A nurse is assisting in the care of a newborn immediately following birth. The nurse notes mucus bubbling out of the newborn's mouth and nose. Which of the following actions should the nurse take first?

When mucus is bubbling from a newborn's mouth and nose immediately after birth, the priority action is to clear the airway to establish effective breathing. Suctioning the mouth first with a bulb syringe is the correct first step because the mouth has a larger volume and suctioning it first prevents aspiration of secretions that could be triggered if the nares are suctioned first, which may stimulate a gasp reflex. Suction mouth before nose — this is a standard mnemonic taught in newborn care. Deep suctioning with an endotracheal tube is invasive and reserved for situations where meconium is present or the newborn is not responding; it is not the first action for routine mucus. Trendelenburg positioning is no longer recommended as routine newborn positioning and would not directly clear secretions. Saline drops into the nares would add fluid to an already obstructed airway and are inappropriate as a first intervention for secretions visible at the mouth and nose. The bulb syringe provides gentle, effective suctioning that a nurse can perform immediately at the bedside without additional equipment or provider orders, making it the safest and most appropriate first action.