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Quizzes > Health & Medicine

Apgar Score Quiz: What Is and Is Not Assessed at Birth

Test your knowledge of Apgar scale components in minutes. Instant results.

Editorial: Review CompletedCreated By: Jill ArnoldUpdated Aug 28, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration showing Apgar score chart newborn embryo stages on dark blue background for quiz.

This Apgar Score quiz helps you review what the newborn test measures at one and five minutes and spot what it does not, so you can check understanding before exams or clinical practice. For more practice, try our intrapartum nclex quiz, take a quick vital signs quiz, or refresh with a nursing assessment test.

What does the 'A' in the Apgar score stand for?
Appearance
Artery
Airway
Activity
The first 'A' in Apgar refers to the newborn's Appearance, specifically skin color evaluation. It assesses whether the baby is pink, blue, or pale. Proper color indicates good oxygenation.
What is the maximum total score possible on the Apgar scale at 1 minute after birth?
6
10
8
12
Each of the five Apgar criteria is scored from 0 to 2, giving a maximum total of 10. Scores range from 0 (severe distress) to 10 (best condition). A 1-minute score assesses initial adaptation.
At 1-minute Apgar assessment, a baby has blue extremities but a pink body. What score does this receive for Appearance?
2
1
0
3
Blue extremities with a pink trunk is termed acrocyanosis and scores 1 for Appearance. A score of 2 requires all pink skin, while 0 is pale or blue all over. Acrocyanosis is common in newborns.
A heart rate over 100 beats per minute on the Apgar scale scores what value for Pulse?
0
3
2
1
Pulse over 100 beats per minute receives the highest Apgar sub-score of 2. A heart rate under 100 bpm scores 1, and absence of heartbeat scores 0. This reflects good cardiovascular function.
Which of the following is NOT one of the five Apgar criteria?
Pulse
Blood pressure
Grimace
Appearance
The Apgar score uses Appearance, Pulse, Grimace, Activity, and Respiration. Blood pressure is not assessed in this scale. The acronym APGAR comes from these five elements.
The Apgar score is most commonly assessed at which two time points after birth?
1 and 5 minutes
2 and 6 minutes
0 and 1 minute
1 and 10 minutes
Apgar scores are routinely recorded at 1 and 5 minutes after birth to evaluate immediate adaptation. If low, additional scores may be taken at 10, 15, and 20 minutes. The 5-minute score is most predictive of outcomes.
Under the Activity component of Apgar, what does a score of 2 indicate?
Some flexion of extremities
Active motion
No movement
Flaccid muscle tone
Active motion with spontaneous movement of arms and legs receives the highest score of 2. Some flexion scores 1, and limp or no movement scores 0. Muscle tone reflects neuromuscular status.
In the Apgar scoring system, what does the 'G' (Grimace) assess?
Muscle tone
Reflex irritability
Respiratory effort
Heart rate
Grimace evaluates reflex irritability, typically a response to stimulation such as a mild pinch. No response scores 0, grimace scores 1, cough or sneeze scores 2. It assesses neurological function.
During embryonic development, the fertilized egg divides to form a solid ball of cells known as the:
Blastocyst
Zygote
Morula
Trilaminar disc
Around day 3 post-fertilization, cell division produces a 16 - 32 cell solid sphere called the morula. The blastocyst forms later when a fluid-filled cavity appears. Morula means 'mulberry' in Latin.
Implantation of the blastocyst into the uterine lining typically occurs how many days after fertilization?
6-10 days
2-3 days
15-18 days
12-14 days
The blastocyst attaches to and invades the endometrium around days 6 to 10 post-fertilization. This is a critical window for establishing blood supply. Failed implantation leads to early pregnancy loss.
Which germ layer gives rise to the lining of the respiratory and digestive tracts?
Ectoderm
Endoderm
Trophoblast
Mesoderm
The endoderm forms the epithelial lining of the gut tube and associated organs, including respiratory and digestive tracts. Ectoderm becomes nervous system and skin, mesoderm forms muscle and skeleton.
The epiblast and hypoblast layers form during which stage of embryogenesis?
Gastrulation
Bilaminar disc
Morula
Blastocyst
During the second week after fertilization, the inner cell mass differentiates into two layers forming the bilaminar embryonic disc: epiblast and hypoblast. Gastrulation follows in week three.
A newborn with slow, irregular breathing receives what score for the Respiration component?
2
0
1
3
Slow or irregular respiration without strong crying scores 1 on the Apgar scale. Good, robust crying and regular breathing score 2, whereas no breathing scores 0.
Which maternal condition can artificially lower a neonate's Apgar score at 1 minute?
Gestational diabetes
Maternal hypothyroidism
Use of regional anesthesia
Iron deficiency anemia
Regional anesthesia such as epidurals or spinal blocks can depress neonatal muscle tone and respiratory drive, lowering the 1-minute Apgar score. Effects usually dissipate by the 5-minute assessment.
In the Apgar scale, complete limpness of muscle tone scores what for Activity?
1
0
2
3
No movement or flaccid muscle tone scores 0 under the Activity criterion. Some flexion scores 1, and active motion scores 2. This assesses neuromuscular integrity.
What Apgar score would a baby receive for Grimace if it coughs or sneezes during stimulation?
2
1
3
0
An infant that coughs, sneezes, or pulls away vigorously when stimulated scores 2 for Grimace (reflex irritability). A mere grimace scores 1, and no response scores 0.
Which of the following substances detected in maternal blood confirms early pregnancy post-implantation?
Estrogen
hPL
hCG
Progesterone
Human chorionic gonadotropin (hCG) is produced by the syncytiotrophoblast after implantation. It is the hormone detected by pregnancy tests. Estrogen and progesterone also rise but are not diagnostic early.
The primitive streak appears on the embryo around which day of development?
Day 15
Day 7
Day 3
Day 21
The primitive streak forms at about day 15 of embryogenesis, marking the start of gastrulation. It establishes bilateral symmetry and germ layer formation. Abnormalities here can lead to serious defects.
Neural crest cells originate from which embryonic germ layer?
Ectoderm
Endoderm
Mesoderm
Extraembryonic
Neural crest cells arise at the border of the neural plate (ectoderm) during neurulation. They migrate extensively to form peripheral nerves, pigment cells, and facial structures.
The allantois contributes primarily to the formation of which structure in the fetus?
Umbilical cord
Placental barrier
Yolk sac
Amniotic fluid
The allantois forms part of the fetal contribution to the umbilical cord and early urinary bladder. It is an extraembryonic membrane important for blood vessel formation.
During which weeks of gestation is the fetal heart most vulnerable to teratogens?
Weeks 1-2
Weeks 11-14
Weeks 7-10
Weeks 3-6
The critical period for cardiac development is between weeks 3 and 6 of gestation when major heart structures form. Exposure to teratogens during this window can cause congenital heart defects.
A neonate with a heart rate below 100 bpm on Apgar is scored how?
0
2
1
3
A heart rate under 100 beats per minute receives a score of 1 if present but slow, and 0 if absent. Over 100 bpm scores 2. This reflects immediate cardiovascular adaptation.
Which Apgar component is most directly affected by neuromuscular disorders in newborns?
Pulse
Grimace
Appearance
Activity
Neuromuscular disorders primarily impair muscle tone and spontaneous movement, which are assessed under the Activity criterion. Affected infants often score 0 or 1 here. Other components remain less impacted.
Preterm infants often have lower Apgar scores than term infants primarily because of which factor?
Maternal blood type
Placental abruption
Fetal weight
Underdeveloped lungs
Preterm infants have immature pulmonary function leading to weak respiratory effort and low muscle tone, which lowers Apgar scores. Lungs mature late in gestation, affecting respiration and reflexes.
The fluid-filled cavity of the blastocyst is called the:
Trophoblast
Blastocoel
Archenteron
Morula
The blastocoel is the central fluid-filled cavity of the blastocyst that forms after the morula stage. It separates the inner cell mass from the trophoblast. The archenteron appears later in gastrulation.
0
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Study Outcomes

