What finding would the nurse expect for a client diagnosed in the primary stage of syphilis?

In the primary stage of syphilis, the hallmark finding is the presence of genital chancres. These chancres are painless ulcers that typically appear at the site of infection, which can be on the genitalia, anus, or mouth. The development of these lesions occurs about three weeks after exposure to the syphilis bacteria, Treponema pallidum.

This stage is characterized by the singular presence of a chancre, which is an important clinical sign that helps in the diagnosis of syphilis. The ulceration has well-defined edges and is not painful, distinguishing it from other types of sores or ulcers that might arise from different infections or conditions.

In contrast, gummas, a type of lesion associated with tertiary syphilis, do not develop during the primary stage. A palmar rash is more commonly associated with secondary syphilis, which occurs after the primary stage and is characterized by systemic symptoms and widespread skin manifestations. Central nervous system lesions are also indicative of advanced syphilis, specifically tertiary syphilis, and would not be expected until later stages of the disease progression. Thus, the presence of genital chancres is the definitive finding expected in a client diagnosed in the primary stage of syphilis.