ARRT CARDIAC INTERVENTIONAL (CI) RADIOGRAPHY EXAM | 2026/2027
American Registry of Radiologic Technologists Cardiac Interventional Certification Exam with
Complete Questions & Verified Answers | Latest Version
Overview
This 2026/2027 updated resource contains the latest ARRT Cardiac Interventional (CI)
Radiography Certification Examination with the exact 170 questions and verified answers,
following current ARRT content specifications, ASRT (American Society of Radiologic Technologists)
practice standards, ACC/AHA (American College of Cardiology/American Heart Association)
interventional guidelines, and evidence-based cardiac imaging and intervention protocols.
Key Features
● ✓ Actual ARRT CI exam format with the official 170 questions
● ✓ Comprehensive coverage of cardiac interventional procedures and imaging techniques
● ✓ Updated 2026/2027 interventional cardiology advancements and imaging technology
● ✓ Radiation safety and patient care in cardiac catheterization laboratories
● ✓ Hemodynamic monitoring and contrast media management applications
Core Content Areas (170 Total Questions)
● Patient Care & Education (35 Qs)
● Radiation Physics & Equipment Operation (30 Qs)
● Cardiac Interventional Procedures (40 Qs)
● Image Acquisition & Processing (30 Qs)
● Radiation Protection & Safety (25 Qs)
● Contrast Media & Pharmacology (10 Qs)
Detailed Content Breakdown
● Patient Assessment & Preparation for Cardiac Procedures (15 Qs)
● Radiation Physics Principles & Equipment Calibration (18 Qs)
● Coronary Angiography Techniques & Imaging Protocols (20 Qs)
● Percutaneous Coronary Interventions (PCI) & Stenting (18 Qs)
● Structural Heart Interventions (TAVR, MitraClip, ASD closure) (15 Qs)
● Electrophysiology Studies & Ablation Procedures (12 Qs)
● Image Processing & Digital Subtraction Angiography (12 Qs)
● Radiation Dose Management & ALARA Principles (15 Qs)
● Contrast Media Administration & Reaction Management (10 Qs)
● Hemodynamic Monitoring & Waveform Interpretation (12 Qs)
● Emergency Procedures & Complication Management (13 Qs)
Answer Format
Correct answers are marked in bold green and include:
● ARRT task inventory specific applications and competency validations
● ACC/AHA procedure guideline references and implementations
● Radiation dose optimization techniques and dose area product calculations
● Hemodynamic waveform interpretation and pressure measurement protocols
● Contrast-induced nephropathy prevention strategies and monitoring
● Emergency complication recognition and management algorithms
,Updates for 2026/2027
● 🔹
🔹 Reflects 2026-2027 ARRT CI content specification comprehensive revisions
●
● 🔹
🔹
Updated TAVR/TAVI and transcatheter mitral valve repair protocols
Enhanced radiation dose monitoring and reporting requirements
●
● 🔹
🔹
New intravascular imaging technologies (OCT, IVUS) integration standards
Revised contrast media safety guidelines for renal-impaired patients
●
●
●
🔹 Updated emergency response protocols for cardiac interventional labs
🔹 New quality assurance standards for hybrid operating rooms
Enhanced infection control protocols for invasive cardiac procedures
ARRT CI EXAM QUESTIONS (1–170)
1. During coronary angiography, which projection best visualizes the left anterior
descending (LAD) artery?
A. Right anterior oblique (RAO) with caudal angulation
B. Left anterior oblique (LAO) with cranial angulation
C. AP with no angulation
D. RAO with cranial angulation
Rationale: The LAO cranial view elongates the LAD and separates it from overlapping branches,
providing optimal visualization per ACC/AHA imaging guidelines (2026).
2. A patient undergoing elective PCI has an eGFR of 42 mL/min/1.73m². The CI
technologist should anticipate:
A. No special precautions
B. Use of iso-osmolar contrast media and pre-procedure hydration
C. Immediate cancellation of the procedure
D. Administration of N-acetylcysteine only
Rationale: For eGFR <60, ACC/AHA guidelines (2026) recommend iso-osmolar or low-osmolar
contrast, intravenous hydration, and minimization of contrast volume to reduce contrast-induced
nephropathy (CIN) risk.
3. The primary purpose of digital subtraction angiography (DSA) in cardiac imaging is to:
, A. Increase radiation dose for better resolution
B. Enhance vessel visibility by removing background bony and soft tissue structures
C. Reduce contrast volume by 50%
D. Eliminate the need for ECG gating
Rationale: DSA subtracts a mask image (pre-contrast) from post-contrast images, removing static
structures and improving vessel contrast—critical for precise coronary and structural heart imaging
(ASRT, 2026).
