The nurse is performing an examination of a patient's ears.Which of the following findings needs immediate referral to a specialist?

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A skull fracture of the temporal bone causes cerebrospinal fluid to leak from the ear canal.Cerebrospinal fluid feels oily and gives a positive glucose reaction on TesTape or Dextrostix.This finding warrants immediate referral to a neurologist or neurosurgeon.Purulent drainage from an ear usually indicates an ear infection,but the patient does not need to be referred to a specialist immediately.An ear that looks like a cauliflower is called perichondrial hematoma and is a common condition among wrestlers and boxers.It is caused by blunt trauma to the external ear resulting in a blood clot formation and fluid collection under the perichondrium.Auricular pain or tenderness is a common finding in external ear infections and is called acute otitis externa.

The Nurse Is Performing an Examination of a Patient's Ears