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Exam Review

Key Facts: RDCS Pediatric Exam

≈145

Exam Questions

Multiple-choice and hotspot

555

Passing Score (scaled)

ARDMS (300-700 scale)

3 hrs

Exam Duration

ARDMS

USD 300

Specialty Exam Fee

Includes USD 100 processing fee

29%

Performing Exam Domain

Largest domain

88%

2023 First-Time Pass Rate

ARDMS, 2023 administration

PE has approximately 145 multiple-choice and hotspot items in a 3-hour examination period. Passing requires 555 on the 300–700 scaled-score range. Version 24.1 weights Performing the Exam 29%, Congenital Anomalies 25%, Postoperative Anatomy 19%, Normal Anatomy and Physiology 15%, and Acquired Heart Disease 12%. The USD 300 PE fee includes USD 100 processing; SPI, if required, is a separate USD 275. Initial credential timing follows the calendar-based five-year rule.

Sample RDCS Pediatric Practice Questions

Try these sample questions to review concepts for the RDCS Pediatric exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 234+ question experience with AI tutoring.

1Which cardiac chamber forms the cardiac apex in a normal heart?
A.Right atrium
B.Left atrium
C.Right ventricle
D.Left ventricle
Explanation: The left ventricle forms the cardiac apex in a normal heart. This is the most inferior and leftward portion of the heart, best visualized in the apical four-chamber view. The left ventricle has thicker walls than the right ventricle due to the higher afterload required to pump blood to the systemic circulation.
2In normal fetal circulation, which structure allows blood to bypass the pulmonary circulation?
A.Ductus venosus
B.Foramen ovale and ductus arteriosus
C.Umbilical vein
D.Coronary sinus
Explanation: The foramen ovale allows blood to flow from the right atrium to the left atrium, bypassing the pulmonary circulation, while the ductus arteriosus allows blood to flow from the pulmonary artery to the aorta. These shunts are essential because the fetal lungs are collapsed and receive minimal blood flow.
3Which statement correctly describes the normal position of the aortic valve relative to the pulmonary valve?
A.The aortic valve is anterior and to the right of the pulmonary valve
B.The aortic valve is posterior and to the right of the pulmonary valve
C.The aortic valve is anterior and to the left of the pulmonary valve
D.The aortic valve is posterior and to the left of the pulmonary valve
Explanation: In a normal heart, the aortic valve is located posterior and to the right of the pulmonary valve. This relationship can be remembered using the acronym "SOLV" (semilunar valves), where the pulmonic valve sits more Superior and Leftward, while the aortic valve is more inferior and rightward.
4Which vessel drains directly into the right atrium in normal anatomy?
A.Pulmonary veins
B.Coronary sinus
C.Superior vena cava only
D.Inferior vena cava only
Explanation: The coronary sinus drains directly into the right atrium at the ostium of the coronary sinus, located between the inferior vena cava and the tricuspid valve. The pulmonary veins drain into the left atrium, while the SVC and IVC also drain into the right atrium but are not the best single answer.
5What is the normal origin of the left coronary artery?
A.Right sinus of Valsalva
B.Left sinus of Valsalva
C.Non-coronary sinus
D.Ascending aorta above sinuses
Explanation: The left coronary artery normally arises from the left sinus of Valsalva (also called the left coronary sinus). The right coronary artery arises from the right sinus of Valsalva. The non-coronary sinus typically does not give rise to any coronary arteries in normal anatomy.
6During the first week of life, what is the expected pressure in the pulmonary artery?
A.Equal to aortic pressure
B.Lower than left ventricular pressure
C.Systemic or near-systemic pressure
D.One-fourth of aortic pressure
Explanation: During the first week of life, the pulmonary artery pressure is typically systemic or near-systemic due to the elevated pulmonary vascular resistance present in the neonatal period. As pulmonary vascular resistance falls over the first weeks to months of life, pulmonary artery pressure decreases to approximately one-fourth to one-fifth of systemic pressure.
7Which finding on echocardiography suggests normal visceral situs solitus?
A.Inferior vena cava to the left of the spine
B.Liver on the left side
C.Aortic arch to the right of the trachea
D.Stomach bubble on the left side with IVC to the right of the spine
Explanation: Normal visceral situs solitus is characterized by the stomach bubble on the left side and the inferior vena cava to the right of the spine. The liver is on the right, and the aortic arch is typically left-sided. These findings help establish the abdominal and thoracic situs during the segmental approach to congenital heart disease evaluation.
8Which of the following best describes the membranous septum?
A.Thick muscular portion between ventricles
B.Thin fibrous portion adjacent to the aortic and tricuspid valves
C.Muscular ridge in the right ventricle
D.Fibrous ring surrounding the mitral valve
Explanation: The membranous septum is a thin fibrous portion of the interventricular septum located adjacent to the aortic valve and the tricuspid valve. It is the site of membranous ventricular septal defects, the most common type of VSD. The membranous septum is much thinner than the muscular interventricular septum.
9What is the most common cardiac manifestation of Kawasaki disease?
A.Pericardial effusion
B.Coronary artery aneurysms
C.Mitral valve prolapse
D.Aortic root dilation
Explanation: Coronary artery aneurysms are the most serious and common cardiac manifestation of Kawasaki disease. These typically develop 2-4 weeks after disease onset. Echocardiographic surveillance of coronary arteries is essential in the acute and convalescent phases to detect aneurysm formation and guide therapy.
10Which echocardiographic finding is characteristic of dilated cardiomyopathy in children?
A.Left ventricular hypertrophy
B.Dilated left ventricle with reduced systolic function
C.Pericardial thickening
D.Asymmetric septal hypertrophy
Explanation: Dilated cardiomyopathy is characterized by a dilated left ventricle (and often right ventricle) with reduced systolic function. The ejection fraction is typically less than 30-40%. This contrasts with hypertrophic cardiomyopathy, which shows ventricular hypertrophy with preserved or hyperdynamic systolic function.

