CARDIOVASCULAR CREDENTIALING INTERNATIONAL (CCI) | REGISTRY EXAM
2026/2027 EDITION | ACROSS ALL PATHWAYS | NEWEST EXAM
CCI
REGISTRY EXAM
CCI Registry Exam
Cardiovascular Credentialing International
2026/2027 Edition | 150 Verified Questions & Answers
Across All Pathways - RCS, RVS, RCCS, ACS, CCT
150Q VERIFIED NEWEST EXAM RATIONALES
REAL EXAM 2026/2027 DETAILED
INCLUDES:
• RCS - Registered Cardiac Sonographer • RVS - Registered Vascular Specialist
• RCCS - Registered Congenital Cardiac Sonographer • ACS - Advanced Cardiac Sonographer
• CCT - Certified Cardiographic Technician • Verified Answers + Clinical Rationales
• Evidence-Based References | Professional Study Guide | Borders + Page Numbers
CCI Registry Exam Preparation | Higher Education Nursing & Allied Health | Not affiliated with CCI
Confidential Study Guide - Educational Purposes Only | 2026/2027 Edition
,RCS - Registered Cardiac Sonographer Pathway
Description: RCS normal LVEF 55-70 Simpson biplane HFrEF less than 40 HFmrEF 41-49 HFpEF greater than or equal 50 ASE, PLAX RV anterior LV posterior LA aorta
AV MV IVS, mitral stenosis rheumatic thickened doming hockey stick PHT greater than 150 ms severe MVA less than 1.0 mean gradient greater than 10, aortic stenosis
severe AVA less than 1.0 indexed less than 0.6 Vmax greater than 4.0 mean gradient greater than 40 DI less than 0.25, diastolic Grade I impaired relaxation E/A less than
0.8 Grade II pseudonormal 0.8-2.0 E/e' greater than 14 Grade III restrictive E/A greater than 2 DT less than 160, pericardial effusion echo-free tamponade RA systole RV
diastole IVC plethora respiratory variation, RV TAPSE greater than 16 S' greater than 9.5 FAC greater than 35, HCM wall thickness greater than or equal 15 mm
asymmetric septal SAM LVOT obstruction greater than 30 rest greater than 50 provocation, AR severe vena contracta greater than 6 mm EROA greater than 0.30 volume
greater than 60 PHT less than 200 holodiastolic reversal, prosthetic valve gradients velocity DI EOA PHT mitral, echo artifacts reverberation shadowing enhancement side
lobe mirror.
RVS - Registered Vascular Specialist Pathway
Description: RVS carotid SRU consensus normal ICA PSV less than 125 ICA/CCA less than 2.0 50-69 percent 125-230 ratio 2.0-4.0 greater than 70 percent greater than
230 ratio greater than 4.0 near occlusion trickle, lower extremity arterial triphasic high resistance forward reverse forward monophasic low resistance continuous forward
stenosis, ABI normal 1.0-1.4 borderline 0.91-0.99 mild PAD 0.70-0.90 moderate 0.40-0.69 severe less than 0.40 noncompressible greater than 1.4 calcified, DVT
noncompressible lack color flow echogenic thrombus distended increased diameter, renal artery stenosis greater than 60 percent PSV greater than 200 RAR greater than
3.5, venous insufficiency reflux greater than 0.5 sec superficial greater than 1.0 sec deep femoral popliteal pathologic, AV fistula maturation Rule of 6s diameter greater
than 6 mm depth less than 6 mm flow greater than 600 length greater than 6 cm 6 weeks, TOS compression subclavian artery vein arm abduction external rotation loss
pulse dampening maneuvers.
