APGAR Scoring System

Notes

The APGAR Scoring System was developed by Dr. Virginia APGAR as a method of assessing the newborn’s adjustment to extrauterine life. It is taken at one minute and five minutes after birth. With depressed infants, repeat scoring every five minutes as needed. The one minute score indicates the necessity for resuscitation. The five minute score is more reliable in predicting mortality and neurologic deficits. The most important is the heart rate, then the respiratory rate, the muscle tone, reflex irritability and color follows in decreasing order. A heart rate below 100 signifies an asphyxiated baby and a heart rate above 160 signifies distress.APGAR Scoring System

 
Assess 0 1 2
Appearance (Skin color) Blue all over Body pink, extremities blue Pink all over
Pulse (Heart Rate) Absent Below 100 Above 100
Grimace (Reflex Irritability) No Response Grimace Vigorous cry
Activity (Muscle Tone) Flaccid Some flexion Active motion
Respiration (Breathing) Absent Slow Good crying

SCORE:

  • 7-10 Good adjustment, vigorous
  • Moderately depressed infant, needs airway clearance
  • Severely depressed infant, in need of resuscitation

Source: Outline in Obstetrics, 2004 Edition by Maria Loreto J. Evangelista-Sia

Exam

Welcome to your APGAR Scoring System Practice Exam! This exam is carefully curated to help you consolidate your knowledge and gain deeper understanding on the topic.

 

Exam Details

  • Number of Questions: 15 items
  • Mode: Practice Mode

Exam Instructions

  1. Practice Mode: This mode aims to facilitate effective learning and review.
  2. Instant Feedback: After each question, the correct answer along with an explanation will be revealed. This is to help you understand the reasoning behind the correct answer, helping to reinforce your learning.
  3. Time Limit: There is no time limit for this exam. Take your time to understand each question and the corresponding choices.

Remember, this exam is not just a test of your knowledge, but also an opportunity to enhance your understanding and skills. Enjoy the learning journey!

 

Click 'Start Exam' when you're ready to begin. Best of luck!

💡 Hint

Peak heartbeats early, but not too high.

1 / 15

1. Within three (3) minutes after birth the normal heart rate of the infant may range between:

💡 Hint

Resuscitation efforts often begin at a specific score to address issues with the newborn's vital signs and overall condition.

2 / 15

2. Nurse Alex is evaluating a newborn using the APGAR score. At what score should Nurse Alex consider starting resuscitation efforts?

💡 Hint

Consider which vital sign is most crucial and heavily weighted in the Apgar scoring system.

3 / 15

3. Nurse Jenna is conducting an Apgar assessment on a newborn. What is the primary critical observation that should be evaluated?

💡 Hint

Consider which vital signs are most likely to be affected by the order in which they are measured in a newborn.

4 / 15

4. Nurse Kate is performing a newborn assessment. In what sequence should she measure the newborn’s vital signs?

💡 Hint

Remember to evaluate each APGAR category: activity, pulse, grimace, appearance, and respiration, assigning points based on the findings.

5 / 15

5. Nurse Williams is assessing a newborn immediately after birth. The baby has a strong cry, is actively moving his blue-tinged extremities when stimulated, and has vital signs showing a pulse of 140 and respiratory rate of 48. What APGAR score should Nurse Williams assign?

💡 Hint

Each APGAR criterion scores between 0 and 2 points. Consider how the newborn’s activity, color, heart rate, reflexes, and respiratory effort fit into these categories.

6 / 15

6. Nurse Sara is assessing a newborn one minute after birth. The baby responds with an active cry to a bulb syringe, has a pink body with blue extremities, is moving his arms and legs, and has a heart rate of 110. What APGAR score should Nurse Sara assign?

💡 Hint

Consider that newborns often have a higher respiratory rate immediately after birth as they transition to breathing independently.

7 / 15

7. Nurse Lisa is assessing the respiratory rate of a neonate within three minutes of birth. What is the maximum expected respiratory rate during this time?

💡 Hint

Evaluate the criteria of the APGAR score, including heart rate, respiratory effort, muscle tone, reflex response, and color.

8 / 15

8. Nurse Ellen is assessing a newborn 5 minutes after delivery. The baby is weakly crying, has a heart rate of 90, is pink all over, and shows some flexion in his arms and legs with weak respirations. Based on these observations, what APGAR score should Nurse Ellen assign?

💡 Hint

Focus on the immediate needs of a newborn with low Apgar scores and what critical steps should be taken to ensure their survival.

9 / 15

9. Nurse Lynn is preparing for the admission of a 43-week-gestation newborn with reported Apgar scores of 1 and 4. Considering the newborn's condition, what should be Nurse Lynn's highest priority action?

💡 Hint

Think about the criteria for the APGAR score, focusing on appearance, pulse, reflex irritability, activity, and respiration.

10 / 15

10. Nurse Thompson is conducting the one-minute APGAR assessment on a newborn. The baby is pink all over, has a heart rate of 130 beats per minute, and begins to cry vigorously while kicking her legs as she is being dried off. What APGAR score should Nurse Thompson assign?

💡 Hint

Consider each APGAR category—appearance, pulse, grimace, activity, and respiration—and assign the appropriate points for each.

11 / 15

11. Nurse Adams is evaluating a newborn's condition one minute after birth. The baby is pink, has a pulse of 102, and is breathing at a rate of 27 breaths per minute. She grimaces when stimulated but shows limited muscle movement. What APGAR score should Nurse Adams assign?

💡 Hint

Consider the criteria for color, muscle tone, heart rate, and respiratory effort when assigning the APGAR score.

12 / 15

12. Nurse Clara is evaluating a newborn shortly after delivery. The infant appears pale and limp, has a slow heart rate, but is showing some effort to breathe. Based on these observations, what APGAR score should Nurse Clara assign?

💡 Hint

Pay close attention to the heart rate, respiratory effort, muscle tone, reflex response, and skin color to calculate the APGAR score.

13 / 15

13. Nurse Kelly is assessing a newborn who has just been delivered. The infant’s trunk is pink, but her hands and feet are blue. She has a pulse rate of 60, does not respond to stimulation, appears limp, and is taking slow, gasping breaths. What APGAR score should Nurse Kelly assign?

💡 Hint

The APGAR score is assessed at one minute and five minutes after birth, evaluating the newborn's physical condition. A typical healthy score reflects good activity and respiration.

14 / 15

14. Nurse Taylor is reviewing the common range for a healthy newborn's one-minute APGAR score during a staff meeting. What is considered a typical APGAR score for a newborn at one minute?

💡 Hint

Evaluate each APGAR category individually—appearance, pulse, grimace, activity, and respiration—to determine the total score.

15 / 15

15. Nurse Jamie has just delivered a baby boy. The infant’s body is pink, but his hands and feet are blue. His heart rate is 110, his respirations are rapid and irregular, he gives a weak cry when stimulated, and he resists attempts to straighten his legs. What APGAR score should Nurse Jamie assign?