Free BCEN Certified Emergency Nurse (CEN) Practice Question

A right upper quadrant ultrasound is the most appropriate initial diagnostic test for suspected cholecystitis. It is highly sensitive and specific for detecting gallstones, biliary sludge, gallbladder wall thickening, and pericholecystic fluid, which are indicative of cholecystitis. An abdominal CT scan may be useful for assessing complications or alternative diagnoses but is not the first-line imaging modality for cholecystitis. A hepatobiliary (HIDA) scan is typically reserved for cases where the diagnosis is uncertain after ultrasound. MRCP is also used in complex cases or when further biliary tree assessment is needed, but not as the initial test.