4. A hemodynamic pressure waveform shows a “square root sign” (dip-and-plateau
pattern). This is characteristic of:
A. Aortic stenosis
B. Constrictive pericarditis
C. Mitral regurgitation
D. Cardiac tamponade
Rationale: The square root sign—rapid early diastolic filling followed by abrupt halt—is classic for
constrictive pericarditis. Tamponade shows equalization of diastolic pressures but not this waveform
pattern (ACC Hemodynamics Guide, 2026).
5. Which radiation protection principle is most effective in reducing operator dose during
fluoroscopy?
A. Increasing kVp
B. Maximizing distance from the radiation source
C. Using higher mA
D. Removing lead apron for mobility
Rationale: Dose follows the inverse square law—doubling distance reduces exposure to 1/4. This is
more effective than shielding alone and is a core ALARA principle (NCRP Report No. 168, 2026).
6. During a TAVR procedure, the CI technologist’s role includes:
, A. Placing the valve prosthesis
B. Providing optimal imaging angles for device deployment and aortography
C. Managing anesthesia
D. Performing transesophageal echocardiography
Rationale: The CI technologist ensures precise angiographic views (e.g., coplanar LAO/RAO) for
valve positioning and post-deployment aortography to assess paravalvular leak, per 2026 ACC
TAVR protocols.
7. The normal range for left ventricular end-diastolic pressure (LVEDP) is:
A. 5–10 mmHg
B. 4–12 mmHg
C. 15–20 mmHg
D. 0–3 mmHg
Rationale: Normal LVEDP is 4–12 mmHg. Elevated LVEDP (>15 mmHg) suggests diastolic
dysfunction, volume overload, or mitral stenosis (ACC Hemodynamics Manual, 2026).
8. A patient develops contrast-induced anaphylactoid reaction during angiography. The
FIRST action by the CI technologist is to:
A. Administer epinephrine IM
B. Notify the physician and prepare emergency medications per protocol
C. Increase fluoroscopy time to assess airway
D. Leave the room to call code team
Rationale: CI technologists must recognize reactions and activate the emergency response.
Epinephrine administration is physician-directed. The team should follow lab-specific anaphylaxis
protocol (AHA ACLS, 2026).
9. Dose Area Product (DAP) is measured in:
A. millisieverts (mSv)
American Registry of Radiologic Technologists Cardiac Interventional Certification Exam with
Complete Questions & Verified Answers | Latest Version
Overview
This 2026/2027 updated resource contains the latest ARRT Cardiac Interventional (CI)
Radiography Certification Examination with the exact 170 questions and verified answers,
following current ARRT content specifications, ASRT (American Society of Radiologic Technologists)
practice standards, ACC/AHA (American College of Cardiology/American Heart Association)
interventional guidelines, and evidence-based cardiac imaging and intervention protocols.
Key Features
● ✓ Actual ARRT CI exam format with the official 170 questions
● ✓ Comprehensive coverage of cardiac interventional procedures and imaging techniques
● ✓ Updated 2026/2027 interventional cardiology advancements and imaging technology
● ✓ Radiation safety and patient care in cardiac catheterization laboratories
● ✓ Hemodynamic monitoring and contrast media management applications
Core Content Areas (170 Total Questions)
● Patient Care & Education (35 Qs)
● Radiation Physics & Equipment Operation (30 Qs)
● Cardiac Interventional Procedures (40 Qs)
● Image Acquisition & Processing (30 Qs)
● Radiation Protection & Safety (25 Qs)
● Contrast Media & Pharmacology (10 Qs)
Detailed Content Breakdown
● Patient Assessment & Preparation for Cardiac Procedures (15 Qs)
● Radiation Physics Principles & Equipment Calibration (18 Qs)
● Coronary Angiography Techniques & Imaging Protocols (20 Qs)
● Percutaneous Coronary Interventions (PCI) & Stenting (18 Qs)
● Structural Heart Interventions (TAVR, MitraClip, ASD closure) (15 Qs)
● Electrophysiology Studies & Ablation Procedures (12 Qs)
● Image Processing & Digital Subtraction Angiography (12 Qs)
● Radiation Dose Management & ALARA Principles (15 Qs)
● Contrast Media Administration & Reaction Management (10 Qs)
● Hemodynamic Monitoring & Waveform Interpretation (12 Qs)
● Emergency Procedures & Complication Management (13 Qs)
Answer Format
Correct answers are marked in bold green and include:
● ARRT task inventory specific applications and competency validations
● ACC/AHA procedure guideline references and implementations
● Radiation dose optimization techniques and dose area product calculations
● Hemodynamic waveform interpretation and pressure measurement protocols
● Contrast-induced nephropathy prevention strategies and monitoring
● Emergency complication recognition and management algorithms
,Updates for 2026/2027
● 🔹
🔹 Reflects 2026-2027 ARRT CI content specification comprehensive revisions
●
● 🔹
🔹
Updated TAVR/TAVI and transcatheter mitral valve repair protocols
Enhanced radiation dose monitoring and reporting requirements
●
● 🔹
🔹
New intravascular imaging technologies (OCT, IVUS) integration standards
Revised contrast media safety guidelines for renal-impaired patients
●
●
●
🔹 Updated emergency response protocols for cardiac interventional labs
🔹 New quality assurance standards for hybrid operating rooms
Enhanced infection control protocols for invasive cardiac procedures
ARRT CI EXAM QUESTIONS (1–170)
1. During coronary angiography, which projection best visualizes the left anterior
descending (LAD) artery?
