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

Options:
A. In broad terms, the heart rate rose from 82 to 108, MAP fell from 95 to 85, and diastolic pressure moved from 75 to 72. Systolic pressure ranged 79-159 and ended at 132, and SpO2 recovered to 93 after a low of 88 around hour 0. Respiratory rate ended at 12; the available labs showed white count was roughly stable (11.5 to 11.9), creatinine was roughly stable (0.8 to 0.7), lactate rose from 4.8 to 325, and urine output fell from 400 to 0.
B. In broad terms, the heart rate rose from 80 to 110, MAP fell from 93 to 88, and diastolic pressure moved from 77 to 70. Systolic pressure ranged 77-144 and ended at 128, and SpO2 recovered to 95 after a low of 86 around hour 1. Respiratory rate ended at 13; the available labs showed white count was roughly stable (10.4 to 10.8), creatinine was roughly stable (0.9 to 0.6), lactate rose from 4.4 to 340, and urine output fell from 385 to 0.
C. In broad terms, the heart rate rose from 86 to 111, MAP fell from 99 to 89, and diastolic pressure moved from 71 to 69. Systolic pressure ranged 83-184 and ended at 157, and SpO2 recovered to 89 after a low of 92 around hour 2. Respiratory rate ended at 10; the available labs showed white count was roughly stable (13.4 to 13.8), creatinine was roughly stable (0.7 to 0.8), lactate rose from 5.4 to 300, and urine output fell from 425 to 2.
D. In broad terms, the heart rate rose from 78 to 112, MAP fell from 90 to 80, and diastolic pressure moved from 80 to 68. Systolic pressure ranged 74-129 and ended at 102, and SpO2 recovered to 98 after a low of 87 around hour 0. Respiratory rate ended at 14; the available labs showed white count was roughly stable (9.2 to 11.1), creatinine was roughly stable (1.0 to 0.5), lactate rose from 4.0 to 355, and urine output fell from 450 to 0.

Answer: A


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

Options:
A. In broad terms, the heart rate fell from 77 to 64, while MAP was roughly stable (81 to 80). Systolic pressure was labile, ranging 82-182, with the lowest value around hour 1.0. SpO2 briefly dipped to 88 around hour 1.3 before recovering to 94, while respiratory rate peaked at 36 and later settled at 28. The associated labs and urine output showed that white count rose from 13.3 to 17.5, creatinine fell from 1.9 to 1.5, lactate stayed broadly stable from 0.9 to 0.8, and urine output was roughly stable (120 to 97), with recorded outputs ranging 72-445.
B. In broad terms, the heart rate fell from 72 to 69, while MAP was roughly stable (76 to 75). Systolic pressure was labile, ranging 89-217, with the lowest value around hour 0.8. SpO2 briefly dipped to 86 around hour 1.0 before recovering to 99, while respiratory rate peaked at 35 and later settled at 25. The associated labs and urine output showed that white count rose from 15.9 to 17.2, creatinine fell from 1.5 to 1.3, lactate stayed broadly stable from 0.7 to 0.6, and urine output was roughly stable (155 to 98), with recorded outputs ranging 21-410.
C. In broad terms, the heart rate fell from 74 to 67, while MAP was roughly stable (78 to 77). Systolic pressure was labile, ranging 85-202, with the lowest value around hour 0.9. SpO2 briefly dipped to 85 around hour 1.1 before recovering to 97, while respiratory rate peaked at 33 and later settled at 26. The associated labs and urine output showed that white count rose from 14.8 to 18.3, creatinine fell from 1.7 to 1.4, lactate stayed broadly stable from 0.8 to 0.7, and urine output was roughly stable (140 to 100), with recorded outputs ranging 22-425.
D. In broad terms, the heart rate fell from 70 to 67, while MAP was roughly stable (74 to 80). Systolic pressure was labile, ranging 90-232, with the lowest value around hour 0.8. SpO2 briefly dipped to 80 around hour 2.1 before recovering to 100, while respiratory rate peaked at 28 and later settled at 24. The associated labs and urine output showed that white count rose from 17.1 to 18.6, creatinine fell from 1.4 to 1.2, lactate stayed broadly stable from 0.7 to 0.5, and urine output fell from 170 to 50, with recorded outputs ranging 20-395.

Answer: C


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 114 to 130, MAP was roughly stable (78 to 77), and heart rate fell from 74 to 67. SpO2 started at 98, ended at 97, and fell as low as 85 around hour 1.1; respiratory rate ranged 5-33. For labs and output, white count rose from 14.8 to 18.3, creatinine fell from 1.7 to 1.4, lactate stayed broadly stable from 0.8 to 0.7, and urine output was roughly stable (140 to 100)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 112 to 145, MAP was roughly stable (76 to 75), and heart rate was roughly stable (76 to 70). SpO2 started at 100, ended at 95, and fell as low as 83 around hour 1.2; respiratory rate ranged 5-35. For labs and output, white count rose from 15.9 to 17.5, creatinine fell from 1.5 to 1.3, lactate stayed broadly stable from 0.7 to 0.6, and urine output was roughly stable (155 to 98)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 118 to 121, MAP was roughly stable (82 to 81), and heart rate fell from 70 to 67. SpO2 started at 94, ended at 100, and fell as low as 89 around hour 0.9; respiratory rate ranged 6-29. For labs and output, white count rose from 12.9 to 20.2, creatinine fell from 1.9 to 1.5, lactate stayed broadly stable from 1 to 0.8, and urine output was roughly stable (115 to 96)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 110 to 126, MAP was roughly stable (74 to 80), and heart rate fell from 78 to 62. SpO2 started at 100, ended at 92, and fell as low as 84 around hour 1.4; respiratory rate ranged 4-38. For labs and output, white count rose from 17.1 to 18.6, creatinine fell from 1.4 to 1.2, lactate stayed broadly stable from 0.7 to 0.5, and urine output was roughly stable (170 to 96)

Answer: A


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

Options:
A. For handoff, the heart rate was roughly stable (77 to 70), MAP was roughly stable (81 to 80), and diastolic pressure moved from 53 to 59. Systolic pressure ranged 88-222 and ended at 150, and SpO2 recovered to 94 after a low of 88 around hour 1.3. Respiratory rate ended at 24; the available labs showed white count rose from 16.3 to 19.8, creatinine fell from 1.5 to 1.3, lactate stayed broadly stable from 0.9 to 0.6, and urine output was roughly stable (160 to 97)
B. For handoff, the heart rate fell from 74 to 67, MAP was roughly stable (78 to 77), and diastolic pressure moved from 56 to 62. Systolic pressure ranged 85-202 and ended at 130, and SpO2 recovered to 97 after a low of 85 around hour 1.1. Respiratory rate ended at 26; the available labs showed white count rose from 14.8 to 18.3, creatinine fell from 1.7 to 1.4, lactate stayed broadly stable from 0.8 to 0.7, and urine output was roughly stable (140 to 100)
C. For handoff, the heart rate fell from 78 to 63, MAP was roughly stable (82 to 81), and diastolic pressure moved from 52 to 66. Systolic pressure ranged 89-227 and ended at 155, and SpO2 recovered to 93 after a low of 84 around hour 1.4. Respiratory rate ended at 24; the available labs showed white count rose from 16.7 to 17.5, creatinine fell from 1.4 to 1.2, lactate stayed broadly stable from 0.9 to 0.6, and urine output fell from 190 to 96.
D. For handoff, the heart rate fell from 70 to 67, MAP was roughly stable (74 to 80), and diastolic pressure moved from 60 to 58. Systolic pressure ranged 80-172 and ended at 126, and SpO2 recovered to 100 after a low of 80 around hour 2.1. Respiratory rate ended at 28; the available labs showed white count rose from 12.6 to 16.1, creatinine fell from 2.0 to 1.1, lactate stayed broadly stable from 0.7 to 0.8, and urine output was roughly stable (110 to 96)

Answer: B


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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 30 to 118, MAP rose from 63 to 75, and heart rate fell from 85 to 78. SpO2 started at 96, ended at 96, and fell as low as 87 around hour 27.6; respiratory rate ranged 10-29. For labs and output, white count rose from 13.8 to 18.9, creatinine stayed around 1.1, lactate fell from 2.7 to 1.5, and urine output fell from 420 to 220.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 28 to 138, MAP rose from 60 to 72, and heart rate fell from 88 to 75. SpO2 started at 99, ended at 93, and fell as low as 84 around hour 29.1; respiratory rate ranged 9-32. For labs and output, white count rose from 15.3 to 17.4, creatinine stayed around 1, lactate fell from 2.5 to 1.3, and urine output fell from 400 to 240.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 30 to 134, MAP rose from 64 to 75, and heart rate fell from 84 to 79. SpO2 started at 95, ended at 97, and fell as low as 83 around hour 27.2; respiratory rate ranged 10-28. For labs and output, white count rose from 13.4 to 19.3, creatinine stayed around 1, lactate fell from 2.2 to 1.6, and urine output fell from 425 to 215.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 26 to 168, MAP rose from 56 to 68, and heart rate fell from 92 to 78. SpO2 started at 100, ended at 88, and fell as low as 80 around hour 31.4; respiratory rate ranged 8-34. For labs and output, white count rose from 17.6 to 19.1, creatinine stayed around 1, lactate fell from 2.8 to 1.0, and urine output fell from 370 to 270.

