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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 116 to 122, MAP rose from 80 to 90, and heart rate rose from 57 to 89. SpO2 started at 82, ended at 100, and fell as low as 88 around hour 2.7; respiratory rate ranged 12-39. For labs and output, white count rose from 9.7 to 13.6, creatinine rose from 2.3 to 2.4, lactate rose from 1.8 to 2.5, and urine output was roughly stable (27 to 53)
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 113 to 142, MAP rose from 77 to 87, and heart rate rose from 60 to 86. SpO2 started at 85, ended at 97, and fell as low as 85 around hour 3.2; respiratory rate ranged 10-37. For labs and output, white count rose from 11.2 to 14.4, creatinine rose from 2.1 to 2.6, lactate rose from 1.6 to 2.3, and urine output was roughly stable (30 to 50)
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 117 to 120, MAP rose from 81 to 91, and heart rate rose from 56 to 90. SpO2 started at 81, ended at 100, and fell as low as 89 around hour 2.6; respiratory rate ranged 12-33. For labs and output, white count rose from 9.3 to 16.3, creatinine rose from 2.4 to 2.7, lactate rose from 1.8 to 2.5, and urine output was roughly stable (26 to 54)
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 108 to 138, MAP rose from 72 to 90, and heart rate rose from 64 to 82. SpO2 started at 90, ended at 92, and fell as low as 84 around hour 4.0; respiratory rate ranged 8-42. For labs and output, white count rose from 13.4 to 14.9, creatinine rose from 1.8 to 2.9, lactate rose from 1.3 to 2.0, and urine output was roughly stable (34 to 46)

Answer: B


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

Options:
A. Across the recorded window, the heart rate rose from 63 to 83, MAP rose from 80 to 90, and diastolic pressure moved from 58 to 72. Systolic pressure ranged 108-174 and ended at 162, and SpO2 recovered to 94 after a low of 84 around hour 3.7. Respiratory rate ended at 28; the available labs showed white count rose from 12.7 to 13.6, creatinine rose from 1.9 to 2.8, lactate rose from 1.8 to 2.1, and urine output was roughly stable (80 to 53)
B. Across the recorded window, the heart rate rose from 58 to 88, MAP rose from 75 to 90, and diastolic pressure moved from 63 to 67. Systolic pressure ranged 103-139 and ended at 138, and SpO2 recovered to 99 after a low of 83 around hour 4.2. Respiratory rate ended at 30; the available labs showed white count rose from 10.1 to 13.3, creatinine rose from 2.2 to 2.5, lactate rose from 1.5 to 2.4, and urine output was roughly stable (28 to 48)
C. Across the recorded window, the heart rate rose from 60 to 86, MAP rose from 77 to 87, and diastolic pressure moved from 61 to 69. Systolic pressure ranged 105-154 and ended at 142, and SpO2 recovered to 97 after a low of 85 around hour 3.2. Respiratory rate ended at 29; the available labs showed white count rose from 11.2 to 14.4, creatinine rose from 2.1 to 2.6, lactate rose from 1.6 to 2.3, and urine output was roughly stable (30 to 50)
D. Across the recorded window, the heart rate rose from 56 to 89, MAP rose from 72 to 82, and diastolic pressure moved from 66 to 66. Systolic pressure ranged 100-124 and ended at 112, and SpO2 recovered to 100 after a low of 80 around hour 2.5. Respiratory rate ended at 31; the available labs showed white count rose from 8.9 to 12.2, creatinine rose from 2.4 to 2.6, lactate rose from 1.3 to 2.6, and urine output was roughly stable (26 to 46)

Answer: C


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

Options:
A. Clinically, the heart rate rose from 53 to 62, while MAP was roughly stable (88 to 90). Systolic pressure was labile, ranging 106-118, with the lowest value around hour 31.1. SpO2 briefly dipped to 89 around hour 0.7 before recovering to 94, while respiratory rate peaked at 23 and later settled at 20. The associated labs and urine output showed that white count rose from 5.8 to 10.0, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output stayed around 43, with recorded outputs ranging 16-200.
B. Clinically, the heart rate rose from 50 to 65, while MAP was roughly stable (85 to 87). Systolic pressure was labile, ranging 102-138, with the lowest value around hour 29.6. SpO2 briefly dipped to 88 around hour 0.6 before recovering to 97, while respiratory rate peaked at 21 and later settled at 18. The associated labs and urine output showed that white count rose from 6.3 to 9.5, creatinine was roughly stable (0.4 to 0.5), lactate was not available, and urine output stayed around 40, with recorded outputs ranging 15-180.
C. Clinically, the heart rate rose from 54 to 61, while MAP was roughly stable (89 to 90). Systolic pressure was labile, ranging 98-113, with the lowest value around hour 31.5. SpO2 briefly dipped to 92 around hour 1.6 before recovering to 93, while respiratory rate peaked at 23 and later settled at 20. The associated labs and urine output showed that white count rose from 5.7 to 10.1, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output was roughly stable (44 to 0), with recorded outputs ranging 0-180.
D. Clinically, the heart rate rose from 46 to 70, while MAP was roughly stable (80 to 82). Systolic pressure was labile, ranging 106-168, with the lowest value around hour 27.4. SpO2 briefly dipped to 84 around hour 0.4 before recovering to 100, while respiratory rate peaked at 19 and later settled at 16. The associated labs and urine output showed that white count rose from 7.0 to 8.7, creatinine rose from 0.2 to 0.6, lactate was not available, and urine output stayed around 36, with recorded outputs ranging 40-150.

Answer: B


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (156 to 118), MAP was roughly stable (88 to 90), and heart rate rose from 47 to 68. SpO2 started at 97, ended at 100, and fell as low as 91 around hour 0.5; respiratory rate ranged 8-20. For labs and output, white count rose from 5.8 to 10.0, creatinine rose from 0.5 to 0.7, lactate was not available, and urine output was roughly stable (43 to 43)
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (121 to 153), MAP was roughly stable (83 to 85), and heart rate rose from 52 to 68. SpO2 started at 98, ended at 95, and fell as low as 86 around hour 0.7; respiratory rate ranged 7-23. For labs and output, white count rose from 6.7 to 8.7, creatinine was roughly stable (0.3 to 0.6), lactate was not available, and urine output was roughly stable (38 to 38)
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (161 to 134), MAP was roughly stable (89 to 90), and heart rate rose from 46 to 69. SpO2 started at 96, ended at 100, and fell as low as 87 around hour 0.5; respiratory rate ranged 8-19. For labs and output, white count rose from 5.7 to 10.1, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output was roughly stable (44 to 44)
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (136 to 138), MAP was roughly stable (85 to 87), and heart rate rose from 50 to 65. SpO2 started at 100, ended at 97, and fell as low as 88 around hour 0.6; respiratory rate ranged 7-21. For labs and output, white count rose from 6.3 to 9.5, creatinine was roughly stable (0.4 to 0.5), lactate was not available, and urine output was roughly stable (40 to 40)

Answer: D


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 106 to 79, diastolic pressure fell from 89 to 59, and heart rate fell from 69 to 56. The lowest MAP was about 67 around hour 25.1, and the lowest valid SpO2 was 88 around hour 11.6; respiratory rate rose as high as 36 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.7-34.8 C, white count was 15.0 on its only check, creatinine was 0.3 on its only check, lactate was checked once at 1.7, and urine output fell from 670 to 430.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 101 to 84, diastolic pressure fell from 84 to 60, and heart rate fell from 74 to 56. The lowest MAP was about 62 around hour 25.2, and the lowest valid SpO2 was 83 around hour 12.1; respiratory rate rose as high as 31 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 39.0-40.0 C, white count was 12.4 on its only check, creatinine was 0.5 on its only check, lactate was checked once at 1.4, and urine output fell from 635 to 465.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 107 to 78, diastolic pressure fell from 90 to 66, and heart rate fell from 68 to 57. The lowest MAP was about 68 around hour 22.2, and the lowest valid SpO2 was 89 around hour 11.2; respiratory rate rose as high as 35 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.0-34.0 C, white count was 15.4 on its only check, creatinine was 0.3 on its only check, lactate was checked once at 1.8, and urine output fell from 675 to 500.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 103 to 82, diastolic pressure fell from 86 to 62, and heart rate fell from 72 to 53. The lowest MAP was about 64 around hour 24.1, and the lowest valid SpO2 was 85 around hour 13.1; respiratory rate rose as high as 33 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 36.7-37.8 C, white count was 13.5 on its only check, creatinine was 0.4 on its only check, lactate was checked once at 1.5, and urine output fell from 650 to 450.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 103 to 82, diastolic pressure fell from 86 to 62, and heart rate fell from 72 to 53. The lowest MAP was about 64 around hour 24.1, and the lowest valid SpO2 was 85 around hour 13.1; respiratory rate rose as high as 33 but ended at 16. The lower-frequency data fit that summary: temperature ranged from 37 to 100, white count was 13.5 on its only check, creatinine was 0.4 on its only check, lactate was checked once at 1.5, and urine output fell from 650 to 450.


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 158 to 139, MAP fell from 103 to 82, and heart rate fell from 72 to 53. SpO2 started at 100, ended at 94, and fell as low as 85 around hour 13.1; respiratory rate ranged 11-33. For labs and output, white count was 13.5 on its only check, creatinine was 0.4 on its only check, lactate was checked once at 1.5, and urine output fell from 650 to 450.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 143 to 123, MAP fell from 101 to 80, and heart rate fell from 74 to 51. SpO2 started at 98, ended at 92, and fell as low as 83 around hour 14.2; respiratory rate ranged 10-35. For labs and output, white count was 14.6 on its only check, creatinine was 0.3 on its only check, lactate was checked once at 1.7, and urine output fell from 665 to 435.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 183 to 114, MAP fell from 107 to 86, and heart rate fell from 68 to 56. SpO2 started at 96, ended at 98, and fell as low as 89 around hour 11.2; respiratory rate ranged 13-35. For labs and output, white count was 11.6 on its only check, creatinine was 0.5 on its only check, lactate was checked once at 1.8, and urine output fell from 625 to 475.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 128 to 108, MAP fell from 98 to 85, and heart rate fell from 76 to 48. SpO2 started at 96, ended at 90, and fell as low as 84 around hour 15.3; respiratory rate ranged 9-38. For labs and output, white count was 15.8 on its only check, creatinine was 0.2 on its only check, lactate was checked once at 1.2, and urine output fell from 680 to 420.

