The anterior fontanel in children closes between?

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

The anterior fontanel is the larger, diamond-shaped soft spot on the top of an infant's skull.
Its primary function is to allow for the significant growth of the brain that occurs during the first year of life.
Normal closure of the anterior fontanel occurs between 9 and 18 months of age.
The option 'One and a half years of age' is equivalent to 18 months, which falls within the expected range for closure.

Option B: One and a half months (6 weeks) is too early for the anterior fontanel to close. This timeframe is closer to the closure of the posterior fontanel.
Option C: Two weeks is an incorrect and abnormally early time for any fontanel to close. Closure this early would be a sign of craniosynostosis.
Option D: One month is too early for the anterior fontanel to close. While the posterior fontanel may be closing around this time, the anterior fontanel remains widely open to accommodate brain growth.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pediatric Developmental Milestones: Fontanel Closure as background academic context rather than a clinical decision trigger.
Fontanel assessment is a key nursing skill in pediatrics. A sunken fontanel is a critical sign of dehydration, while a bulging fontanel can indicate dangerous increases in intracranial pressure.
Nurses must educate parents about the normal 'soft spot' and reassure them, while also teaching them to report signs like bulging, sinking, or rapid changes in head size.
What if? If a 2-year-old child presents with a still-open anterior fontanel, the nurse should suspect delayed closure and anticipate orders for investigating underlying conditions like hypothyroidism or rickets.

How to Approach the Question

First, identify the key term in the question: 'anterior fontanel'.
This is a factual recall question that tests your knowledge of pediatric developmental milestones.
Mentally differentiate between the anterior and posterior fontanels, as they have very different closure times. The anterior is larger and closes much later.
Recall the normal timeframe for anterior fontanel closure (9-18 months).
Evaluate the given options against this timeframe. 'One and a half years' is 18 months, which is the upper limit of the normal range.
Eliminate the other options as they are all significantly too early and more closely related to the posterior fontanel's closure or are simply incorrect.

Concept Tested & Keywords

QZ-2uJf3ifr9xw0GUyj6DC

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

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1357-1359

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Attempt every question from this paper in a timed mock, then review the full solution for each one.