency data fit that summary: temperature ranged from 97.5 to 99.1, white count fell from 24.9 to 20.8, creatinine fell from 1 to 0.8, lactate fell from 2.5 to 1, and urine output rose from 225 to 375.


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

Options:
A. Taken together, the heart rate rose from 53 to 101, while MAP rose from 58 to 77. Systolic pressure was labile, ranging 73-111, with the lowest value around hour 1.9. SpO2 briefly dipped to 88 around hour 6.4 before recovering to 88, while respiratory rate peaked at 52 and later settled at 41. The associated labs and urine output showed that white count rose from 2.8 to 12, creatinine stayed around 1, lactate fell from 1.2 to 1.0, and urine output rose from 270 to 550, with recorded outputs ranging 220-580.
B. Taken together, the heart rate rose from 50 to 104, while MAP rose from 55 to 74. Systolic pressure was labile, ranging 76-131, with the lowest value around hour 1.7. SpO2 briefly dipped to 85 around hour 5.4 before recovering to 91, while respiratory rate peaked at 49 and later settled at 38. The associated labs and urine output showed that white count rose from 3.3 to 11, creatinine stayed around 1, lactate fell from 1.4 to 1.1, and urine output rose from 250 to 600, with recorded outputs ranging 200-600.
C. Taken together, the heart rate rose from 54 to 100, while MAP rose from 59 to 78. Systolic pressure was labile, ranging 78-106, with the lowest value around hour 1.9. SpO2 briefly dipped to 86 around hour 6.0 before recovering to 87, while respiratory rate peaked at 51 and later settled at 42. The associated labs and urine output showed that white count rose from 2.7 to 13, creatinine stayed around 1, lactate fell from 1.1 to 0.9, and urine output rose from 275 to 575, with recorded outputs ranging 225-575.
D. Taken together, the heart rate rose from 46 to 108, while MAP rose from 50 to 70. Systolic pressure was labile, ranging 80-161, with the lowest value around hour 1.4. SpO2 briefly dipped to 80 around hour 4.7 before recovering to 96, while respiratory rate peaked at 44 and later settled at 34. The associated labs and urine output showed that white count rose from 4.0 to 10.2, creatinine stayed around 1.1, lactate fell from 1.7 to 0.8, and urine output rose from 220 to 630, with recorded outputs ranging 250-630.

Answer: B


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

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 58 to 71, diastolic pressure rose from 52 to 71, and heart rate rose from 47 to 107. The lowest MAP was about 48 around hour 29.3, and the lowest valid SpO2 was 88 around hour 4.4; respiratory rate rose as high as 52 but ended at 41. The lower-frequency data fit that summary: temperature stayed around 32.4-35.6 C, white count rose from 3.8 to 10, creatinine stayed around 1, lactate fell from 1.6 to 0.9, and urine output rose from 270 to 620.
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 53 to 76, diastolic pressure rose from 47 to 66, and heart rate rose from 52 to 102. The lowest MAP was about 43 around hour 34.5, and the lowest valid SpO2 was 83 around hour 5.8; respiratory rate rose as high as 51 but ended at 36. The lower-frequency data fit that summary: temperature stayed around 37.6-40.9 C, white count rose from 2.9 to 12, creatinine stayed around 1.1, lactate fell from 1.2 to 1.0, and urine output rose from 235 to 650.
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 55 to 74, diastolic pressure rose from 49 to 68, and heart rate rose from 50 to 104. The lowest MAP was about 45 around hour 32.3, and the lowest valid SpO2 was 85 around hour 5.4; respiratory rate rose as high as 49 but ended at 38. The lower-frequency data fit that summary: temperature stayed around 35.4-38.6 C, white count rose from 3.3 to 11, creatinine stayed around 1, lactate fell from 1.4 to 1.1, and urine output rose from 250 to 600.
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 50 to 78, diastolic pressure rose from 44 to 65, and heart rate rose from 54 to 100. The lowest MAP was about 48 around hour 33.3, and the lowest valid SpO2 was 80 around hour 6.2; respiratory rate rose as high as 44 but ended at 34. The lower-frequency data fit that summary: temperature stayed around 39.9-43.1 C, white count rose from 2.5 to 13, creatinine stayed around 1, lactate fell from 1.1 to 0.9, and urine output rose from 220 to 570.

