Evolve Maternity Practice Test 2026 - Free Maternity Practice Questions and Study Guide

To determine the Apgar score for the neonate, it is essential to evaluate the five criteria: heart rate, respiration, muscle tone, reflex response, and skin color, each scored from 0 to 2 points.

In this case, the neonate has a heart rate of 90 beats per minute, which is scored as 1 point because a heart rate below 100 beats per minute falls into the 'below normal' category.

The strong cry indicates good respiratory effort, which would score 2 points.

For muscle tone, assuming the neonate is moving well or at least showing some flexion (which is generally expected in a healthy neonate), that is scored as 2 points.

The reflex response is typically scored based on response characteristics (like grimacing), so if this neonate cries strongly, it likely indicates a decent reflex response scoring 2 points.

Skin color is also taken into account; if the neonate is pink (with perhaps bluish extremities, which is not uncommon), they would receive 1 point for peripheral cyanosis but 2 points for overall skin color being generally good.

Adding these scores together:

1 (heart rate) + 2 (respiration) + 2 (