CCT - Certified Cardiographic Technician Pathway
Description: CCT ECG normal PR 0.12-0.20 QRS less than 0.12 QTc less than 450 male 470 female axis -30 to +90, atrial fibrillation irregularly irregular no P waves atrial
400-600, atrial flutter sawtooth atrial 300 bpm 2:1 conduction ventricular 150, VT vs SVT aberrancy wide QRS greater than 120 AV dissociation fusion capture Brugada RS
greater than 100 ms morphology, MI localization anterior V1-V4 LAD septal V1-V2 lateral I aVL V5-V6 inferior II III aVF RCA posterior tall R V1-V2 ST depression V1-V3,
hyperkalemia tall peaked T PR prolongation QRS widening sine wave asystole K greater than 6.5-7.0, long QT congenital acquired drugs class Ia III macrolides
antipsychotics hypokalemia hypomagnesemia hypocalcemia bradycardia torsades QTc greater than 450 male 470 female greater than 500 high risk, stress testing
absolute contraindications acute MI within 2 days unstable angina uncontrolled arrhythmia severe aortic stenosis uncontrolled HF acute myocarditis pericarditis dissection,
Holter 24-48 hr extended 14 days syncope palpitations AF burden arrhythmia detection diary, pacemaker NBG first chamber paced second sensed third response I
inhibited T triggered D dual fourth rate modulation R fifth multisite, IABP inflates diastole dicrotic notch augments diastolic coronary perfusion deflates systole reduces
afterload.
RCCS & ACS Pathways
Description: RCCS PFO flap-like septum primum secundum small shunt vs ASD true defect secundum most common 75 percent primum AV canal sinus venosus PAPVR
coronary sinus unroofed, Tetralogy Fallot VSD overriding aorta pulmonary stenosis RVH anterior malalignment conal septum, ACS anesthesia critical care IABP timing.
Page 2 - CCI Registry 150Q Improved Cover 2026/2027
,Question 1: Q1: RCS - Normal LVEF by echo?
A. 55-70 percent normal EF by Simpson biplane less than 40 HFrEF 41-49 HFmrEF greater than or equal 50 HFpEF
B. Less than 20 normal
C. 20-30 normal
D. 90-100 normal
CORRECT ANSWER: A. 55-70 percent normal EF by Simpson biplane less than 40 HFrEF 41-49 HFmrEF greater than or equal 50 HFpEF
RATIONALE:
Normal LVEF 55-70 percent Simpson biplane HFrEF less than 40 HFmrEF 41-49 HFpEF greater than or equal 50 ASE guidelines.
Question 2: Q2: RCS - PLAX view structures?
A. Only LA RA
B. Only LV RV
C. RV anterior LV posterior LA aorta AV MV IVS posterior wall
D. Only aorta
CORRECT ANSWER: C. RV anterior LV posterior LA aorta AV MV IVS posterior wall
RATIONALE:
PLAX RV anterior LV posterior LA aorta AV MV IVS posterior wall pericardium.
Question 3: Q3: RCS - Mitral stenosis echo pressure half-time?
A. Only regurgitation
B. Thin normal leaflets
C. No PHT concept
D. Thickened doming hockey stick diastolic doming PHT greater than 150 ms severe MVA less than 1.0 cm2
CORRECT ANSWER: D. Thickened doming hockey stick diastolic doming PHT greater than 150 ms severe MVA less than 1.0 cm2
RATIONALE:
MS rheumatic thickened doming hockey stick commissural fusion PHT 220/PHT=MVA severe greater than 150 ms MVA less than 1.0 mean gradient greater than 10.
Question 4: Q4: RCS - Severe aortic stenosis criteria?
A. Mild AS AVA less than 1.0
B. Severe AS AVA less than 1.0 cm2 Vmax greater than 4.0 m/s mean gradient greater than 40 mmHg DI less than 0.25
C. AVA greater than 2.0 severe
D. Vmax less than 1.0 severe
CORRECT ANSWER: B. Severe AS AVA less than 1.0 cm2 Vmax greater than 4.0 m/s mean gradient greater than 40 mmHg DI less than 0.25
RATIONALE:
Severe AS AVA less than 1.0 indexed less than 0.6 Vmax greater than 4.0 mean gradient greater than 40 DI less than 0.25 ASE.
Question 5: Q5: RVS - Carotid duplex ICA PSV ICA/CCA ratio?
A. Normal ICA PSV less than 125 ICA/CCA less than 2.0 50-69 percent 125-230 ratio 2.0-4.0 greater than 70 percent greater than 230 ratio greater than
4.0
B. Normal PSV greater than 300
C. No ratio criteria
D. All same PSV
CORRECT ANSWER: A. Normal ICA PSV less than 125 ICA/CCA less than 2.0 50-69 percent 125-230 ratio 2.0-4.0 greater than 70 percent
greater than 230 ratio greater than 4.0
RATIONALE:
Carotid SRU consensus normal ICA PSV less than 125 ratio less than 2.0 50-69 percent 125-230 ratio 2.0-4.0 greater than 70 percent greater than 230 ratio greater than
4.0 near occlusion trickle.