Answer: A


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

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 142 to 107, MAP rose from 91 to 97, and heart rate was roughly stable (80 to 84). SpO2 started at 97, ended at 97, and fell as low as 84 around hour 20; respiratory rate ranged 14-24. For labs and output, white count rose from 8.9 to 14.1, creatinine was roughly stable (0.6 to 0.5), lactate rose from 0.8 to 1.4, and urine output fell from 630 to 22.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 107 to 104, MAP rose from 86 to 92, and heart rate was roughly stable (85 to 79). SpO2 started at 98, ended at 98, and fell as low as 83 around hour 22; respiratory rate ranged 11-27. For labs and output, white count rose from 11.5 to 13.0, creatinine rose from 0.4 to 0.7, lactate rose from 0.9 to 1.0, and urine output fell from 665 to 20.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 122 to 111, MAP rose from 88 to 94, and heart rate was roughly stable (83 to 81). SpO2 started at 100, ended at 100, and fell as low as 85 around hour 21; respiratory rate ranged 12-26. For labs and output, white count rose from 10.4 to 12.6, creatinine was roughly stable (0.5 to 0.6), lactate rose from 0.7 to 1.2, and urine output fell from 650 to 21.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 92 to 89, MAP rose from 84 to 90, and heart rate was roughly stable (88 to 84). SpO2 started at 96, ended at 96, and fell as low as 80 around hour 23; respiratory rate ranged 10-28. For labs and output, white count rose from 12.7 to 14.2, creatinine was roughly stable (0.3 to 0.8), lactate rose from 0.5 to 0.9, and urine output fell from 680 to 19.

Answer: C


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

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 147 to 116, MAP fell from 88 to 69, and heart rate rose from 77 to 100. SpO2 started at 97, ended at 98, and fell as low as 88 around hour 1.3; respiratory rate ranged 6-26. For labs and output, white count was roughly stable (8.7 to 9.2), creatinine was roughly stable (0.6 to 0.6), lactate stayed broadly stable from 1.8 to 1.7, and urine output was roughly stable (20 to 50)
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 112 to 109, MAP fell from 83 to 69, and heart rate rose from 82 to 96. SpO2 started at 98, ended at 93, and fell as low as 84 around hour 1.6; respiratory rate ranged 5-28. For labs and output, white count was roughly stable (9.6 to 8.3), creatinine stayed around 0.4, lactate stayed broadly stable from 1.8 to 1.5, and urine output was roughly stable (19 to 52)
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 152 to 115, MAP fell from 89 to 70, and heart rate rose from 76 to 101. SpO2 started at 96, ended at 99, and fell as low as 89 around hour 1.2; respiratory rate ranged 6-29. For labs and output, white count fell from 8.6 to 7.9, creatinine stayed around 0.6, lactate stayed broadly stable from 1.4 to 1.9, and urine output was roughly stable (22 to 46)
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 127 to 119, MAP fell from 85 to 66, and heart rate rose from 80 to 98. SpO2 started at 100, ended at 95, and fell as low as 85 around hour 1.5; respiratory rate ranged 5-27. For labs and output, white count was roughly stable (9.2 to 8.7), creatinine stayed around 0.5, lactate stayed broadly stable from 1.6 to 1.7, and urine output was roughly stable (20 to 50)

Answer: D


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

Options:
A. For handoff, the heart rate was roughly stable (83 to 79), while MAP fell from 72 to 65. Systolic pressure was labile, ranging 90-110, with the lowest value around hour 29.1. SpO2 briefly dipped to 86 around hour 3.9 before recovering to 96, while respiratory rate peaked at 31 and later settled at 28. The associated labs and urine output showed that white count fell from 11.6 to 9.9, creatinine stayed around 0.8, lactate fell from 4 to 3.1, and urine output fell from 1085 to 47, with recorded outputs ranging 43-925.
B. For handoff, the heart rate was roughly stable (78 to 84), while MAP was roughly stable (67 to 65). Systolic pressure was labile, ranging 88-145, with the lowest value around hour 26.5. SpO2 briefly dipped to 83 around hour 4.4 before recovering to 100, while respiratory rate peaked at 28 and later settled at 25. The associated labs and urine output showed that white count fell from 14.2 to 9.0, creatinine stayed around 0.6, lactate fell from 4 to 2.8, and urine output fell from 945 to 0, with recorded outputs ranging 0-1065.
C. For handoff, the heart rate was roughly stable (84 to 78), while MAP fell from 73 to 66. Systolic pressure was labile, ranging 82-105, with the lowest value around hour 29.5. SpO2 briefly dipped to 89 around hour 4.0 before recovering to 95, while respiratory rate peaked at 31 and later settled at 28. The associated labs and urine output showed that white count fell from 11.2 to 8.6, creatinine was roughly stable (0.8 to 0.8), lactate fell from 4 to 2.9, and urine output fell from 1005 to 50, with recorded outputs ranging 50-1005.
D. For handoff, the heart rate was roughly stable (80 to 82), while MAP fell from 69 to 62. Systolic pressure was labile, ranging 86-130, with the lowest value around hour 27.6. SpO2 briefly dipped to 85 around hour 3.4 before recovering to 99, while respiratory rate peaked at 29 and later settled at 26. The associated labs and urine output showed that white count fell from 13.1 to 9.4, creatinine stayed around 0.7, lactate fell from 4 to 2.9, and urine output fell from 1005 to 50, with recorded outputs ranging 40-1005.

Answer: D


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

Options:
A. Clinically, the heart rate rose from 100 to 112, while MAP was roughly stable (81 to 79). Systolic pressure was labile, ranging 120-130, with the lowest value around hour 14.1. SpO2 briefly dipped to 86 around hour 1.8 before recovering to 94, while respiratory rate peaked at 24 and later settled at 20. The associated labs and urine output showed that white count rose from 2 to 12.2, creatinine was roughly stable (0.8 to 0.5), lactate was not available, and urine output was roughly stable (83 to 97), with recorded outputs ranging 32-200.
B. Clinically, the heart rate rose from 98 to 115, while MAP was roughly stable (78 to 76). Systolic pressure was labile, ranging 116-150, with the lowest value around hour 12.6. SpO2 briefly dipped to 85 around hour 1.6 before recovering to 97, while respiratory rate peaked at 22 and later settled at 19. The associated labs and urine output showed that white count rose from 3 to 10.7, creatinine was roughly stable (0.7 to 0.6), lactate was not available, and urine output was roughly stable (80 to 100), with recorded outputs ranging 35-220.
C. Clinically, the heart rate rose from 100 to 111, while MAP was roughly stable (82 to 79). Systolic pressure was labile, ranging 112-125, with the lowest value around hour 14.5. SpO2 briefly dipped to 89 around hour 2.6 before recovering to 93, while respiratory rate peaked at 24 and later settled at 21. The associated labs and urine output showed that white count rose from 2 to 12.6, creatinine was roughly stable (0.8 to 0.5), lactate was not available, and urine output was roughly stable (84 to 50), with recorded outputs ranging 31-195.
D. Clinically, the heart rate rose from 94 to 120, while MAP was roughly stable (74 to 72). Systolic pressure was labile, ranging 120-180, with the lowest value around hour 10.3. SpO2 briefly dipped to 80 around hour 1.3 before recovering to 100, while respiratory rate peaked at 20 and later settled at 17. The associated labs and urine output showed that white count rose from 4 to 9.9, creatinine stayed around 0.5, lactate was not available, and urine output was roughly stable (80 to 100), with recorded outputs ranging 80-220.

Answer: B


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 161 to 132, MAP was roughly stable (81 to 79), and heart rate rose from 95 to 118. SpO2 started at 93, ended at 100, and fell as low as 84 around hour 1.4; respiratory rate ranged 12-20. For labs and output, white count rose from 2 to 12.2, creatinine was roughly stable (0.8 to 0.5), lactate was not available, and urine output was roughly stable (83 to 97)
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (126 to 151), MAP was roughly stable (76 to 74), and heart rate rose from 100 to 118. SpO2 started at 98, ended at 95, and fell as low as 83 around hour 1.8; respiratory rate ranged 10-24. For labs and output, white count rose from 3 to 9.9, creatinine was roughly stable (0.6 to 0.7), lactate was not available, and urine output was roughly stable (78 to 98)
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (166 to 111), MAP was roughly stable (82 to 80), and heart rate rose from 94 to 119. SpO2 started at 92, ended at 100, and fell as low as 89 around hour 1.4; respiratory rate ranged 13-20. For labs and output, white count rose from 2.2 to 12.6, creatinine stayed around 0.8, lactate was not available, and urine output was roughly stable (80 to 100)
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (141 to 136), MAP was roughly stable (78 to 76), and heart rate rose from 98 to 115. SpO2 started at 96, ended at 97, and fell as low as 85 around hour 1.6; respiratory rate ranged 11-22. For labs and output, white count rose from 3 to 10.7, creatinine was roughly stable (0.7 to 0.6), lactate was not available, and urine output was roughly stable (80 to 100)

