In assessing the Apgar score of a neonate after 5 minutes, which signs indicate 2 points each?

In the Apgar scoring system, each of the five criteria—heart rate, respiratory effort, muscle tone, reflex irritability, and color—receives a score from 0 to 2, with a maximum possible score of 10. Two points are awarded for signs that indicate normal or optimal function.

The sign indicating reflex irritability has a scoring criterion where a strong cry or active withdrawal in response to stimulation is awarded 2 points. A strong cry demonstrates that the neonate is responsive and has a healthy neurological function, which is an important aspect of the overall health assessment shortly after birth.

In contrast, the other signs listed do not meet the criteria for 2 points. For example, absent heart rate and flaccid muscle tone indicate serious issues, deserving 0 points. Similarly, a weak cry represents an inadequate respiratory response, meriting only 1 point. Thus, the only sign that aligns with the award of 2 points is the presence of a strong cry, reflecting a healthy degree of reflexive activity in the neonate.