Question 6: Q6: RVS - Lower extremity arterial triphasic waveform?
A. Only biphasic abnormal
B. Only monophasic normal
C. Triphasic high resistance forward reverse forward monophasic low resistance continuous forward indicates stenosis proximally
D. No waveform types
CORRECT ANSWER: C. Triphasic high resistance forward reverse forward monophasic low resistance continuous forward indicates stenosis
proximally
RATIONALE:
Normal peripheral arterial triphasic high resistance forward reverse forward monophasic low resistance continuous forward indicates stenosis proximal low resistance
distal.
Question 7: Q7: RVS - ABI interpretation?
A. Greater than 1.4 normal
B. Normal ABI 0.5
C. No interpretation
D. Normal ABI 1.0-1.4 borderline 0.91-0.99 mild PAD 0.70-0.90 moderate 0.40-0.69 severe less than 0.40 noncompressible greater than 1.4
CORRECT ANSWER: D. Normal ABI 1.0-1.4 borderline 0.91-0.99 mild PAD 0.70-0.90 moderate 0.40-0.69 severe less than 0.40 noncompressible
greater than 1.4
RATIONALE:
ABI ankle systolic divided by brachial higher arm normal 1.0-1.4 borderline 0.91-0.99 mild 0.70-0.90 moderate 0.40-0.69 severe less than 0.40 noncompressible greater
than 1.4 calcified diabetes CKD.
Question 8: Q8: RVS - DVT ultrasound criteria?
Page 3 - CCI Registry 150Q Improved Cover 2026/2027
, A. Compressible vein normal
B. Noncompressible vein lack color flow echogenic thrombus distended increased diameter
C. Only color flow
D. No compression criteria
CORRECT ANSWER: B. Noncompressible vein lack color flow echogenic thrombus distended increased diameter
RATIONALE:
DVT primary criterion noncompressible with probe pressure secondary lack color Doppler echogenic thrombus distended increased diameter.
Page 4 - CCI Registry 150Q Improved Cover 2026/2027
2026/2027 EDITION | ACROSS ALL PATHWAYS | NEWEST EXAM
CCI
REGISTRY EXAM
CCI Registry Exam
Cardiovascular Credentialing International
2026/2027 Edition | 150 Verified Questions & Answers
Across All Pathways - RCS, RVS, RCCS, ACS, CCT
150Q VERIFIED NEWEST EXAM RATIONALES
REAL EXAM 2026/2027 DETAILED
INCLUDES:
• RCS - Registered Cardiac Sonographer • RVS - Registered Vascular Specialist
• RCCS - Registered Congenital Cardiac Sonographer • ACS - Advanced Cardiac Sonographer
• CCT - Certified Cardiographic Technician • Verified Answers + Clinical Rationales
• Evidence-Based References | Professional Study Guide | Borders + Page Numbers
CCI Registry Exam Preparation | Higher Education Nursing & Allied Health | Not affiliated with CCI
Confidential Study Guide - Educational Purposes Only | 2026/2027 Edition
,RCS - Registered Cardiac Sonographer Pathway
Description: RCS normal LVEF 55-70 Simpson biplane HFrEF less than 40 HFmrEF 41-49 HFpEF greater than or equal 50 ASE, PLAX RV anterior LV posterior LA aorta
AV MV IVS, mitral stenosis rheumatic thickened doming hockey stick PHT greater than 150 ms severe MVA less than 1.0 mean gradient greater than 10, aortic stenosis
severe AVA less than 1.0 indexed less than 0.6 Vmax greater than 4.0 mean gradient greater than 40 DI less than 0.25, diastolic Grade I impaired relaxation E/A less than
0.8 Grade II pseudonormal 0.8-2.0 E/e' greater than 14 Grade III restrictive E/A greater than 2 DT less than 160, pericardial effusion echo-free tamponade RA systole RV
diastole IVC plethora respiratory variation, RV TAPSE greater than 16 S' greater than 9.5 FAC greater than 35, HCM wall thickness greater than or equal 15 mm
asymmetric septal SAM LVOT obstruction greater than 30 rest greater than 50 provocation, AR severe vena contracta greater than 6 mm EROA greater than 0.30 volume
greater than 60 PHT less than 200 holodiastolic reversal, prosthetic valve gradients velocity DI EOA PHT mitral, echo artifacts reverberation shadowing enhancement side
lobe mirror.