Answer: B


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 fell from 165 to 129, MAP was roughly stable (83 to 81), and heart rate was roughly stable (84 to 86). SpO2 started at 91, ended at 97, and fell as low as 81 around hour 33.6; respiratory rate ranged 14-31. For labs and output, white count rose from 11.7 to 17.0, creatinine fell from 1 to 0.7, lactate was checked once at 327, and urine output was roughly stable (83 to 97)
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 130 to 110, MAP was roughly stable (78 to 76), and heart rate was roughly stable (89 to 86). SpO2 started at 96, ended at 92, and fell as low as 80 around hour 38.9; respiratory rate ranged 12-36. For labs and output, white count rose from 14.3 to 14.7, creatinine fell from 1 to 0.9, lactate was checked once at 292, and urine output was roughly stable (78 to 98)
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 145 to 133, MAP was roughly stable (80 to 78), and heart rate was roughly stable (87 to 83). SpO2 started at 94, ended at 94, and fell as low as 82 around hour 36.6; respiratory rate ranged 13-34. For labs and output, white count rose from 13.2 to 15.5, creatinine fell from 1 to 0.8, lactate was checked once at 307, and urine output was roughly stable (80 to 100)
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 115 to 95, MAP was roughly stable (76 to 74), and heart rate was roughly stable (92 to 78). SpO2 started at 98, ended at 90, and fell as low as 78 around hour 41.1; respiratory rate ranged 11-38. For labs and output, white count rose from 15.4 to 16.9, creatinine was roughly stable (1 to 0.9), lactate was checked once at 307.2, and urine output was roughly stable (76 to 96)

Answer: C


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 was roughly stable (80 to 73), diastolic pressure rose from 18 to 59, and heart rate was roughly stable (77 to 88). The lowest MAP was about 65 around hour 7.2, and the lowest valid SpO2 was 88 around hour 1.0; respiratory rate rose as high as 24 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 32.5-35.4 C, white count rose from 4.8 to 8.1, creatinine rose from 1 to 1.4, lactate was checked once at 1.6, and urine output fell from 470 to 43.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (75 to 78), diastolic pressure rose from 16 to 60, and heart rate was roughly stable (82 to 83). The lowest MAP was about 60 around hour 6.6, and the lowest valid SpO2 was 83 around hour 1.4; respiratory rate rose as high as 25 but ended at 13. The lower-frequency data fit that summary: temperature stayed around 37.8-40.6 C, white count rose from 3.9 to 9.0, creatinine rose from 1 to 1.3, lactate was checked once at 2.0, and urine output fell from 435 to 90.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (77 to 76), diastolic pressure rose from 17 to 62, and heart rate was roughly stable (80 to 85). The lowest MAP was about 62 around hour 6.2, and the lowest valid SpO2 was 85 around hour 1.2; respiratory rate rose as high as 23 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 35.5-38.4 C, white count rose from 4.3 to 8.6, creatinine rose from 1 to 1.2, lactate was checked once at 1.8, and urine output fell from 450 to 40.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (72 to 80), diastolic pressure rose from 15 to 58, and heart rate rose from 84 to 88. The lowest MAP was about 58 around hour 7.0, and the lowest valid SpO2 was 80 around hour 0.2; respiratory rate rose as high as 21 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 40.0-42.9 C, white count rose from 3.5 to 9.3, creatinine rose from 1 to 1.2, lactate was checked once at 2.1, and urine output fell from 420 to 36.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (77 to 76), diastolic pressure rose from 17 to 62, and heart rate was roughly stable (80 to 85). The lowest MAP was about 62 around hour 6.2, and the lowest valid SpO2 was 85 around hour 1.2; respiratory rate rose as high as 23 but ended at 14. The lower-frequency data fit that summary: temperature ranged from 35.5 to 98.9, white count rose from 4.3 to 8.6, creatinine rose from 1 to 1.2, lactate was checked once at 1.8, and urine output fell from 450 to 40.


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 33 to 104, MAP was roughly stable (80 to 79), and heart rate rose from 77 to 88. SpO2 started at 97, ended at 97, and fell as low as 88 around hour 1.0; respiratory rate ranged 8-25. For labs and output, white count rose from 3.8 to 7.8, creatinine rose from 1 to 1.2, lactate was checked once at 2.0, and urine output fell from 470 to 37.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 28 to 139, MAP was roughly stable (75 to 74), and heart rate was roughly stable (82 to 83). SpO2 started at 98, ended at 92, and fell as low as 83 around hour 1.4; respiratory rate ranged 8-24. For labs and output, white count rose from 4.7 to 8.2, creatinine rose from 1 to 1.3, lactate was checked once at 2, and urine output fell from 435 to 42.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 34 to 120, MAP was roughly stable (81 to 79), and heart rate was roughly stable (76 to 89). SpO2 started at 96, ended at 98, and fell as low as 84 around hour 0.9; respiratory rate ranged 9-21. For labs and output, white count rose from 3.7 to 9.2, creatinine rose from 1 to 1.2, lactate was checked once at 2.0, and urine output fell from 475 to 36.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 30 to 124, MAP was roughly stable (77 to 76), and heart rate was roughly stable (80 to 85). SpO2 started at 100, ended at 94, and fell as low as 85 around hour 1.2; respiratory rate ranged 8-23. For labs and output, white count rose from 4.3 to 8.6, creatinine rose from 1 to 1.2, lactate was checked once at 1.8, and urine output fell from 450 to 40.

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 (80 to 85), MAP was roughly stable (77 to 76), and diastolic pressure moved from 17 to 62. Systolic pressure ranged 18-125 and ended at 124, and SpO2 recovered to 94 after a low of 85 around hour 1.2. Respiratory rate ended at 14; the available labs showed white count rose from 4.3 to 8.6, creatinine rose from 1 to 1.2, lactate was checked once at 1.8, and urine output fell from 450 to 40.
B. Over the available measurements, the heart rate was roughly stable (78 to 87), MAP was roughly stable (75 to 79), and diastolic pressure moved from 18 to 60. Systolic pressure ranged 17-110 and ended at 120, and SpO2 recovered to 96 after a low of 83 around hour 2.2. Respiratory rate ended at 15; the available labs showed white count rose from 3.9 to 8.2, creatinine rose from 1 to 1.2, lactate was checked once at 1.6, and urine output fell from 465 to 38.
C. Over the available measurements, the heart rate rose from 84 to 88, MAP was roughly stable (81 to 80), and diastolic pressure moved from 15 to 59. Systolic pressure ranged 20-150 and ended at 149, and SpO2 recovered to 90 after a low of 89 around hour 1.4. Respiratory rate ended at 12; the available labs showed white count rose from 4.9 to 9.2, creatinine rose from 1 to 1.4, lactate was checked once at 2.0, and urine output fell from 425 to 44.
D. Over the available measurements, the heart rate was roughly stable (76 to 90), MAP was roughly stable (72 to 72), and diastolic pressure moved from 19 to 58. Systolic pressure ranged 16-95 and ended at 94, and SpO2 recovered to 98 after a low of 84 around hour 0.9. Respiratory rate ended at 16; the available labs showed white count rose from 3.5 to 7.8, creatinine rose from 1 to 1.2, lactate was checked once at 1.5, and urine output fell from 500 to 36.

Answer: A


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

Options:
A. Over the available measurements, the heart rate rose from 83 to 97, while MAP fell from 85 to 74. Systolic pressure was labile, ranging 82-126, with the lowest value around hour 6.9. SpO2 briefly dipped to 88 around hour 4.5 before recovering to 90, while respiratory rate peaked at 42 and later settled at 20. The associated labs and urine output showed that white count fell from 11.4 to 8.8, creatinine fell from 1.0 to 0.6, lactate stayed broadly stable from 2.0 to 2, and urine output fell from 480 to 0, with recorded outputs ranging 0-520.
B. Over the available measurements, the heart rate rose from 78 to 98, while MAP fell from 80 to 69. Systolic pressure was labile, ranging 87-161, with the lowest value around hour 6.0. SpO2 briefly dipped to 83 around hour 3.1 before recovering to 95, while respiratory rate peaked at 37 and later settled at 18. The associated labs and urine output showed that white count fell from 14.0 to 7.5, creatinine was roughly stable (0.8 to 0.8), lactate stayed broadly stable from 1.6 to 2, and urine output fell from 515 to 48, with recorded outputs ranging 50-485.
C. Over the available measurements, the heart rate rose from 80 to 100, while MAP fell from 82 to 71. Systolic pressure was labile, ranging 85-146, with the lowest value around hour 6.4. SpO2 briefly dipped to 85 around hour 3.5 before recovering to 93, while respiratory rate peaked at 39 and later settled at 19. The associated labs and urine output showed that white count fell from 12.9 to 8.3, creatinine fell from 0.9 to 0.7, lactate stayed broadly stable from 1.8 to 2, and urine output fell from 500 to 50, with recorded outputs ranging 30-500.
D. Over the available measurements, the heart rate rose from 76 to 96, while MAP fell from 78 to 66. Systolic pressure was labile, ranging 89-176, with the lowest value around hour 5.7. SpO2 briefly dipped to 86 around hour 2.8 before recovering to 98, while respiratory rate peaked at 41 and later settled at 17. The associated labs and urine output showed that white count fell from 15.2 to 7.6, creatinine fell from 0.8 to 0.7, lactate stayed broadly stable from 1.5 to 2, and urine output fell from 530 to 46, with recorded outputs ranging 26-470.

Answer: C


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 85 to 68, diastolic pressure fell from 62 to 55, and heart rate rose from 77 to 97. The lowest MAP was about 55 around hour 5.9, and the lowest valid SpO2 was 88 around hour 3.0; respiratory rate rose as high as 41 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.7-34.8 C, white count fell from 14.4 to 7.8, creatinine was roughly stable (1.0 to 0.8), lactate stayed broadly stable from 1.6 to 2, and urine output fell from 520 to 100.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 80 to 73, diastolic pressure fell from 57 to 49, and heart rate rose from 82 to 98. The lowest MAP was about 55 around hour 7.4, and the lowest valid SpO2 was 83 around hour 3.9; respiratory rate rose as high as 37 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 39.0-40.0 C, white count fell from 11.8 to 8.7, creatinine fell from 0.8 to 0.6, lactate stayed broadly stable from 2.0 to 2, and urine output fell from 485 to 52.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 67, diastolic pressure fell from 63 to 56, and heart rate rose from 76 to 103. The lowest MAP was about 56 around hour 5.8, and the lowest valid SpO2 was 89 around hour 2.5; respiratory rate rose as high as 43 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 33.0-34.0 C, white count fell from 14.8 to 7.7, creatinine fell from 1.0 to 0.8, lactate stayed broadly stable from 1.6 to 2, and urine output fell from 525 to 46.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 82 to 71, diastolic pressure fell from 59 to 52, and heart rate rose from 80 to 100. The lowest MAP was about 52 around hour 6.4, and the lowest valid SpO2 was 85 around hour 3.5; respiratory rate rose as high as 39 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 36.7-37.8 C, white count fell from 12.9 to 8.3, creatinine fell from 0.9 to 0.7, lactate stayed broadly stable from 1.8 to 2, and urine output fell from 500 to 50.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 82 to 71, diastolic pressure fell from 59 to 52, and heart rate rose from 80 to 100. The lowest MAP was about 52 around hour 6.4, and the lowest valid SpO2 was 85 around hour 3.5; respiratory rate rose as high as 39 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 98 to 100, white count fell from 12.9 to 8.3, creatinine fell from 0.9 to 0.7, lactate stayed broadly stable from 1.8 to 2, and urine output fell from 500 to 50.


