R C I S C E R T I F I C AT I ON E X A M I NAT I ON PR E PA R AT I ON
GLOWACKI &
SOMMERS
RCIS Questions | With Complete Solutions
A comprehensive certification examination for
cardiovascular invasive technology and registry review:
150 scenario-based, application, and analysis questions
with complete solutions, mapped to the eleven domains
of the CCI RCIS Exam Content Outline and current
catheterization laboratory standards.
30 9 Q UES T IO NS · CO M P LET E S O LUT IO NS · 55 PAGES
Cardiovascular Invasive Technology & Registry
Review
C C I EXAM C ONTENT OU TLINE ALIG NED · 2026/ 2027 EDITION
,RCIS Certification Examination | Glowacki & Sommers 2026/2027 CCI Exam Content Outline Aligned
GLOWACKI & SOMMERS (RCIS QUESTIONS)
309 QUESTIONS | WITH COMPLETE SOLUTIONS | 55 PAGES | 2026/2027
Comprehensive Certification Examination - Cardiovascular Invasive Technology & Registry Review - Aligned with the CCI
RCIS Exam Content Outline, Invasive Cardiovascular Technology Competencies, and Cath Lab Standards
Section 1: Cardiovascular Anatomy & Physiology
Questions 1-20 | Complete Solutions
Q1. Which cardiac chamber receives venous blood from the coronary sinus?
A. Left atrium
B. Right ventricle
C. Right atrium [CORRECT]
D. Left ventricle
Correct Answer: C
Rationale: The coronary sinus, the principal venous drainage channel of the heart, empties deoxygenated blood
directly into the right atrium through the coronary sinus ostium located between the inferior vena cava and the
tricuspid valve annulus. The left atrium receives pulmonary venous blood, and the ventricles receive inflow from
their respective atria. This is core knowledge from the CCI RCIS content outline domain of Cardiovascular
Anatomy and Physiology, cardiac venous anatomy subsection.
Q2. Which of the following lists the normal sequence of cardiac electrical activation in the correct
order?
A. SA node, AV node, bundle of His, bundle branches, Purkinje fibers [CORRECT]
B. AV node, SA node, bundle branches, bundle of His, Purkinje fibers
C. SA node, bundle of His, AV node, Purkinje fibers, bundle branches
D. Bundle of His, SA node, AV node, bundle branches, Purkinje fibers
Correct Answer: A
Rationale: The impulse originates in the sinoatrial node, conducts to the atrioventricular node where
physiological delay occurs, then traverses the bundle of His, the right and left bundle branches, and finally the
Purkinje fibers, which deliver the impulse to ventricular myocardium. Every other choice inverts or scrambles
this physiologic cascade. The CCI RCIS content outline requires command of the conduction system sequence
because it underpins intracardiac electrogram interpretation in the cath lab.
Cardiovascular Invasive Technology & Registry Review 1
,RCIS Certification Examination | Glowacki & Sommers 2026/2027 CCI Exam Content Outline Aligned
Q3. During a diagnostic catheterization, a patient's blood pressure rises acutely from 130/80 mmHg to
170/100 mmHg. Baroreceptor activation in the carotid sinuses and aortic arch would be expected to
produce which compensatory response?
A. Increased sympathetic outflow, raising heart rate and contractility
B. Decreased parasympathetic outflow with vasoconstriction
C. Increased renin release from the kidneys
D. Increased vagal tone with decreased heart rate and vasodilation [CORRECT]
Correct Answer: D
Rationale: Rising pressure stretches the carotid sinus and aortic arch baroreceptors, increasing afferent firing to
the medulla, which raises parasympathetic (vagal) tone and suppresses sympathetic outflow, lowering heart rate,
contractility, and vascular resistance. Choices A and B describe the opposite direction of reflex change, and
renin release (choice C) is a slower hormonal response, not the acute baroreceptor reflex. This physiology from
the CCI RCIS outline on blood pressure regulation and cardiac innervation explains why lab hypertension is
often transient and why vasovagal responses move in the reverse direction.
