A nurse is caring for a child who has acute otitis media. Which of the following classic assessment findings should the nurse expect?

A. Itching and tenderness when manipulating the affected ear lobe is more characteristic of an external ear infection (otitis externa) rather than acute otitis media. B. Fullness in the ear and a clogged sensation might be experienced in acute otitis media, but it usually occurs with systemic signs of infection such as fever and pain. C. Edema and erythema of the external canal only would indicate an external ear infection (otitis externa), not otitis media, which affects the middle ear. D. Pulling on the affected ear, acute onset of fever, and otalgia (ear pain) are classic signs of acute otitis media. Children often pull or tug at the affected ear in response to pain.