Answer - C - Decreased appetite, weight gain, and constipation are indications that the client has Hashimoto’s disease, which is the most common cause of hypothyroidism. 41 years old is early for Hashimoto's onset but well within the range (40 to 60). According to the NIH, Hashimoto's is 4 to 10 times more common in women. Other signs and symptoms to watch for with Hashimoto's are lethargy, brittle nails, coarse hair, muscle cramps, weakness, and apnea. Choice A includes signs of hyperthyroidism. Symptoms presented in Choice B are characteristic of uncontrolled diabetes mellitus. Symptoms presented in Choice D are characteristic of hypercortisolism.