Nurse Grace is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?
A. Rashes on the palms of the hands and soles of the feet.
B. Cauliflower-like warts on the penis.
C. Painful red papules on the shaft of the penis.
D. Foul-smelling discharge from the penis.
Correct Answer: D. Foul-smelling discharge from the penis
Symptoms of gonorrhea in men include purulent, foul-smelling drainage from the penis and painful urination. The most common clinical manifestations of gonococcal disease in males include penile purulent discharge, dysuria, and testicular discomfort. Although many females, more than 50%, will not manifest symptoms of their gonococcal cervix infections, most males, more than 90%, will manifest urogenital gonorrhea symptomatically.
Option A: Rashes on the palms of the hands and soles of the feet are symptoms of the secondary stage of syphilis. The clinical manifestations of secondary syphilis result from hematogenous dissemination of the infection and are protean: condyloma lata (papulosquamous eruption), hands and feet lesions, macular rash, diffuse lymphadenopathy, headache, myalgia, arthralgia, pharyngitis, hepatosplenomegaly, alopecia, and malaise.
Option B: Cauliflower-like warts on the penis are a sign of human papillomavirus. Examine the anogenital region. Patients may additionally require a speculum examination of the vaginal walls and/or anus. Men may require an examination of the urethra, depending on signs and symptoms. Depending on the history of sexual practices, and oropharyngeal examination may be prudent.
Option C: Painful red papules on the shaft of the penis may be a sign of the first stage of genital herpes. The classical features are macular or papular skin and mucous membrane lesions progressing to vesicles and pustules that often last for up to 3 weeks. Genital lesions can be especially painful, leading to swelling of the vulva in women, burning pain, and dysuria.
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