Q4. A patient's ventriculogram demonstrates a left ventricular end-diastolic volume of 130 mL and an
end-systolic volume of 50 mL. What is the ejection fraction?
A. 38%
B. 50%
C. 62% [CORRECT]
D. 77%
Correct Answer: C
Rationale: Ejection fraction equals stroke volume divided by end-diastolic volume: (130 - 50) / 130 = 80/130 =
0.615, or approximately 62%. Choice A (38%) results from dividing by the wrong denominator (80/210), choice
B (50%) ignores the correct volumes, and choice D (130/170) misapplies the formula. EF calculation from
volumetric data is an explicit CCI RCIS content outline competency within hemodynamic data interpretation,
and an EF above 55% is generally considered normal.
Q5. A hypovolemic patient in the cath lab is given a 500 mL intravenous fluid bolus. According to the
Frank-Starling law, the most likely immediate result is:
A. Decreased contractility due to ventricular distention
B. No change in stroke volume because contractility is fixed
C. Increased stroke volume due to increased preload and sarcomere stretch [CORRECT]
D. Decreased stroke volume due to increased afterload
Correct Answer: C
Rationale: The Frank-Starling mechanism states that stroke volume rises with increased end-diastolic volume
because optimal sarcomere stretch lengthens the overlap of actin and myosin filaments, augmenting contractile
force. Choice A contradicts the law within physiologic limits, choice B ignores preload dependence, and choice
D incorrectly links volume loading to afterload. Mastery of the Frank-Starling relationship is required by the
CCI RCIS content outline (stroke volume determinants) and guides fluid management of hypotension in the lab.
Cardiovascular Invasive Technology & Registry Review 2
, RCIS Certification Examination | Glowacki & Sommers 2026/2027 CCI Exam Content Outline Aligned
Q6. The left main coronary artery typically divides into which two arteries?
A. LAD and left circumflex [CORRECT]
B. RCA and posterior descending artery
C. LAD and posterior descending artery
D. Left circumflex and acute marginal
Correct Answer: A
Rationale: In the standard distribution, the left main coronary artery arises from the left sinus of Valsalva,
crosses behind the pulmonary artery, and bifurcates into the left anterior descending artery and the left
circumflex artery. The posterior descending artery is a branch of the RCA in right-dominant systems, and the
acute marginal is an RCA branch. Left main anatomy is foundational knowledge in the CCI RCIS coronary
anatomy domain, since left main disease and left main engagement are high-stakes cath lab situations.
Q7. A patient with severe aortic stenosis develops chronically elevated LV systolic wall stress. In terms
of cardiac physiology, the stenotic valve primarily increases which determinant of stroke volume?
A. Preload
B. Contractility
C. Heart rate
D. Afterload [CORRECT]
Correct Answer: D
Rationale: Afterload is the resistance against which the ventricle ejects; a stenotic aortic valve creates a fixed
obstruction that raises LV systolic wall stress and impedes ejection, thereby reducing stroke volume over time
and triggering concentric hypertrophy. Preload (choice A) relates to end-diastolic fiber length, contractility
(choice B) is intrinsic myocardial performance, and heart rate (choice C) affects output but not the obstructive
load. Classification of valvular lesions as preload, afterload, or contractility problems is a CCI RCIS content
outline application competency.
Q8. In approximately 60% of individuals, the sinoatrial node artery arises from which vessel?
A. Left circumflex artery
B. Right coronary artery [CORRECT]
C. Left anterior descending artery
D. Left main coronary artery
Correct Answer: B
Rationale: The SA nodal artery originates from the proximal RCA in about 60% of people and from the LCx in
roughly 40%, a distinction with direct clinical impact because RCA occlusion can produce sinus bradycardia or
arrest during inferior infarction. The LAD and left main do not typically supply the SA node. Coronary branch
variations and their electrophysiologic consequences appear in the CCI RCIS outline under coronary circulation
and conduction system anatomy.
