What finding is most consistent with hyperthyroidism on a patient's physical exam?

A goiter is indeed a finding that is most consistent with hyperthyroidism. Hyperthyroidism is characterized by an overproduction of thyroid hormones, which can lead to various metabolic changes and physical findings. A goiter refers to an enlargement of the thyroid gland, which can occur in conditions like Graves' disease, the most common cause of hyperthyroidism. In Graves' disease, the autoimmune stimulation of the thyroid leads to its enlargement and increased hormone production, which is often palpable during a physical examination.

The other options describe symptoms or findings that are typically associated with different conditions. Bradycardia, or a slow heart rate, is more common in hypothyroidism, where thyroid hormone levels are low. Weight gain is also associated more often with hypothyroidism due to a slower metabolism, whereas hyperthyroidism usually leads to weight loss. Additionally, dry skin is characteristic of hypothyroidism, as inadequate levels of thyroid hormone can impair skin hydration and metabolism. Thus, the presence of a goiter is the most indicative physical exam finding in a patient with hyperthyroidism.