RRT Style Question And Apgar Scores Explanation Example 2

You at the delivery of a term infant delivery the mother has no risk factors.  At one minute of age the baby has a hr of 35, irregular rr effort, is limp ,has no reflexes and has a pale blue body. What would you recommend?

  1. Warm and stimulate the baby
  2. Monitor the baby to see if it improves on it’s own
  3. Apply blow by oxygen
  4. Start resuscitative efforts

For this question we need to know how to score an apgar and how to treat each apgar score.

Apgar scores are done at 1 and 5 minutes of birth.  A number is given to the newborn’s condition, all the values are added up.and the number provides evaluation of the infant and provides a guide for interventions.


012
HRAbsent<100 bpm>100 bpm
Respiratory AbsentSlow, irregularCrying
Muscle toneLimpSlight flexion ofextremitiesWell flexed
ReflexNo responseGrimaceCry, cough or sneeze
ColorPale blue colorCentral cyanosisBody pink but, extremities are blue acrocyanosispink
  • Apgar of 7-10, monitor patient
  • Apgar of  4-6 Dry and stimulate, provide oxygen with a bag and mask,CPAP
  • Apgar of 0-3 Provide resuscitation efforts

When do the apgar score it is 2, one point is for a hr less than 100 and one point for irregular respiratory effort. All rest of the categories score 0. With a an apgar of 2 we need to begin resuscitation efforts.

TMC Style Question And Apgar Scores Explanation Example 1

You are called to a delivery because there is suspected meconium.  You arrive approximately 2 minutes after the baby was born, the neonatal nurse says that the Apgar score was 9 at one minute of age, you examine the baby and agree with her assessment.  What would you do?

  1. Warm and stimulate the baby
  2. Monitor the baby
  3. Apply blow by oxygen
  4. Start resuscitation efforts

First we need to know what the range of apgar scores are and how we care for the infant in each range, see below.

Apgar of 7-10, monitor patient
Apgar of 4-6 Dry and stimulate, provide oxygen with a bag and mask,CPAP
Apgar of 0-3 Provide resuscitation efforts

The infant has an apgar of 9 so we would monitor the patient.

Just a reminder you need to know normal values and how to treat abnormal values for all conditions and diseases. Knowing the normal values aren’t enough. This was an example of an application style question, the most common type of question on the exam. For more information on the type of questions on the types of questions and how to study for here are my tips.