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 and irregular heartbeat. A pulse rate of 157 beats per minute is tachycardic and may indicate AF, especially in the context of palpitations, dyspnea, and syncope. Choice B reason: Low blood pressure may be associated with multiple cardiac conditions but is not specific for AF. Choice C reason: Bradycardia is generally not associated with typical atrial fibrillation unless there is a conduction defect or medication effect. Choice D reason: Elevated blood pressure alone is not diagnostic of atrial fibrillation. It may be a chronic condition or a comorbidity.