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 141, MAP fell from 82 to 71, and heart rate rose from 80 to 100. SpO2 started at 99, ended at 93, and fell as low as 85 around hour 3.5; respiratory rate ranged 13-39. For labs and output, white count fell from 12.9 to 8.3, creatinine fell from 0.9 to 0.7, lactate stayed broadly stable from 1.8 to 2, and urine output fell from 500 to 50.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 126, MAP fell from 84 to 69, and heart rate rose from 78 to 98. SpO2 started at 97, ended at 95, and fell as low as 83 around hour 3.1; respiratory rate ranged 14-41. For labs and output, white count fell from 11.8 to 8.7, creatinine was roughly stable (0.8 to 0.8), lactate stayed broadly stable from 2 to 2, and urine output fell from 485 to 52.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 166, MAP fell from 78 to 75, and heart rate rose from 84 to 103. SpO2 started at 100, ended at 89, and fell as low as 89 around hour 4.1; respiratory rate ranged 11-41. For labs and output, white count fell from 14.8 to 7.5, creatinine fell from 1.0 to 0.8, lactate stayed broadly stable from 1.6 to 2, and urine output fell from 525 to 46.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (111 to 137), MAP fell from 82 to 74, and heart rate rose from 80 to 100. SpO2 started at 99, ended at 93, and fell as low as 84 around hour 3.5; respiratory rate ranged 13-39. For labs and output, white count fell from 12.9 to 8.3, creatinine fell from 0.9 to 0.7, lactate stayed broadly stable from 1.8 to 2, and urine output fell from 500 to 50.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate rose from 83 to 97, MAP fell from 85 to 74, and diastolic pressure moved from 56 to 55. Systolic pressure ranged 88-166 and ended at 137, and SpO2 recovered to 90 after a low of 88 around hour 4.5. Respiratory rate ended at 18; the available labs showed white count fell from 14.4 to 8.8, creatinine fell from 0.8 to 0.7, lactate stayed broadly stable from 2.0 to 2, and urine output fell from 520 to 53.
B. Viewed chronologically, the heart rate rose from 80 to 100, MAP fell from 82 to 71, and diastolic pressure moved from 59 to 52. Systolic pressure ranged 85-146 and ended at 141, and SpO2 recovered to 93 after a low of 85 around hour 3.5. Respiratory rate ended at 19; the available labs showed white count fell from 12.9 to 8.3, creatinine fell from 0.9 to 0.7, lactate stayed broadly stable from 1.8 to 2, and urine output fell from 500 to 50.
C. Viewed chronologically, the heart rate rose from 84 to 103, MAP fell from 86 to 75, and diastolic pressure moved from 55 to 49. Systolic pressure ranged 89-171 and ended at 166, and SpO2 recovered to 89 after a low of 89 around hour 4.1. Respiratory rate ended at 17; the available labs showed white count fell from 14.8 to 8.9, creatinine fell from 0.8 to 0.7, lactate stayed broadly stable from 2.0 to 2, and urine output fell from 525 to 54.
D. Viewed chronologically, the heart rate rose from 76 to 96, MAP fell from 78 to 66, and diastolic pressure moved from 64 to 48. Systolic pressure ranged 80-116 and ended at 111, and SpO2 recovered to 98 after a low of 84 around hour 2.8. Respiratory rate ended at 21; the available labs showed white count fell from 10.7 to 7.5, creatinine fell from 1.1 to 0.5, lactate stayed broadly stable from 1.5 to 2, and urine output fell from 550 to 46.

Answer: B


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

Options:
A. Viewed chronologically, the heart rate rose from 83 to 90, while MAP rose from 53 to 64. Systolic pressure was labile, ranging 87-144, with the lowest value around hour 1.7. SpO2 briefly dipped to 88 around hour 30.5 before recovering to 94, while respiratory rate peaked at 42 and later settled at 22. The associated labs and urine output showed that white count was roughly stable (13.4 to 16), creatinine fell from 4 to 2.2, lactate was checked once at 1.3, and urine output fell from 370 to 75, with recorded outputs ranging 58-390.
B. Viewed chronologically, the heart rate rose from 78 to 95, while MAP rose from 48 to 59. Systolic pressure was labile, ranging 92-179, with the lowest value around hour 1.4. SpO2 briefly dipped to 83 around hour 28.4 before recovering to 99, while respiratory rate peaked at 37 and later settled at 19. The associated labs and urine output showed that white count fell from 16.0 to 13.2, creatinine fell from 3 to 2.5, lactate was checked once at 1.0, and urine output fell from 335 to 140, with recorded outputs ranging 105-425.
C. Viewed chronologically, the heart rate rose from 84 to 89, while MAP rose from 54 to 65. Systolic pressure was labile, ranging 91-139, with the lowest value around hour 1.8. SpO2 briefly dipped to 86 around hour 31.4 before recovering to 93, while respiratory rate peaked at 41 and later settled at 22. The associated labs and urine output showed that white count was roughly stable (13.0 to 16), creatinine fell from 4 to 2.1, lactate was checked once at 1.4, and urine output fell from 375 to 100, with recorded outputs ranging 59-385.
D. Viewed chronologically, the heart rate rose from 80 to 93, while MAP rose from 50 to 61. Systolic pressure was labile, ranging 90-164, with the lowest value around hour 1.5. SpO2 briefly dipped to 85 around hour 29.5 before recovering to 97, while respiratory rate peaked at 39 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (14.9 to 14), creatinine fell from 3 to 2.4, lactate was checked once at 1.1, and urine output fell from 350 to 125, with recorded outputs ranging 55-410.

Answer: D


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

Options:
A. Overall, the heart rate rose from 83 to 90, MAP rose from 53 to 64, and diastolic pressure moved from 34 to 57. Systolic pressure ranged 88-184 and ended at 88, and SpO2 recovered to 94 after a low of 88 around hour 30.5. Respiratory rate ended at 18; the available labs showed white count was roughly stable (16.4 to 16), creatinine fell from 2 to 1.8, lactate was checked once at 1.3, and urine output fell from 330 to 145.
B. Overall, the heart rate rose from 78 to 95, MAP rose from 48 to 59, and diastolic pressure moved from 39 to 52. Systolic pressure ranged 88-149 and ended at 90, and SpO2 recovered to 99 after a low of 84 around hour 28.4. Respiratory rate ended at 21; the available labs showed white count fell from 13.8 to 13.2, creatinine fell from 3 to 2.2, lactate was checked once at 1.0, and urine output fell from 400 to 110.
C. Overall, the heart rate rose from 80 to 93, MAP rose from 50 to 61, and diastolic pressure moved from 37 to 54. Systolic pressure ranged 90-164 and ended at 92, and SpO2 recovered to 97 after a low of 85 around hour 29.5. Respiratory rate ended at 20; the available labs showed white count was roughly stable (14.9 to 14), creatinine fell from 3 to 2.4, lactate was checked once at 1.1, and urine output fell from 350 to 125.
D. Overall, the heart rate rose from 76 to 96, MAP rose from 46 to 56, and diastolic pressure moved from 42 to 51. Systolic pressure ranged 86-134 and ended at 88, and SpO2 recovered to 100 after a low of 80 around hour 27.2. Respiratory rate ended at 22; the available labs showed white count was roughly stable (12.7 to 12), creatinine fell from 4 to 2.1, lactate was checked once at 0.8, and urine output fell from 380 to 95.

Answer: C


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

Options:
A. Overall, the heart rate was roughly stable (90 to 92), while MAP was roughly stable (93 to 91). Systolic pressure was labile, ranging 120-157, with the lowest value around hour 9.9. SpO2 briefly dipped to 88 around hour 0.6 before recovering to 98, while respiratory rate peaked at 26 and later settled at 18. The associated labs and urine output showed that white count was roughly stable (19.3 to 18.7), creatinine rose from 0.6 to 0.8, lactate was not available, and urine output fell from 1135 to 1000, with recorded outputs ranging 1000-1900.
B. Overall, the heart rate was roughly stable (88 to 94), while MAP was roughly stable (91 to 89). Systolic pressure was labile, ranging 121-172, with the lowest value around hour 9.5. SpO2 briefly dipped to 89 around hour 0.5 before recovering to 100, while respiratory rate peaked at 28 and later settled at 17. The associated labs and urine output showed that white count was roughly stable (20.4 to 17.6), creatinine rose from 0.5 to 0.9, lactate was not available, and urine output fell from 1075 to 940, with recorded outputs ranging 1060-1960.
C. Overall, the heart rate was roughly stable (94 to 88), while MAP was roughly stable (97 to 94). Systolic pressure was labile, ranging 95-132, with the lowest value around hour 10.5. SpO2 briefly dipped to 92 around hour 1.6 before recovering to 94, while respiratory rate peaked at 28 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (17.4 to 20.6), creatinine rose from 0.7 to 0.8, lactate was not available, and urine output fell from 1235 to 950, with recorded outputs ranging 950-1800.
D. Overall, the heart rate was roughly stable (86 to 96), while MAP was roughly stable (88 to 86). Systolic pressure was labile, ranging 150-187, with the lowest value around hour 9.2. SpO2 briefly dipped to 84 around hour 0.4 before recovering to 100, while respiratory rate peaked at 24 and later settled at 16. The associated labs and urine output showed that white count fell from 21.6 to 17.9, creatinine rose from 0.4 to 0.9, lactate was not available, and urine output fell from 1015 to 880, with recorded outputs ranging 1120-1950.

