100+ Free RCIS Practice Questions

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Question 1

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In a right-dominant coronary circulation, which artery gives rise to the posterior descending artery (PDA)?

Left anterior descending (LAD)

Left circumflex (LCx)

Right coronary artery (RCA)

First diagonal branch

to track

2026 Statistics

Key Facts: RCIS Exam

170

Total Questions

CCI RCIS Detailed Test Outline

155 + 15

Scored + Pretest

CCI RCIS exam format

3 hours

Exam Time

CCI RCIS exam format

$375

Application Fee

CCI fee schedule

24%

Intra-Procedure (largest)

CCI RCIS Detailed Test Outline

22%

Imaging & Hemodynamics

CCI RCIS Detailed Test Outline

3 years

Certification Validity

CCI recertification policy

Pearson VUE

Test Provider

CCI testing partner

CCI's RCIS exam consists of 170 multiple-choice questions (155 scored + 15 pretest) delivered over 3 hours through Pearson VUE. The exam validates cath lab technologist competence across coronary anatomy and physiology, diagnostic catheterization, angiographic projections, PCI hardware, hemodynamics (Fick, thermodilution, Bernoulli, Gorlin), pharmacology (heparin/bivalirudin/P2Y12), structural heart procedures (TAVR, MitraClip, Watchman, IABP, Impella), and ALARA radiation safety. Eligibility runs through CCI-recognized educational or clinical pathways (accredited invasive cardiovascular technology programs, hospital-based training, or documented cath lab hours).

Sample RCIS Practice Questions

Try these sample questions to test your RCIS exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1In a right-dominant coronary circulation, which artery gives rise to the posterior descending artery (PDA)?

A.Left anterior descending (LAD)

B.Left circumflex (LCx)

C.Right coronary artery (RCA)

D.First diagonal branch

Explanation: Coronary dominance is defined by the origin of the PDA. In approximately 85% of patients (right-dominant), the PDA arises from the distal RCA after the crux of the heart. About 8% are left-dominant (PDA from LCx) and 7% are co-dominant.

2Which coronary artery is BEST visualized in a left anterior oblique (LAO) cranial projection?

A.Mid and distal left anterior descending (LAD)

B.Proximal left circumflex

C.Right coronary artery ostium

D.Posterior descending artery only

Explanation: LAO cranial (typically LAO 30-50 degrees with 20-30 degrees cranial angulation) elongates the LAD and separates it from the diagonal branches, providing optimal visualization of the mid-to-distal LAD and septal/diagonal bifurcations.

3Which test is performed BEFORE radial artery access to confirm dual blood supply to the hand?

A.Trendelenburg test

B.Allen or Barbeau test

C.Romberg test

D.Phalen test

Explanation: The Allen test (clinical compression) and Barbeau test (pulse oximetry plethysmography) assess ulnar collateral perfusion before radial access. The Barbeau test is more objective (Type A/B = acceptable, Type C = transient loss/return, Type D = no return = contraindication).

4A pulmonary artery catheter measurement records a pulmonary capillary wedge pressure (PCWP) of 22 mmHg. This MOST likely reflects which condition?

A.Hypovolemic shock

B.Elevated left atrial / left ventricular end-diastolic pressure

C.Right ventricular failure with normal LV function

D.Tricuspid stenosis

Explanation: PCWP normally is 8-12 mmHg and approximates left atrial pressure and LV end-diastolic pressure when the mitral valve is normal. A PCWP of 22 mmHg indicates elevated LA/LVEDP, classic for left heart failure or significant mitral disease.

5Which catheter is preferred for left ventriculography to permit power injection of contrast without recoil?

A.Judkins right (JR4)

B.Pigtail catheter

C.Amplatz left (AL1)

D.Multipurpose A1

Explanation: The pigtail catheter has multiple side holes and a curled tip that distributes high-pressure contrast injection, prevents myocardial staining/dissection, and avoids whip from the ventricle. Standard LV gram is RAO 30 degrees with 30-40 mL contrast at 10-15 mL/s.