RVS - Registered Vascular Specialist Pathway
Description: RVS carotid SRU consensus normal ICA PSV less than 125 ICA/CCA less than 2.0 50-69 percent 125-230 ratio 2.0-4.0 greater than 70 percent greater than
230 ratio greater than 4.0 near occlusion trickle, lower extremity arterial triphasic high resistance forward reverse forward monophasic low resistance continuous forward
stenosis, ABI normal 1.0-1.4 borderline 0.91-0.99 mild PAD 0.70-0.90 moderate 0.40-0.69 severe less than 0.40 noncompressible greater than 1.4 calcified, DVT
noncompressible lack color flow echogenic thrombus distended increased diameter, renal artery stenosis greater than 60 percent PSV greater than 200 RAR greater than
3.5, venous insufficiency reflux greater than 0.5 sec superficial greater than 1.0 sec deep femoral popliteal pathologic, AV fistula maturation Rule of 6s diameter greater
than 6 mm depth less than 6 mm flow greater than 600 length greater than 6 cm 6 weeks, TOS compression subclavian artery vein arm abduction external rotation loss
pulse dampening maneuvers.
CCT - Certified Cardiographic Technician Pathway
Description: CCT ECG normal PR 0.12-0.20 QRS less than 0.12 QTc less than 450 male 470 female axis -30 to +90, atrial fibrillation irregularly irregular no P waves atrial
400-600, atrial flutter sawtooth atrial 300 bpm 2:1 conduction ventricular 150, VT vs SVT aberrancy wide QRS greater than 120 AV dissociation fusion capture Brugada RS
greater than 100 ms morphology, MI localization anterior V1-V4 LAD septal V1-V2 lateral I aVL V5-V6 inferior II III aVF RCA posterior tall R V1-V2 ST depression V1-V3,
hyperkalemia tall peaked T PR prolongation QRS widening sine wave asystole K greater than 6.5-7.0, long QT congenital acquired drugs class Ia III macrolides
antipsychotics hypokalemia hypomagnesemia hypocalcemia bradycardia torsades QTc greater than 450 male 470 female greater than 500 high risk, stress testing
absolute contraindications acute MI within 2 days unstable angina uncontrolled arrhythmia severe aortic stenosis uncontrolled HF acute myocarditis pericarditis dissection,
Holter 24-48 hr extended 14 days syncope palpitations AF burden arrhythmia detection diary, pacemaker NBG first chamber paced second sensed third response I
inhibited T triggered D dual fourth rate modulation R fifth multisite, IABP inflates diastole dicrotic notch augments diastolic coronary perfusion deflates systole reduces
afterload.
RCCS & ACS Pathways
Description: RCCS PFO flap-like septum primum secundum small shunt vs ASD true defect secundum most common 75 percent primum AV canal sinus venosus PAPVR
coronary sinus unroofed, Tetralogy Fallot VSD overriding aorta pulmonary stenosis RVH anterior malalignment conal septum, ACS anesthesia critical care IABP timing.
Page 2 - CCI Registry 150Q Improved Cover 2026/2027
,Question 1: Q1: RCS - Normal LVEF by echo?
A. 55-70 percent normal EF by Simpson biplane less than 40 HFrEF 41-49 HFmrEF greater than or equal 50 HFpEF
B. Less than 20 normal
C. 20-30 normal
D. 90-100 normal
CORRECT ANSWER: A. 55-70 percent normal EF by Simpson biplane less than 40 HFrEF 41-49 HFmrEF greater than or equal 50 HFpEF
RATIONALE:
Normal LVEF 55-70 percent Simpson biplane HFrEF less than 40 HFmrEF 41-49 HFpEF greater than or equal 50 ASE guidelines.
Question 2: Q2: RCS - PLAX view structures?
A. Only LA RA
B. Only LV RV
C. RV anterior LV posterior LA aorta AV MV IVS posterior wall
D. Only aorta
CORRECT ANSWER: C. RV anterior LV posterior LA aorta AV MV IVS posterior wall
RATIONALE:
PLAX RV anterior LV posterior LA aorta AV MV IVS posterior wall pericardium.
