1|Page
PEDIATRIC ARDMS EXAM AND PRACTICE EXAM
NEWEST 2026/ 2027 TEST BANK| PEDIATRIC ARDMS
EXAM REVIEW WITH COMPLETE 350 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
A preterm neonate undergoes cranial sonography after a sudden drop in
hematocrit and an episode of apnea. Ultrasound demonstrates echogenic
material within the caudothalamic groove that does not extend into the
ventricular system. Which finding is most consistent with this
appearance?
A. Choroid plexus cyst
B. Germinal matrix hemorrhage
C. Periventricular leukomalacia
D. Subdural hemorrhage - Correct Answer - B. Germinal matrix
hemorrhage
In premature infants, the germinal matrix is highly vascular and
susceptible to hemorrhage. A hemorrhage confined to the caudothalamic
groove is characteristic of a grade I germinal matrix hemorrhage.
Extension into the ventricles would indicate intraventricular
hemorrhage.
During a neonatal cranial examination, the sonographer notes
enlargement of both lateral ventricles. The atrial diameter measures 12
mm bilaterally. Which interpretation is most appropriate?
A. Normal ventricular size
B. Agenesis of the corpus callosum
C. Mild ventriculomegaly
pg. 1
,2|Page
D. Dandy-Walker malformation - Correct Answer - C. Mild
ventriculomegaly
An atrial width of approximately 10 mm or greater is considered
abnormal and supports ventriculomegaly. The finding should prompt
evaluation of the ventricular system, midline structures, posterior fossa,
and potential underlying cause.
An infant presents with persistent nonbilious vomiting shortly after
feeding. Ultrasound demonstrates an elongated pyloric channel
measuring 18 mm with muscular wall thickness of 4 mm. Which
diagnosis is most likely?
A. Intussusception
B. Pyloric stenosis
C. Malrotation
D. Necrotizing enterocolitis - Correct Answer - B. Pyloric stenosis
Infantile hypertrophic pyloric stenosis produces thickening of the pyloric
muscle and elongation of the pyloric channel. A muscle thickness greater
than approximately 3 mm and channel length exceeding approximately
15–17 mm strongly support the diagnosis. The clinical presentation of
progressive nonbilious vomiting is classic.
A sonographer evaluates the hips of an infant referred because of limited
hip abduction. On dynamic examination, the femoral head is displaced
posteriorly and laterally when stress is applied. Which additional finding
would support developmental dysplasia of the hip?
A. Alpha angle of 42°
B. Alpha angle of 68°
C. Femoral head centered within the acetabulum
D. Normal acetabular coverage - Correct Answer - A. Alpha angle of 42°
pg. 2
,3|Page
The Graf alpha angle assesses acetabular development. An alpha angle
below approximately 60° indicates an abnormal/developmentally
immature acetabulum, with lower values associated with increasing
dysplasia. Dynamic displacement further supports instability.
A newborn with respiratory distress undergoes chest ultrasound. The
sonographer identifies a solid-appearing echogenic mass in the left lower
thorax containing multiple cystic spaces. Color Doppler demonstrates a
systemic arterial vessel arising from the abdominal aorta and supplying
the lesion. Which diagnosis is most likely?
A. Pleural effusion
B. Pulmonary sequestration
C. Congenital diaphragmatic hernia
D. Pulmonary edema - Correct Answer - B. Pulmonary sequestration
Pulmonary sequestration is characterized by nonfunctioning lung tissue
with an abnormal systemic arterial supply, commonly originating from
the thoracic or abdominal aorta. Identification of this feeding artery is an
important sonographic clue.
An infant develops abdominal distention and bloody stools. Ultrasound
demonstrates multiple dilated bowel loops with thickened bowel walls
and small echogenic foci within the bowel wall. Which condition should
be suspected?
A. Pyloric stenosis
B. Hirschsprung disease
C. Hypertrophic pyloric obstruction
D. Necrotizing enterocolitis - Correct Answer - D. Necrotizing
enterocolitis
pg. 3
, 4|Page
Pneumatosis intestinalis, represented by echogenic gas within the bowel
wall, is a key sonographic finding of necrotizing enterocolitis. Bowel-
wall thickening, abnormal peristalsis, free fluid, and portal venous gas
may also occur.
A child presents with episodic severe abdominal pain and vomiting.
Ultrasound demonstrates concentric hypoechoic and hyperechoic bowel
rings with an enlarged bowel segment measuring 4.0 cm in transverse
diameter. Which diagnosis best explains the findings?
A. Appendicitis
B. Volvulus
C. Intussusception
D. Pyloric stenosis - Correct Answer - C. Intussusception
The classic sonographic appearance of intussusception is the target or
doughnut sign, produced by telescoping bowel. Multiple concentric
bowel layers are seen, and an enlarged target measuring several
centimeters supports the diagnosis in the appropriate clinical setting.
During an abdominal ultrasound on a child with fever and right lower-
quadrant pain, the appendix is visualized as a blind-ending,
noncompressible tubular structure measuring 8 mm in outer diameter.
There is surrounding echogenic mesenteric fat. Which interpretation is
most appropriate?
