Twenty-five years Photoshop experience here. I studied that image, because something about it didn't gel.

It's a reasonably well put together fake, until one looks at his right thumb. You can see a highlight all around it. That wouldn't happen if the whole thing was just one shot. It would fall into shadow there. Also, too much light on the papers in front of him.

The whole thing has a very carefully setup, yet casual look to it. Fake photo of a fake president.