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 55 to 74, diastolic pressure rose from 49 to 68, and heart rate rose from 50 to 104. The lowest MAP was about 45 around hour 32.3, and the lowest valid SpO2 was 85 around hour 5.4; respiratory rate rose as high as 49 but ended at 38. The lower-frequency data fit that summary: temperature ranged from 95.7 to 101.4, white count rose from 3.3 to 11, creatinine stayed around 1, lactate fell from 1.4 to 1.1, and urine output rose from 250 to 600.


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

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 81 to 95, MAP rose from 58 to 77, and heart rate rose from 47 to 107. SpO2 started at 92, ended at 94, and fell as low as 88 around hour 4.9; respiratory rate ranged 26-51. For labs and output, white count rose from 2.8 to 10.2, creatinine stayed around 1, lactate fell from 1.2 to 1.0, and urine output rose from 270 to 580.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 76 to 94, MAP rose from 53 to 77, and heart rate rose from 52 to 102. SpO2 started at 97, ended at 89, and fell as low as 84 around hour 5.8; respiratory rate ranged 23-51. For labs and output, white count rose from 3.7 to 10, creatinine stayed around 1, lactate fell from 1.5 to 1.0, and urine output rose from 235 to 615.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 82 to 94, MAP rose from 59 to 78, and heart rate rose from 46 to 108. SpO2 started at 91, ended at 95, and fell as low as 89 around hour 4.8; respiratory rate ranged 26-45. For labs and output, white count rose from 2.7 to 13, creatinine stayed around 1.1, lactate fell from 1.6 to 1.4, and urine output rose from 275 to 575.
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 78 to 98, MAP rose from 55 to 74, and heart rate rose from 50 to 104. SpO2 started at 95, ended at 91, and fell as low as 85 around hour 5.4; respiratory rate ranged 24-49. For labs and output, white count rose from 3.3 to 11, creatinine stayed around 1, lactate fell from 1.4 to 1.1, and urine output rose from 250 to 600.

Answer: D


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

Options:
A. For handoff, the heart rate fell from 90 to 78, while MAP fell from 82 to 75. Systolic pressure was labile, ranging 14-119, with the lowest value around hour 5.2. SpO2 briefly dipped to 88 around hour 22.2 before recovering to 93, while respiratory rate peaked at 24 and later settled at 18. The associated labs and urine output showed that white count fell from 16.0 to 11.2, creatinine was roughly stable (0.8 to 0.8), lactate was checked once at 2.4, and urine output rose from 50 to 220, with recorded outputs ranging 50-560.
B. For handoff, the heart rate fell from 85 to 83, while MAP was roughly stable (77 to 75). Systolic pressure was labile, ranging 16-154, with the lowest value around hour 4.3. SpO2 briefly dipped to 83 around hour 21.7 before recovering to 98, while respiratory rate peaked at 21 and later settled at 15. The associated labs and urine output showed that white count fell from 18.6 to 11, creatinine stayed around 0.6, lactate was checked once at 2.5, and urine output rose from 48 to 170, with recorded outputs ranging 47-575.
C. For handoff, the heart rate fell from 91 to 77, while MAP fell from 83 to 76. Systolic pressure was labile, ranging 19-114, with the lowest value around hour 5.3. SpO2 briefly dipped to 86 around hour 22.6 before recovering to 92, while respiratory rate peaked at 24 and later settled at 18. The associated labs and urine output showed that white count fell from 15.6 to 14, creatinine stayed around 0.8, lactate was checked once at 2.1, and urine output rose from 54 to 245, with recorded outputs ranging 41-535.
D. For handoff, the heart rate fell from 87 to 81, while MAP fell from 79 to 72. Systolic pressure was labile, ranging 15-139, with the lowest value around hour 4.7. SpO2 briefly dipped to 85 around hour 20.7 before recovering to 96, while respiratory rate peaked at 22 and later settled at 16. The associated labs and urine output showed that white count fell from 17.5 to 12, creatinine stayed around 0.7, lactate was checked once at 2.4, and urine output rose from 50 to 220, with recorded outputs ranging 45-560.

