You are assessing a client for acute cholecystitis. What sign would you assess for?

Acute cholecystitis is an inflammatory condition of the gallbladder most commonly caused by cystic duct obstruction due to gallstones, leading to bile stasis, gallbladder wall inflammation, and visceral irritation. Clinical assessment relies on characteristic physical examination findings that reflect gallbladder inflammation and localized peritoneal irritation in the right upper quadrant. Rationale: A. Psoas sign is associated with appendiceal irritation, particularly retrocecal appendicitis. It is elicited by hip extension causing pain due to inflammation of the iliopsoas muscle. It is not related to gallbladder pathology and therefore not appropriate for assessing cholecystitis. B. Murphy sign is a key indicator of acute cholecystitis, elicited by deep palpation of the right upper quadrant during inspiration, causing abrupt inspiratory arrest due to gallbladder inflammation contacting the examiner’s hand. This reflects localized peritoneal irritation over the inflamed gallbladder. C. Obstipation refers to severe constipation with inability to pass stool or flatus, commonly seen in bowel obstruction. It is a gastrointestinal motility symptom and has no diagnostic relationship to gallbladder inflammation or right upper quadrant tenderness. D. Cutaneous hyperesthesia involves increased skin sensitivity, often associated with herpes zoster or nerve irritation. While it may occur in some visceral conditions, it is not a specific or reliable clinical sign for diagnosing acute cholecystitis.