About the RDCS Pediatric Exam

The ARDMS Pediatric Echocardiography (PE) specialty examination assesses pediatric cardiac sonography, including normal anatomy, congenital and acquired disease, postoperative evaluations and examination techniques. An initial RDCS credential requires the applicable pathway and SPI plus a qualifying specialty; the owner’s additional-specialty exception applies to Active registrants.

Exam sponsor: ARDMS (American Registry for Diagnostic Medical Sonography) / Pearson VUE. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

145 questions

Time Limit

3 hours

Passing Score

Scaled score 555 on a 300-700 scale

Exam / Certification Fees

USD 300

Exam sponsor website

Reported exam pass rate: 88%. first-time takers in 2023; 72% overall (ARDMS published statistics) This describes exam candidates, not OpenExamPrep users or results from using our resources. 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.

15%

Normal Anatomy and Physiology

Great arteries, systemic and pulmonary veins, cardiac valves, ventricles, atria, normal transitional circulation, coronary arteries and abdominal situs

12%

Acquired Heart Disease

Cardiomyopathies, Kawasaki disease, endocarditis, pulmonary hypertension, pericardial effusion

25%

Congenital Anomalies

Septal defects (ASD, VSD), conotruncal defects (TOF, TGA), single ventricle, arch anomalies

19%

Postoperative (surgically corrected/palliated) Anatomy

TOF repair, Fontan procedure, Norwood/Glenn, arterial switch, VSD/ASD repairs, conduit evaluation

29%

Performing the Exam

2D imaging, M-mode, spectral Doppler, color Doppler, standard views, Bernoulli equation, shunt quantification

Preparing for the RDCS Pediatric Exam

What You Need to Know

  • Passing score: Scaled score 555 on a 300-700 scale
  • Exam length: 145 questions
  • Time limit: 3 hours
  • Exam / certification fees: USD 300 Official sources

Using Our Practice Resources

  • Work through all 234 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

RDCS Pediatric: Suggested Study Strategy

1Focus on Performing the Exam (29%) — master 2D imaging, M-mode, spectral/color Doppler, and standard pediatric views
2Study Congenital Anomalies thoroughly (25%) — know diagnostic criteria for ASD, VSD, TOF, TGA, single ventricle, and coarctation
3Learn postoperative evaluations (19%) — Fontan, Norwood, Glenn, TOF repair, and arterial switch assessments
4Use Bernoulli for appropriate pressure-gradient estimates and area × VTI at anatomically appropriate sampling sites for flow ratios.
5Know normal transitional circulation and transitional newborn physiology
6Review Kawasaki disease echo findings — coronary artery aneurysms, LV dysfunction, and serial monitoring

Frequently Asked Questions

What is the RDCS Pediatric Echocardiography exam?

RDCS Pediatric Echocardiography (PE) is an ARDMS specialty exam that validates expertise in pediatric cardiac sonography including congenital heart disease evaluation, postoperative assessment, and echocardiographic techniques for neonates through adolescents.

How many questions are on the RDCS Pediatric exam?

The exam has approximately 145 multiple-choice and hotspot questions delivered over 3 hours. Scoring uses a 300-700 point scale on which 555 or better passes; ARDMS states that the result is pass/fail and is not percentage-based or curve-based. The exam is administered at Pearson VUE test centers.

What are the prerequisites for the RDCS Pediatric exam?

Meet an applicable pathway in the October 2026 ARDMS prerequisite chart. Clinical Verification (CV) requirements vary by pathway and application stage. For Pathway 2 graduates, CV is not required when the application is submitted and received within one year after successful program completion; after that year, new documentation and a current CV for each specialty are required. Eligible Pathway 2 students may apply through their Program Director's Paperless process up to 60 days before graduation and must successfully complete the program to retain passed exam results. Pathway 3B students applying within one year before program completion are CV-exempt only after completing at least 12 months of full-time clinical experience and at least 1,680 hours of clinical scanning within the program. After graduation, Pathway 3B requires a graduate letter and current CV; graduates whose program qualifies for Pathway 2 should apply under Pathway 2 instead. CAAHEP or CMA/HSO programmatic accreditation applies to Pathway 2. For an initial credential, pass SPI and PE in either order under the calendar-based five-year rule: a first pass on June 6, 2026 gives until December 31, 2031 for the second exam. An already Active ARDMS registrant adding a specialty has the published additional-specialty exception. The PE examination fee is USD 300 including USD 100 non-refundable processing; SPI, when required, is USD 275 separately.

What congenital heart defects should I study?

The official congenital domain includes septal, conotruncal, single-ventricle, obstructive, arch, venous, coronary and other anomalies. Review the entire Version 24.1 task list; these study resources do not establish which particular lesions appear most often on live forms.

How should I prepare for the RDCS Pediatric exam?

OpenExamPrep suggests an adjustable 150–200-hour plan over 12–16 weeks; this is an editorial estimate, not an ARDMS requirement or measured candidate average. The five phases shown here total 180 hours. Performing the Exam (29%) and Congenital Anomalies (25%) together account for 54% of the official domain weighting; review every domain and practise interpreting images.