Answer: D


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 105 to 72, diastolic pressure fell from 97 to 74, and heart rate was roughly stable (92 to 96). The lowest MAP was about 61 around hour 30.1, and the lowest valid SpO2 was 91 around hour 24.1; respiratory rate rose as high as 28 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 33.7-34.7 C, white count was roughly stable (13.9 to 9.9), creatinine was roughly stable (1.0 to 0.8), lactate fell from 207 to 3.1, and urine output was roughly stable (93 to 27)
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 77, diastolic pressure fell from 92 to 69, and heart rate was roughly stable (97 to 91). The lowest MAP was about 56 around hour 35.4, and the lowest valid SpO2 was 86 around hour 26.2; respiratory rate rose as high as 29 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 39.0-40.0 C, white count was roughly stable (11.3 to 12.5), creatinine was roughly stable (0.8 to 0.8), lactate fell from 242 to 2.8, and urine output was roughly stable (88 to 80)
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 106 to 71, diastolic pressure fell from 98 to 68, and heart rate was roughly stable (91 to 97). The lowest MAP was about 61 around hour 34.1, and the lowest valid SpO2 was 92 around hour 23.2; respiratory rate rose as high as 29 but ended at 29. The lower-frequency data fit that summary: temperature stayed around 33.0-34.0 C, white count was roughly stable (14.3 to 9.5), creatinine was roughly stable (1.0 to 0.8), lactate fell from 202 to 3.1, and urine output was roughly stable (94 to 26)
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 102 to 75, diastolic pressure fell from 94 to 71, and heart rate was roughly stable (95 to 93). The lowest MAP was about 58 around hour 33.1, and the lowest valid SpO2 was 88 around hour 25.1; respiratory rate rose as high as 27 but ended at 27. The lower-frequency data fit that summary: temperature stayed around 36.7-37.7 C, white count was roughly stable (12.4 to 11.4), creatinine was roughly stable (0.9 to 0.7), lactate fell from 227 to 2.9, and urine output was roughly stable (90 to 30)

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 102 to 75, diastolic pressure fell from 94 to 71, and heart rate was roughly stable (95 to 93). The lowest MAP was about 58 around hour 33.1, and the lowest valid SpO2 was 88 around hour 25.1; respiratory rate rose as high as 27 but ended at 27. The lower-frequency data fit that summary: temperature ranged from 98 to 99.8, white count was roughly stable (12.4 to 11.4), creatinine was roughly stable (0.9 to 0.7), lactate fell from 227 to 2.9, and urine output was roughly stable (90 to 30)


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

Options:
A. Viewed chronologically, the heart rate rose from 63 to 106, while MAP rose from 74 to 86. Systolic pressure was labile, ranging 92-132, with the lowest value around hour 23.3. SpO2 briefly dipped to 88 around hour 2 before recovering to 97, while respiratory rate peaked at 28 and later settled at 22. The associated labs and urine output showed that white count was roughly stable (9.4 to 10.1), creatinine stayed around 0.9, lactate was not available, and urine output rose from 30 to 160, with recorded outputs ranging 30-200.
B. Viewed chronologically, the heart rate rose from 58 to 111, while MAP rose from 69 to 81. Systolic pressure was labile, ranging 99-167, with the lowest value around hour 20.7. SpO2 briefly dipped to 84 around hour 0 before recovering to 98, while respiratory rate peaked at 29 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (10.3 to 9.8), creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output rose from 28 to 145, with recorded outputs ranging 21-215.
C. Viewed chronologically, the heart rate rose from 64 to 105, while MAP rose from 75 to 86. Systolic pressure was labile, ranging 91-127, with the lowest value around hour 23.7. SpO2 briefly dipped to 89 around hour 1 before recovering to 96, while respiratory rate peaked at 29 and later settled at 23. The associated labs and urine output showed that white count was roughly stable (9.3 to 12.8), creatinine was roughly stable (0.9 to 0.6), lactate was not available, and urine output rose from 34 to 110, with recorded outputs ranging 18-175.
D. Viewed chronologically, the heart rate rose from 60 to 109, while MAP rose from 71 to 83. Systolic pressure was labile, ranging 95-152, with the lowest value around hour 21.8. SpO2 briefly dipped to 85 around hour 0 before recovering to 100, while respiratory rate peaked at 27 and later settled at 21. The associated labs and urine output showed that white count was roughly stable (9.9 to 10.9), creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output rose from 30 to 160, with recorded outputs ranging 20-200.

Answer: D


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

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 118 to 91, diastolic pressure fell from 95 to 63, and heart rate rose from 40 to 71. The lowest MAP was about 75 around hour 3.0, and the lowest valid SpO2 was 88 around hour 16.4; respiratory rate rose as high as 30 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.9-35.2 C, white count fell from 17.2 to 11.9, creatinine was roughly stable (1.9 to 1.3), lactate was checked once at 1.9, and urine output was roughly stable (220 to 250)
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 115 to 94, diastolic pressure fell from 92 to 60, and heart rate rose from 43 to 68. The lowest MAP was about 72 around hour 3.5, and the lowest valid SpO2 was 85 around hour 17.9; respiratory rate rose as high as 28 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 35.9-38.2 C, white count fell from 15.7 to 13.4, creatinine was roughly stable (1.7 to 1.2), lactate was checked once at 2.1, and urine output was roughly stable (200 to 200)
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 119 to 90, diastolic pressure fell from 96 to 57, and heart rate rose from 39 to 72. The lowest MAP was about 75 around hour 4.5, and the lowest valid SpO2 was 89 around hour 16.0; respiratory rate rose as high as 30 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 32.1-34.5 C, white count fell from 17.6 to 11.5, creatinine was roughly stable (1.9 to 1.4), lactate was checked once at 1.9, and urine output was roughly stable (225 to 225)
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 110 to 98, diastolic pressure fell from 88 to 56, and heart rate rose from 48 to 71. The lowest MAP was about 68 around hour 4.2, and the lowest valid SpO2 was 80 around hour 16.9; respiratory rate rose as high as 26 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 40.4-42.7 C, white count fell from 13.4 to 11.9, creatinine was roughly stable (1.4 to 0.9), lactate was checked once at 2.4, and urine output was roughly stable (170 to 170)

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 115 to 94, diastolic pressure fell from 92 to 60, and heart rate rose from 43 to 68. The lowest MAP was about 72 around hour 3.5, and the lowest valid SpO2 was 85 around hour 17.9; respiratory rate rose as high as 28 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 96.6 to 100.8, white count fell from 15.7 to 13.4, creatinine was roughly stable (1.7 to 1.2), lactate was checked once at 2.1, and urine output was roughly stable (200 to 200)


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

Options:
A. Taken together, the heart rate rose from 46 to 71, MAP fell from 118 to 97, and diastolic pressure moved from 89 to 57. Systolic pressure ranged 163-202 and ended at 185, and SpO2 recovered to 96 after a low of 88 around hour 19.4. Respiratory rate ended at 18; the available labs showed white count fell from 17.2 to 14.9, creatinine was roughly stable (1.5 to 1.4), lactate was checked once at 2.3, and urine output was roughly stable (180 to 220)
B. Taken together, the heart rate rose from 41 to 70, MAP fell from 113 to 92, and diastolic pressure moved from 94 to 58. Systolic pressure ranged 128-167 and ended at 150, and SpO2 recovered to 100 after a low of 84 around hour 16.8. Respiratory rate ended at 20; the available labs showed white count fell from 14.6 to 12.6, creatinine was roughly stable (1.9 to 1.0), lactate was checked once at 2.0, and urine output was roughly stable (250 to 185)
C. Taken together, the heart rate rose from 47 to 64, MAP fell from 119 to 97, and diastolic pressure moved from 88 to 64. Systolic pressure ranged 168-207 and ended at 161, and SpO2 recovered to 95 after a low of 89 around hour 18.9. Respiratory rate ended at 17; the available labs showed white count fell from 17.6 to 15.3, creatinine was roughly stable (1.4 to 1.4), lactate was checked once at 2.4, and urine output was roughly stable (175 to 225)
D. Taken together, the heart rate rose from 43 to 68, MAP fell from 115 to 94, and diastolic pressure moved from 92 to 60. Systolic pressure ranged 143-182 and ended at 165, and SpO2 recovered to 99 after a low of 85 around hour 17.9. Respiratory rate ended at 19; the available labs showed white count fell from 15.7 to 13.4, creatinine was roughly stable (1.7 to 1.2), lactate was checked once at 2.1, and urine output was roughly stable (200 to 200)

Answer: D


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

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 100, diastolic pressure rose from 65 to 113, and heart rate rose from 52 to 99. The lowest MAP was about 68 around hour 1.2, and the lowest valid SpO2 was 91 around hour 9.7; respiratory rate rose as high as 34 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.4-34 C, white count was 13.3 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 97 to 370.
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 69 to 135, diastolic pressure rose from 60 to 114, and heart rate rose from 57 to 99. The lowest MAP was about 69 around hour 0.3, and the lowest valid SpO2 was 86 around hour 10.2; respiratory rate rose as high as 29 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 38.6-39 C, white count was 10.7 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 98 to 335.
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 71 to 120, diastolic pressure rose from 62 to 116, and heart rate rose from 55 to 96. The lowest MAP was about 71 around hour 0.2, and the lowest valid SpO2 was 88 around hour 11.2; respiratory rate rose as high as 31 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.4-37 C, white count was 11.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 100 to 350.
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 66 to 150, diastolic pressure rose from 58 to 112, and heart rate rose from 60 to 92. The lowest MAP was about 66 around hour 0.4, and the lowest valid SpO2 was 84 around hour 13.4; respiratory rate rose as high as 33 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 40.9-42 C, white count was 9.6 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 96 to 400.

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 71 to 120, diastolic pressure rose from 62 to 116, and heart rate rose from 55 to 96. The lowest MAP was about 71 around hour 0.2, and the lowest valid SpO2 was 88 around hour 11.2; respiratory rate rose as high as 31 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 0 to 98.6, white count was 11.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 100 to 350.


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

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 107 to 115, MAP rose from 74 to 140, and heart rate rose from 52 to 99. SpO2 started at 97, ended at 100, and fell as low as 91 around hour 9.7; respiratory rate ranged 18-33. For labs and output, white count was 10.3 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 97 to 330.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 102 to 150, MAP rose from 69 to 105, and heart rate rose from 57 to 94. SpO2 started at 98, ended at 95, and fell as low as 86 around hour 12.3; respiratory rate ranged 16-33. For labs and output, white count was 12.9 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output rose from 98 to 365.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 108 to 131, MAP rose from 75 to 123, and heart rate rose from 51 to 100. SpO2 started at 96, ended at 100, and fell as low as 87 around hour 9.3; respiratory rate ranged 19-27. For labs and output, white count was 9.9 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 96 to 325.
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 104 to 135, MAP rose from 71 to 120, and heart rate rose from 55 to 96. SpO2 started at 100, ended at 97, and fell as low as 88 around hour 11.2; respiratory rate ranged 17-31. For labs and output, white count was 11.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output rose from 100 to 350.

