Final answer:
The initial symptom an elderly patient with pneumonia may manifest is often a d) cough, which is the body's response to clear fluid from the alveoli.
Step-by-step explanation:
Pneumonia is a disease in which the alveoli of the lungs become inflamed and filled with fluid, leading to symptoms such as cough, chest pain, fever, and difficulty breathing.
While all the symptoms listed are associated with pneumonia, the initial symptom that an elderly patient may manifest is often a cough. Coughing occurs as the body's response to the fluid in the alveoli, attempting to clear the obstruction and improve breathing.