Which of the following is a common symptom of lung cancer?

Appeared in: OSSSC Nursing Officer-2021

Explanation

A new, persistent cough (lasting more than a few weeks) is the most frequent symptom of lung cancer.
A change in the character of a chronic cough, often seen in smokers, is a significant warning sign and should not be ignored.
The cough may start as dry and non-productive but can become productive if an airway obstruction leads to infection.

Option B: Wheezing indicates airway obstruction, which can be caused by a tumor, but it is not as common as a cough.
Option C: The key descriptor is 'foamy'. While blood-tinged sputum (hemoptysis) is a symptom of lung cancer, pink and frothy sputum is a hallmark sign of acute pulmonary edema, typically associated with heart failure.
Option D: Dyspnea (shortness of breath) is a very common symptom of lung cancer, but a cough is generally reported as the most frequent and often the earliest sign.

Clinical Relevance

Nursing practice connection: Knowing Identifying the most common presenting symptom of lung cancer helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a crucial role in patient education, particularly for high-risk individuals like smokers, emphasizing that a new or changing cough requires prompt medical evaluation.
Early detection of lung cancer, often prompted by investigating a persistent cough, is critical as it significantly improves the chances of successful treatment and survival.
What if? If a patient with a chronic cough also reports hoarseness, facial swelling, and distended neck veins, the nurse should suspect Superior Vena Cava (SVC) syndrome, an oncologic emergency requiring immediate intervention.

How to Approach the Question

First, identify the core of the question, which is asking for the 'common' or most frequent symptom of lung cancer.
Evaluate each option based on your knowledge of the pathophysiology of lung cancer.
Recall that tumors in the airways are a common presentation, and the body's primary reflex to clear the airway is coughing.
Differentiate between the options. While dyspnea and hemoptysis are also symptoms, a persistent cough is documented as the most frequent initial complaint.
Critically analyze combined descriptions like 'foamy, blood-tinged sputum'. The word 'foamy' points to a different condition (pulmonary edema), making this option less likely to be the correct answer for lung cancer.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 17-19

E6 Medicine Macleod Clinical Examination 15e p. 95-97

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