Answer: D


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

Options:
A. In broad terms, the heart rate was roughly stable (88 to 80), while MAP rose from 53 to 63. Systolic pressure was labile, ranging 85-102, with the lowest value around hour 68.7. SpO2 briefly dipped to 86 around hour 19.2 before recovering to 90, while respiratory rate peaked at 34 and later settled at 18. The associated labs and urine output showed that white count fell from 10.8 to 10, creatinine was roughly stable (6.3 to 5.2), lactate rose from 2.7 to 349, and urine output was not recorded.
B. In broad terms, the heart rate was roughly stable (83 to 85), while MAP rose from 48 to 58. Systolic pressure was labile, ranging 83-137, with the lowest value around hour 63.5. SpO2 briefly dipped to 83 around hour 16.6 before recovering to 95, while respiratory rate peaked at 30 and later settled at 15. The associated labs and urine output showed that white count fell from 13.4 to 8.2, creatinine was roughly stable (5.9 to 5.8), lactate rose from 2.4 to 314, and urine output was not recorded.
C. In broad terms, the heart rate was roughly stable (85 to 83), while MAP rose from 50 to 60. Systolic pressure was labile, ranging 81-122, with the lowest value around hour 65.7. SpO2 briefly dipped to 85 around hour 17.7 before recovering to 93, while respiratory rate peaked at 32 and later settled at 16. The associated labs and urine output showed that white count fell from 12.3 to 9, creatinine was roughly stable (5.8 to 5.7), lactate rose from 2.5 to 329, and urine output was not recorded.
D. In broad terms, the heart rate was roughly stable (80 to 88), while MAP rose from 46 to 63. Systolic pressure was labile, ranging 86-152, with the lowest value around hour 61.2. SpO2 briefly dipped to 80 around hour 18.7 before recovering to 98, while respiratory rate peaked at 28 and later settled at 14. The associated labs and urine output showed that white count fell from 14.6 to 8, creatinine was roughly stable (5.0 to 5.6), lactate rose from 2.2 to 299, and urine output was not recorded.

Answer: C


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 53 to 57, diastolic pressure was roughly stable (49 to 44), and heart rate was roughly stable (82 to 86). The lowest MAP was about 49 around hour 83.7, and the lowest valid SpO2 was 88 around hour 16.2; respiratory rate rose as high as 35 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.4-35.5 C, white count fell from 13.8 to 8, creatinine was roughly stable (6.3 to 6.2), lactate rose from 2.3 to 349, and urine output was not recorded.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 48 to 62, diastolic pressure was roughly stable (44 to 45), and heart rate was roughly stable (87 to 81). The lowest MAP was about 44 around hour 85.0, and the lowest valid SpO2 was 83 around hour 18.8; respiratory rate rose as high as 34 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 38.6-40.8 C, white count fell from 11.2 to 9, creatinine stayed around 5.4, lactate rose from 2.5 to 329, and urine output was not recorded.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 54 to 56, diastolic pressure was roughly stable (50 to 51), and heart rate was roughly stable (81 to 86). The lowest MAP was about 50 around hour 79.0, and the lowest valid SpO2 was 89 around hour 16.7; respiratory rate rose as high as 36 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 32.6-34.8 C, white count fell from 14.2 to 8, creatinine was roughly stable (6.4 to 6.3), lactate rose from 2.2 to 354, and urine output was not recorded.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 50 to 60, diastolic pressure was roughly stable (46 to 47), and heart rate was roughly stable (85 to 83). The lowest MAP was about 46 around hour 82.7, and the lowest valid SpO2 was 85 around hour 17.7; respiratory rate rose as high as 32 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 36.4-38.5 C, white count fell from 12.3 to 9, creatinine was roughly stable (5.8 to 5.7), lactate rose from 2.5 to 329, and urine output was not recorded.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 50 to 60, diastolic pressure was roughly stable (46 to 47), and heart rate was roughly stable (85 to 83). The lowest MAP was about 46 around hour 82.7, and the lowest valid SpO2 was 85 around hour 17.7; respiratory rate rose as high as 32 but ended at 16. The lower-frequency data fit that summary: temperature ranged from 97.6 to 101.3, white count fell from 12.3 to 9, creatinine was roughly stable (5.8 to 5.7), lactate rose from 2.5 to 329, and urine output was not recorded.


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

Options:
A. For handoff, the heart rate was roughly stable (88 to 80), MAP rose from 53 to 63, and diastolic pressure moved from 43 to 50. Systolic pressure ranged 84-142 and ended at 97, and SpO2 recovered to 90 after a low of 88 around hour 18.7. Respiratory rate ended at 14; the available labs showed white count fell from 13.8 to 10, creatinine was roughly stable (5.3 to 6.2), lactate rose from 2.7 to 309, and urine output was not recorded.
B. For handoff, the heart rate was roughly stable (85 to 83), MAP rose from 50 to 60, and diastolic pressure moved from 46 to 47. Systolic pressure ranged 81-122 and ended at 101, and SpO2 recovered to 93 after a low of 85 around hour 17.7. Respiratory rate ended at 16; the available labs showed white count fell from 12.3 to 9, creatinine was roughly stable (5.8 to 5.7), lactate rose from 2.5 to 329, and urine output was not recorded.
C. For handoff, the heart rate was roughly stable (89 to 86), MAP rose from 54 to 64, and diastolic pressure moved from 42 to 44. Systolic pressure ranged 85-147 and ended at 105, and SpO2 recovered to 89 after a low of 89 around hour 19.6. Respiratory rate ended at 14; the available labs showed white count fell from 14.2 to 10, creatinine was roughly stable (5.2 to 6.3), lactate rose from 2.8 to 304, and urine output was not recorded.
D. For handoff, the heart rate was roughly stable (80 to 88), MAP rose from 53 to 56, and diastolic pressure moved from 50 to 42. Systolic pressure ranged 76-92 and ended at 96, and SpO2 recovered to 98 after a low of 84 around hour 15.4. Respiratory rate ended at 18; the available labs showed white count fell from 10.1 to 8.2, creatinine was roughly stable (6.5 to 5.0), lactate rose from 2.2 to 359, and urine output was not recorded.

Answer: B


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

Options:
A. For handoff, the heart rate fell from 116 to 93, while MAP fell from 106 to 92. Systolic pressure was labile, ranging 84-181, with the lowest value around hour 14.4. SpO2 briefly dipped to 86 around hour 26.4 before recovering to 90, while respiratory rate peaked at 42 and later settled at 41. The associated labs and urine output showed that white count fell from 16.6 to 13.3, creatinine was roughly stable (0.7 to 0.5), lactate was not available, and urine output was roughly stable (53 to 78), with recorded outputs ranging 50-130.
B. For handoff, the heart rate fell from 111 to 98, while MAP fell from 101 to 92. Systolic pressure was labile, ranging 89-216, with the lowest value around hour 11.8. SpO2 briefly dipped to 81 around hour 25.9 before recovering to 95, while respiratory rate peaked at 37 and later settled at 36. The associated labs and urine output showed that white count fell from 19.2 to 13.0, creatinine fell from 0.5 to 0.4, lactate was not available, and urine output was roughly stable (48 to 25), with recorded outputs ranging 21-165.
C. For handoff, the heart rate fell from 117 to 92, while MAP fell from 107 to 93. Systolic pressure was labile, ranging 91-176, with the lowest value around hour 14.8. SpO2 briefly dipped to 84 around hour 26.8 before recovering to 89, while respiratory rate peaked at 41 and later settled at 42. The associated labs and urine output showed that white count fell from 16.2 to 16.0, creatinine fell from 0.7 to 0.3, lactate was not available, and urine output was roughly stable (54 to 79), with recorded outputs ranging 18-125.
D. For handoff, the heart rate fell from 113 to 96, while MAP fell from 103 to 89. Systolic pressure was labile, ranging 87-201, with the lowest value around hour 12.9. SpO2 briefly dipped to 83 around hour 24.9 before recovering to 93, while respiratory rate peaked at 39 and later settled at 38. The associated labs and urine output showed that white count fell from 18.1 to 14.1, creatinine fell from 0.6 to 0.4, lactate was not available, and urine output was roughly stable (50 to 75), with recorded outputs ranging 20-150.

Answer: D


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 fell from 167 to 100, MAP fell from 100 to 65, and heart rate fell from 100 to 94. SpO2 started at 97, ended at 99, and fell as low as 76 around hour 10.3; respiratory rate ranged 14-27. For labs and output, white count rose from 7.2 to 9.9, creatinine fell from 0.8 to 0.4, lactate was checked once at 404, and urine output was roughly stable (220 to 180)
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 132 to 106, MAP fell from 95 to 60, and heart rate fell from 135 to 94. SpO2 started at 98, ended at 94, and fell as low as 75 around hour 12.9; respiratory rate ranged 11-32. For labs and output, white count was roughly stable (8.1 to 8.6), creatinine fell from 0.6 to 0.5, lactate was checked once at 369, and urine output was roughly stable (185 to 215)
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 172 to 100, MAP fell from 100 to 66, and heart rate fell from 95 to 92. SpO2 started at 96, ended at 100, and fell as low as 81 around hour 9.9; respiratory rate ranged 14-26. For labs and output, white count rose from 7.1 to 10.0, creatinine was roughly stable (0.8 to 0.6), lactate was checked once at 384.2, and urine output was roughly stable (225 to 175)
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 147 to 104, MAP fell from 97 to 62, and heart rate fell from 120 to 91. SpO2 started at 100, ended at 96, and fell as low as 77 around hour 11.8; respiratory rate ranged 12-30. For labs and output, white count rose from 7.7 to 9.4, creatinine fell from 0.7 to 0.5, lactate was checked once at 384, and urine output was roughly stable (200 to 200)

Answer: D


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 158 to 143, MAP fell from 120 to 101, and heart rate rose from 50 to 104. SpO2 started at 84, ended at 94, and fell as low as 84 around hour 0.1; respiratory rate ranged 5-37. For labs and output, white count rose from 3 to 4.4, creatinine fell from 2.7 to 2.1, lactate stayed broadly stable from 1.4 to 1.8, and urine output rose from 80 to 220.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 143 to 123, MAP fell from 105 to 99, and heart rate rose from 52 to 107. SpO2 started at 86, ended at 92, and fell as low as 82 around hour 0.2; respiratory rate ranged 5-39. For labs and output, white count stayed around 3.6, creatinine fell from 2.7 to 2.1, lactate stayed broadly stable from 1.4 to 1.8, and urine output rose from 80 to 220.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 183 to 139, MAP fell from 145 to 104, and heart rate rose from 46 to 108. SpO2 started at 80, ended at 98, and fell as low as 83 around hour 0.0; respiratory rate ranged 6-33. For labs and output, white count rose from 2 to 5.0, creatinine fell from 3.0 to 1.9, lactate stayed broadly stable from 1.6 to 2.0, and urine output rose from 76 to 245.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 128 to 108, MAP fell from 90 to 87, and heart rate rose from 54 to 100. SpO2 started at 88, ended at 90, and fell as low as 80 around hour 0.2; respiratory rate ranged 4-42. For labs and output, white count rose from 4 to 4.5, creatinine fell from 2.4 to 2.2, lactate stayed broadly stable from 1.6 to 1.5, and urine output rose from 84 to 190.