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 112 to 97, MAP was roughly stable (82 to 75), and heart rate fell from 84 to 81. SpO2 started at 97, ended at 99, and fell as low as 84 around hour 19.2; respiratory rate ranged 14-20. For labs and output, white count fell from 16.0 to 14, creatinine stayed around 0.8, lactate was checked once at 2.2, and urine output rose from 53 to 240.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 109 to 101, MAP fell from 79 to 72, and heart rate fell from 87 to 81. SpO2 started at 100, ended at 96, and fell as low as 85 around hour 20.7; respiratory rate ranged 12-22. For labs and output, white count fell from 17.5 to 12, creatinine stayed around 0.7, lactate was checked once at 2.4, and urine output rose from 50 to 220.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 113 to 97, MAP fell from 83 to 76, and heart rate was roughly stable (83 to 84). SpO2 started at 96, ended at 100, and fell as low as 89 around hour 18.8; respiratory rate ranged 14-24. For labs and output, white count fell from 15.6 to 11.2, creatinine stayed around 0.8, lactate was checked once at 2.1, and urine output rose from 54 to 245.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 104 to 101, MAP fell from 74 to 68, and heart rate fell from 92 to 76. SpO2 started at 96, ended at 92, and fell as low as 80 around hour 22.9; respiratory rate ranged 10-24. For labs and output, white count fell from 19.8 to 10, creatinine was roughly stable (0.5 to 0.8), lactate was checked once at 2.6, and urine output rose from 50 to 220.

Answer: B


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 87 to 103, diastolic pressure rose from 66 to 79, and heart rate was roughly stable (65 to 66). The lowest MAP was about 60 around hour 5.7, and the lowest valid SpO2 was 88 around hour 2.6; respiratory rate rose as high as 24 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 32.8-34.7 C, white count rose from 5.9 to 6.0, creatinine stayed around 1.0, lactate was not available, and urine output fell from 570 to 37.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 82 to 108, diastolic pressure rose from 61 to 73, and heart rate was roughly stable (70 to 61). The lowest MAP was about 60 around hour 7.2, and the lowest valid SpO2 was 83 around hour 4.0; respiratory rate rose as high as 22 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 38.0-40.0 C, white count rose from 5.0 to 6.9, creatinine stayed around 0.8, lactate was not available, and urine output fell from 535 to 42.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 88 to 102, diastolic pressure rose from 67 to 80, and heart rate was roughly stable (64 to 67). The lowest MAP was about 61 around hour 5.6, and the lowest valid SpO2 was 89 around hour 3.0; respiratory rate rose as high as 25 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 32.0-34.0 C, white count rose from 6.0 to 6.5, creatinine was roughly stable (1.0 to 1), lactate was not available, and urine output fell from 550 to 90.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 84 to 106, diastolic pressure rose from 63 to 76, and heart rate was roughly stable (68 to 63). The lowest MAP was about 57 around hour 6.2, and the lowest valid SpO2 was 85 around hour 3.6; respiratory rate rose as high as 23 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 35.8-37.7 C, white count rose from 5.4 to 6.5, creatinine stayed around 0.9, lactate was not available, and urine output fell from 550 to 40.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 84 to 106, diastolic pressure rose from 63 to 76, and heart rate was roughly stable (68 to 63). The lowest MAP was about 57 around hour 6.2, and the lowest valid SpO2 was 85 around hour 3.6; respiratory rate rose as high as 23 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 96.4 to 99.8, white count rose from 5.4 to 6.5, creatinine stayed around 0.9, lactate was not available, and urine output fell from 550 to 40.


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

Options:
A. Viewed chronologically, the heart rate was roughly stable (71 to 66), MAP rose from 87 to 109, and diastolic pressure moved from 60 to 73. Systolic pressure ranged 113-211 and ended at 211, and SpO2 recovered to 92 after a low of 88 around hour 4.1. Respiratory rate ended at 20; the available labs showed white count rose from 5.9 to 7.0, creatinine stayed around 0.8, lactate was not available, and urine output fell from 570 to 43.
B. Viewed chronologically, the heart rate was roughly stable (68 to 63), MAP rose from 84 to 106, and diastolic pressure moved from 63 to 76. Systolic pressure ranged 110-191 and ended at 191, and SpO2 recovered to 95 after a low of 85 around hour 3.6. Respiratory rate ended at 21; the available labs showed white count rose from 5.4 to 6.5, creatinine stayed around 0.9, lactate was not available, and urine output fell from 550 to 40.
C. Viewed chronologically, the heart rate was roughly stable (72 to 59), MAP rose from 88 to 109, and diastolic pressure moved from 59 to 80. Systolic pressure ranged 114-216 and ended at 187, and SpO2 recovered to 91 after a low of 89 around hour 4.6. Respiratory rate ended at 19; the available labs showed white count rose from 6.0 to 7.1, creatinine stayed around 0.8, lactate was not available, and urine output fell from 575 to 44.
D. Viewed chronologically, the heart rate was roughly stable (64 to 68), MAP rose from 80 to 102, and diastolic pressure moved from 68 to 72. Systolic pressure ranged 106-161 and ended at 161, and SpO2 recovered to 100 after a low of 84 around hour 2.9. Respiratory rate ended at 23; the available labs showed white count was roughly stable (4.7 to 5.7), creatinine stayed around 1.1, lactate was not available, and urine output fell from 600 to 36.

