A nurse is reinforcing teaching about sexual activity during pregnancy for a client in a monogamous, same-sex relationship. Which of the following statements should the nurse make?

A. "Our child has increased his daily caloric intake." Methylphenidate is a stimulant that commonly suppresses appetite, leading to decreased caloric intake and potential weight loss. An increase in appetite would not indicate medication effectiveness but might suggest the dose is too low or the medication is wearing off.
B. "Our child is able to complete his homework on time." Methylphenidate is used to improve attention, impulse control, and focus in children with ADHD. The ability to complete tasks, such as finishing homework on time, demonstrates improved concentration and executive functioning, which indicates the medication is working effectively.
C. "Our child has a better grasp of reality." ADHD is not primarily associated with a loss of reality testing, as seen in psychotic disorders. While methylphenidate improves focus and impulse control, it does not target symptoms such as delusions or hallucinations.
D. "Our child has lost some weight since his last appointment." Weight loss is a common side effect of methylphenidate due to appetite suppression. While this can be monitored, it does not indicate medication effectiveness in treating ADHD symptoms.

A. Anterior fontanel closed. The anterior fontanel typically closes between 12 to 18 months of age. Closure at 4 months is premature and may indicate conditions such as craniosynostosis, which can affect skull and brain development. The provider should be notified for further evaluation.
B. Moves objects to mouth. This is an expected developmental milestone for a 4-month-old infant. At this age, infants begin to grasp objects and bring them to their mouths as part of their sensory exploration.
C. Rolls from back to abdomen. Most infants begin rolling from back to abdomen around 5 to 6 months. If a 4-month-old achieves this milestone early, it is not necessarily concerning but rather an indication of advanced motor development.
D. Posterior fontanel closed. The posterior fontanel typically closes between 6 to 8 weeks of age, so closure by 4 months is expected and does not require provider notification.