Arrange the following movements of the fetal head during delivery in the correct order:

(a) Rotation
(b) Engagement
(c) Restitution
(d) Extension and delivery
(e) Descent and flexion

1. A

   c, e, a, d, b

2. B

   b, e, a, d, c

3. C

   b, a, e, d, c

4. D

   c, e, d, a, b

Appeared in: IGNOU PB Bsc Nsg.Entrance-2026

Explanation

• The correct sequence of the cardinal movements of labor is essential for a successful vaginal delivery.
• The process begins with the fetal head entering the pelvis (Engagement).
• This is followed by the head moving down and tucking its chin (Descent and Flexion).
• The head then turns to align with the pelvic outlet (Internal Rotation).
• Next, the head extends to pass under the pubic bone and is delivered (Extension).
• Finally, the head realigns with the shoulders after delivery (Restitution).

Why Other Options Were Wrong

• Option A: This sequence (c, e, a, d, b) incorrectly starts with Restitution (c), which is one of the final movements after the head is delivered.
• Option C: This sequence (b, a, e, d, c) incorrectly places Rotation (a) before Descent and Flexion (e). Internal rotation occurs after the head has descended and flexed.
• Option D: This sequence (c, e, d, a, b) incorrectly starts with Restitution (c) and ends with Engagement (b). Engagement is the first movement, and restitution is one of the last.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The concept tested is the correct sequence of the cardinal movements of labor, which describes the positional changes of the fetal head during delivery as background academic context rather than a clinical decision trigger.
• Understanding the cardinal movements is fundamental for nurses and midwives to accurately assess the progress of labor.
• It allows healthcare providers to identify labor dystocia (abnormal or difficult labor) if the movements do not occur as expected, prompting timely interventions.
• Knowledge of this sequence helps in anticipating the next stage of labor and preparing for delivery, including potential maneuvers to assist if there is a delay in a specific movement.

How to Approach the Question

• This is a sequencing question that requires recalling a physiological process.
• First, identify the topic: the cardinal movements of the fetal head during delivery.
• Recall the steps in the correct order. A helpful mnemonic is: Every Darn Fetus Is Extremely Eager to Exit (Engagement, Descent, Flexion, Internal Rotation, Extension, External Rotation/Restitution, Expulsion).
• Match the given items (a, b, c, d, e) to the steps of the mnemonic.
• (b) Engagement -> E
• (e) Descent and Flexion -> D, F

Concept Tested & Keywords

• Concept Tested: The concept tested is the correct sequence of the cardinal movements of labor, which describes the positional changes of the fetal head during delivery.
• Stem keywords: fetal head, delivery, movements, correct order
• Lead-in keywords: Arrange

Question ID

QDIBYhqlDVxm6eBoWr61z8

Copy ID

Reference Book

E6 Obstetrics Williams p. 21-39