Answer: B


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

Options:
A. Overall, the heart rate rose from 53 to 70, MAP was roughly stable (64 to 74), and diastolic pressure moved from 48 to 62. Systolic pressure ranged 89-191 and ended at 110, and SpO2 recovered to 94 after a low of 75 around hour 0.4. Respiratory rate ended at 14; the available labs showed white count rose from 6.6 to 10.8, creatinine was roughly stable (0.9 to 1), lactate fell from 277 to 1.3, and urine output fell from 370 to 220.
B. Overall, the heart rate rose from 48 to 75, MAP rose from 59 to 74, and diastolic pressure moved from 53 to 57. Systolic pressure ranged 84-156 and ended at 103, and SpO2 recovered to 99 after a low of 74 around hour 1.3. Respiratory rate ended at 16; the available labs showed white count rose from 5.7 to 10.5, creatinine was roughly stable (1.2 to 1), lactate fell from 242 to 1.6, and urine output fell from 305 to 185.
C. Overall, the heart rate rose from 50 to 73, MAP was roughly stable (61 to 71), and diastolic pressure moved from 51 to 59. Systolic pressure ranged 86-171 and ended at 107, and SpO2 recovered to 97 after a low of 76 around hour 0.3. Respiratory rate ended at 15; the available labs showed white count rose from 6.1 to 11.6, creatinine was roughly stable (1.1 to 1), lactate fell from 257 to 1.5, and urine output fell from 320 to 200.
D. Overall, the heart rate rose from 46 to 76, MAP was roughly stable (56 to 66), and diastolic pressure moved from 56 to 56. Systolic pressure ranged 82-141 and ended at 102, and SpO2 recovered to 100 after a low of 72 around hour 0.1. Respiratory rate ended at 17; the available labs showed white count rose from 5.3 to 9.3, creatinine was roughly stable (1.4 to 1), lactate fell from 227 to 1.8, and urine output fell from 290 to 170.

Answer: C


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

Options:
A. Overall, the heart rate was roughly stable (74 to 71), while MAP rose from 60 to 86. Systolic pressure was labile, ranging 97-168, with the lowest value around hour 18.8. SpO2 briefly dipped to 88 around hour 0.1 before recovering to 100, while respiratory rate peaked at 23 and later settled at 10. The associated labs and urine output showed that white count fell from 16.3 to 13.2, creatinine stayed around 0.5, lactate was not available, and urine output rose from 125 to 300, with recorded outputs ranging 60-325.
B. Overall, the heart rate was roughly stable (72 to 73), while MAP rose from 58 to 84. Systolic pressure was labile, ranging 101-183, with the lowest value around hour 17.7. SpO2 briefly dipped to 89 around hour 0.0 before recovering to 98, while respiratory rate peaked at 25 and later settled at 9. The associated labs and urine output showed that white count fell from 17.4 to 12.1, creatinine stayed around 0.4, lactate was not available, and urine output rose from 140 to 285, with recorded outputs ranging 58-310.
C. Overall, the heart rate was roughly stable (78 to 67), while MAP rose from 64 to 89. Systolic pressure was labile, ranging 93-143, with the lowest value around hour 20.7. SpO2 briefly dipped to 92 around hour 1.1 before recovering to 96, while respiratory rate peaked at 25 and later settled at 12. The associated labs and urine output showed that white count fell from 14.4 to 12.9, creatinine stayed around 0.6, lactate was not available, and urine output rose from 100 to 250, with recorded outputs ranging 64-350.
D. Overall, the heart rate was roughly stable (70 to 76), while MAP rose from 56 to 82. Systolic pressure was labile, ranging 100-198, with the lowest value around hour 16.6. SpO2 briefly dipped to 84 around hour 0.0 before recovering to 96, while respiratory rate peaked at 21 and later settled at 8. The associated labs and urine output showed that white count fell from 18.6 to 12.4, creatinine was roughly stable (0.3 to 0.6), lactate was not available, and urine output rose from 125 to 300, with recorded outputs ranging 110-325.

