During a physical exam of otitis media, which of the following findings might be observed?

In the context of otitis media, the observation of bulging of the tympanic membrane (TM) is a key finding. This occurs due to the accumulation of fluid and pressure behind the TM caused by inflammation or infection in the middle ear. The bulging indicates that there is an increased pressure in the ear, often due to the presence of pus or serous fluid, which is characteristic of an ear infection.

In contrast, a clear TM suggests that there is no fluid present and does not align with the diagnosis of otitis media. Fluid-filled sinuses are not directly associated with the TM or middle ear but rather indicate sinus issues. Redness in the sclera pertains to eye health and does not correlate with the findings typically associated with otitis media. Therefore, bulging of the TM is the definitive and relevant finding during a physical exam for this condition.