Answer: A


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

Options:
A. Overall, the heart rate fell from 53 to 31, MAP fell from 167 to 60, and diastolic pressure moved from 124 to 47. Systolic pressure ranged 81-216 and ended at 81, and SpO2 recovered to 73 after a low of 79 around hour 40.2. Respiratory rate ended at 14; the available labs showed white count rose from 16.3 to 19.1, creatinine was roughly stable (0.3 to 0.6), lactate was not available, and urine output was not recorded.
B. Overall, the heart rate fell from 48 to 29, MAP fell from 132 to 60, and diastolic pressure moved from 159 to 48. Systolic pressure ranged 74-181 and ended at 74, and SpO2 recovered to 78 after a low of 74 around hour 38. Respiratory rate ended at 17; the available labs showed white count rose from 13.7 to 16.5, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output was not recorded.
C. Overall, the heart rate fell from 50 to 28, MAP fell from 147 to 57, and diastolic pressure moved from 144 to 50. Systolic pressure ranged 78-196 and ended at 78, and SpO2 recovered to 76 after a low of 76 around hour 37.2. Respiratory rate ended at 16; the available labs showed white count rose from 14.8 to 17.6, creatinine was roughly stable (0.4 to 0.5), lactate was not available, and urine output was not recorded.
D. Overall, the heart rate fell from 46 to 30, MAP fell from 117 to 52, and diastolic pressure moved from 174 to 47. Systolic pressure ranged 74-166 and ended at 74, and SpO2 recovered to 80 after a low of 75 around hour 32.7. Respiratory rate ended at 18; the available labs showed white count rose from 12.6 to 16.8, creatinine was roughly stable (0.6 to 0.3), lactate was not available, and urine output was not recorded.

Answer: C


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

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 85 to 66, diastolic pressure fell from 79 to 62, and heart rate fell from 89 to 80. The lowest MAP was about 60 around hour 6.7, and the lowest valid SpO2 was 88 around hour 0.2; respiratory rate rose as high as 28 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.6-34.4 C, white count fell from 18.1 to 12.1, creatinine fell from 1.9 to 1, lactate was not available, and urine output fell from 280 to 33.
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 82 to 69, diastolic pressure fell from 76 to 59, and heart rate fell from 92 to 77. The lowest MAP was about 57 around hour 7.2, and the lowest valid SpO2 was 85 around hour 1.2; respiratory rate rose as high as 26 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.6-37.4 C, white count fell from 16.6 to 13.6, creatinine fell from 1.7 to 1, lactate was not available, and urine output fell from 300 to 30.
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 65, diastolic pressure fell from 80 to 56, and heart rate fell from 88 to 81. The lowest MAP was about 60 around hour 8.2, and the lowest valid SpO2 was 89 around hour 0.9; respiratory rate rose as high as 28 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 32.9-33.6 C, white count fell from 18.5 to 11.7, creatinine fell from 1.9 to 1, lactate was not available, and urine output fell from 275 to 34.
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 78 to 74, diastolic pressure fell from 72 to 54, and heart rate fell from 96 to 72. The lowest MAP was about 52 around hour 8.0, and the lowest valid SpO2 was 80 around hour 1.5; respiratory rate rose as high as 28 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 41.1-41.9 C, white count fell from 14.4 to 12.9, creatinine fell from 1.4 to 1.1, lactate was not available, and urine output fell from 330 to 80.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 82 to 69, diastolic pressure fell from 76 to 59, and heart rate fell from 92 to 77. The lowest MAP was about 57 around hour 7.2, and the lowest valid SpO2 was 85 around hour 1.2; respiratory rate rose as high as 26 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 97.8 to 99.4, white count fell from 16.6 to 13.6, creatinine fell from 1.7 to 1, lactate was not available, and urine output fell from 300 to 30.


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

Options:
A. Taken together, the heart rate fell from 95 to 74, MAP fell from 85 to 72, and diastolic pressure moved from 73 to 62. Systolic pressure ranged 72-155 and ended at 94, and SpO2 recovered to 92 after a low of 88 around hour 2.2. Respiratory rate ended at 16; the available labs showed white count fell from 18.1 to 15.1, creatinine fell from 1.5 to 1, lactate was not available, and urine output fell from 320 to 27.
B. Taken together, the heart rate fell from 90 to 79, MAP fell from 80 to 67, and diastolic pressure moved from 78 to 57. Systolic pressure ranged 67-120 and ended at 96, and SpO2 recovered to 97 after a low of 84 around hour 1.0. Respiratory rate ended at 18; the available labs showed white count fell from 15.5 to 12.8, creatinine fell from 1.9 to 1, lactate was not available, and urine output fell from 350 to 32.
C. Taken together, the heart rate fell from 96 to 80, MAP fell from 86 to 73, and diastolic pressure moved from 72 to 56. Systolic pressure ranged 73-160 and ended at 100, and SpO2 recovered to 91 after a low of 89 around hour 1.4. Respiratory rate ended at 15; the available labs showed white count fell from 18.5 to 15.5, creatinine fell from 1.4 to 1, lactate was not available, and urine output fell from 325 to 26.
D. Taken together, the heart rate fell from 92 to 77, MAP fell from 82 to 69, and diastolic pressure moved from 76 to 59. Systolic pressure ranged 69-135 and ended at 98, and SpO2 recovered to 95 after a low of 85 around hour 1.2. Respiratory rate ended at 17; the available labs showed white count fell from 16.6 to 13.6, creatinine fell from 1.7 to 1, lactate was not available, and urine output fell from 300 to 30.

Answer: D


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

Options:
A. For handoff, the heart rate fell from 113 to 52, while MAP fell from 66 to 41. Systolic pressure was labile, ranging 37-103, with the lowest value around hour 28.9. SpO2 briefly dipped to 83 around hour 30.9 before recovering to 88, while respiratory rate peaked at 34 and later settled at 18. The associated labs and urine output showed that white count was 17.0 on its only check, creatinine rose from 2.3 to 2.5, lactate was checked once at 1.1, and urine output fell from 220 to 28, with recorded outputs ranging 27-180.
B. For handoff, the heart rate fell from 108 to 57, while MAP fell from 61 to 41. Systolic pressure was labile, ranging 42-138, with the lowest value around hour 26.3. SpO2 briefly dipped to 78 around hour 30.4 before recovering to 93, while respiratory rate peaked at 29 and later settled at 16. The associated labs and urine output showed that white count was 19.6 on its only check, creatinine was roughly stable (2.0 to 2.1), lactate was checked once at 1.5, and urine output fell from 185 to 0, with recorded outputs ranging 0-215.
C. For handoff, the heart rate fell from 114 to 51, while MAP fell from 67 to 42. Systolic pressure was labile, ranging 44-98, with the lowest value around hour 29.3. SpO2 briefly dipped to 81 around hour 31.3 before recovering to 87, while respiratory rate peaked at 33 and later settled at 19. The associated labs and urine output showed that white count was 16.6 on its only check, creatinine was roughly stable (2.4 to 2.5), lactate was checked once at 1.1, and urine output fell from 225 to 29, with recorded outputs ranging 13-175.
D. For handoff, the heart rate fell from 110 to 55, while MAP fell from 63 to 38. Systolic pressure was labile, ranging 40-123, with the lowest value around hour 27.4. SpO2 briefly dipped to 80 around hour 29.4 before recovering to 91, while respiratory rate peaked at 31 and later settled at 17. The associated labs and urine output showed that white count was 18.5 on its only check, creatinine was roughly stable (2.1 to 2.2), lactate was checked once at 1.3, and urine output fell from 200 to 27, with recorded outputs ranging 15-200.

Answer: D


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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 91 to 49, MAP fell from 66 to 41, and heart rate fell from 107 to 58. SpO2 started at 90, ended at 94, and fell as low as 83 around hour 27.9; respiratory rate ranged 16-28. For labs and output, white count was 17.0 on its only check, creatinine rose from 2.3 to 2.5, lactate was checked once at 1.5, and urine output fell from 220 to 28.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 88 to 52, MAP fell from 63 to 38, and heart rate fell from 110 to 55. SpO2 started at 93, ended at 91, and fell as low as 80 around hour 29.4; respiratory rate ranged 15-31. For labs and output, white count was 18.5 on its only check, creatinine was roughly stable (2.1 to 2.2), lactate was checked once at 1.3, and urine output fell from 200 to 27.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 92 to 48, MAP fell from 67 to 41, and heart rate fell from 106 to 59. SpO2 started at 89, ended at 95, and fell as low as 79 around hour 27.5; respiratory rate ranged 17-27. For labs and output, white count was 16.6 on its only check, creatinine was roughly stable (2.4 to 2.5), lactate was checked once at 1.1, and urine output fell from 225 to 29.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 84 to 56, MAP fell from 58 to 34, and heart rate fell from 114 to 58. SpO2 started at 98, ended at 86, and fell as low as 76 around hour 31.6; respiratory rate ranged 13-33. For labs and output, white count was 20.8 on its only check, creatinine was roughly stable (1.8 to 1.9), lactate was checked once at 1.6, and urine output fell from 170 to 25.