A. Normal appendix
B. Meckel diverticulum
C. Intestinal duplication cyst
D. Appendicitis - Correct Answer - D. Appendicitis
A normal appendix is generally compressible and ≤6 mm in outer
diameter. An enlarged, noncompressible appendix greater than 6 mm,
pg. 4
PEDIATRIC ARDMS EXAM AND PRACTICE EXAM
NEWEST 2026/ 2027 TEST BANK| PEDIATRIC ARDMS
EXAM REVIEW WITH COMPLETE 350 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
A preterm neonate undergoes cranial sonography after a sudden drop in
hematocrit and an episode of apnea. Ultrasound demonstrates echogenic
material within the caudothalamic groove that does not extend into the
ventricular system. Which finding is most consistent with this
appearance?
A. Choroid plexus cyst
B. Germinal matrix hemorrhage
C. Periventricular leukomalacia
D. Subdural hemorrhage - Correct Answer - B. Germinal matrix
hemorrhage
In premature infants, the germinal matrix is highly vascular and
susceptible to hemorrhage. A hemorrhage confined to the caudothalamic
groove is characteristic of a grade I germinal matrix hemorrhage.
Extension into the ventricles would indicate intraventricular
hemorrhage.
During a neonatal cranial examination, the sonographer notes
enlargement of both lateral ventricles. The atrial diameter measures 12
mm bilaterally. Which interpretation is most appropriate?
A. Normal ventricular size
B. Agenesis of the corpus callosum
C. Mild ventriculomegaly
pg. 1
,2|Page
D. Dandy-Walker malformation - Correct Answer - C. Mild
ventriculomegaly
An atrial width of approximately 10 mm or greater is considered
abnormal and supports ventriculomegaly. The finding should prompt
evaluation of the ventricular system, midline structures, posterior fossa,
and potential underlying cause.
An infant presents with persistent nonbilious vomiting shortly after
feeding. Ultrasound demonstrates an elongated pyloric channel
measuring 18 mm with muscular wall thickness of 4 mm. Which
diagnosis is most likely?
A. Intussusception
B. Pyloric stenosis
C. Malrotation
D. Necrotizing enterocolitis - Correct Answer - B. Pyloric stenosis
Infantile hypertrophic pyloric stenosis produces thickening of the pyloric
muscle and elongation of the pyloric channel. A muscle thickness greater
than approximately 3 mm and channel length exceeding approximately
15–17 mm strongly support the diagnosis. The clinical presentation of
progressive nonbilious vomiting is classic.
A sonographer evaluates the hips of an infant referred because of limited
hip abduction. On dynamic examination, the femoral head is displaced
posteriorly and laterally when stress is applied. Which additional finding
would support developmental dysplasia of the hip?
A. Alpha angle of 42°
B. Alpha angle of 68°
C. Femoral head centered within the acetabulum
D. Normal acetabular coverage - Correct Answer - A. Alpha angle of 42°
pg. 2
,3|Page
The Graf alpha angle assesses acetabular development. An alpha angle
below approximately 60° indicates an abnormal/developmentally
immature acetabulum, with lower values associated with increasing
dysplasia. Dynamic displacement further supports instability.
A newborn with respiratory distress undergoes chest ultrasound. The
sonographer identifies a solid-appearing echogenic mass in the left lower
thorax containing multiple cystic spaces. Color Doppler demonstrates a
systemic arterial vessel arising from the abdominal aorta and supplying
the lesion. Which diagnosis is most likely?
A. Pleural effusion
B. Pulmonary sequestration
C. Congenital diaphragmatic hernia
D. Pulmonary edema - Correct Answer - B. Pulmonary sequestration
Pulmonary sequestration is characterized by nonfunctioning lung tissue
with an abnormal systemic arterial supply, commonly originating from
the thoracic or abdominal aorta. Identification of this feeding artery is an
important sonographic clue.
An infant develops abdominal distention and bloody stools. Ultrasound
demonstrates multiple dilated bowel loops with thickened bowel walls
and small echogenic foci within the bowel wall. Which condition should
be suspected?
A. Pyloric stenosis
B. Hirschsprung disease
C. Hypertrophic pyloric obstruction
D. Necrotizing enterocolitis - Correct Answer - D. Necrotizing
enterocolitis
pg. 3
, 4|Page
Pneumatosis intestinalis, represented by echogenic gas within the bowel
wall, is a key sonographic finding of necrotizing enterocolitis. Bowel-
wall thickening, abnormal peristalsis, free fluid, and portal venous gas
may also occur.
A child presents with episodic severe abdominal pain and vomiting.
Ultrasound demonstrates concentric hypoechoic and hyperechoic bowel
rings with an enlarged bowel segment measuring 4.0 cm in transverse
diameter. Which diagnosis best explains the findings?
A. Appendicitis
B. Volvulus
C. Intussusception
D. Pyloric stenosis - Correct Answer - C. Intussusception
The classic sonographic appearance of intussusception is the target or
doughnut sign, produced by telescoping bowel. Multiple concentric
bowel layers are seen, and an enlarged target measuring several
centimeters supports the diagnosis in the appropriate clinical setting.
During an abdominal ultrasound on a child with fever and right lower-
quadrant pain, the appendix is visualized as a blind-ending,
noncompressible tubular structure measuring 8 mm in outer diameter.
There is surrounding echogenic mesenteric fat. Which interpretation is
most appropriate?
A. Normal appendix
B. Meckel diverticulum
C. Intestinal duplication cyst
D. Appendicitis - Correct Answer - D. Appendicitis
A normal appendix is generally compressible and ≤6 mm in outer
diameter. An enlarged, noncompressible appendix greater than 6 mm,
pg. 4
