A 66-year-old woman presents to the nurse practitioner with complaints of dyspnea, syncope, and palpitations. She believes she is having anxiety, but she has no history of mental health issues and is undergoing no major stressors. Which findings on physical exam would lead the NP to suspect atrial fibrillation?

Choice A reason: Atrial fibrillation typically presents with a rapid, irregularly irregular pulse, often exceeding 100 bpm. A rate of 157 indicates tachyarrhythmia consistent with AF. Choice B reason: Hypotension may result from AF complications but is not diagnostic by itself. Choice C reason: Bradycardia (pulse 43) is inconsistent with typical AF, which is usually tachyarrhythmic unless on rate-controlling medications. Choice D reason: Hypertension alone does not confirm AF; the irregular tachycardic pulse is the key finding.