Cardiovascular Invasive Technology & Registry Review 3
GLOWACKI &
SOMMERS
RCIS Questions | With Complete Solutions
A comprehensive certification examination for
cardiovascular invasive technology and registry review:
150 scenario-based, application, and analysis questions
with complete solutions, mapped to the eleven domains
of the CCI RCIS Exam Content Outline and current
catheterization laboratory standards.
30 9 Q UES T IO NS · CO M P LET E S O LUT IO NS · 55 PAGES
Cardiovascular Invasive Technology & Registry
Review
C C I EXAM C ONTENT OU TLINE ALIG NED · 2026/ 2027 EDITION
,RCIS Certification Examination | Glowacki & Sommers 2026/2027 CCI Exam Content Outline Aligned
GLOWACKI & SOMMERS (RCIS QUESTIONS)
309 QUESTIONS | WITH COMPLETE SOLUTIONS | 55 PAGES | 2026/2027
Comprehensive Certification Examination - Cardiovascular Invasive Technology & Registry Review - Aligned with the CCI
RCIS Exam Content Outline, Invasive Cardiovascular Technology Competencies, and Cath Lab Standards
Section 1: Cardiovascular Anatomy & Physiology
Questions 1-20 | Complete Solutions
Q1. Which cardiac chamber receives venous blood from the coronary sinus?
A. Left atrium
B. Right ventricle
C. Right atrium [CORRECT]
D. Left ventricle
Correct Answer: C
Rationale: The coronary sinus, the principal venous drainage channel of the heart, empties deoxygenated blood
directly into the right atrium through the coronary sinus ostium located between the inferior vena cava and the
tricuspid valve annulus. The left atrium receives pulmonary venous blood, and the ventricles receive inflow from
their respective atria. This is core knowledge from the CCI RCIS content outline domain of Cardiovascular
Anatomy and Physiology, cardiac venous anatomy subsection.
Q2. Which of the following lists the normal sequence of cardiac electrical activation in the correct
order?
A. SA node, AV node, bundle of His, bundle branches, Purkinje fibers [CORRECT]
B. AV node, SA node, bundle branches, bundle of His, Purkinje fibers
C. SA node, bundle of His, AV node, Purkinje fibers, bundle branches
D. Bundle of His, SA node, AV node, bundle branches, Purkinje fibers
Correct Answer: A
Rationale: The impulse originates in the sinoatrial node, conducts to the atrioventricular node where
physiological delay occurs, then traverses the bundle of His, the right and left bundle branches, and finally the
Purkinje fibers, which deliver the impulse to ventricular myocardium. Every other choice inverts or scrambles
this physiologic cascade. The CCI RCIS content outline requires command of the conduction system sequence
because it underpins intracardiac electrogram interpretation in the cath lab.
Cardiovascular Invasive Technology & Registry Review 1
,RCIS Certification Examination | Glowacki & Sommers 2026/2027 CCI Exam Content Outline Aligned
Q3. During a diagnostic catheterization, a patient's blood pressure rises acutely from 130/80 mmHg to
170/100 mmHg. Baroreceptor activation in the carotid sinuses and aortic arch would be expected to
produce which compensatory response?
A. Increased sympathetic outflow, raising heart rate and contractility
B. Decreased parasympathetic outflow with vasoconstriction
C. Increased renin release from the kidneys
D. Increased vagal tone with decreased heart rate and vasodilation [CORRECT]
Correct Answer: D
Rationale: Rising pressure stretches the carotid sinus and aortic arch baroreceptors, increasing afferent firing to
the medulla, which raises parasympathetic (vagal) tone and suppresses sympathetic outflow, lowering heart rate,
contractility, and vascular resistance. Choices A and B describe the opposite direction of reflex change, and
renin release (choice C) is a slower hormonal response, not the acute baroreceptor reflex. This physiology from
the CCI RCIS outline on blood pressure regulation and cardiac innervation explains why lab hypertension is
often transient and why vasovagal responses move in the reverse direction.
