A client presents with several ulcerative sores on his penis that are firm, round, and painless. He also has rough, reddish brown spots on his palms and the bottoms of his feet
He acknowledges that he is sexually active with multiple partners and is inconsistent in his use of a condom. Which sexually transmitted infection should the nurse most suspect in this client?
A) Gonorrhea
B) Chlamydia
C) Syphilis
D) Human papillomavirus
Ans: C
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Syphilis is primarily indicated by ulcerative sores occurring mainly on the external genitals, vagina, anus, or in the rectum, although they can occur on the lips or in the mouth. The sore is usually firm, round, and painless. Rashes associated with secondary syphilis appear as rough, red, or reddish brown spots both on the palms of the hands and/or the bottoms of the feet. Infections with Neisseria gonorrhoeae, like those resulting from Chlamydia trachomatis, cause several clinical syndromes including urogenital, pharyngeal, and rectal infections in males and females, and conjunctivitis in adults and neonates. Chlamydia is known as a "silent" infection because most infected people are asymptomatic and lack abnormal physical examination findings. Men who are symptomatic typically have urethritis, with a mucoid or watery urethral discharge and dysuria. A minority of infected men develop epididymitis (with or without symptomatic urethritis), presenting with unilateral testicular pain, tenderness, and swelling. Human papillomavirus infections, if manifest, are primarily indicated by genital warts.
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