6TIMI flow grade 2 is BEST described as which of the following?

A.No perfusion past the lesion

B.Penetration without complete distal perfusion (slow filling)

C.Complete perfusion at normal speed

D.Penetration with delayed but full distal perfusion

Explanation: TIMI 0 = no flow; TIMI 1 = penetration without distal perfusion (faint contrast trickle); TIMI 2 = delayed but complete distal perfusion (slower than non-target vessel); TIMI 3 = normal brisk flow.

7Per current AHA/ACC and ESC guidelines, which vascular access site is associated with LOWER bleeding and mortality in primary PCI for STEMI?

A.Femoral artery

B.Radial artery

C.Brachial cutdown

D.Translumbar approach

Explanation: Multiple RCTs (RIVAL, MATRIX, SAFARI-STEMI in selection) and meta-analyses show transradial access reduces major bleeding, vascular complications, and mortality compared with transfemoral access in ACS/STEMI when performed by experienced operators. Current guidelines recommend radial as default.

8Which guide catheter shape is MOST commonly used to engage a left main coronary artery with normal aortic root anatomy during PCI?

A.Judkins Left (JL) 3.5 or 4

B.Amplatz Right 1 (AR1)

C.Multipurpose A2

D.Hockey-stick

Explanation: JL 3.5 and JL 4 are the workhorse guides for the left main in normal-sized aortic roots. Larger roots may require JL 4.5 or 5; small roots use JL 3 or JL 3.5.

9Which guidewire category is specifically designed for crossing chronic total occlusions (CTOs)?

A.Workhorse wires (BMW, Runthrough)

B.Tapered-tip stiff wires (Fielder XT-A, Gaia, Confianza/Conquest, Hornet)

C.Hydrophilic floppy wires (Whisper, Pilot 50)

D.Extra-support exchange wires (Iron Man)

Explanation: CTO crossing wires include tapered-tip polymer or stiff wires such as Fielder XT-A (1.0g), Gaia 1/2/3 (composite-core, controllable tip), Conquest/Confianza Pro (9-12g, tapered), and Hornet 10/14 (penetration). Tip load is selected based on cap morphology.

10A patient with severe aortic stenosis has a peak instantaneous transvalvular gradient. Using the modified Bernoulli equation, what is the gradient if peak velocity across the valve is 4.5 m/s?

A.18 mmHg

B.36 mmHg

C.81 mmHg

D.162 mmHg

Explanation: Modified Bernoulli: gradient (mmHg) = 4 x V^2, where V is velocity in m/s. 4 x (4.5)^2 = 4 x 20.25 = 81 mmHg.

About the RCIS Exam

RCIS is CCI's credential for cath lab technologists who assist physicians during diagnostic and interventional cardiac catheterization. It validates competence across pre-procedure assessment, intra-procedural monitoring/assistance, post-procedure care, hemodynamics, pharmacology, equipment operation, and professional standards.

Questions

170 scored questions

Time Limit

3 hours

Passing Score

Scaled passing score (CCI)

Exam Fee

$375 (CCI (Cardiovascular Credentialing International))

RCIS Exam Content Outline

24%

Patient Care: Intra-Procedure

Hemodynamic monitoring, anticoagulation/ACT targets, sterile assistance, conscious sedation, recognition of arrhythmias, ischemia, vasovagal, perforation, and tamponade during diagnostic and interventional cases

22%

Procedural Imaging and Hemodynamic Assessment

Pressure waveforms (a/c/v, x/y), Fick/thermodilution CO, valve gradients, Gorlin formula, oximetry shunt detection, fluoroscopic projections (RAO/LAO/cranial/caudal/spider), TIMI flow, IVUS/OCT, FFR/iFR

16%

Patient Care: Pre-Procedure

History, allergy, lab/eGFR review, NPO, medication management (metformin/anticoagulants/antiplatelets), informed consent, Allen/Barbeau testing, patient education

