During an assessment of a 20-year-old African-American's external auditory meatus, the nurse notes the presence of cerumen.

What is the significance of this finding?

Choice A rationale

Cerumen, or earwax, is a normal physiological secretion produced by the apocrine and sebaceous glands in the external auditory canal. While excessive or impacted cerumen can lead to conductive hearing loss or harbor bacterial growth, its mere presence, especially in a healthy individual, is not indicative of an external ear infection. An infection would typically present with pain, redness, discharge, or fever.

Choice B rationale

Cerumen is a natural substance composed of exfoliated skin cells, fatty acids, cholesterol, and lysozymes. It serves a protective role by lubricating the ear canal, trapping dust and foreign particles, and possessing antibacterial and antifungal properties. Its presence in the external auditory meatus, as observed in this patient, is a normal physiological finding.

Choice C rationale

While skin conditions like eczema can affect the external ear canal and lead to inflammation, itching, and scaling, the presence of cerumen alone does not indicate eczema lesions. Eczema would typically present with characteristic erythematous, pruritic, and possibly weeping or crusted lesions, which are distinct from normal cerumen.

Choice D rationale

Cerumen production is a normal bodily function and its presence is not an indicator of poor hygiene. Attempts to excessively clean the ear canal with cotton swabs can actually push cerumen deeper, leading to impaction, rather than indicating poor hygiene. The ear is generally self-cleaning, with cerumen naturally migrating out of the canal.