Consider the following events and arrange them into chronological order:
I. Eruption of lower central incisors
II. Closure time of anterior fontanelle
III. Appearance of physiological jaundice in baby
IV. Standing of infant without support.
Select the correct answer using the code given below.

1. A

   I, II, III, IV

2. B

   III, I, IV, II

3. C

   II, III, I, IV

4. D

   IV, III, II, I

Appeared in: UPPSC 2022

Explanation

• The correct sequence of events is based on standard infant developmental timelines.
• Physiological jaundice (III) is the first event, appearing 2-3 days after birth.
• Eruption of lower central incisors (I) follows, typically around 6-8 months.
• Standing without support (IV) is a gross motor skill achieved around 11-12 months.
• Closure of the anterior fontanelle (II) is the last event, occurring between 12-18 months to accommodate brain growth.

Why Other Options Were Wrong

• Option A: This option incorrectly places tooth eruption (I) and fontanelle closure (II) before physiological jaundice (III), which is one of the earliest neonatal events.
• Option C: This option incorrectly places the closure of the anterior fontanelle (II) as the first event. This is the last milestone in the list to be achieved.
• Option D: This option incorrectly starts with standing without support (IV), a milestone of a one-year-old, placing it before neonatal jaundice (III) and teething (I).

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Chronological order of infant developmental milestones as background academic context rather than a clinical decision trigger.
• Nurses use knowledge of developmental milestones to assess an infant's growth and identify potential developmental delays during health check-ups.
• Deviations from these timelines can indicate underlying health issues. For example, delayed tooth eruption could signal nutritional deficiencies, while early or late fontanelle closure can indicate problems with bone development or intracranial pressure.
• What if? If an infant's anterior fontanelle closes at 6 months, this is considered craniosynostosis (premature fusion of cranial sutures). The nurse must report this immediately as it can restrict brain growth and requires urgent neurosurgical evaluation.

How to Approach the Question

• First, identify the question type. This is a sequencing question that requires knowledge of infant developmental milestones.
• Analyze each event listed. Recall the typical age range for each milestone: physiological jaundice, first tooth eruption, standing alone, and anterior fontanelle closure.
• Mentally arrange the events from the earliest to the latest based on their timing: Jaundice (days), Teething (months), Standing (around 1 year), Fontanelle closure (12-18 months).
• Write down the sequence using the corresponding Roman numerals: III, I, IV, II.
• Finally, compare your derived sequence with the given options to find the correct match.

Concept Tested & Keywords

• Concept Tested: Chronological order of infant developmental milestones.
• Stem keywords: chronological order, Eruption of lower central incisors, Closure time of anterior fontanelle, Appearance of physiological jaundice, Standing of infant without support
• Lead-in keywords: Arrange, Select the correct answer
• Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

Question ID

QBtjBaIWaw5xDRcwFLNf6K

Copy ID

Reference Book

E6 Comprehensive Textbook of Community Health NursingShyamala D part 1 (pp 26-389 of 389) p. 300-302

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 24-26