A 39-year-old female client presents to the nurse practitioner with complaints of depression, fatigue, weight gain, sensitivity to cold, and dry skin and hair. What are other expected findings in a patient with hypothyroidism?

Choice A reason: Buffalo hump, easy bruising, and abdominal striae are hallmark features of Cushing's syndrome, which results from excess cortisol. These findings are not associated with hypothyroidism, which is characterized by a slowing of metabolic processes rather than hypercortisolism. Choice B reason: Periorbital puffiness, bradycardia, and changes in blood pressure (decreased systolic and increased diastolic) are consistent with hypothyroidism. These symptoms reflect fluid retention, reduced cardiac output, and systemic vascular resistance changes due to low thyroid hormone levels. Bradycardia is a classic cardiovascular manifestation of hypothyroidism due to decreased sympathetic tone. Choice C reason: Increased systolic blood pressure, decreased diastolic pressure, tachycardia, and moon facies are more indicative of hyperthyroidism or Cushing's syndrome. Tachycardia and widened pulse pressure are not typical in hypothyroidism, which tends to cause bradycardia and narrowed pulse pressure. Choice D reason: An enlarged thyroid gland and protruding eyeballs (exophthalmos) are features of Graves' disease, a form of hyperthyroidism. Hypothyroidism does not typically present with these findings unless it follows treatment for Graves' disease, in which case ophthalmopathy may persist.