When inspecting the ears of a toddler without the use of an otoscope, which action should the nurse take?

Rationale: A. Note location of the pinna in relation to the eye: Observing the external ear for proper placement and symmetry provides important information about possible congenital abnormalities. This can be done without an otoscope and is a safe initial assessment. B. Pull the pinna up and back during visualization: Pulling the pinna up and back is required for otoscopic examination of the ear canal and tympanic membrane, not for inspection without an otoscope. Attempting this without visualization may cause discomfort or injury. C. Examine the tympanic membrane for swelling: Examination of the tympanic membrane requires an otoscope. Without the device, the nurse cannot accurately assess the membrane for swelling or other pathology. D. Observe color and appearance of ear drum: Similar to swelling assessment, observing the color and appearance of the tympanic membrane requires an otoscope. Visual inspection without it only allows assessment of external structures.