APGAR Scoring System Practice Exam

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1. You are assessing the one minute APGAR score for a newborn. She is pink all over and has a pulse of 130. As you dry her off she begins to cry vigorously and kick her legs. Her APGAR score is

  1. 7
  2. 8
  3. 9
  4. 10

2. A neonatal patient has a pink color, a pulse rate of 102, and a respiration rate of 27. She grimaces in response to stimuli, has limited muscle movement. This patient has an APGAR score of

  1. 6
  2. 7
  3. 8
  4. 9

3. A newborn has a strong cry and is actively moving his blue extremities when stimulated. Vital signs are P140, R48. What is his APGAR score

  1. 7
  2. 8
  3. 9
  4. 10

4. What is a typical one minute APGAR score for a newborn

  1. 4-6
  2. 5-7
  3. 7-9
  4. 8-10

5. It has been 5 minutes since your patient delivered her baby. The infant is crying weakly and is curling his arms and legs. He is pink all over with a pulse of 90 and weak respirations. What is his APGAR score

  1. 4
  2. 5
  3. 6
  4. 7

6. After assisting in the delivery of a newborn the infant is pale and limp, has a slow heartbeat but shows some respiratory effort. What APGAR score would you give this infant

  1. 1
  2. 2
  3. 3
  4. 4

7. You just delivered a baby boy. His body is pink, but his hands and feet are blue. Vital signs are P110, R rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His APGAR score is

  1. 7
  2. 8
  3. 9
  4. 10

8. A newly delivered infanthas a pink trunk and blue hands and feet, pulse rate of 60 and does not respond to your attempts to stimulate her. She also appears to be limp and taking slow, gasping breaths. What is her APGAR score

  1. 3
  2. 4
  3. 5
  4. 6

9. One minute after birth, your newborn patient is actively crying in response to your bulb syringe. His body is pink, and he is moving his extremities which are blue. His heart rate is 110. What is the newborns APGAR score

  1. 7
  2. 8
  3. 9
  4. 10

10. Starting at which number on the APGAR score should you need to start resuscitation efforts

  1. 4
  2. 5
  3. 6
  4. 7

11. A nurse in a newborn nursery receives a phone call to prepare for the admission of a 43-week-gestation newborn with Apgar scores of 1 and 4. In planning for the admission of this infant, the nurse’s highest priority should be to:

  1. Connect the resuscitation bag to the oxygen outlet
  2. Turn on the apnea and cardiorespiratory monitors
  3. Set up the intravenous line with 5% dextrose in water
  4. Set the radiant warmer control temperature at 36.5* C (97.6*F)

12. The primary critical observation for Apgar scoring is the:

  1. Heart rate
  2. Respiratory rate
  3. Presence of meconium
  4. Evaluation of the Moro reflex

13. When performing a newborn assessment. the nurse should measure the vital signs in the following sequence:

  1. Pulse. respirations. temperature
  2. Temperature. pulse. respirations
  3. Respirations. temperature. pulse
  4. Respirations. pulse. temperature

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

  1. 100 and 180
  2. 130 and 170
  3. 120 and 160
  4. 100 and 130

15. The expected respiratory rate of a neonate within three (3) minutes of birth may be as high as:

  1. 50
  2. 60
  3. 80
  4. 100
Answers & Rationales
  1. D.10
  2. B.7
  3. C.9
  4. D.8-10
  5. C.6
  6. B.2
  7. A.7
  8. A.3
  9. C.9
  10. C.6
  11. A. Connect the resuscitation bag to the oxygen outlet. The highest priority on admission to the nursery for a newborn with low Apgar scores is airway, which would involve preparing respiratory resuscitation equipment. The other options are also important, although they are of lower priority.
  12. A. Heart rate. The heart rate is vital for life and is the most critical observation in Apgar scoring. Respiratory effect rather than rate is included in the Apgar score; the rate is very erratic.
  13. D. Respirations. pulse. temperature. This sequence is least disturbing. Touching with the stethoscope and inserting the thermometer increase anxiety and elevate vital signs.
  14. C. 120 and 160. The heart rate varies with activity; crying will increase the rate. whereas deep sleep will lower it; a rate between 120 and 160 is expected.
  15. B. 60. The respiratory rate is associated with activity and can be as rapid as 60 breaths per minute; over 60 breaths per minute are considered tachypneic in the infant.