Answer: A


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

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 151 to 101, MAP was roughly stable (96 to 94), and heart rate was roughly stable (87 to 95). SpO2 started at 96, ended at 100, and fell as low as 91 around hour 0.5; respiratory rate ranged 16-24. For labs and output, white count fell from 20.1 to 18.6, creatinine rose from 0.7 to 0.8, lactate was not available, and urine output fell from 1215 to 1080.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 116 to 96, MAP was roughly stable (91 to 89), and heart rate was roughly stable (92 to 95). SpO2 started at 100, ended at 96, and fell as low as 86 around hour 0.7; respiratory rate ranged 13-28. For labs and output, white count fell from 20.4 to 17.9, creatinine rose from 0.5 to 0.9, lactate was not available, and urine output fell from 1075 to 940.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 131 to 121, MAP was roughly stable (93 to 91), and heart rate was roughly stable (90 to 92). SpO2 started at 99, ended at 98, and fell as low as 88 around hour 0.6; respiratory rate ranged 14-26. For labs and output, white count was roughly stable (19.3 to 18.7), creatinine rose from 0.6 to 0.8, lactate was not available, and urine output fell from 1135 to 1000.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 101 to 98, MAP was roughly stable (88 to 94), and heart rate was roughly stable (94 to 88). SpO2 started at 100, ended at 94, and fell as low as 87 around hour 0.8; respiratory rate ranged 12-28. For labs and output, white count was roughly stable (21.6 to 16.4), creatinine rose from 0.4 to 1.0, lactate was not available, and urine output fell from 1015 to 880.

Answer: C


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

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (76 to 72), diastolic pressure was roughly stable (60 to 59), and heart rate was roughly stable (63 to 69). The lowest MAP was about 61 around hour 17.6, and the lowest valid SpO2 was 85 around hour 0.2; respiratory rate rose as high as 38 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 37-38.2 C, white count fell from 14.7 to 10.7, creatinine fell from 8.1 to 7.2, lactate stayed broadly stable from 1 to 1.2, and urine output was roughly stable (25 to 20)
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (71 to 77), diastolic pressure was roughly stable (55 to 53), and heart rate stayed around 68. The lowest MAP was about 64 around hour 18.6, and the lowest valid SpO2 was 83 around hour 1.0; respiratory rate rose as high as 40 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 35-36.0 C, white count fell from 13.6 to 9.6, creatinine fell from 8.5 to 6.8, lactate stayed broadly stable from 1 to 1.4, and urine output was roughly stable (24 to 19)
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (73 to 75), diastolic pressure was roughly stable (57 to 56), and heart rate stayed around 66. The lowest MAP was about 61 around hour 17.6, and the lowest valid SpO2 was 85 around hour 1.2; respiratory rate rose as high as 38 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 37-38.2 C, white count fell from 14.7 to 10.7, creatinine fell from 8.1 to 7.2, lactate stayed broadly stable from 1 to 1.2, and urine output was roughly stable (25 to 20)
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (68 to 80), diastolic pressure was roughly stable (52 to 52), and heart rate stayed around 70. The lowest MAP was about 56 around hour 15.4, and the lowest valid SpO2 was 80 around hour 0.9; respiratory rate rose as high as 40 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 32-33.7 C, white count fell from 12.4 to 8.4, creatinine fell from 8.8 to 7.3, lactate stayed broadly stable from 1 to 1.5, and urine output was roughly stable (23 to 70)

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (73 to 75), diastolic pressure was roughly stable (57 to 56), and heart rate stayed around 66. The lowest MAP was about 61 around hour 17.6, and the lowest valid SpO2 was 85 around hour 1.2; respiratory rate rose as high as 38 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 37 to 100.7, white count fell from 14.7 to 10.7, creatinine fell from 8.1 to 7.2, lactate stayed broadly stable from 1 to 1.2, and urine output was roughly stable (25 to 20)


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

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 147 to 167, MAP was roughly stable (76 to 78), and heart rate was roughly stable (63 to 69). SpO2 started at 93, ended at 100, and fell as low as 85 around hour 1.2; respiratory rate ranged 16-40. For labs and output, white count fell from 14.7 to 9.9, creatinine fell from 8.1 to 7.2, lactate stayed broadly stable from 1 to 1.2, and urine output was roughly stable (25 to 20)
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 112 to 151, MAP was roughly stable (71 to 73), and heart rate stayed around 68. SpO2 started at 91, ended at 98, and fell as low as 83 around hour 1.0; respiratory rate ranged 17-40. For labs and output, white count fell from 13.6 to 11.8, creatinine fell from 7.7 to 7.3, lactate stayed broadly stable from 1.2 to 1.0, and urine output was roughly stable (24 to 21)
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (152 to 132), MAP was roughly stable (77 to 78), and heart rate stayed around 62. SpO2 started at 97, ended at 96, and fell as low as 84 around hour 1.4; respiratory rate ranged 14-34. For labs and output, white count fell from 16.6 to 8.8, creatinine fell from 8.7 to 7.8, lactate stayed broadly stable from 1 to 1.4, and urine output was roughly stable (27 to 18)
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 127 to 136, MAP was roughly stable (73 to 75), and heart rate stayed around 66. SpO2 started at 93, ended at 100, and fell as low as 85 around hour 1.2; respiratory rate ranged 16-38. For labs and output, white count fell from 14.7 to 10.7, creatinine fell from 8.1 to 7.2, lactate stayed broadly stable from 1 to 1.2, and urine output was roughly stable (25 to 20)

Answer: D


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

Options:
A. In broad terms, the heart rate stayed around 66, MAP was roughly stable (73 to 75), and diastolic pressure moved from 57 to 56. Systolic pressure ranged 93-147 and ended at 136, and SpO2 recovered to 100 after a low of 85 around hour 1.2. Respiratory rate ended at 19; the available labs showed white count fell from 14.7 to 10.7, creatinine fell from 8.1 to 7.2, lactate stayed broadly stable from 1 to 1.2, and urine output was roughly stable (25 to 20)
B. In broad terms, the heart rate stayed around 64, MAP was roughly stable (75 to 78), and diastolic pressure moved from 55 to 58. Systolic pressure ranged 91-162 and ended at 132, and SpO2 recovered to 98 after a low of 87 around hour 2.2. Respiratory rate ended at 18; the available labs showed white count fell from 15.8 to 9.6, creatinine fell from 7.7 to 7.6, lactate stayed broadly stable from 1 to 1.0, and urine output was roughly stable (26 to 19)
C. In broad terms, the heart rate stayed around 70, MAP was roughly stable (69 to 79), and diastolic pressure moved from 61 to 52. Systolic pressure ranged 97-122 and ended at 111, and SpO2 recovered to 96 after a low of 84 around hour 1.4. Respiratory rate ended at 21; the available labs showed white count fell from 12.8 to 9.9, creatinine fell from 8.7 to 6.6, lactate stayed broadly stable from 1 to 1.4, and urine output was roughly stable (75 to 22)
D. In broad terms, the heart rate was roughly stable (62 to 69), MAP was roughly stable (73 to 75), and diastolic pressure moved from 57 to 53. Systolic pressure ranged 93-147 and ended at 136, and SpO2 recovered to 100 after a low of 85 around hour 1.2. Respiratory rate ended at 19; the available labs showed white count fell from 14.7 to 10.7, creatinine fell from 8.1 to 7.2, lactate stayed broadly stable from 1 to 1.2, and urine output was roughly stable (25 to 20)

Answer: A


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

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (84 to 77), diastolic pressure rose from 62 to 67, and heart rate fell from 65 to 58. The lowest MAP was about 67 around hour 3.2, and the lowest valid SpO2 was 88 around hour 0.3; respiratory rate rose as high as 30 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.7-33.9 C, white count was roughly stable (21.2 to 19.2), creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (320 to 280)
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (79 to 82), diastolic pressure rose from 57 to 68, and heart rate fell from 70 to 53. The lowest MAP was about 62 around hour 2.4, and the lowest valid SpO2 was 83 around hour 0.5; respiratory rate rose as high as 31 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 39.0-39.1 C, white count was roughly stable (18.6 to 21.8), creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (285 to 350)
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (85 to 76), diastolic pressure rose from 63 to 74, and heart rate fell from 64 to 58. The lowest MAP was about 68 around hour 2.0, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 31 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.0-33.1 C, white count was roughly stable (21.6 to 18.8), creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (325 to 275)
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (81 to 80), diastolic pressure rose from 59 to 70, and heart rate fell from 68 to 55. The lowest MAP was about 64 around hour 2.2, and the lowest valid SpO2 was 85 around hour 0.4; respiratory rate rose as high as 29 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 36.7-36.9 C, white count was roughly stable (19.7 to 20.7), creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (300 to 300)

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (81 to 80), diastolic pressure rose from 59 to 70, and heart rate fell from 68 to 55. The lowest MAP was about 64 around hour 2.2, and the lowest valid SpO2 was 85 around hour 0.4; respiratory rate rose as high as 29 but ended at 18. The lower-frequency data fit that summary: temperature ranged from 98 to 98.4, white count was roughly stable (19.7 to 20.7), creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (300 to 300)


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (131 to 125), MAP was roughly stable (81 to 80), and heart rate fell from 68 to 55. SpO2 started at 100, ended at 98, and fell as low as 85 around hour 0.4; respiratory rate ranged 13-29. For labs and output, white count was roughly stable (19.7 to 20.7), creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (300 to 300)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (116 to 140), MAP was roughly stable (79 to 78), and heart rate fell from 70 to 53. SpO2 started at 98, ended at 99, and fell as low as 83 around hour 0.5; respiratory rate ranged 12-30. For labs and output, white count was roughly stable (20.8 to 19.6), creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (315 to 285)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 156 to 121, MAP was roughly stable (85 to 83), and heart rate fell from 64 to 59. SpO2 started at 96, ended at 100, and fell as low as 84 around hour 0.3; respiratory rate ranged 15-27. For labs and output, white count was roughly stable (17.8 to 22.6), creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (275 to 325)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (101 to 155), MAP was roughly stable (76 to 76), and heart rate fell from 72 to 58. SpO2 started at 96, ended at 94, and fell as low as 80 around hour 0.6; respiratory rate ranged 11-31. For labs and output, white count was roughly stable (21.9 to 19.9), creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (330 to 270)