Answer: B


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

Options:
A. Across the recorded window, the heart rate fell from 113 to 58, MAP fell from 66 to 41, and diastolic pressure moved from 51 to 26. Systolic pressure ranged 43-143 and ended at 55, and SpO2 recovered to 88 after a low of 83 around hour 30.9. Respiratory rate ended at 16; the available labs showed white count was 20.0 on its only check, creatinine was roughly stable (2.3 to 2.0), lactate was checked once at 1.5, and urine output fell from 220 to 26.
B. Across the recorded window, the heart rate fell from 108 to 57, MAP fell from 61 to 36, and diastolic pressure moved from 56 to 28. Systolic pressure ranged 38-108 and ended at 50, and SpO2 recovered to 93 after a low of 79 around hour 28.3. Respiratory rate ended at 18; the available labs showed white count was 17.4 on its only check, creatinine was roughly stable (2.0 to 2.4), lactate was checked once at 1.1, and urine output fell from 250 to 28.
C. Across the recorded window, the heart rate fell from 110 to 55, MAP fell from 63 to 38, and diastolic pressure moved from 54 to 29. Systolic pressure ranged 40-123 and ended at 52, and SpO2 recovered to 91 after a low of 80 around hour 29.4. Respiratory rate ended at 17; the available labs showed white count was 18.5 on its only check, creatinine was roughly stable (2.1 to 2.2), lactate was checked once at 1.3, and urine output fell from 200 to 27.
D. Across the recorded window, the heart rate fell from 106 to 60, MAP fell from 58 to 41, and diastolic pressure moved from 58 to 27. Systolic pressure ranged 36-93 and ended at 48, and SpO2 recovered to 96 after a low of 76 around hour 30.4. Respiratory rate ended at 19; the available labs showed white count was 16.2 on its only check, creatinine was roughly stable (1.8 to 2.5), lactate was checked once at 1.0, and urine output fell from 170 to 29.

Answer: C


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 171 to 112, MAP fell from 99 to 85, and heart rate fell from 73 to 6. SpO2 started at 97, ended at 64, and fell as low as 63 around hour 56.6; respiratory rate ranged 6-26. For labs and output, white count fell from 9.1 to 7.9, creatinine was roughly stable (1.3 to 1), lactate was not available, and urine output rose from 58 to 220.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 136 to 117, MAP fell from 94 to 80, and heart rate fell from 78 to 9. SpO2 started at 98, ended at 59, and fell as low as 58 around hour 61.9; respiratory rate ranged 5-30. For labs and output, white count fell from 10.0 to 7.9, creatinine fell from 1.0 to 0.8, lactate was not available, and urine output rose from 53 to 185.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 176 to 111, MAP fell from 100 to 85, and heart rate fell from 72 to 7. SpO2 started at 96, ended at 65, and fell as low as 59 around hour 55.9; respiratory rate ranged 6-26. For labs and output, white count was roughly stable (9.0 to 9.3), creatinine fell from 1.4 to 0.8, lactate was not available, and urine output rose from 59 to 225.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 151 to 115, MAP fell from 96 to 82, and heart rate fell from 76 to 6. SpO2 started at 100, ended at 61, and fell as low as 60 around hour 59.6; respiratory rate ranged 5-28. For labs and output, white count was roughly stable (9.6 to 8.7), creatinine fell from 1.1 to 0.9, lactate was not available, and urine output rose from 55 to 200.

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 fell from 96 to 72, diastolic pressure fell from 78 to 57, and heart rate fell from 77 to 65. The lowest MAP was about 27 around hour 94.6, and the lowest valid SpO2 was 86 around hour 65.6; respiratory rate rose as high as 35 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 33.6-35 C, white count rose from 8 to 10.1, creatinine was roughly stable (1.6 to 2.1), lactate rose from 0.8 to 1.4, and urine output rose from 97 to 230.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 91 to 77, diastolic pressure fell from 73 to 58, and heart rate fell from 82 to 65. The lowest MAP was about 23 around hour 95.8, and the lowest valid SpO2 was 81 around hour 67.6; respiratory rate rose as high as 30 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 38.9-40 C, white count rose from 7 to 12.7, creatinine was roughly stable (1.2 to 1.8), lactate rose from 1.0 to 1.2, and urine output rose from 98 to 265.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 97 to 71, diastolic pressure fell from 79 to 64, and heart rate fell from 76 to 66. The lowest MAP was about 26 around hour 89.8, and the lowest valid SpO2 was 87 around hour 64.8; respiratory rate rose as high as 34 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 32.9-34 C, white count rose from 8 to 9.7, creatinine was roughly stable (1.6 to 2), lactate rose from 0.8 to 1.4, and urine output rose from 96 to 300.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 93 to 75, diastolic pressure fell from 75 to 60, and heart rate fell from 80 to 62. The lowest MAP was about 24 around hour 93.6, and the lowest valid SpO2 was 83 around hour 68.6; respiratory rate rose as high as 32 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 36.6-38 C, white count rose from 7 to 11.6, creatinine was roughly stable (1.4 to 1.9), lactate rose from 0.9 to 1.2, and urine output rose from 100 to 250.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 93 to 75, diastolic pressure fell from 75 to 60, and heart rate fell from 80 to 62. The lowest MAP was about 24 around hour 93.6, and the lowest valid SpO2 was 83 around hour 68.6; respiratory rate rose as high as 32 but ended at 15. The lower-frequency data fit that summary: temperature ranged from 97.8 to 100.4, white count rose from 7 to 11.6, creatinine was roughly stable (1.4 to 1.9), lactate rose from 0.9 to 1.2, and urine output rose from 100 to 250.


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

Options:
A. For handoff, the heart rate was roughly stable (55 to 47), while MAP fell from 95 to 86. Systolic pressure was labile, ranging 106-177, with the lowest value around hour 4.2. SpO2 briefly dipped to 93 around hour 5.2 before recovering to 90, while respiratory rate peaked at 24 and later settled at 18. The associated labs and urine output showed that white count fell from 6 to 4.8, creatinine was roughly stable (2 to 1.9), lactate was checked once at 1.4, and urine output was roughly stable (370 to 280), with recorded outputs ranging 300-380.
B. For handoff, the heart rate was roughly stable (50 to 52), while MAP fell from 90 to 86. Systolic pressure was labile, ranging 141-212, with the lowest value around hour 3.3. SpO2 briefly dipped to 88 around hour 5.7 before recovering to 95, while respiratory rate peaked at 21 and later settled at 16. The associated labs and urine output showed that white count fell from 7 to 5.2, creatinine fell from 2 to 1.8, lactate was checked once at 1.0, and urine output fell from 335 to 250, with recorded outputs ranging 235-415.
C. For handoff, the heart rate was roughly stable (56 to 46), while MAP fell from 96 to 87. Systolic pressure was labile, ranging 130-172, with the lowest value around hour 4.3. SpO2 briefly dipped to 91 around hour 5.3 before recovering to 89, while respiratory rate peaked at 24 and later settled at 19. The associated labs and urine output showed that white count fell from 6 to 5.5, creatinine fell from 2 to 1.6, lactate was checked once at 1.4, and urine output was roughly stable (375 to 275), with recorded outputs ranging 275-375.
D. For handoff, the heart rate was roughly stable (52 to 50), while MAP fell from 92 to 83. Systolic pressure was labile, ranging 126-197, with the lowest value around hour 3.7. SpO2 briefly dipped to 90 around hour 4.7 before recovering to 93, while respiratory rate peaked at 22 and later settled at 17. The associated labs and urine output showed that white count fell from 7 to 5.6, creatinine fell from 2 to 1.8, lactate was checked once at 1.2, and urine output was roughly stable (350 to 300), with recorded outputs ranging 250-400.

Answer: D


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

Options:
A. Across the recorded window, the heart rate was roughly stable (55 to 53), MAP fell from 95 to 86, and diastolic pressure moved from 49 to 49. Systolic pressure ranged 146-217 and ended at 188, and SpO2 recovered to 90 after a low of 93 around hour 5.2. Respiratory rate ended at 16; the available labs showed white count fell from 8 to 6.1, creatinine fell from 2 to 1.8, lactate was checked once at 1.4, and urine output was roughly stable (330 to 320)
B. Across the recorded window, the heart rate was roughly stable (50 to 52), MAP fell from 90 to 81, and diastolic pressure moved from 54 to 50. Systolic pressure ranged 111-182 and ended at 153, and SpO2 recovered to 95 after a low of 89 around hour 4.3. Respiratory rate ended at 18; the available labs showed white count fell from 7 to 4.8, creatinine fell from 2 to 1.6, lactate was checked once at 1.0, and urine output fell from 400 to 285.
C. Across the recorded window, the heart rate was roughly stable (52 to 50), MAP fell from 92 to 83, and diastolic pressure moved from 52 to 52. Systolic pressure ranged 126-197 and ended at 168, and SpO2 recovered to 93 after a low of 90 around hour 4.7. Respiratory rate ended at 17; the available labs showed white count fell from 7 to 5.6, creatinine fell from 2 to 1.8, lactate was checked once at 1.2, and urine output was roughly stable (350 to 300)
D. Across the recorded window, the heart rate was roughly stable (48 to 54), MAP fell from 88 to 86, and diastolic pressure moved from 56 to 48. Systolic pressure ranged 96-167 and ended at 164, and SpO2 recovered to 98 after a low of 86 around hour 5.7. Respiratory rate ended at 19; the available labs showed white count fell from 6 to 4.8, creatinine fell from 2 to 1.5, lactate was checked once at 0.9, and urine output was roughly stable (380 to 270)

