In an obese patient with a BMI of 42.7 kg/m2, which physical exam finding is most likely expected?

In obese patients, particularly those with a BMI significantly above the normal range, physical examination may reveal several characteristic findings. Increased lumbar lordosis is often observed due to the excess weight that alters the center of mass and affects posture. The additional weight can lead to an anterior pelvic tilt, which causes the lumbar spine to curve more excessively, resulting in increased lordosis. This compensatory mechanism helps to maintain balance and posture despite altered body weight distribution.

While an increased respiratory rate may occur in some instances due to obesity-related respiratory issues, it is not a definitive finding. Furthermore, obesity is typically linked with hypoventilation rather than straightforward increases in respiratory rate. A decreased heart rate is generally not associated with obesity; in fact, obesity can often lead to increased heart rates due to increased demand on the cardiovascular system. Similarly, blood pressure typically rises rather than decreases in obese individuals due to factors such as vascular resistance and increased cardiac output from excess body mass.

Thus, the expected finding of increased lumbar lordosis directly correlates with the physical changes induced by obesity, making it the most appropriate choice in this scenario.