A. Right anterior oblique (RAO) with caudal angulation
B. Left anterior oblique (LAO) with cranial angulation
C. AP with no angulation
D. RAO with cranial angulation
Rationale: The LAO cranial view elongates the LAD and separates it from overlapping branches,
providing optimal visualization per ACC/AHA imaging guidelines (2026).
2. A patient undergoing elective PCI has an eGFR of 42 mL/min/1.73m². The CI
technologist should anticipate:
A. No special precautions
B. Use of iso-osmolar contrast media and pre-procedure hydration
C. Immediate cancellation of the procedure
D. Administration of N-acetylcysteine only
Rationale: For eGFR <60, ACC/AHA guidelines (2026) recommend iso-osmolar or low-osmolar
contrast, intravenous hydration, and minimization of contrast volume to reduce contrast-induced
nephropathy (CIN) risk.
3. The primary purpose of digital subtraction angiography (DSA) in cardiac imaging is to:
, A. Increase radiation dose for better resolution
B. Enhance vessel visibility by removing background bony and soft tissue structures
C. Reduce contrast volume by 50%
D. Eliminate the need for ECG gating
Rationale: DSA subtracts a mask image (pre-contrast) from post-contrast images, removing static
structures and improving vessel contrast—critical for precise coronary and structural heart imaging
(ASRT, 2026).
4. A hemodynamic pressure waveform shows a “square root sign” (dip-and-plateau
pattern). This is characteristic of:
A. Aortic stenosis
B. Constrictive pericarditis
C. Mitral regurgitation
D. Cardiac tamponade
Rationale: The square root sign—rapid early diastolic filling followed by abrupt halt—is classic for
constrictive pericarditis. Tamponade shows equalization of diastolic pressures but not this waveform
pattern (ACC Hemodynamics Guide, 2026).
5. Which radiation protection principle is most effective in reducing operator dose during
fluoroscopy?
A. Increasing kVp
B. Maximizing distance from the radiation source
C. Using higher mA
D. Removing lead apron for mobility
Rationale: Dose follows the inverse square law—doubling distance reduces exposure to 1/4. This is
more effective than shielding alone and is a core ALARA principle (NCRP Report No. 168, 2026).
6. During a TAVR procedure, the CI technologist’s role includes:
, A. Placing the valve prosthesis
B. Providing optimal imaging angles for device deployment and aortography
C. Managing anesthesia
D. Performing transesophageal echocardiography
Rationale: The CI technologist ensures precise angiographic views (e.g., coplanar LAO/RAO) for
valve positioning and post-deployment aortography to assess paravalvular leak, per 2026 ACC
TAVR protocols.
7. The normal range for left ventricular end-diastolic pressure (LVEDP) is:
A. 5–10 mmHg
B. 4–12 mmHg
C. 15–20 mmHg
D. 0–3 mmHg
Rationale: Normal LVEDP is 4–12 mmHg. Elevated LVEDP (>15 mmHg) suggests diastolic
dysfunction, volume overload, or mitral stenosis (ACC Hemodynamics Manual, 2026).
8. A patient develops contrast-induced anaphylactoid reaction during angiography. The
FIRST action by the CI technologist is to:
A. Administer epinephrine IM
B. Notify the physician and prepare emergency medications per protocol
C. Increase fluoroscopy time to assess airway
D. Leave the room to call code team
Rationale: CI technologists must recognize reactions and activate the emergency response.
Epinephrine administration is physician-directed. The team should follow lab-specific anaphylaxis
protocol (AHA ACLS, 2026).
9. Dose Area Product (DAP) is measured in:
A. millisieverts (mSv)
