B is the correct answer.
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This patient is most likely suffering from a Bell’s palsy secondary to herpes zoster flare. Bell’s palsy is classically described as paralysis of facial muscles due to trauma/inflammation of the facial nerve, CN VII. There are a few etiologies of Bell’s palsy which include various herpes viral infections, Lyme disease, HIV, and sarcoidosis. In addition to facial muscle paralysis, there other symptoms associated with damage to the facial nerve. The facial nerve is a mixed nerve that contain fibers to salivary glands, afferent fibers for taste, and efferent fibers to the stapedius muscle in the middle ear. The stapedius muscle functions to control the amplitude of sound waves transmitted to the inner ear by stabilizing the stapes. Paralysis of the stapedius will result in hyperacusis (choice B) in which normal sounds are perceived to be louder. The inability to abduct the right eye (choice A) suggests paralysis of the lateral rectus muscle which is innervated by CN VI. CN VI should be not be affected in CN VII inflammation. Presbycusis (choice C) is progressive hearing loss usually found in the elderly. High-frequency sounds are preferentially lost first. Voice hoarseness (choice D) can be observed in unilateral damage to the recurrent laryngeal nerve. The RLN is a branch of the vagus nerve, CNX, that carries fibers from the spinal accessory nerve, CNXI. Anosmia (choice E) is the loss of olfactory sense. Although facial nerve inflammation can affect sense of taste, sense of smell, CN I, in unlikely to be affected.