A nurse is completing an otoscopic examination on a 3-year-old child brought in with a fever and "pulling at the left ear for 2 days.” What should the nurse anticipate on examination of the left ear?

Choice A reason: A flat and slightly pulled membrane with a cone of light at 5 o’clock is a normal finding in the right ear. This does not indicate infection or inflammation. Choice B reason: An erythematous, bulging membrane with an absent cone of light is the expected finding in otitis media. The bulging and redness indicate inflammation and fluid accumulation behind the tympanic membrane, while the absent cone of light confirms abnormality. This matches the child’s symptoms of fever and ear pain. Choice C reason: A bright red membrane with a cone of light at 7 o’clock would be a normal finding in the left ear if the membrane were otherwise translucent. Bright red color alone could indicate irritation, but the presence of a cone of light suggests normality, not infection. Choice D reason: A translucent and pearly gray membrane with a prominent cone of light is the normal appearance of a healthy tympanic membrane. This would not be expected in a child with fever and ear pain.