A newborn is limp, cyanotic, and not responding to stimulation. What action should you take?

In the scenario where a newborn is limp, cyanotic, and unresponsive to stimulation, the most appropriate initial action is to ventilate with a bag-valve mask. Newborns in this condition often require immediate assistance with breathing, which is critical for restoring adequate oxygenation.

Ventilating with a bag-valve mask allows for the administration of positive pressure ventilation, which can help provide the necessary oxygen to the lungs, facilitating the revival of the newborn's color and responsiveness. The cyanosis indicates that the baby is not receiving enough oxygen, so addressing ventilation is crucial.

While it's important to consider the possibility of chest compressions if the newborn shows no signs of breathing or heart rate, the first step prioritizes ensuring that oxygen is delivered. This immediate intervention can have a significant impact on the newborn’s condition.

Other interventions like administering oxygen via nasal cannula or providing direct stimulation are not suitable as initial steps in this distressing situation, as they would not adequately address the pressing need for respiratory support. Furthermore, chest compressions are typically warranted only if there is evidence of severe bradycardia or cardiac arrest, which should be assessed after ensuring adequate ventilation.