Answer: A


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

Options:
A. For handoff, the heart rate fell from 71 to 52, MAP was roughly stable (84 to 83), and diastolic pressure moved from 56 to 73. Systolic pressure ranged 99-170 and ended at 121, and SpO2 recovered to 95 after a low of 88 around hour 1.4. Respiratory rate ended at 16; the available labs showed white count was roughly stable (21.2 to 22.2), creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (320 to 320)
B. For handoff, the heart rate fell from 68 to 55, MAP was roughly stable (81 to 80), and diastolic pressure moved from 59 to 70. Systolic pressure ranged 96-150 and ended at 125, and SpO2 recovered to 98 after a low of 85 around hour 0.4. Respiratory rate ended at 18; the available labs showed white count was roughly stable (19.7 to 20.7), creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (300 to 300)
C. For handoff, the heart rate fell from 72 to 58, MAP was roughly stable (85 to 84), and diastolic pressure moved from 55 to 67. Systolic pressure ranged 100-175 and ended at 150, and SpO2 recovered to 94 after a low of 89 around hour 0.5. Respiratory rate ended at 16; the available labs showed white count was roughly stable (21.6 to 22.6), creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (325 to 325)
D. For handoff, the heart rate fell from 64 to 60, MAP was roughly stable (76 to 76), and diastolic pressure moved from 64 to 66. Systolic pressure ranged 92-120 and ended at 95, and SpO2 recovered to 100 after a low of 84 around hour 0.2. Respiratory rate ended at 20; the available labs showed white count was roughly stable (17.4 to 19.9), creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (350 to 270)

Answer: B


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (71 to 69), diastolic pressure was roughly stable (54 to 54), and heart rate was roughly stable (57 to 66). The lowest MAP was about 62 around hour 6.1, and the lowest valid SpO2 was 88 around hour 3.4; respiratory rate rose as high as 24 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.3-34.1 C, white count fell from 9.8 to 8, creatinine was roughly stable (1.4 to 1.3), lactate rose from 1.5 to 3.0, and urine output fell from 490 to 105.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (68 to 72), diastolic pressure rose from 51 to 57, and heart rate was roughly stable (60 to 63). The lowest MAP was about 59 around hour 5.1, and the lowest valid SpO2 was 85 around hour 3.9; respiratory rate rose as high as 22 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.3-37.1 C, white count fell from 9.3 to 8, creatinine was roughly stable (1.2 to 1.1), lactate rose from 1.7 to 2.8, and urine output fell from 470 to 125.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (72 to 68), diastolic pressure rose from 55 to 61, and heart rate rose from 56 to 66. The lowest MAP was about 63 around hour 4.5, and the lowest valid SpO2 was 89 around hour 2.9; respiratory rate rose as high as 24 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 32.5-33.4 C, white count fell from 9.9 to 7, creatinine was roughly stable (1.4 to 1.4), lactate rose from 1.4 to 3.0, and urine output fell from 495 to 100.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (64 to 76), diastolic pressure rose from 46 to 52, and heart rate was roughly stable (64 to 58). The lowest MAP was about 54 around hour 5.8, and the lowest valid SpO2 was 80 around hour 4.7; respiratory rate rose as high as 24 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 40.8-41.6 C, white count fell from 8.6 to 8, creatinine stayed around 0.9, lactate rose from 1.7 to 2.8, and urine output fell from 470 to 175.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (68 to 72), diastolic pressure rose from 51 to 57, and heart rate was roughly stable (60 to 63). The lowest MAP was about 59 around hour 5.1, and the lowest valid SpO2 was 85 around hour 3.9; respiratory rate rose as high as 22 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 97.4 to 98.8, white count fell from 9.3 to 8, creatinine was roughly stable (1.2 to 1.1), lactate rose from 1.7 to 2.8, and urine output fell from 470 to 125.


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

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 97 to 113, MAP was roughly stable (71 to 75), and heart rate was roughly stable (57 to 66). SpO2 started at 82, ended at 97, and fell as low as 88 around hour 3.4; respiratory rate ranged 12-20. For labs and output, white count fell from 8.8 to 8, creatinine stayed around 1.4, lactate rose from 1.9 to 2.8, and urine output fell from 470 to 125.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 98 to 118, MAP was roughly stable (66 to 70), and heart rate rose from 62 to 66. SpO2 started at 87, ended at 98, and fell as low as 83 around hour 4.3; respiratory rate ranged 10-24. For labs and output, white count fell from 9.7 to 7.2, creatinine was roughly stable (1.0 to 1.2), lactate rose from 1.5 to 2.6, and urine output fell from 485 to 110.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 100 to 116, MAP was roughly stable (68 to 72), and heart rate was roughly stable (60 to 63). SpO2 started at 85, ended at 100, and fell as low as 85 around hour 3.9; respiratory rate ranged 11-22. For labs and output, white count fell from 9.3 to 8, creatinine was roughly stable (1.2 to 1.1), lactate rose from 1.7 to 2.8, and urine output fell from 470 to 125.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 96 to 112, MAP rose from 64 to 75, and heart rate was roughly stable (64 to 58). SpO2 started at 90, ended at 96, and fell as low as 84 around hour 4.7; respiratory rate ranged 9-24. For labs and output, white count fell from 10.1 to 7, creatinine was roughly stable (0.9 to 1.4), lactate rose from 1.4 to 2.5, and urine output fell from 500 to 95.

Answer: C


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

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (109 to 106), diastolic pressure was roughly stable (90 to 92), and heart rate rose from 47 to 90. The lowest MAP was about 61 around hour 95.4, and the lowest valid SpO2 was 88 around hour 0.8; respiratory rate rose as high as 32 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 33.4-35.4 C, white count rose from 7.6 to 11.8, creatinine was roughly stable (0.6 to 2.2), lactate was checked once at 1.1, and urine output was roughly stable (145 to 100)
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (104 to 111), diastolic pressure was roughly stable (85 to 87), and heart rate rose from 52 to 90. The lowest MAP was about 56 around hour 100.7, and the lowest valid SpO2 was 83 around hour 0; respiratory rate rose as high as 28 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 38.6-40.6 C, white count rose from 6.7 to 14.4, creatinine was roughly stable (0.4 to 2.0), lactate was checked once at 1.5, and urine output was roughly stable (110 to 48)
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (106 to 109), diastolic pressure was roughly stable (87 to 89), and heart rate rose from 50 to 87. The lowest MAP was about 58 around hour 98.4, and the lowest valid SpO2 was 85 around hour 0.9; respiratory rate rose as high as 30 but ended at 13. The lower-frequency data fit that summary: temperature stayed around 36.4-38.4 C, white count rose from 7.1 to 13.3, creatinine was roughly stable (0.5 to 2.1), lactate was checked once at 1.3, and urine output was roughly stable (125 to 50)
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (102 to 114), diastolic pressure was roughly stable (82 to 86), and heart rate rose from 54 to 82. The lowest MAP was about 61 around hour 99.4, and the lowest valid SpO2 was 80 around hour 1.1; respiratory rate rose as high as 26 but ended at 11. The lower-frequency data fit that summary: temperature stayed around 40.9-42.9 C, white count rose from 6.3 to 15.6, creatinine was roughly stable (0.3 to 1.8), lactate was checked once at 1.6, and urine output was roughly stable (95 to 46)

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (106 to 109), diastolic pressure was roughly stable (87 to 89), and heart rate rose from 50 to 87. The lowest MAP was about 58 around hour 98.4, and the lowest valid SpO2 was 85 around hour 0.9; respiratory rate rose as high as 30 but ended at 13. The lower-frequency data fit that summary: temperature ranged from 97.5 to 101.1, white count rose from 7.1 to 13.3, creatinine was roughly stable (0.5 to 2.1), lactate was checked once at 1.3, and urine output was roughly stable (125 to 50)


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 was roughly stable (107 to 102), MAP was roughly stable (64 to 65), and heart rate rose from 50 to 65. SpO2 started at 88, ended at 98, and fell as low as 88 around hour 0.1; respiratory rate ranged 12-27. For labs and output, white count fell from 16.5 to 13.5, creatinine fell from 1.9 to 1.7, lactate stayed broadly stable from 1.3 to 1.5, and urine output was roughly stable (220 to 250)
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (105 to 104), MAP was roughly stable (62 to 63), and heart rate rose from 52 to 63. SpO2 started at 90, ended at 96, and fell as low as 86 around hour 0.2; respiratory rate ranged 11-28. For labs and output, white count fell from 17.6 to 12.4, creatinine was roughly stable (1.8 to 1.8), lactate stayed broadly stable from 1.5 to 1.4, and urine output was roughly stable (235 to 235)
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (111 to 98), MAP was roughly stable (68 to 69), and heart rate rose from 46 to 68. SpO2 started at 84, ended at 100, and fell as low as 92 around hour 0.0; respiratory rate ranged 14-29. For labs and output, white count fell from 14.6 to 12.7, creatinine fell from 2.1 to 1.4, lactate stayed broadly stable from 1.6 to 1.8, and urine output was roughly stable (195 to 275)
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 102 to 98, MAP was roughly stable (60 to 68), and heart rate rose from 54 to 60. SpO2 started at 92, ended at 94, and fell as low as 87 around hour 0.2; respiratory rate ranged 10-29. For labs and output, white count fell from 18.8 to 11.2, creatinine fell from 1.6 to 1.4, lactate stayed broadly stable from 1.0 to 1.2, and urine output was roughly stable (250 to 220)

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 176 to 144, MAP was roughly stable (100 to 95), and heart rate rose from 47 to 63. SpO2 started at 85, ended at 100, and fell as low as 84 around hour 80.9; respiratory rate ranged 14-37. For labs and output, white count rose from 2 to 7.6, creatinine was roughly stable (3.9 to 3.0), lactate was not available, and urine output rose from 53 to 520.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 141 to 121, MAP was roughly stable (95 to 90), and heart rate rose from 52 to 58. SpO2 started at 90, ended at 95, and fell as low as 83 around hour 86.2; respiratory rate ranged 11-42. For labs and output, white count rose from 3 to 6.7, creatinine was roughly stable (3.5 to 3.6), lactate was not available, and urine output rose from 48 to 485.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 156 to 148, MAP was roughly stable (97 to 92), and heart rate rose from 50 to 60. SpO2 started at 88, ended at 97, and fell as low as 85 around hour 83.9; respiratory rate ranged 12-40. For labs and output, white count rose from 3 to 7.1, creatinine was roughly stable (3.4 to 3.5), lactate was not available, and urine output rose from 50 to 500.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 126 to 106, MAP was roughly stable (92 to 88), and heart rate rose from 54 to 63. SpO2 started at 92, ended at 92, and fell as low as 80 around hour 88.4; respiratory rate ranged 10-42. For labs and output, white count rose from 4 to 6.3, creatinine was roughly stable (2.6 to 4.2), lactate was not available, and urine output rose from 46 to 470.

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 rose from 140 to 160, MAP rose from 90 to 110, and heart rate rose from 47 to 76. SpO2 started at 85, ended at 95, and fell as low as 87 around hour 0; respiratory rate ranged 12-35. For labs and output, white count fell from 10.3 to 8.2, creatinine fell from 1.5 to 1, lactate was not available, and urine output fell from 3780 to 420.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 105 to 153, MAP rose from 85 to 105, and heart rate rose from 52 to 76. SpO2 started at 90, ended at 90, and fell as low as 86 around hour 2; respiratory rate ranged 10-40. For labs and output, white count fell from 12.9 to 6.9, creatinine fell from 1.1 to 1, lactate was not available, and urine output fell from 3640 to 385.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 145 to 165, MAP rose from 91 to 111, and heart rate rose from 46 to 77. SpO2 started at 84, ended at 96, and fell as low as 92 around hour 0; respiratory rate ranged 13-34. For labs and output, white count fell from 9.9 to 8.3, creatinine was roughly stable (1.2 to 1.1), lactate was not available, and urine output fell from 3800 to 425.
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 120 to 138, MAP rose from 87 to 107, and heart rate rose from 50 to 73. SpO2 started at 88, ended at 92, and fell as low as 88 around hour 0; respiratory rate ranged 11-38. For labs and output, white count fell from 11.8 to 7.7, creatinine fell from 1.3 to 1, lactate was not available, and urine output fell from 3700 to 400.

Answer: D


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

Options:
A. In broad terms, the heart rate rose from 50 to 73, MAP rose from 87 to 107, and diastolic pressure moved from 74 to 92. Systolic pressure ranged 101-142 and ended at 138, and SpO2 recovered to 92 after a low of 88 around hour 0. Respiratory rate ended at 18; the available labs showed white count fell from 11.8 to 7.7, creatinine fell from 1.3 to 1, lactate was not available, and urine output fell from 3700 to 400.
B. In broad terms, the heart rate rose from 48 to 75, MAP rose from 85 to 110, and diastolic pressure moved from 76 to 90. Systolic pressure ranged 99-127 and ended at 134, and SpO2 recovered to 94 after a low of 86 around hour 1. Respiratory rate ended at 19; the available labs showed white count fell from 10.7 to 7.3, creatinine fell from 1.5 to 1, lactate was not available, and urine output fell from 3640 to 415.
C. In broad terms, the heart rate rose from 54 to 69, MAP rose from 91 to 111, and diastolic pressure moved from 70 to 96. Systolic pressure ranged 105-167 and ended at 163, and SpO2 recovered to 88 after a low of 87 around hour 2. Respiratory rate ended at 16; the available labs showed white count fell from 13.7 to 6.9, creatinine fell from 1.1 to 1, lactate was not available, and urine output fell from 3750 to 375.
D. In broad terms, the heart rate rose from 46 to 76, MAP rose from 82 to 102, and diastolic pressure moved from 78 to 89. Systolic pressure ranged 96-112 and ended at 108, and SpO2 recovered to 96 after a low of 84 around hour 0. Respiratory rate ended at 20; the available labs showed white count fell from 9.6 to 7.0, creatinine fell from 1.6 to 1, lactate was not available, and urine output fell from 3580 to 430.

Answer: A


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

Options:
A. In broad terms, the heart rate rose from 63 to 68, while MAP was roughly stable (73 to 75). Systolic pressure was labile, ranging 91-178, with the lowest value around hour 7.6. SpO2 briefly dipped to 88 around hour 4.6 before recovering to 92, while respiratory rate peaked at 51 and later settled at 24. The associated labs and urine output showed that white count rose from 9.4 to 17.1, creatinine stayed around 0.9, lactate rose from 1.3 to 2, and urine output was roughly stable (113 to 105), with recorded outputs ranging 48-546.
B. In broad terms, the heart rate rose from 58 to 73, while MAP was roughly stable (68 to 70). Systolic pressure was labile, ranging 89-213, with the lowest value around hour 6.7. SpO2 briefly dipped to 83 around hour 3.7 before recovering to 97, while respiratory rate peaked at 47 and later settled at 21. The associated labs and urine output showed that white count rose from 10.3 to 14.8, creatinine was roughly stable (0.7 to 0.9), lactate rose from 1.5 to 2, and urine output was roughly stable (110 to 125), with recorded outputs ranging 95-566.
C. In broad terms, the heart rate rose from 60 to 71, while MAP was roughly stable (70 to 72). Systolic pressure was labile, ranging 87-198, with the lowest value around hour 7.1. SpO2 briefly dipped to 85 around hour 4.1 before recovering to 95, while respiratory rate peaked at 49 and later settled at 22. The associated labs and urine output showed that white count rose from 9.9 to 15.6, creatinine stayed around 0.8, lactate rose from 1.5 to 2, and urine output was roughly stable (110 to 125), with recorded outputs ranging 45-566.
D. In broad terms, the heart rate rose from 56 to 76, while MAP was roughly stable (66 to 75). Systolic pressure was labile, ranging 92-228, with the lowest value around hour 6.3. SpO2 briefly dipped to 80 around hour 5.1 before recovering to 100, while respiratory rate peaked at 44 and later settled at 20. The associated labs and urine output showed that white count rose from 10.7 to 13.3, creatinine stayed around 0.7, lactate rose from 1.8 to 2, and urine output was roughly stable (106 to 75), with recorded outputs ranging 40-596.

Answer: C


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 100 to 110, MAP was roughly stable (70 to 72), and heart rate rose from 60 to 71. SpO2 started at 85, ended at 95, and fell as low as 85 around hour 4.1; respiratory rate ranged 7-49. For labs and output, white count rose from 9.9 to 15.6, creatinine stayed around 0.8, lactate rose from 1.5 to 2, and urine output was roughly stable (110 to 125)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (98 to 106), MAP was roughly stable (68 to 75), and heart rate rose from 62 to 69. SpO2 started at 87, ended at 93, and fell as low as 84 around hour 4.5; respiratory rate ranged 7-51. For labs and output, white count rose from 10.3 to 14.5, creatinine stayed around 0.7, lactate rose from 1.6 to 2, and urine output was roughly stable (108 to 140)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 96 to 106, MAP was roughly stable (74 to 76), and heart rate rose from 56 to 75. SpO2 started at 81, ended at 99, and fell as low as 89 around hour 3.5; respiratory rate ranged 8-45. For labs and output, white count rose from 9.3 to 17.5, creatinine was roughly stable (0.9 to 0.9), lactate rose from 1.7 to 2, and urine output was roughly stable (110 to 125)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 96 to 114, MAP was roughly stable (66 to 68), and heart rate rose from 64 to 74. SpO2 started at 90, ended at 90, and fell as low as 80 around hour 4.8; respiratory rate ranged 6-51. For labs and output, white count rose from 10.7 to 14.8, creatinine stayed around 0.7, lactate rose from 1.8 to 2, and urine output was roughly stable (106 to 155)

Answer: A


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

Options:
A. Across the recorded window, the heart rate rose from 53 to 101, MAP fell from 159 to 93, and diastolic pressure moved from 113 to 84. Systolic pressure ranged 76-215 and ended at 125, and SpO2 recovered to 92 after a low of 88 around hour 4.6. Respiratory rate ended at 28; the available labs showed white count rose from 9.1 to 33.4, creatinine fell from 0.9 to 0.7, lactate stayed broadly stable from 9.3 to 0.8, and urine output fell from 370 to 73.
B. Across the recorded window, the heart rate rose from 48 to 106, MAP fell from 124 to 88, and diastolic pressure moved from 118 to 79. Systolic pressure ranged 71-180 and ended at 114, and SpO2 recovered to 97 after a low of 84 around hour 3.2. Respiratory rate ended at 30; the available labs showed white count rose from 8.2 to 29.6, creatinine fell from 1.2 to 0.8, lactate stayed broadly stable from 8.4 to 1.0, and urine output fell from 400 to 68.
C. Across the recorded window, the heart rate rose from 50 to 104, MAP fell from 139 to 90, and diastolic pressure moved from 116 to 81. Systolic pressure ranged 73-195 and ended at 129, and SpO2 recovered to 95 after a low of 85 around hour 3.6. Respiratory rate ended at 29; the available labs showed white count rose from 8.6 to 30.4, creatinine fell from 1.1 to 0.9, lactate stayed broadly stable from 8.8 to 0.9, and urine output fell from 350 to 70.
D. Across the recorded window, the heart rate rose from 46 to 107, MAP fell from 109 to 86, and diastolic pressure moved from 120 to 78. Systolic pressure ranged 68-165 and ended at 99, and SpO2 recovered to 100 after a low of 80 around hour 2.9. Respiratory rate ended at 31; the available labs showed white count rose from 7.8 to 25.9, creatinine fell from 1.4 to 0.8, lactate stayed broadly stable from 8.1 to 1.1, and urine output fell from 320 to 66.

