CNM Certified Nurse Midwife

Answer: C - The next action of the nurse is to initiate clearing of the airways and oxygen therapy. The newborn has an APGAR of 4, calculated as follows: flexed arms and legs with limited active movement = 1; pulse rate below 100 beats per minute = 1; grimacing after inserting a tube through one of the nostrils = 1; bluish skin tone, including the extremities = 0; slow, irregular breaths = 1. An APGAR score of 4 to 6 indicates that the newborn requires oxygen therapy. An APGAR score of less than 4 indicates that the newborn needs immediate resuscitation. An APGAR score greater than 6 indicates well-being of the newborn. Options B and D are most appropriate for a newborn who has an APGAR score between 7 and 10.