Ace the NCLEX 2026 – Hit the Books and Nail That Nursing Badge!

Bruising behind the ears, particularly after a head injury such as the one described, is indicative of a basilar skull fracture. This type of fracture involves the base of the skull and can lead to significant complications, including cerebrospinal fluid leakage and cranial nerve damage. The bruising observed behind the ears is often referred to as "Battle's sign," which specifically points to potential trauma to the base of the skull.

In contrast, although a clavicle fracture can cause significant pain and swelling, it is not associated with bruising behind the ears. A concussion typically presents with symptoms such as headache, confusion, dizziness, and other cognitive impairments, but not external bruising. An orbital fracture may lead to bruising around the eyes, known as "raccoon eyes," but does not explain bruising behind the ears. Therefore, the combination of the injury context and the specific signs noted strongly supports the diagnosis of a basilar skull fracture.