Answer: C


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 96 to 66, and heart rate rose from 37 to 147. The lowest MAP was about 70 around hour 40.5, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 41 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 33.4-34.4 C, white count fell from 13.8 to 9.1, creatinine stayed around 1.3, lactate stayed broadly stable from 1.5 to 1.0, and urine output rose from 26 to 245.
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 91 to 67, and heart rate rose from 42 to 112. The lowest MAP was about 65 around hour 41.8, and the lowest valid SpO2 was 83 around hour 2; respiratory rate rose as high as 40 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 38.6-39.6 C, white count fell from 11.2 to 10.0, creatinine rose from 1 to 1.2, lactate stayed broadly stable from 1.3 to 1.2, and urine output rose from 25 to 275.
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 97 to 73, and heart rate rose from 36 to 130. The lowest MAP was about 71 around hour 35.8, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 42 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 32.6-33.6 C, white count fell from 14.2 to 9.0, creatinine stayed around 1.4, lactate stayed broadly stable from 1.6 to 0.9, and urine output rose from 27 to 250.
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 93 to 69, and heart rate rose from 40 to 127. The lowest MAP was about 67 around hour 39.5, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 38 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 36.4-37.4 C, white count fell from 12.3 to 9.6, creatinine stayed around 1.1, lactate stayed broadly stable from 1.3 to 1.2, and urine output rose from 25 to 225.

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 93 to 69, and heart rate rose from 40 to 127. The lowest MAP was about 67 around hour 39.5, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 38 but ended at 23. The lower-frequency data fit that summary: temperature ranged from 97.5 to 99.3, white count fell from 12.3 to 9.6, creatinine stayed around 1.1, lactate stayed broadly stable from 1.3 to 1.2, and urine output rose from 25 to 225.


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 115 to 97, MAP fell from 102 to 75, and heart rate rose from 40 to 127. SpO2 started at 85, ended at 95, and fell as low as 85 around hour 0; respiratory rate ranged 14-38. For labs and output, white count fell from 12.3 to 9.6, creatinine stayed around 1.1, lactate stayed broadly stable from 1.3 to 1.2, and urine output rose from 25 to 225.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 113 to 99, MAP fell from 100 to 73, and heart rate rose from 42 to 112. SpO2 started at 87, ended at 93, and fell as low as 83 around hour 2; respiratory rate ranged 13-40. For labs and output, white count fell from 13.4 to 9.2, creatinine rose from 1 to 1.2, lactate fell from 1.5 to 1.2, and urine output rose from 25 to 225.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 119 to 93, MAP fell from 106 to 79, and heart rate rose from 36 to 130. SpO2 started at 81, ended at 99, and fell as low as 89 around hour 0; respiratory rate ranged 16-40. For labs and output, white count fell from 10.4 to 8.8, creatinine stayed around 1.4, lactate stayed broadly stable from 1.1 to 1.4, and urine output rose from 27 to 200.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 110 to 93, MAP fell from 98 to 78, and heart rate rose from 44 to 97. SpO2 started at 90, ended at 90, and fell as low as 84 around hour 3; respiratory rate ranged 12-42. For labs and output, white count fell from 14.6 to 8.8, creatinine stayed around 0.8, lactate stayed broadly stable from 1.6 to 0.9, and urine output rose from 23 to 255.

Answer: A


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

Options:
A. Overall, the heart rate rose from 50 to 98, while MAP rose from 70 to 98. Systolic pressure was labile, ranging 108-178, with the lowest value around hour 23.1. SpO2 briefly dipped to 85 around hour 2.1 before recovering to 98, while respiratory rate peaked at 22 and later settled at 18. The associated labs and urine output showed that white count fell from 15.3 to 11.9, creatinine was roughly stable (0.9 to 0.8), lactate fell from 215 to 0.8, and urine output rose from 13 to 200, with recorded outputs ranging 10-220.
B. Overall, the heart rate rose from 48 to 100, while MAP rose from 68 to 96. Systolic pressure was labile, ranging 110-193, with the lowest value around hour 22.0. SpO2 briefly dipped to 83 around hour 2.0 before recovering to 100, while respiratory rate peaked at 21 and later settled at 17. The associated labs and urine output showed that white count fell from 16.4 to 11.1, creatinine stayed around 0.8, lactate fell from 215 to 0.8, and urine output rose from 13 to 200, with recorded outputs ranging 13-220.
C. Overall, the heart rate rose from 54 to 94, while MAP rose from 74 to 100. Systolic pressure was labile, ranging 112-153, with the lowest value around hour 25.0. SpO2 briefly dipped to 86 around hour 2.4 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 fell from 13.4 to 11.9, creatinine was roughly stable (1.0 to 0.7), lactate fell from 240 to 0.9, and urine output rose from 11 to 225, with recorded outputs ranging 12-245.
D. Overall, the heart rate rose from 46 to 100, while MAP rose from 66 to 101. Systolic pressure was labile, ranging 112-208, with the lowest value around hour 20.9. SpO2 briefly dipped to 80 around hour 3.1 before recovering to 100, while respiratory rate peaked at 20 and later settled at 16. The associated labs and urine output showed that white count fell from 17.6 to 9.7, creatinine was roughly stable (0.8 to 1.0), lactate fell from 185 to 0.7, and urine output rose from 15 to 150, with recorded outputs ranging 8-190.

Answer: A


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

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (170 to 136), MAP rose from 73 to 100, and heart rate rose from 47 to 100. SpO2 started at 87, ended at 100, and fell as low as 88 around hour 1.9; respiratory rate ranged 14-20. For labs and output, white count fell from 13.8 to 13.4, creatinine stayed around 1.0, lactate fell from 215.2 to 0.8, and urine output rose from 13 to 200.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (135 to 171), MAP rose from 68 to 96, and heart rate rose from 52 to 101. SpO2 started at 92, ended at 96, and fell as low as 83 around hour 2.2; respiratory rate ranged 11-24. For labs and output, white count fell from 16.4 to 11.1, creatinine was roughly stable (0.8 to 0.9), lactate fell from 200 to 0.7, and urine output rose from 14 to 185.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (150 to 156), MAP rose from 70 to 98, and heart rate rose from 50 to 98. SpO2 started at 90, ended at 98, and fell as low as 85 around hour 2.1; respiratory rate ranged 12-22. For labs and output, white count fell from 15.3 to 11.9, creatinine was roughly stable (0.9 to 0.8), lactate fell from 215 to 0.8, and urine output rose from 13 to 200.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (120 to 152), MAP rose from 66 to 101, and heart rate rose from 54 to 94. SpO2 started at 94, ended at 94, and fell as low as 84 around hour 2.4; respiratory rate ranged 10-24. For labs and output, white count fell from 17.6 to 9.7, creatinine was roughly stable (0.8 to 1.0), lactate fell from 185 to 0.7, and urine output rose from 15 to 170.

Answer: C


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

Options:
A. In broad terms, the heart rate was roughly stable (88 to 87), MAP rose from 64 to 87, and diastolic pressure moved from 18 to 76. Systolic pressure ranged 21-142 and ended at 108, and SpO2 recovered to 95 after a low of 84 around hour 9.9. Respiratory rate ended at 30; the available labs showed white count fell from 24.8 to 14.1, creatinine stayed around 1.1, lactate fell from 2.7 to 1.5, and urine output fell from 300 to 50.
B. In broad terms, the heart rate was roughly stable (86 to 89), MAP rose from 62 to 90, and diastolic pressure moved from 19 to 74. Systolic pressure ranged 20-127 and ended at 104, and SpO2 recovered to 97 after a low of 82 around hour 10.9. Respiratory rate ended at 32; the available labs showed white count fell from 23.7 to 13.0, creatinine stayed around 1.2, lactate fell from 2.6 to 1.4, and urine output fell from 315 to 48.
C. In broad terms, the heart rate was roughly stable (92 to 83), MAP rose from 68 to 91, and diastolic pressure moved from 16 to 80. Systolic pressure ranged 23-167 and ended at 112, and SpO2 recovered to 91 after a low of 83 around hour 10.5. Respiratory rate ended at 26; the available labs showed white count fell from 26.7 to 13.3, creatinine stayed around 0.9, lactate fell from 3.0 to 1.8, and urine output fell from 350 to 54.
D. In broad terms, the heart rate was roughly stable (84 to 90), MAP rose from 60 to 82, and diastolic pressure moved from 20 to 73. Systolic pressure ranged 19-112 and ended at 104, and SpO2 recovered to 100 after a low of 80 around hour 9.2. Respiratory rate ended at 34; the available labs showed white count fell from 22.6 to 11.8, creatinine stayed around 1.4, lactate fell from 2.4 to 1.2, and urine output fell from 330 to 46.

Answer: A


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

Options:
A. In broad terms, the heart rate fell from 83 to 65, while MAP fell from 70 to 64. Systolic pressure was labile, ranging 22-121, with the lowest value around hour 20.9. SpO2 briefly dipped to 88 around hour 4.3 before recovering to 95, while respiratory rate peaked at 26 and later settled at 24. The associated labs and urine output showed that white count fell from 17.6 to 12.2, creatinine was roughly stable (1.0 to 1), lactate was checked once at 1.8, and urine output fell from 265 to 50, with recorded outputs ranging 50-600.
B. In broad terms, the heart rate fell from 78 to 70, while MAP was roughly stable (65 to 64). Systolic pressure was labile, ranging 24-156, with the lowest value around hour 18.3. SpO2 briefly dipped to 83 around hour 4.8 before recovering to 100, while respiratory rate peaked at 24 and later settled at 21. The associated labs and urine output showed that white count fell from 20.2 to 12, creatinine stayed around 0.8, lactate was checked once at 2.0, and urine output fell from 250 to 0, with recorded outputs ranging 0-615.
C. In broad terms, the heart rate fell from 80 to 68, while MAP fell from 67 to 61. Systolic pressure was labile, ranging 23-141, with the lowest value around hour 19.4. SpO2 briefly dipped to 85 around hour 3.8 before recovering to 98, while respiratory rate peaked at 25 and later settled at 22. The associated labs and urine output showed that white count fell from 19.1 to 13, creatinine stayed around 0.9, lactate was checked once at 1.8, and urine output fell from 265 to 50, with recorded outputs ranging 35-600.
D. In broad terms, the heart rate fell from 76 to 72, while MAP fell from 62 to 56. Systolic pressure was labile, ranging 25-171, with the lowest value around hour 17.1. SpO2 briefly dipped to 86 around hour 3.0 before recovering to 100, while respiratory rate peaked at 27 and later settled at 20. The associated labs and urine output showed that white count fell from 21.4 to 11, creatinine stayed around 0.8, lactate was checked once at 2.1, and urine output fell from 235 to 46, with recorded outputs ranging 40-630.

