Practice Quiz

CPM Certified Professional Midwife

Category - Labor, Birth, and Immediate Postpartum

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A 37 - week female newborn is born to a 28 - year - old female through cesarean birth. A midwife assesses the newborn a minute after birth for APGAR scoring. The following assessment findings are obtained: flexed arms and legs with limited active movement; a pulse rate of 90 beats per minute; grimacing observed after inserting a tube through one of the nostrils; bluish skin tone, including the extremities; and slow, irregular breaths. Which of the following is the next action of the midwife?
  1. Initiate immediate resuscitation.
  2. Change the newborn’s position and wrap her loosely with a warm blanket.
  3. Initiate clearing of the airways and oxygen therapy.
  4. Obtain another APGAR score in 5 minutes.
Explanation
Answer: C - The next action of the midwife 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.
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