Answer: A


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

Options:
A. Taken together, the heart rate was roughly stable (94 to 89), while MAP rose from 96 to 116. Systolic pressure was labile, ranging 86-117, with the lowest value around hour 5.7. SpO2 briefly dipped to 91 around hour 0.6 before recovering to 91, while respiratory rate peaked at 28 and later settled at 14. The associated labs and urine output showed that white count was 14.8 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 3655 to 380, with recorded outputs ranging 400-3495.
B. Taken together, the heart rate was roughly stable (91 to 92), while MAP rose from 93 to 113. Systolic pressure was labile, ranging 89-137, with the lowest value around hour 5.2. SpO2 briefly dipped to 88 around hour 0.5 before recovering to 94, while respiratory rate peaked at 26 and later settled at 13. The associated labs and urine output showed that white count was 16.3 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 3575 to 400, with recorded outputs ranging 350-3575.
C. Taken together, the heart rate was roughly stable (95 to 88), while MAP rose from 97 to 117. Systolic pressure was labile, ranging 93-112, with the lowest value around hour 5.8. SpO2 briefly dipped to 89 around hour 0.6 before recovering to 90, while respiratory rate peaked at 28 and later settled at 15. The associated labs and urine output showed that white count was 14.4 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 3675 to 375, with recorded outputs ranging 375-3475.
D. Taken together, the heart rate was roughly stable (86 to 96), while MAP rose from 88 to 116. Systolic pressure was labile, ranging 94-167, with the lowest value around hour 4.5. SpO2 briefly dipped to 84 around hour 1.5 before recovering to 98, while respiratory rate peaked at 24 and later settled at 11. The associated labs and urine output showed that white count was 18.6 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 3455 to 350, with recorded outputs ranging 320-3695.

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 100 to 103, MAP rose from 96 to 116, and heart rate was roughly stable (88 to 95). SpO2 started at 95, ended at 97, and fell as low as 91 around hour 0.4; respiratory rate ranged 14-24. For labs and output, white count was 17.1 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 3655 to 380.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 95 to 119, MAP rose from 91 to 116, and heart rate was roughly stable (93 to 90). SpO2 started at 100, ended at 92, and fell as low as 87 around hour 0.6; respiratory rate ranged 12-27. For labs and output, white count was 17.4 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 3515 to 415.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 100 to 103, MAP rose from 97 to 117, and heart rate was roughly stable (87 to 95). SpO2 started at 94, ended at 98, and fell as low as 92 around hour 0.4; respiratory rate ranged 15-28. For labs and output, white count was 14.4 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 3675 to 375.
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 97 to 123, MAP rose from 93 to 113, and heart rate was roughly stable (91 to 92). SpO2 started at 98, ended at 94, and fell as low as 88 around hour 0.5; respiratory rate ranged 13-26. For labs and output, white count was 16.3 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 3575 to 400.

Answer: D


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

Options:
A. For handoff, the heart rate was roughly stable (67 to 57), MAP fell from 114 to 97, and diastolic pressure moved from 69 to 75. Systolic pressure ranged 121-240 and ended at 161, and SpO2 recovered to 94 after a low of 88 around hour 26.9. Respiratory rate ended at 16; the available labs showed white count stayed around 7.7, creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 1, and urine output fell from 220 to 97.
B. For handoff, the heart rate was roughly stable (64 to 60), MAP fell from 111 to 94, and diastolic pressure moved from 72 to 72. Systolic pressure ranged 118-220 and ended at 165, and SpO2 recovered to 97 after a low of 85 around hour 25.9. Respiratory rate ended at 17; the available labs showed white count stayed around 7.2, creatinine was roughly stable (0.8 to 0.9), lactate was checked once at 1, and urine output fell from 200 to 100.
C. For handoff, the heart rate was roughly stable (68 to 63), MAP fell from 115 to 98, and diastolic pressure moved from 68 to 69. Systolic pressure ranged 122-245 and ended at 190, and SpO2 recovered to 93 after a low of 89 around hour 27.8. Respiratory rate ended at 15; the available labs showed white count stayed around 7.8, creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 1, and urine output fell from 225 to 96.
D. For handoff, the heart rate was roughly stable (60 to 64), MAP fell from 106 to 90, and diastolic pressure moved from 76 to 68. Systolic pressure ranged 114-190 and ended at 135, and SpO2 recovered to 100 after a low of 84 around hour 23.6. Respiratory rate ended at 19; the available labs showed white count was roughly stable (7 to 6.4), creatinine was roughly stable (0.8 to 0.9), lactate was checked once at 1, and urine output fell from 250 to 100.

Answer: B