Answer: C


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

Options:
A. For handoff, the heart rate fell from 83 to 71, MAP fell from 70 to 64, and diastolic pressure moved from 10 to 46. Systolic pressure ranged 24-161 and ended at 100, and SpO2 recovered to 95 after a low of 88 around hour 4.3. Respiratory rate ended at 20; the available labs showed white count fell from 20.6 to 14, creatinine stayed around 0.8, lactate was checked once at 2.0, and urine output fell from 285 to 47.
B. For handoff, the heart rate fell from 80 to 68, MAP fell from 67 to 61, and diastolic pressure moved from 11 to 49. Systolic pressure ranged 23-141 and ended at 97, and SpO2 recovered to 98 after a low of 85 around hour 3.8. Respiratory rate ended at 22; the available labs showed white count fell from 19.1 to 13, creatinine stayed around 0.9, lactate was checked once at 1.8, and urine output fell from 265 to 50.
C. For handoff, the heart rate fell from 84 to 64, MAP was roughly stable (71 to 64), and diastolic pressure moved from 9 to 53. Systolic pressure ranged 25-166 and ended at 93, and SpO2 recovered to 94 after a low of 89 around hour 4.8. Respiratory rate ended at 20; the available labs showed white count fell from 21.0 to 15, creatinine stayed around 0.8, lactate was checked once at 2.0, and urine output fell from 290 to 46.
D. For handoff, the heart rate fell from 76 to 72, MAP fell from 62 to 56, and diastolic pressure moved from 13 to 44. Systolic pressure ranged 21-111 and ended at 92, and SpO2 recovered to 100 after a low of 84 around hour 3.0. Respiratory rate ended at 24; the available labs showed white count fell from 16.9 to 12.2, creatinine stayed around 1.1, lactate was checked once at 1.5, and urine output fell from 315 to 54.

Answer: B


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 94, diastolic pressure was roughly stable (67 to 77), and heart rate was roughly stable (107 to 109). The lowest MAP was about 71 around hour 12.4, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 22 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 40.2-41.4 C, white count was 14.4 on its only check, creatinine fell from 1.7 to 0.9, lactate was checked once at 2.4, and urine output was roughly stable (97 to 97)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 91, diastolic pressure was roughly stable (70 to 74), and heart rate was roughly stable (104 to 106). The lowest MAP was about 68 around hour 10.9, and the lowest valid SpO2 was 85 around hour 0.2; respiratory rate rose as high as 24 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 37.2-38.4 C, white count was 12.9 on its only check, creatinine fell from 1.5 to 1.1, lactate was checked once at 2.2, and urine output was roughly stable (100 to 100)
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 95, diastolic pressure was roughly stable (66 to 78), and heart rate was roughly stable (108 to 102). The lowest MAP was about 72 around hour 12.8, and the lowest valid SpO2 was 89 around hour 0.3; respiratory rate rose as high as 26 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 41.0-42.1 C, white count was 14.8 on its only check, creatinine fell from 1.8 to 1.2, lactate was checked once at 2.5, and urine output was roughly stable (96 to 150)
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 86, diastolic pressure was roughly stable (74 to 71), and heart rate was roughly stable (100 to 110). The lowest MAP was about 71 around hour 11.9, and the lowest valid SpO2 was 80 around hour 0.0; respiratory rate rose as high as 26 but ended at 13. The lower-frequency data fit that summary: temperature stayed around 32.7-33.9 C, white count was 10.7 on its only check, creatinine fell from 1.2 to 1.0, lactate was checked once at 1.9, and urine output was roughly stable (96 to 96)

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP stayed around 91, diastolic pressure was roughly stable (70 to 74), and heart rate was roughly stable (104 to 106). The lowest MAP was about 68 around hour 10.9, and the lowest valid SpO2 was 85 around hour 0.2; respiratory rate rose as high as 24 but ended at 15. The lower-frequency data fit that summary: temperature ranged from 98.9 to 101.2, white count was 12.9 on its only check, creatinine fell from 1.5 to 1.1, lactate was checked once at 2.2, and urine output was roughly stable (100 to 100)


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

Options:
A. Over the available measurements, the heart rate was roughly stable (75 to 74), MAP fell from 116 to 75, and diastolic pressure moved from 109 to 68. Systolic pressure ranged 91-150 and ended at 92, and SpO2 recovered to 88 after a low of 88 around hour 0.3. Respiratory rate ended at 37; the available labs showed white count fell from 15.4 to 14.1, creatinine was roughly stable (0.9 to 0.8), lactate was checked once at 0.9, and urine output rose from 40 to 350.
B. Over the available measurements, the heart rate was roughly stable (73 to 76), MAP fell from 114 to 78, and diastolic pressure moved from 111 to 66. Systolic pressure ranged 88-135 and ended at 88, and SpO2 recovered to 90 after a low of 86 around hour 1.3. Respiratory rate ended at 39; the available labs showed white count fell from 14.3 to 13.0, creatinine was roughly stable (1.0 to 0.7), lactate was checked once at 0.8, and urine output rose from 42 to 335.
C. Over the available measurements, the heart rate was roughly stable (79 to 70), MAP fell from 120 to 79, and diastolic pressure moved from 105 to 72. Systolic pressure ranged 95-175 and ended at 96, and SpO2 recovered to 84 after a low of 87 around hour 0.4. Respiratory rate ended at 33; the available labs showed white count fell from 17.3 to 13.3, creatinine was roughly stable (0.8 to 0.9), lactate was checked once at 1.0, and urine output rose from 90 to 375.
D. Over the available measurements, the heart rate was roughly stable (70 to 77), MAP fell from 112 to 70, and diastolic pressure moved from 114 to 65. Systolic pressure ranged 86-120 and ended at 88, and SpO2 recovered to 92 after a low of 84 around hour 0.1. Respiratory rate ended at 42; the available labs showed white count fell from 13.2 to 11.8, creatinine was roughly stable (1.1 to 0.7), lactate was checked once at 0.8, and urine output rose from 44 to 320.

Answer: A


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 88 to 66, diastolic pressure fell from 70 to 49, and heart rate rose from 70 to 169. The lowest MAP was about 69 around hour 8.6, and the lowest valid SpO2 was 51 around hour 19.1; respiratory rate rose as high as 28 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.9-36.4 C, white count was 16.6 on its only check, creatinine was 0.7 on its only check, lactate stayed broadly stable from 1.5 to 1.3, and urine output fell from 755 to 53.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 83 to 71, diastolic pressure fell from 65 to 50, and heart rate rose from 75 to 152. The lowest MAP was about 66 around hour 8.0, and the lowest valid SpO2 was 46 around hour 19.6; respiratory rate rose as high as 26 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 39.1-41.6 C, white count was 14.0 on its only check, creatinine was 0.9 on its only check, lactate stayed broadly stable from 1.1 to 1.0, and urine output fell from 790 to 48.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 89 to 65, diastolic pressure fell from 71 to 56, and heart rate rose from 69 to 174. The lowest MAP was about 72 around hour 7.0, and the lowest valid SpO2 was 52 around hour 18.7; respiratory rate rose as high as 29 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 33.1-35.6 C, white count was 17.0 on its only check, creatinine was 0.7 on its only check, lactate stayed broadly stable from 1.6 to 1.4, and urine output fell from 750 to 100.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 85 to 69, diastolic pressure fell from 67 to 52, and heart rate rose from 73 to 149. The lowest MAP was about 68 around hour 7.6, and the lowest valid SpO2 was 48 around hour 20.6; respiratory rate rose as high as 27 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36.9-39.4 C, white count was 15.1 on its only check, creatinine was 0.8 on its only check, lactate stayed broadly stable from 1.3 to 1.1, and urine output fell from 775 to 50.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 85 to 69, diastolic pressure fell from 67 to 52, and heart rate rose from 73 to 149. The lowest MAP was about 68 around hour 7.6, and the lowest valid SpO2 was 48 around hour 20.6; respiratory rate rose as high as 27 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 98.4 to 102.9, white count was 15.1 on its only check, creatinine was 0.8 on its only check, lactate stayed broadly stable from 1.3 to 1.1, and urine output fell from 775 to 50.


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 143 to 112, MAP fell from 85 to 69, and heart rate rose from 73 to 149. SpO2 started at 100, ended at 51, and fell as low as 48 around hour 20.6; respiratory rate ranged 14-27. For labs and output, white count was 15.1 on its only check, creatinine was 0.8 on its only check, lactate stayed broadly stable from 1.3 to 1.1, and urine output fell from 775 to 50.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 128 to 114, MAP fell from 83 to 67, and heart rate rose from 75 to 134. SpO2 started at 98, ended at 49, and fell as low as 46 around hour 21.7; respiratory rate ranged 13-28. For labs and output, white count was 16.2 on its only check, creatinine was 0.7 on its only check, lactate fell from 1.5 to 1.2, and urine output fell from 760 to 48.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 168 to 108, MAP fell from 89 to 73, and heart rate rose from 69 to 152. SpO2 started at 96, ended at 55, and fell as low as 52 around hour 18.7; respiratory rate ranged 16-29. For labs and output, white count was 13.2 on its only check, creatinine was 0.9 on its only check, lactate stayed broadly stable from 1.6 to 0.9, and urine output fell from 800 to 54.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 113 to 108, MAP fell from 80 to 72, and heart rate rose from 78 to 119. SpO2 started at 96, ended at 46, and fell as low as 47 around hour 22.9; respiratory rate ranged 12-29. For labs and output, white count was 17.4 on its only check, creatinine was 0.7 on its only check, lactate stayed broadly stable from 1.0 to 1.4, and urine output fell from 745 to 46.

Answer: A