10%

Pharmacology

Heparin and bivalirudin dosing/ACT, ticagrelor/prasugrel/clopidogrel, GP IIb/IIIa, intracoronary nitroglycerin/verapamil/adenosine/nicardipine, vasopressors, antiarrhythmics, contrast media (low/iso-osmolar)

10%

Patient Care: Post-Procedure

Sheath management, hemostasis (manual, TR Band, closure devices), access-site complications (RAO, hematoma, retroperitoneal bleed, pseudoaneurysm), CIN monitoring, discharge education

10%

Equipment Operation, QA, and Sterile Technique

Fluoroscopy, hemodynamic monitoring, ACT analyzers, IABP/Impella consoles, sterile draping/scrubbing, manifold management, contrast handling, equipment QA

Professional Standards

RCIS scope vs operator role, time-out/Universal Protocol, ALARA radiation safety, dosimetry, documentation, infection control, advocacy, CCI ethics/recertification

How to Pass the RCIS Exam

What You Need to Know

Passing score: Scaled passing score (CCI)
Exam length: 170 questions
Time limit: 3 hours
Exam fee: $375

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

RCIS Study Tips from Top Performers

1Master coronary anatomy and dominance — RCA gives the PDA in ~85%, the LCx in ~8% (left dominant), and either in ~7% (co-dominant)

2Memorize angiographic projections: LAO cranial = LAD, RAO cranial = LAD/diagonals, LAO caudal (spider) = left main bifurcation, LAO 30-45 = RCA

3Drill ACT targets: 250-300 sec for PCI with GP IIb/IIIa, 300+ sec without; 200-250 for diagnostic-only catheterization

4Memorize current DES platforms (Synergy, Promus, Xience, Resolute Onyx, Onyx Frontier) and current TAVR valves (SAPIEN 3 Ultra, Evolut FX)

5Practice Bernoulli (4V^2) and Gorlin (with constants 44.3 aortic, 37.7 mitral) calculations until automatic

6Learn complication recognition cold: Ellis perforation grades, NHLBI dissection A-F, TIMI flow 0-3 and TIMI thrombus 0-5

7Drill ALARA and dosimetry: Time-Distance-Shielding, dual badge monitoring, lens dose 20 mSv/yr, 5 Gy reference air kerma threshold for follow-up

8Stay clear on RCIS scope: support the operator, monitor, anticipate, and document — do not direct treatment decisions

Frequently Asked Questions

How many questions are on the RCIS exam?

The RCIS exam consists of 170 multiple-choice questions: 155 scored items plus 15 unscored pretest items. Candidates have 3 hours to complete the exam at a Pearson VUE testing center or via available proctored options.

What score do I need to pass RCIS?

CCI uses a scaled scoring system for the RCIS. The passing score is set by CCI and reported as a scaled value. The exam covers seven content areas weighted from 8% to 24% per the current Detailed Test Outline.

How much does the RCIS exam cost?

The standard CCI RCIS application fee is $375. There may be additional fees for retakes, recertification, or specific testing accommodations per the CCI fee schedule.

Who is eligible to take RCIS?

CCI offers multiple pathways including completion of an accredited invasive cardiovascular technology program (CAAHEP/CoARC), hospital-based training programs, or documented cath lab clinical experience. Verify the specific pathway requirements in the current CCI RCIS Exam Application before applying.

What is the difference between RCIS and RCES?

RCIS validates competence in the cardiac cath lab (diagnostic angiography and percutaneous coronary intervention). RCES validates competence in the electrophysiology lab (EP studies, ablation, device implantation). Both are CCI cardiovascular technologist credentials but cover different procedural environments.

How long is RCIS certification valid?

RCIS is valid for 3 years. Recertification is achieved by earning continuing education points or by retaking the RCIS exam, per current CCI recertification policy.

What domains carry the most weight on the RCIS exam?

Patient Care: Intra-Procedure (24%) and Procedural Imaging and Hemodynamic Assessment (22%) carry the highest weight together accounting for nearly half of scored items. Patient Care: Pre-Procedure (16%) and Pharmacology, Post-Procedure care, Equipment, and Professional Standards round out the blueprint.