Given expression is

Recall that the order of operations is
1. Paratheses
2. Exponents.
3. Multiplication.
4. Division.
5. Addition.
6. Subtraction.
First, we need to solve inside the paratheses.
LCM of 4 and 2 is 4, making the denominator 4, we get




Second, we need to solve multiplication.
Multiply 3 and 6, we get

Multiply 4 and 1, we get

Third, we need to solve division.
Divide 4 into 4, we get

Fourth, we need to solve addition.
Add 1 and 18, we get

Hence the answer is 19.
Option A is correct.