Which of the following symptoms are most characteristic of a patient with cancer of the lungs?

HPSSC - 2015

Medical & Surgical Nursing

Hard

Appeared in: HPSSC - 2015

Explanation

A persistent cough or a notable change in a chronic cough is the most frequent and often the earliest symptom of lung cancer.
This symptom is frequently ignored by patients, who may attribute it to smoking or a simple respiratory infection, making it a critical red flag for nurses to identify.
The cough may initially be dry and non-productive but can change in character, frequency, or sound as the disease progresses or causes an airway obstruction.

Option A: While dyspnea (shortness of breath) is a common symptom in lung cancer, exertional dyspnea is non-specific and is also a primary symptom of many other cardiopulmonary conditions like COPD and heart failure.
Option B: The term 'air hunger' describes a severe, desperate feeling of needing to breathe, often associated with acute respiratory distress or advanced congestive heart failure.
Option D: The combination of a persistent cough and drenching night sweats is a classic presentation for an infectious disease, most notably tuberculosis (TB).

Clinical Relevance

Nursing practice connection: Use the key finding related to Characteristic signs and symptoms of lung cancer to guide bedside assessment, documentation, and the next nursing action.
Nurses have a vital role in patient assessment. A thorough history focusing on any new cough or change in a chronic 'smoker's cough' is essential for early detection of lung cancer.
Patient education is key. Nurses should advise patients, especially those with risk factors like a history of smoking, to seek prompt medical evaluation for any persistent or changing cough.
What if? If the patient with a persistent cough also reports hemoptysis (coughing up blood), the suspicion for lung cancer (or TB) increases significantly. This finding necessitates urgent referral for investigation, typically starting with a chest X-ray.

How to Approach the Question

First, identify the core of the question: it asks for the 'most characteristic' symptom, which means you need to find the sign most specifically linked to lung cancer, not just any possible symptom.
Evaluate each option for its specificity. Think about which conditions are associated with each symptom.
Recall that a new, persistent cough or a change in a long-standing cough is the most common initial presentation of lung cancer.
Eliminate the distractors. 'Exertional dyspnoea' is too general. 'Air hunger' points to acute distress or heart failure. 'Cough with night sweats' is a classic sign of tuberculosis.
Conclude that the 'persistent changing cough' is the most specific and frequent early indicator of lung cancer among the choices.

Concept Tested & Keywords

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