A nurse is caring for a 3-year-old client who has persistent otitis media. To help identify contributing factors, the nurse should ask the parents which of the following questions?

A. Exposure to environmental tobacco smoke (passive smoking) is a known risk factor for otitis media, as it can irritate the upper respiratory tract and increase susceptibility to respiratory infections, including those affecting the ears. B. Excessive earwax buildup can sometimes contribute to ear discomfort or hearing problems but it is not a common cause of persistent otitis media. However, it's still important for the nurse to assess for any earwax issues as part of the overall assessment of the child's ear health. C. Drinking water is generally beneficial for overall health but is not directly linked to otitis media unless there are specific concerns about hydration status or exposure to contaminated water sources. D. Water entering the ears during bathing is not generally considered a significant risk factor for otitis media, but it can be associated with otitis externa, which is an infection of the outer ear canal.