Which of the following symptoms is most characteristic of a patient with a cancer of the lung?

BHU NO - 2015

Medical & Surgical Nursing

Easy

Appeared in: BHU NO - 2015

Explanation

A persistent or new cough that does not go away is the most common and often the earliest symptom of lung cancer.
The cough is caused by the tumor irritating, compressing, or obstructing the bronchial airways.
Unlike symptoms of acute infections, this cough persists and may change in character over time, for example, becoming more frequent or producing blood.
While other symptoms like dyspnea or chest pain are common, a persistent cough is considered the most characteristic initial sign.

Option A: The term 'air hunger' is a sensation of suffocation more commonly described by patients with congestive heart failure rather than lung cancer.
Option B: Exertional dyspnea (shortness of breath with activity) is a very common and non-specific symptom. It is an early sign of many different underlying lung and heart diseases, including COPD, asthma, and heart failure, not just lung cancer.
Option C: The combination of a persistent cough and drenching night sweats is the classic presentation for tuberculosis (TB). While night sweats can be a constitutional symptom of malignancy, they are not the most characteristic feature of lung cancer when combined with a cough.

Clinical Relevance

Nursing practice connection: Use the key finding related to Identifying the most characteristic symptom of lung cancer to guide bedside assessment, documentation, and the next nursing action.
A key nursing responsibility is to conduct a thorough health history. Asking about the onset, duration, and character of a cough is crucial for identifying red flags for lung cancer.
Patient education should emphasize the importance of not ignoring a persistent cough, especially for individuals with a smoking history, and seeking timely medical evaluation.
What if? If a patient with a persistent cough also reports hemoptysis (coughing up blood), the suspicion for lung cancer increases dramatically, and this finding requires urgent investigation.

How to Approach the Question

First, identify the core of the question, which asks for the 'most characteristic' symptom of lung cancer. This implies you need to find the most specific and common sign among the options.
Evaluate each option's association with lung cancer. A persistent cough is a direct local effect of a tumor in the airway.
Consider the other options in the context of differential diagnosis. 'Air hunger' points more towards heart failure. 'Exertional dyspnea' is very general. 'Cough with night sweats' is a classic sign of tuberculosis.
Eliminate the less specific symptoms or those more characteristic of other common diseases.
Select the symptom that is most directly and consistently linked to the pathophysiology of lung cancer, which is the persistent cough caused by bronchial irritation.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 104-105

E6 Medicine Macleod Clinical Examination 15e p. 96-98