The Nurse Is Performing a Focused Interview with a Client

The nurse is performing a focused interview with a client who has been cleaning the ears with a cotton-tipped applicator. Which complications of this practice will the nurse include in the teaching session for this client? Select all that apply.

A) Increasing risk of developing otitis externa.
B) Developing tophi along the outer rim of the ears.
C) Perforating the tympanic membrane.
D) Needing tympanostomy tubes.
E) Impacting cerumen.