While performing a hearing assessment on an older adult client, the nurse suspects otitis externa. What symptom is most commonly associated with otitis externa that the nurse should inquire about during the assessment?

Choice A reason: Tinnitus refers to ringing or buzzing in the ears. While tinnitus can occur with various ear conditions such as sensorineural hearing loss or inner ear disorders, it is not the hallmark symptom of otitis externa. Otitis externa is primarily an infection of the external auditory canal, and tinnitus is not the most common presenting complaint. Choice B reason: Bluish discoloration is typically associated with cyanosis or vascular compromise. It is not a feature of otitis externa, which is an inflammatory condition of the external ear canal. Discoloration of this type would suggest systemic hypoxia or circulatory issues rather than localized infection. Choice C reason: Pain and swelling are the most characteristic symptoms of otitis externa. The infection causes inflammation of the external ear canal, leading to edema, tenderness, and discomfort, especially when the ear is manipulated. This symptom is the most reliable indicator for the nurse to assess when suspecting otitis externa. Choice D reason: Hearing loss can occur in otitis externa, but it is usually secondary to swelling or debris obstructing the canal rather than being the primary symptom. It is less common compared to pain and swelling, which are the direct manifestations of the infection.