Family Nurse Practitioner Exam

A 70-year-old male patient is being evaluated for persistent cough. What should be prioritized in his assessment?

1. History of smoking

2. Family history of lung disease

3. Allergy history

4. Medication review

The correct answer is: History of smoking

In the assessment of a 70-year-old male patient with a persistent cough, prioritizing the history of smoking is crucial. Smoking is a significant risk factor for various respiratory conditions, including chronic obstructive pulmonary disease (COPD), lung cancer, and other pulmonary diseases. Given the age of the patient, the likelihood of smoking-related complications increases, making this history essential in determining the underlying cause of the cough. Gathering a comprehensive smoking history can help identify potential exposure to carcinogens or irritants that could contribute to chronic respiratory symptoms. It also aids in risk stratification for diseases common among smokers, guiding further evaluation and management options. Understanding the extent and duration of the smoking history allows the healthcare provider to assess the risk of various pulmonary diagnoses, warranting appropriate diagnostic testing and interventions. While family history of lung disease, allergy history, and medication review can be relevant, they may not have as direct of an impact on the immediate assessment and management of coughing in a patient with significant smoking history. Each of these aspects can be explored following the completion of a thorough smoking history and initial evaluation of the cough's etiology.