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The presence of a Cushingoid appearance and hypertension serves as a direct indicator of excessive steroid therapy. When steroids are administered in higher than therapeutic doses or over an extended period, they can lead to a condition known as Cushing's syndrome. This syndrome is characterized by physical changes such as facial rounding, increased fat deposits on the back and abdomen, and thinning of the skin, collectively referred to as Cushingoid features.

Hypertension is also commonly observed due to the mineralocorticoid effects of corticosteroids, which can lead to sodium retention and fluid overload, contributing to increased blood pressure. Recognizing these signs is crucial for nursing care, as it allows for timely intervention to adjust corticosteroid dosages and monitor for potential complications associated with long-term steroid therapy.

The other options do not typically correlate with excessive steroid therapy. For instance, weight loss and lethargy might be seen in conditions of adrenal insufficiency rather than excess steroid levels. Increased appetite accompanied by low blood pressure suggests a different pathophysiology unrelated to steroid excess. Dry skin and hair loss do not specifically indicate excessive steroid use either, as they can arise from various other conditions.