Question 3: Q3: RCS - Mitral stenosis echo pressure half-time?
A. Only regurgitation
B. Thin normal leaflets
C. No PHT concept
D. Thickened doming hockey stick diastolic doming PHT greater than 150 ms severe MVA less than 1.0 cm2
CORRECT ANSWER: D. Thickened doming hockey stick diastolic doming PHT greater than 150 ms severe MVA less than 1.0 cm2
RATIONALE:
MS rheumatic thickened doming hockey stick commissural fusion PHT 220/PHT=MVA severe greater than 150 ms MVA less than 1.0 mean gradient greater than 10.
Question 4: Q4: RCS - Severe aortic stenosis criteria?
A. Mild AS AVA less than 1.0
B. Severe AS AVA less than 1.0 cm2 Vmax greater than 4.0 m/s mean gradient greater than 40 mmHg DI less than 0.25
C. AVA greater than 2.0 severe
D. Vmax less than 1.0 severe
CORRECT ANSWER: B. Severe AS AVA less than 1.0 cm2 Vmax greater than 4.0 m/s mean gradient greater than 40 mmHg DI less than 0.25
RATIONALE:
Severe AS AVA less than 1.0 indexed less than 0.6 Vmax greater than 4.0 mean gradient greater than 40 DI less than 0.25 ASE.
Question 5: Q5: RVS - Carotid duplex ICA PSV ICA/CCA ratio?
A. Normal ICA PSV less than 125 ICA/CCA less than 2.0 50-69 percent 125-230 ratio 2.0-4.0 greater than 70 percent greater than 230 ratio greater than
4.0
B. Normal PSV greater than 300
C. No ratio criteria
D. All same PSV
CORRECT ANSWER: A. Normal ICA PSV less than 125 ICA/CCA less than 2.0 50-69 percent 125-230 ratio 2.0-4.0 greater than 70 percent
greater than 230 ratio greater than 4.0
RATIONALE:
Carotid SRU consensus normal ICA PSV less than 125 ratio less than 2.0 50-69 percent 125-230 ratio 2.0-4.0 greater than 70 percent greater than 230 ratio greater than
4.0 near occlusion trickle.
Question 6: Q6: RVS - Lower extremity arterial triphasic waveform?
A. Only biphasic abnormal
B. Only monophasic normal
C. Triphasic high resistance forward reverse forward monophasic low resistance continuous forward indicates stenosis proximally
D. No waveform types
CORRECT ANSWER: C. Triphasic high resistance forward reverse forward monophasic low resistance continuous forward indicates stenosis
proximally
RATIONALE:
Normal peripheral arterial triphasic high resistance forward reverse forward monophasic low resistance continuous forward indicates stenosis proximal low resistance
distal.
Question 7: Q7: RVS - ABI interpretation?
A. Greater than 1.4 normal
B. Normal ABI 0.5
C. No interpretation
D. Normal ABI 1.0-1.4 borderline 0.91-0.99 mild PAD 0.70-0.90 moderate 0.40-0.69 severe less than 0.40 noncompressible greater than 1.4
CORRECT ANSWER: D. Normal ABI 1.0-1.4 borderline 0.91-0.99 mild PAD 0.70-0.90 moderate 0.40-0.69 severe less than 0.40 noncompressible
greater than 1.4
RATIONALE:
ABI ankle systolic divided by brachial higher arm normal 1.0-1.4 borderline 0.91-0.99 mild 0.70-0.90 moderate 0.40-0.69 severe less than 0.40 noncompressible greater
than 1.4 calcified diabetes CKD.
Question 8: Q8: RVS - DVT ultrasound criteria?
Page 3 - CCI Registry 150Q Improved Cover 2026/2027
, A. Compressible vein normal
B. Noncompressible vein lack color flow echogenic thrombus distended increased diameter
C. Only color flow
D. No compression criteria
CORRECT ANSWER: B. Noncompressible vein lack color flow echogenic thrombus distended increased diameter
RATIONALE:
DVT primary criterion noncompressible with probe pressure secondary lack color Doppler echogenic thrombus distended increased diameter.
Page 4 - CCI Registry 150Q Improved Cover 2026/2027