Answer: C


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 89, diastolic pressure fell from 88 to 81, and heart rate fell from 75 to 53. The lowest MAP was about 83 around hour 1.9, and the lowest valid SpO2 was 91 around hour 1.5; respiratory rate rose as high as 25 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.5-34.1 C, white count was 14.7 on its only check, creatinine fell from 0.9 to 0.7, lactate was not available, and urine output was not recorded.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 98 to 92, diastolic pressure fell from 85 to 78, and heart rate fell from 78 to 50. The lowest MAP was about 80 around hour 2.1, and the lowest valid SpO2 was 88 around hour 1.7; respiratory rate rose as high as 23 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 36.5-37.1 C, white count was 13.2 on its only check, creatinine fell from 0.8 to 0.6, lactate was not available, and urine output was not recorded.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 88, diastolic pressure fell from 89 to 82, and heart rate fell from 74 to 53. The lowest MAP was about 84 around hour 1.9, and the lowest valid SpO2 was 87 around hour 0.7; respiratory rate rose as high as 25 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 32.8-33.4 C, white count was 15.1 on its only check, creatinine fell from 0.7 to 0.6, lactate was not available, and urine output was not recorded.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 91, diastolic pressure fell from 80 to 75, and heart rate fell from 82 to 46. The lowest MAP was about 83 around hour 3.1, and the lowest valid SpO2 was 84 around hour 2.0; respiratory rate rose as high as 21 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 41.0-41.6 C, white count was 10.9 on its only check, creatinine fell from 1.0 to 0.4, lactate was not available, and urine output was not recorded.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 98 to 92, diastolic pressure fell from 85 to 78, and heart rate fell from 78 to 50. The lowest MAP was about 80 around hour 2.1, and the lowest valid SpO2 was 88 around hour 1.7; respiratory rate rose as high as 23 but ended at 23. The lower-frequency data fit that summary: temperature ranged from 97.7 to 98.7, white count was 13.2 on its only check, creatinine fell from 0.8 to 0.6, lactate was not available, and urine output was not recorded.


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

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (146 to 100), MAP fell from 100 to 95, and heart rate fell from 75 to 53. SpO2 started at 95, ended at 91, and fell as low as 91 around hour 1.5; respiratory rate ranged 22-24. For labs and output, white count was 11.7 on its only check, creatinine was roughly stable (0.9 to 0.7), lactate was not available, and urine output was not recorded.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 111 to 108, MAP was roughly stable (96 to 95), and heart rate fell from 80 to 48. SpO2 started at 100, ended at 86, and fell as low as 87 around hour 1.9; respiratory rate ranged 22-24. For labs and output, white count was 14.3 on its only check, creatinine fell from 0.7 to 0.5, lactate was not available, and urine output was not recorded.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (126 to 120), MAP fell from 98 to 92, and heart rate fell from 78 to 50. SpO2 started at 98, ended at 88, and fell as low as 88 around hour 1.7; respiratory rate ranged 23-23. For labs and output, white count was 13.2 on its only check, creatinine fell from 0.8 to 0.6, lactate was not available, and urine output was not recorded.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (96 to 150), MAP fell from 94 to 88, and heart rate fell from 82 to 53. SpO2 started at 100, ended at 84, and fell as low as 84 around hour 2.0; respiratory rate ranged 21-25. For labs and output, white count was 15.4 on its only check, creatinine fell from 0.7 to 0.4, lactate was not available, and urine output was not recorded.

Answer: C


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

Options:
A. Clinically, the heart rate fell from 81 to 47, MAP fell from 100 to 95, and diastolic pressure moved from 82 to 81. Systolic pressure ranged 109-158 and ended at 140, and SpO2 recovered to 87 after a low of 87 around hour 1.9. Respiratory rate ended at 22; the available labs showed white count was 14.7 on its only check, creatinine fell from 0.9 to 0.5, lactate was not available, and urine output was not recorded.
B. Clinically, the heart rate fell from 76 to 53, MAP fell from 96 to 90, and diastolic pressure moved from 87 to 75. Systolic pressure ranged 104-123 and ended at 105, and SpO2 recovered to 90 after a low of 86 around hour 1.5. Respiratory rate ended at 24; the available labs showed white count was 12.1 on its only check, creatinine fell from 0.7 to 0.6, lactate was not available, and urine output was not recorded.
C. Clinically, the heart rate fell from 82 to 46, MAP was roughly stable (100 to 95), and diastolic pressure moved from 81 to 82. Systolic pressure ranged 110-163 and ended at 116, and SpO2 recovered to 84 after a low of 92 around hour 2.7. Respiratory rate ended at 21; the available labs showed white count was 15.1 on its only check, creatinine fell from 0.9 to 0.5, lactate was not available, and urine output was not recorded.
D. Clinically, the heart rate fell from 78 to 50, MAP fell from 98 to 92, and diastolic pressure moved from 85 to 78. Systolic pressure ranged 106-138 and ended at 120, and SpO2 recovered to 88 after a low of 88 around hour 1.7. Respiratory rate ended at 23; the available labs showed white count was 13.2 on its only check, creatinine fell from 0.8 to 0.6, lactate was not available, and urine output was not recorded.

Answer: D


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

Options:
A. Clinically, the heart rate was roughly stable (99 to 97), while MAP rose from 71 to 81. Systolic pressure was labile, ranging 104-133, with the lowest value around hour 29.4. SpO2 briefly dipped to 86 around hour 8.4 before recovering to 93, while respiratory rate peaked at 34 and later settled at 35. The associated labs and urine output showed that white count fell from 11.9 to 10.4, creatinine fell from 1.7 to 1.0, lactate rose from 2.5 to 236, and urine output fell from 580 to 53, with recorded outputs ranging 12-620.
B. Clinically, the heart rate was roughly stable (96 to 100), while MAP rose from 68 to 78. Systolic pressure was labile, ranging 100-153, with the lowest value around hour 27.9. SpO2 briefly dipped to 85 around hour 7.9 before recovering to 96, while respiratory rate peaked at 32 and later settled at 32. The associated labs and urine output showed that white count fell from 13.4 to 11.6, creatinine fell from 1.5 to 1.2, lactate rose from 2.3 to 216, and urine output fell from 600 to 50, with recorded outputs ranging 10-600.
C. Clinically, the heart rate was roughly stable (100 to 96), while MAP rose from 72 to 81. Systolic pressure was labile, ranging 96-128, with the lowest value around hour 29.8. SpO2 briefly dipped to 89 around hour 8.9 before recovering to 92, while respiratory rate peaked at 36 and later settled at 36. The associated labs and urine output showed that white count fell from 11.5 to 10.0, creatinine fell from 1.8 to 0.9, lactate rose from 2.5 to 241, and urine output fell from 575 to 0, with recorded outputs ranging 0-625.
D. Clinically, the heart rate was roughly stable (92 to 96), while MAP rose from 64 to 74. Systolic pressure was labile, ranging 96-183, with the lowest value around hour 25.6. SpO2 briefly dipped to 80 around hour 7.2 before recovering to 100, while respiratory rate peaked at 28 and later settled at 28. The associated labs and urine output showed that white count fell from 15.7 to 10.8, creatinine fell from 1.2 to 1.0, lactate rose from 2.0 to 186, and urine output fell from 630 to 46, with recorded outputs ranging 50-570.

Answer: B


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

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 71 to 75, diastolic pressure rose from 55 to 65, and heart rate was roughly stable (93 to 97). The lowest MAP was about 50 around hour 27.4, and the lowest valid SpO2 was 88 around hour 7.4; respiratory rate rose as high as 34 but ended at 35. The lower-frequency data fit that summary: temperature stayed around 32.9-34.7 C, white count fell from 14.9 to 10.1, creatinine fell from 1.7 to 1.3, lactate rose from 2.1 to 236, and urine output fell from 620 to 100.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 66 to 80, diastolic pressure rose from 50 to 59, and heart rate was roughly stable (98 to 98). The lowest MAP was about 50 around hour 29.9, and the lowest valid SpO2 was 83 around hour 8.3; respiratory rate rose as high as 30 but ended at 30. The lower-frequency data fit that summary: temperature stayed around 38.1-40.0 C, white count fell from 12.3 to 10.8, creatinine fell from 1.4 to 1.0, lactate rose from 2.4 to 201, and urine output fell from 585 to 52.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 78, diastolic pressure rose from 52 to 62, and heart rate was roughly stable (96 to 100). The lowest MAP was about 47 around hour 28.9, and the lowest valid SpO2 was 85 around hour 7.9; respiratory rate rose as high as 32 but ended at 32. The lower-frequency data fit that summary: temperature stayed around 35.9-37.7 C, white count fell from 13.4 to 11.6, creatinine fell from 1.5 to 1.2, lactate rose from 2.3 to 216, and urine output fell from 600 to 50.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 64 to 82, diastolic pressure rose from 48 to 58, and heart rate rose from 100 to 103. The lowest MAP was about 42 around hour 31.1, and the lowest valid SpO2 was 80 around hour 6.9; respiratory rate rose as high as 28 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 40.4-42.2 C, white count fell from 11.2 to 9.7, creatinine fell from 1.2 to 0.9, lactate rose from 2.6 to 186, and urine output fell from 570 to 54.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 78, diastolic pressure rose from 52 to 62, and heart rate was roughly stable (96 to 100). The lowest MAP was about 47 around hour 28.9, and the lowest valid SpO2 was 85 around hour 7.9; respiratory rate rose as high as 32 but ended at 32. The lower-frequency data fit that summary: temperature ranged from 96.6 to 99.8, white count fell from 13.4 to 11.6, creatinine fell from 1.5 to 1.2, lactate rose from 2.3 to 216, and urine output fell from 600 to 50.


