A nurse performs a physical examination of a 24-month-old infant. The anterior fontanelle is open, soft, and flat. Which conclusion should the nurse make?

A. Increased intracranial pressure is suspected and requires immediate intervention: Signs of increased intracranial pressure include a bulging, tense fontanelle, irritability, vomiting, or changes in consciousness. A soft, flat fontanelle does not indicate elevated intracranial pressure. B. Delayed skull ossification is present and requires referral to the primary health care provider: Anterior fontanelle closure beyond 18 months may warrant evaluation for delayed ossification or underlying conditions, but at 24 months, a soft, flat fontanelle is slightly later than average but can still be within normal variation, especially in healthy toddlers. C. Closure of anterior fontanelle should have occurred by 6 months of age: The anterior fontanelle typically remains open well past 6 months. Closure by 6 months is early; most infants still have an open anterior fontanelle at that age. D. The anterior fontanelle normally closes between 12 and 18 months of age: The anterior fontanelle usually closes in this age range, but slight variation is common. A soft, flat fontanelle in a 24-month-old without other neurological signs is generally considered normal and not a cause for concern.