At 1 minute after birth, the nurse assesses the newborn to a…

At 1 minute after birth, the nurse assesses the newborn to assign an Apgar score. The apical heart rate is 110 beats/minute, and the infant is crying and gags when suctioned.  His limbs are flexed and active. The infant’s trunk is pink, but the hands and feet are blue. The Apgar score for this infant is: