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Exam Review

Key Facts: RVS Exam

170

Total Items

CCI RVS examination details

150 + 20

Scored + Unscored

CCI RVS examination details

170 minutes

Question-Answering Time

CCI RVS examination details

650 / 0–900

Passing Score / Scale

CCI RVS score reporting

USD 365

Application + Exam Fee

CCI RVS fee

22%

Extremity Arterial Duty

Current CCI RVS matrix

3 years

Renewal After First Renewal

CCI renewal requirements

CCI RVS has 170 items, including 150 scored and 20 unscored, with 170 minutes answering time within a three-hour Pearson VUE appointment. Passing requires 650 on a 0–900 scaled-score range. The current matrix covers patient care 11%, physics 15%, abdominal/visceral 10%, cerebrovascular 20%, extremity arterial 22%, extremity venous 19%, and hemodialysis 3%.

Sample RVS Practice Questions

Try these sample questions to review concepts for the RVS exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1For optimal Doppler velocity measurement during carotid duplex imaging, the angle between the ultrasound beam and the direction of blood flow should be:
A.As close to 90 degrees as possible
B.60 degrees or less
C.Between 70 and 80 degrees
D.Exactly 0 degrees
Explanation: Doppler angle correction must be 60 degrees or less to maintain velocity accuracy. As the angle approaches 90 degrees, the cosine of the angle approaches zero and velocity calculations become unreliable. Society of Radiologists in Ultrasound (SRU) and IAC standards require Doppler angles of 60 degrees or less for vascular velocity measurements.
2A sonographer scanning a deep abdominal vessel needs to balance penetration with resolution. Which transducer frequency is most appropriate for an aortic duplex on an average-sized adult?
A.12-15 MHz linear
B.7-9 MHz linear
C.2-5 MHz curvilinear
D.15-18 MHz hockey stick
Explanation: A 2-5 MHz curvilinear (curved array) transducer provides adequate penetration for deep abdominal structures like the aorta, IVC, renal arteries, and mesenteric vessels. Lower frequencies penetrate deeper but with reduced spatial resolution. Higher frequency linear probes are reserved for superficial peripheral vessels.
3Aliasing on color Doppler imaging occurs when:
A.The Doppler shift exceeds half the pulse repetition frequency
B.Tissue harmonic imaging is enabled
C.The wall filter is set too high
D.The gain is set too low
Explanation: Aliasing occurs when the Doppler frequency shift exceeds the Nyquist limit, which is one-half of the pulse repetition frequency (PRF). This causes the displayed velocity to wrap around, appearing as flow in the opposite direction. Aliasing can be reduced by increasing PRF (scale), shifting baseline, or decreasing transmit frequency.
4Which adjustment will MOST effectively reduce aliasing during a renal artery Doppler exam when peak velocities exceed the displayed scale?
A.Decrease the color gain
B.Increase the pulse repetition frequency (scale)
C.Increase the wall filter
D.Switch to power Doppler
Explanation: Increasing PRF (scale) raises the Nyquist limit and is the most direct way to resolve aliasing when high velocities are present. Other options include shifting the baseline, decreasing the transducer frequency, and reducing the Doppler angle. Increasing PRF is the standard first-line correction.
5Tissue harmonic imaging improves image quality primarily by:
A.Increasing penetration depth in obese patients
B.Reducing near-field clutter and side-lobe artifacts
C.Eliminating the need for Doppler angle correction
D.Increasing temporal resolution for cardiac applications
Explanation: Tissue harmonic imaging (THI) uses returning echoes at twice the transmitted frequency. Because harmonics are generated within tissue rather than at the transducer surface, near-field clutter, side-lobe artifacts, and reverberation are reduced. THI improves contrast resolution especially in technically difficult patients.
6The spectral Doppler sample volume (gate) for measuring peak systolic velocity in the internal carotid artery should be:
A.Placed at the wall to detect plaque
B.As wide as the vessel lumen
C.Centered in the lumen and 1.5-2 mm in size
D.Placed just distal to the carotid bulb only
Explanation: For peak velocity measurement, the sample volume should be small (typically 1.5-2 mm), centered in the vessel lumen, and aligned with the direction of flow. A small gate captures the central laminar flow stream. Sampling at the wall or with an oversized gate introduces spectral broadening artifacts.
7During a peripheral arterial duplex, the sonographer notices excessive color bleed into surrounding tissue and the color box overflowing the lumen. The MOST appropriate first correction is to:
A.Decrease color gain
B.Increase color persistence
C.Increase wall filter to maximum
D.Switch to a lower frequency probe
Explanation: Color bleed (overwriting of true color signals onto surrounding tissues) typically results from excessive color gain. The technique is to increase gain until noise appears, then back off slightly. Other refinements include reducing the color box size and optimizing PRF.
8In the Doppler equation, which variable is squared and therefore has the greatest effect on Doppler shift error from misalignment?
A.Cosine of the Doppler angle
B.Speed of sound in tissue
C.Transmit frequency
D.Reflector velocity
Explanation: In the Doppler equation, the Doppler shift is proportional to cos(theta). Although cos(theta) itself is not squared, it changes nonlinearly: a small angle error at high angles (e.g., 70 to 75 degrees) produces a much larger velocity error than the same change at low angles. This is why ARDMS, IAC, and CCI standards mandate angles 60 degrees or less.
9Power (energy) Doppler differs from color Doppler in that power Doppler:
A.Displays direction and velocity of flow
B.Is more sensitive to slow flow but lacks direction information
C.Always uses higher PRF settings
D.Cannot be used in superficial vessels
Explanation: Power Doppler displays the integrated amplitude of the Doppler signal, providing higher sensitivity to slow flow with less angle dependence. However, it does not encode flow direction or velocity. Power Doppler is useful for detecting flow in small vessels, distal extremities, and slow renal flow.
10Spectral broadening on a carotid Doppler waveform is BEST described as:
A.Filling in of the spectral window during peak systole
B.A loss of color signal in the vessel center
C.An increase in gray-scale brightness
D.A change in flow direction during diastole
Explanation: Spectral broadening refers to a filling-in of the normally clear spectral window beneath the peak systolic envelope. It indicates a wider range of velocities (turbulent or disturbed flow) within the sample volume. While spectral broadening can suggest stenosis, it can also be caused by oversized sample gates or improper gain.

