we have the function
f(x)= 4x2 + 9x +4
so
step 1
Find f(x+h)
f(x+h)=4(x+h)^2+9(x+h)+4
f(x+h)=4(x^2+2xh+h^2)+9x+9h+4
f(x+h)=4x^2+8xh+4h^2+9x+9h+4
step 2
Find {f(x+h)-f(x)}/h
substitute
{f(x+h)-f(x)}/h={4x^2+8xh+4h^2+9x+9h+4-4x^2-9x-4}/h
simplify
{f(x+h)-f(x)}/h={8xh+4h^2+9h}/h
simplify h
{f(x+h)-f(x)}/h=8x+4h+9
therefore
the answer is
8x+4h+9