Q4. A patient's ventriculogram demonstrates a left ventricular end-diastolic volume of 130 mL and an
end-systolic volume of 50 mL. What is the ejection fraction?
A. 38%
B. 50%
C. 62% [CORRECT]
D. 77%
Correct Answer: C
Rationale: Ejection fraction equals stroke volume divided by end-diastolic volume: (130 - 50) / 130 = 80/130 =
0.615, or approximately 62%. Choice A (38%) results from dividing by the wrong denominator (80/210), choice
B (50%) ignores the correct volumes, and choice D (130/170) misapplies the formula. EF calculation from
volumetric data is an explicit CCI RCIS content outline competency within hemodynamic data interpretation,
and an EF above 55% is generally considered normal.
Q5. A hypovolemic patient in the cath lab is given a 500 mL intravenous fluid bolus. According to the
Frank-Starling law, the most likely immediate result is:
A. Decreased contractility due to ventricular distention
B. No change in stroke volume because contractility is fixed
C. Increased stroke volume due to increased preload and sarcomere stretch [CORRECT]
D. Decreased stroke volume due to increased afterload
Correct Answer: C
Rationale: The Frank-Starling mechanism states that stroke volume rises with increased end-diastolic volume
because optimal sarcomere stretch lengthens the overlap of actin and myosin filaments, augmenting contractile
force. Choice A contradicts the law within physiologic limits, choice B ignores preload dependence, and choice
D incorrectly links volume loading to afterload. Mastery of the Frank-Starling relationship is required by the
CCI RCIS content outline (stroke volume determinants) and guides fluid management of hypotension in the lab.
Cardiovascular Invasive Technology & Registry Review 2
, RCIS Certification Examination | Glowacki & Sommers 2026/2027 CCI Exam Content Outline Aligned
Q6. The left main coronary artery typically divides into which two arteries?
A. LAD and left circumflex [CORRECT]
B. RCA and posterior descending artery
C. LAD and posterior descending artery
D. Left circumflex and acute marginal
Correct Answer: A
Rationale: In the standard distribution, the left main coronary artery arises from the left sinus of Valsalva,
crosses behind the pulmonary artery, and bifurcates into the left anterior descending artery and the left
circumflex artery. The posterior descending artery is a branch of the RCA in right-dominant systems, and the
acute marginal is an RCA branch. Left main anatomy is foundational knowledge in the CCI RCIS coronary
anatomy domain, since left main disease and left main engagement are high-stakes cath lab situations.
Q7. A patient with severe aortic stenosis develops chronically elevated LV systolic wall stress. In terms
of cardiac physiology, the stenotic valve primarily increases which determinant of stroke volume?
A. Preload
B. Contractility
C. Heart rate
D. Afterload [CORRECT]
Correct Answer: D
Rationale: Afterload is the resistance against which the ventricle ejects; a stenotic aortic valve creates a fixed
obstruction that raises LV systolic wall stress and impedes ejection, thereby reducing stroke volume over time
and triggering concentric hypertrophy. Preload (choice A) relates to end-diastolic fiber length, contractility
(choice B) is intrinsic myocardial performance, and heart rate (choice C) affects output but not the obstructive
load. Classification of valvular lesions as preload, afterload, or contractility problems is a CCI RCIS content
outline application competency.
Q8. In approximately 60% of individuals, the sinoatrial node artery arises from which vessel?
A. Left circumflex artery
B. Right coronary artery [CORRECT]
C. Left anterior descending artery
D. Left main coronary artery
Correct Answer: B
Rationale: The SA nodal artery originates from the proximal RCA in about 60% of people and from the LCx in
roughly 40%, a distinction with direct clinical impact because RCA occlusion can produce sinus bradycardia or
arrest during inferior infarction. The LAD and left main do not typically supply the SA node. Coronary branch
variations and their electrophysiologic consequences appear in the CCI RCIS outline under coronary circulation
and conduction system anatomy.
Cardiovascular Invasive Technology & Registry Review 3