About the RVS Exam

CCI RVS is a comprehensive vascular ultrasound credential covering cerebrovascular, extremity arterial and venous, abdominal/visceral, dialysis access, physics, and patient safety.

Exam sponsor: CCI / Pearson VUE Testing. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

170 questions

Time Limit

3-hour appointment; 170 minutes for questions

Passing Score

650 (0–900 scaled-score range)

Exam / Certification Fees

$365

Exam sponsor website

Reported exam pass rate: Not published on current exam page. Do not use an unsupported estimated first-time pass rate. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

11%

Maintaining Patient Care and Safety

Patient assessment, appropriateness, positioning, critical and preliminary findings, infection control, ergonomics, QA, bioeffects, and equipment care.

15%

Applying Principles of Physics and Hemodynamics

Equipment setup, grayscale optimization, hemodynamics, PW and CW Doppler, color and power Doppler, and artifacts.

10%

Performing Abdominal/Visceral Examinations

Renal, mesenteric, aortoiliac including EVAR, iliocaval including venous stents, and kidney/liver transplant duplex.

20%

Performing Extracranial/Intracranial Examinations

Extracranial duplex, imaging and non-imaging transcranial Doppler, and extracranial postoperative duplex.

22%

Performing Arterial Examinations of the Upper and Lower Extremities

Native and postoperative duplex, ABI and segmental pressures, PVR, exercise, specialty physiologic testing, and puncture complications.

19%

Performing Venous Examinations of the Upper and Lower Extremities

Extremity venous duplex, reflux testing, vein mapping, and peri-procedural ablation/PICC assessment.

3%

Performing Hemodialysis Examinations

Dialysis access examination and preoperative/postoperative testing.

Preparing for the RVS Exam

What You Need to Know

  • Passing score: 650 (0–900 scaled-score range)
  • Exam length: 170 questions
  • Time limit: 3-hour appointment; 170 minutes for questions
  • Exam / certification fees: $365 Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

RVS: Suggested Study Strategy

1Use IAC-modified SRU native ICA criteria: primary PSV threshold 180 cm/s for 50–69%, with plaque, ratios, EDV, and the 125–180 cm/s exception considered together.
2Report resting ABI as abnormal ≤0.90, borderline 0.91–0.99, normal 1.00–1.40, or noncompressible >1.40.
3TBI ≤0.70 is abnormal; interpret toe pressure and waveforms with symptoms and wound findings.
4Reflux: >0.5 seconds in superficial trunks, tibial/deep femoral veins and perforators; >1 second in common femoral, femoral and popliteal veins.
5AAA ≥3 cm warrants appropriate surveillance; symptoms, growth, diameter, sex, and operative risk influence referral.
6Use validated renal duplex criteria and multiple parameters rather than one isolated velocity.
7For peripheral velocity measurements use an angle ≤60 degrees parallel to actual flow; non-imaging TCD uses its own protocol.

Frequently Asked Questions

How many questions and how much testing time does RVS have?

CCI RVS has 170 total items: 150 scored and 20 unscored. The three-hour appointment includes 170 minutes answering questions and 10 minutes for the tutorial/survey. Formats include multiple-choice and innovative items.

What score is required to pass CCI RVS?

CCI requires a total scaled score of 650 on its 0–900 reporting range. This is not a raw percentage or a published fixed number of correct responses.

How much does the CCI RVS exam cost?

The current application and examination fee is USD 365, including a nonrefundable USD 100 processing component. A failed attempt requires a new application and the applicable full examination fee; no discounted USD 295 retake is stated in the linked handbook.

Which RVS eligibility pathways are current?

Current pathways are RVS235, RVS4, RVS5, and RVS6, covering qualifying health-science education/work, accredited vascular programs, qualifying nonaccredited vascular programs, or active ultrasound credentials plus vascular experience. Each has specific documentation requirements. RVS1 closed to first-time applicants in July 2023.

When can a candidate retake RVS after failing?

CCI's linked applicant handbook requires a new application and fees and specifies a mandatory 45-day waiting period before a new Authorization to Test start date. The re-examination application may be submitted during that wait.

How should I plan my RVS study and find official resources?

Use the current task matrix on CCI's Registered Vascular Specialist page, linked applicant handbook, and your clinical training materials. A 12-week review is a planning suggestion, not a CCI eligibility requirement; adjust it to your experience and demonstrated understanding.

How is RVS renewed?

The first renewal is due approximately 9–12 months after earning the credential and requires a fee and ethics attestation, with no CEUs. Subsequent three-year renewals require 36 CEUs, at least 30 cardiovascular-related, plus the renewal fee and ethics attestation.