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 120 to 140, MAP rose from 71 to 81, and heart rate was roughly stable (93 to 97). SpO2 started at 93, ended at 99, and fell as low as 88 around hour 7.4; respiratory rate ranged 14-29. For labs and output, white count fell from 11.9 to 10.4, creatinine fell from 1.7 to 1.3, lactate rose from 2.5 to 236, and urine output fell from 580 to 53.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 115 to 144, MAP rose from 66 to 76, and heart rate rose from 98 to 103. SpO2 started at 98, ended at 94, and fell as low as 83 around hour 8.3; respiratory rate ranged 12-34. For labs and output, white count fell from 14.5 to 10.8, creatinine fell from 1.4 to 1.2, lactate rose from 2.1 to 201, and urine output fell from 615 to 48.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 121 to 125, MAP rose from 72 to 81, and heart rate was roughly stable (92 to 96). SpO2 started at 92, ended at 100, and fell as low as 84 around hour 7.3; respiratory rate ranged 15-28. For labs and output, white count fell from 11.5 to 10.0, creatinine fell from 1.8 to 0.9, lactate rose from 2.5 to 241, and urine output fell from 575 to 54.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 117 to 129, MAP rose from 68 to 78, and heart rate was roughly stable (96 to 100). SpO2 started at 96, ended at 96, and fell as low as 85 around hour 7.9; respiratory rate ranged 13-32. For labs and output, white count fell from 13.4 to 11.6, creatinine fell from 1.5 to 1.2, lactate rose from 2.3 to 216, and urine output fell from 600 to 50.

Answer: D


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

Options:
A. Over the available measurements, the heart rate was roughly stable (96 to 100), MAP rose from 68 to 78, and diastolic pressure moved from 52 to 62. Systolic pressure ranged 100-153 and ended at 129, and SpO2 recovered to 96 after a low of 85 around hour 7.9. Respiratory rate ended at 32; the available labs showed white count fell from 13.4 to 11.6, creatinine fell from 1.5 to 1.2, lactate rose from 2.3 to 216, and urine output fell from 600 to 50.
B. Over the available measurements, the heart rate was roughly stable (94 to 98), MAP rose from 66 to 81, and diastolic pressure moved from 54 to 60. Systolic pressure ranged 98-138 and ended at 125, and SpO2 recovered to 98 after a low of 83 around hour 8.9. Respiratory rate ended at 34; the available labs showed white count fell from 12.3 to 10.5, creatinine fell from 1.6 to 1.0, lactate rose from 2.1 to 231, and urine output fell from 585 to 48.
C. Over the available measurements, the heart rate was roughly stable (100 to 96), MAP rose from 72 to 82, and diastolic pressure moved from 48 to 66. Systolic pressure ranged 96-178 and ended at 154, and SpO2 recovered to 92 after a low of 84 around hour 8.5. Respiratory rate ended at 28; the available labs showed white count fell from 15.3 to 10.8, creatinine fell from 1.2 to 1.0, lactate rose from 2.5 to 191, and urine output fell from 650 to 54.
D. Over the available measurements, the heart rate rose from 92 to 103, MAP rose from 64 to 74, and diastolic pressure moved from 56 to 59. Systolic pressure ranged 96-123 and ended at 99, and SpO2 recovered to 100 after a low of 80 around hour 7.2. Respiratory rate ended at 36; the available labs showed white count fell from 11.2 to 9.3, creatinine fell from 1.8 to 0.9, lactate rose from 2.0 to 246, and urine output fell from 570 to 46.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate fell from 97 to 79, while MAP fell from 157 to 92. Systolic pressure was labile, ranging 61-180, with the lowest value around hour 0.3. SpO2 briefly dipped to 81 around hour 1.5 before recovering to 93, while respiratory rate peaked at 41 and later settled at 24. The associated labs and urine output showed that white count rose from 11.2 to 21.7, creatinine rose from 1.4 to 1.6, lactate rose from 4.7 to 366, and urine output fell from 440 to 90, with recorded outputs ranging 2-480.
B. Viewed chronologically, the heart rate fell from 98 to 84, while MAP fell from 122 to 87. Systolic pressure was labile, ranging 66-215, with the lowest value around hour 0.1. SpO2 briefly dipped to 76 around hour 0.4 before recovering to 98, while respiratory rate peaked at 36 and later settled at 21. The associated labs and urine output showed that white count rose from 13.8 to 19.4, creatinine rose from 1.0 to 1.6, lactate rose from 3.8 to 331, and urine output fell from 475 to 125, with recorded outputs ranging 50-445.
C. Viewed chronologically, the heart rate fell from 96 to 78, while MAP fell from 162 to 93. Systolic pressure was labile, ranging 68-175, with the lowest value around hour 0.3. SpO2 briefly dipped to 79 around hour 0.6 before recovering to 92, while respiratory rate peaked at 40 and later settled at 24. The associated labs and urine output showed that white count rose from 10.8 to 22.1, creatinine rose from 1.4 to 1.6, lactate rose from 4.8 to 371, and urine output fell from 435 to 165, with recorded outputs ranging 2-485.
D. Viewed chronologically, the heart rate fell from 100 to 82, while MAP fell from 137 to 89. Systolic pressure was labile, ranging 64-200, with the lowest value around hour 0.2. SpO2 briefly dipped to 78 around hour 0.5 before recovering to 96, while respiratory rate peaked at 38 and later settled at 22. The associated labs and urine output showed that white count rose from 12.7 to 20.2, creatinine rose from 1.2 to 1.5, lactate rose from 4.2 to 346, and urine output fell from 460 to 140, with recorded outputs ranging 0-460.

Answer: D


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

Options:
A. In broad terms, the heart rate fell from 89 to 69, while MAP fell from 97 to 71. Systolic pressure was labile, ranging 90-119, with the lowest value around hour 9.1. SpO2 briefly dipped to 96 around hour 26.1 before recovering to 90, while respiratory rate peaked at 38 and later settled at 22. The associated labs and urine output showed that white count was 8.9 on its only check, creatinine was 1.3 on its only check, lactate was not available, and urine output rose from 240 to 430, with recorded outputs ranging 150-730.
B. In broad terms, the heart rate fell from 84 to 74, while MAP fell from 97 to 66. Systolic pressure was labile, ranging 97-154, with the lowest value around hour 8.2. SpO2 briefly dipped to 91 around hour 23.5 before recovering to 95, while respiratory rate peaked at 37 and later settled at 20. The associated labs and urine output showed that white count was 11.5 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output rose from 205 to 465, with recorded outputs ranging 98-765.
C. In broad terms, the heart rate fell from 86 to 72, while MAP fell from 94 to 68. Systolic pressure was labile, ranging 93-139, with the lowest value around hour 8.6. SpO2 briefly dipped to 93 around hour 24.6 before recovering to 93, while respiratory rate peaked at 35 and later settled at 21. The associated labs and urine output showed that white count was 10.4 on its only check, creatinine was 1.1 on its only check, lactate was not available, and urine output rose from 220 to 450, with recorded outputs ranging 100-750.
D. In broad terms, the heart rate fell from 82 to 76, while MAP fell from 90 to 71. Systolic pressure was labile, ranging 98-169, with the lowest value around hour 7.8. SpO2 briefly dipped to 88 around hour 25 before recovering to 98, while respiratory rate peaked at 30 and later settled at 19. The associated labs and urine output showed that white count was 12.7 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 190 to 400, with recorded outputs ranging 96-780.

Answer: C


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

Options:
A. For handoff, the heart rate fell from 89 to 69, MAP fell from 97 to 71, and diastolic pressure moved from 70 to 63. Systolic pressure ranged 96-159 and ended at 105, and SpO2 recovered to 90 after a low of 92 around hour 26.1. Respiratory rate ended at 20; the available labs showed white count was 11.9 on its only check, creatinine was 1.3 on its only check, lactate was not available, and urine output rose from 270 to 470.
B. For handoff, the heart rate fell from 86 to 72, MAP fell from 94 to 68, and diastolic pressure moved from 73 to 60. Systolic pressure ranged 93-139 and ended at 102, and SpO2 recovered to 93 after a low of 93 around hour 24.6. Respiratory rate ended at 21; the available labs showed white count was 10.4 on its only check, creatinine was 1.1 on its only check, lactate was not available, and urine output rose from 220 to 450.
C. For handoff, the heart rate fell from 90 to 75, MAP fell from 98 to 72, and diastolic pressure moved from 69 to 57. Systolic pressure ranged 97-164 and ended at 106, and SpO2 recovered to 89 after a low of 97 around hour 26.5. Respiratory rate ended at 19; the available labs showed white count was 12.3 on its only check, creatinine was 1.4 on its only check, lactate was not available, and urine output rose from 195 to 475.
D. For handoff, the heart rate fell from 82 to 76, MAP fell from 90 to 71, and diastolic pressure moved from 78 to 56. Systolic pressure ranged 88-109 and ended at 98, and SpO2 recovered to 98 after a low of 88 around hour 25. Respiratory rate ended at 23; the available labs showed white count was 8.2 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output rose from 250 to 420.

Answer: B


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

Options:
A. For handoff, the heart rate was roughly stable (72 to 67), while MAP rose from 83 to 89. Systolic pressure was labile, ranging 104-111, with the lowest value around hour 7.1. SpO2 briefly dipped to 89 around hour 1.8 before recovering to 93, while respiratory rate peaked at 24 and later settled at 20. The associated labs and urine output showed that white count was 12.2 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 2930 to 380, with recorded outputs ranging 420-2770.
B. For handoff, the heart rate was roughly stable (67 to 72), while MAP rose from 78 to 84. Systolic pressure was labile, ranging 98-135, with the lowest value around hour 6.2. SpO2 briefly dipped to 89 around hour 1.5 before recovering to 98, while respiratory rate peaked at 21 and later settled at 17. The associated labs and urine output showed that white count was 14.8 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 2790 to 415, with recorded outputs ranging 385-2910.
C. For handoff, the heart rate was roughly stable (73 to 66), while MAP rose from 84 to 89. Systolic pressure was labile, ranging 96-106, with the lowest value around hour 7.2. SpO2 briefly dipped to 92 around hour 2.6 before recovering to 92, while respiratory rate peaked at 24 and later settled at 20. The associated labs and urine output showed that white count was 11.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 2950 to 350, with recorded outputs ranging 350-2750.
D. For handoff, the heart rate was roughly stable (69 to 70), while MAP rose from 80 to 86. Systolic pressure was labile, ranging 100-131, with the lowest value around hour 6.6. SpO2 briefly dipped to 88 around hour 1.6 before recovering to 96, while respiratory rate peaked at 22 and later settled at 18. The associated labs and urine output showed that white count was 13.7 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 2850 to 400, with recorded outputs ranging 400-2850.

Answer: D