A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? (Select all that apply.)

Rationale: A. Moon face: Rounded facial appearance, commonly called moon face, occurs due to fat redistribution associated with cortisol excess. This is one of the characteristic physical features of Cushing’s syndrome. B. Purple striations: Striae on the abdomen, thighs, and breasts appear as purple or violaceous streaks because elevated cortisol weakens skin integrity and causes collagen breakdown. These striations are a classic sign of Cushing’s syndrome. C. Buffalo hump: Fat accumulation on the upper back and between the shoulders forms the buffalo hump. This results from abnormal fat redistribution caused by prolonged hypercortisolism. D. Tremors: Tremors are not a common feature of Cushing’s syndrome. They are more commonly associated with hyperthyroidism, stimulant use, or neurological conditions rather than cortisol excess. E. Hypertension: Elevated cortisol levels increase vascular sensitivity to catecholamines, promoting sodium and water retention. This leads to persistent hypertension, which is a frequent manifestation of Cushing’s syndrome.