"The pain gets worse when I lie down.”.

Choice A rationale:

"I feel a sharp pain in my ear sometimes.”.

This statement suggests intermittent ear pain, which can occur in otitis media when there is a sudden change in pressure in the middle ear.

It is a possible symptom, but it is not specific to otitis media as other ear conditions can also cause sharp ear pain.

Choice B rationale:

"My ear hurts all the time.”.

Constant ear pain is a common symptom of acute otitis media.

The pain is caused by inflammation and pressure in the middle ear.

This symptom is indicative of otitis media but does not provide specific information about the pain worsening when lying down, which is a crucial aspect to assess.

Choice C rationale:

"The pain gets worse when I lie down.”.

This statement is indicative of otitis media.

When the child lies down, the fluid in the middle ear can put additional pressure on the eardrum, causing increased pain.

This worsening of pain in specific positions helps differentiate otitis media from other ear conditions.

Choice D rationale:

"I have no pain in my ear.”.

Absence of ear pain is not consistent with otitis media.

Otitis media is characterized by ear pain, especially in acute cases when there is inflammation and pressure in the middle ear.

Lack of ear pain suggests the absence of this condition.