A newborn is evaluated at 1 and 5 minutes following bih. Evaluation of the infant at 5 minutes showed pink body and blue extremities, hea rate of 90, with slow respiratory effo actively moving the extremities and was coughing when catheter was inseed into nostril. What is the APGAR score of the infant at 5 minutes?

**Core Concept**
The APGAR score is a method of assessing the health of a newborn child immediately after birth, considering five components: Appearance, Pulse, Grimace, Activity, and Respiration. This score helps healthcare providers identify newborns who may need additional medical care.

**Why the Correct Answer is Right**
The APGAR score is calculated by evaluating each of the five components and assigning a score of 0, 1, or 2, depending on the infant's condition. In this case, the infant has a pink body and blue extremities, indicating some difficulty with circulation (1 point for Appearance). The heart rate is 90, which is lower than the normal range of 100-140 beats per minute (1 point for Pulse). The infant grimaces when the nostril is stimulated, indicating a normal response (1 point for Grimace). The infant is actively moving the extremities, indicating some level of muscle tone (1 point for Activity). However, the infant is having slow respiratory efforts, indicating some difficulty with breathing (1 point for Respiration).

**Why Each Wrong Option is Incorrect**
**Option A:** This option would require the infant to have a perfect score in all five components, which is highly unlikely.
**Option B:** This option would require the infant to have a score of 0 in one or more components, which is not consistent with the information provided.
**Option C:** This option would require the infant to have a score of 2 in one or more components, which is not consistent with the information provided.

**Clinical Pearl / High-Yield Fact**
The APGAR score is not a definitive predictor of a newborn's long-term health, but it can help identify infants who may need additional medical care. A score of 7 or higher is generally considered normal, while a score of 4 or lower may indicate the need for resuscitation.

**Correct Answer: D. 7.**