  1. Understand Apgar Scale Criteria -

    Gain a clear grasp of the five factors assessed in the Apgar Scale and their role in evaluating newborn health through this apgar scale quiz.

  2. Apply Newborn Reflex Assessment -

    Practice scoring reflex responses such as grimace, activity, and respiration to sharpen your newborn reflex assessment skills.

  3. Evaluate Exclusions in the Apgar Scale -

    Tackle questions like "the apgar scale evaluates all of the following except" to test your recall and reasoning about what the scale does not measure.

  4. Apply Apgar Scoring to Clinical Scenarios -

    Use hypothetical newborn cases to calculate Apgar scores accurately and interpret results in a clinical context.

  5. Describe Embryonic Development Milestones -

    Identify key stages of organ formation and differentiation during early embryonic development quiz content.

  6. Differentiate Preterm Development Stages -

    Contrast characteristics of preterm versus full-term infants to recognize critical developmental differences in preterm development stages.

Cheat Sheet

  1. Apgar Scale Components Mnemonic -

    Use the mnemonic "A P G A R" to remember Appearance, Pulse, Grimace, Activity, Respiration - each scored 0 - 2 at 1 and 5 minutes post-birth (source: AAP guidelines). For example, "2 Perfused pink body" for Appearance scores a full 2. This trick boosts recall when preparing for an apgar scale quiz.

  2. Understanding "All of the Following Except" -

    Recall that the apgar scale evaluates all of the following except core body temperature or birth weight (source: WHO clinical guidelines). This exclusion question style sharpens your ability to identify non-assessed factors so you won't get tripped up in a quiz. Practice identifying correct and distractor items ahead of your apgar scale quiz to master exclusion questions.

  3. Organogenesis in the Embryonic Period -

    During weeks 3 - 8 post-fertilization, primary organ systems form in a process called organogenesis (source: NIH embryology archive). For example, neural tube closure occurs by week 4, and the heart tube begins beating by week 6. Review these timeline milestones and test yourself with an embryonic development quiz.

  4. Preterm Development Stages and Assessment -

    Preterm neonates born before 37 weeks classify into late preterm (34 - 36 weeks), moderate (32 - 34), very (28 - 32), and extremely preterm (≤28) (source: WHO preterm birth report). Each stage impacts lung maturity and reflex responses such as the Moro reflex. Incorporate this preterm development stages breakdown into flashcards for newborn reflex assessment drills.

  5. Reflex Responses in Newborns -

    Key reflexes - rooting, sucking, Moro, and grasp - signal neurological integrity and should appear within the first month of life (source: AAP Pediatrics). For instance, the Moro reflex peaks at 1 month and fades by 3 - 6 months. Use a comparison table of onset and integration ages when reviewing for both the apgar scale quiz and newborn reflex assessment.

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