Registered Cardiac Sonographer (RCS)

Click here for sample Employment Verification Letter, Student Verification Letter and Clinical Verification Letter (Graduates of Non-accredited Programs in Cardiac Medical Sonography (Echocardiography)).

CCI requires the Employment Verification Letter contain the following:

1) Employer’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by employer/supervisor.
3) Indicate the name of the applicant.
4) Indicate full- or part-time employment.
5) Indicate the time period of employment.
6) Indicate the primary duties of applicant, related to the field of cardiovascular technology.
7) Original signature of direct supervisor, who must be a MD or hold an active RCCS, RCES, RCIS, RCS, RDCS, RDMS, RPhS, RVS or RVT credential.

CCI requires the Student Verification Letter contain the following:

1) Educational program’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by educational director.
3) Indicate the name of the applicant.
4) Indicate full- or part-time student.
5) Indicate the date or expected date of graduation.
6) Indicate the specialty of the educational program.
7) For Non-programmatically accredited educational programs, indicate the
program length, program specialty (Echo),the number and specialty of clinical hours accrued.
8) Original signature of the educational director.

CCI requires the Clinical Verification Letter (Graduates of Non-accredited Programs in Cardiac Medical Sonography (Echocardiography)) contain the following:

1) Clinical Site’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by the clinical supervisor.
3) Indicate the name of the applicant.
4) Indicate the number of clinical hours.
5) Indicate the time period during which the clinical hours were performed.
6) Original signature of the clinical supervisor.
IMPORTANT: If an individual’s clinical hours were obtained after graduation or if the hours are not a requirement for their educational program, then those hours WOULD NOT count toward the 800 minimum under qualification RCS5.

1. In which of the following patients would enteric isolation technique be used?
   1. Influenza
   2. Draining wounds
   3. Respiratory disease
   4. Diseases spread by fecal contamination
2. While performing two-dimensional echocardiography on Ms. Heinz, you discover what appears to be a large thrombus in the left ventricle. Ms. Heinz states that she just can’t wait to talk with her doctor and that any information you could supply concerning what you see would be a big relief to her. You should inform Ms. Heinz that:
   1. Her nurse is the only person qualified to discuss the results of her test
   2. There is a large thrombus in the main pumping chamber of her heart and that surgery is definitely necessary
   3. You do see a small abnormality in her Echocardiogram, but it is not something she should concern herself with
   4. You cannot interpret her Echocardiogram, but assure her that her doctor will be reviewing it as soon as possible
3. Mr. Smith is a 90-year-old male scheduled for a Transesophageal Echocardiogram. As a preoperative measure, his doctor has given him 25mg of Demoral. Upon entry to the laboratory, his breathing is shallow and he is unresponsive. After notifying the physician, which of the following medications would be MOST useful for counteracting the effects of the narcotic given?
   1. Versed
   2. Narcan
   3. Oxygen
   4. Valium
4. Splitting of S2 is best heard at the
   1. Apex
   2. Third left intercostal space
   3. Fourth left intercostal space
   4. Second right intercostal space
5. During the holding phase of the Valsalva Maneuver, which of the following occurs?
   1. increased cardiac output
   2. decreased intrathoracic pressure
   3. increased venous return to the heart
   4. decreased venous return to the heart
6. Mr. Kline reported to the non-invasive laboratory for an exercise stress test. While preparing Mr. Kline for his examination, he complains of chest pain radiating down his left arm. The resting 12 lead ECG indicates ST segment elevation is present in leads V1 through V6, and the T wave is inverted. Before the physician can be notified, Mr. Kline converts to ventricular tachycardia, lapses to an unconscious state, and has no palpable pulse. According to ACLS guidelines, the technologist should:
   1. Begin CPR
   2. Administer intracardiac epinephrine
   3. Defibrillate the patient at 360 watts/second
   4. Prepare an external pacemaker for immediate use
7. Sound travels through tissue at approximately:
   1. 154.0 m/sec
   2. 1,540.0 m/sec
   3. 15,400 m/sec
   4. 154,000 m/sec
8. Which of the following is most influenced by distance from the face of the transducer?
   1. Frequency
   2. Wavelength
   3. Axial resolution
   4. Lateral resolution
9. If the relative output of an ultrasound instrument is calibrated in decibels and the technologist increases the output by 50 dB, how many times will the beam intensity increase?
   1. 2
   2. 100
   3. 100,000
   4. 1,000,000
10. A ventricular wall motion abnormality that is reversible with nitroglycerine is associated with:
    1. Pericarditis
    2. Myocardial fibrosis
    3. Myocardial ischemia
    4. Myocardial infarction
11. Difficulty in determining echocardiographic signs of tamponade may occur in the presence of:
    1. Right pleural effusion
    2. Systemic hypertension
    3. Left ventricular dysfunction
    4. Right ventricular hypertrophy
12. While performing a 2-D Echocardiogram on Ms. Cane for assessment of her left ventricular function, you discover regional wall motion abnormalities and a dilated hypokinetic left ventricle. The pericardium contains no fluid, valvular pathology and function are normal. The patients chart indicates a history of rheumatic heart fever, and a recent history of fever, fatigue and precordial pain. Her 12 lead EKG exhibits a LBBB and nonspecific ST-T wave changes and a prolonged QT interval. Pulmonary congestion and a moderate cardiomegaly are evidenced by chest X-ray. Correlating these data you would suspect a
    diagnosis of:
    1. Myocarditis
    2. Cardiac tamponade
    3. Pericardial effusion
    4. Congestive heart failure
13. According to the American Society of Echocardiography, the left ventricle should be measured at the region of the:
    1. Papillary muscles
    2. Chordae tendineae above the papillary muscles
    3. Mitral valve where only the anterior leaflet is seen
    4. Mitral valve where both the anterior and posterior leaflets are visualized
14. Your patient’s history shows recent cardiac catheterization data indicating elevated right heart pressures and an IV end-diastolic pressure less then the left atrial mean pressure. The EKG demonstrates atrial fibrillation. A holosystolic murmur can be auscultated. Which of the following imaging methods would be useful during two dimensional echocardiography of this patient?
    1. Continuous wave Doppler and m-mode echocardiography
    2. Two-dimensional echocardiography for the measurement of aortic valve orifice size
    3. Two-dimensional echocardiography in combination with Doppler for the measurement and determination of the mitral orifice size
    4. Color flow imaging in combination with two-dimensional echocardiography for the evaluation of flow disturbance across the aortic valve
15. In the performance of echocardiography, which of the following methods requires invasive introduction of the transducer?
    1. Stress echocardiography
    2. Contrast echocardiography
    3. Assisted pericardiocentesis
    4. Transesophageal echocardiography
16. Which of the following conditions would be a contraindication to the performance of contrast Echocardiography?
    1. VaIvular regurgitation
    2. Left ventricular dysfunction
    3. Complex congenital heart disease
    4. A large right-to-left intracardiac shunt
17. How many colors can be displayed in a single pixel of color flow image?
    1. 1
    2. 2
    3. 3
    4. 4
18. Which of the following Doppler frequencies would result in the shallowest penetration depth?
    1. 2 MHz
    2. 8 MHz
    3. 10 MHz
    4. 20 MHz
19. Which of the following frequency shifts would produce aliasing, when using a 5 MHz pulsed Doppler transducer, with a pulse repetition frequency of 15 kHz?
    1. 3 kHz
    2. 5 kHz
    3. 6 kHz
    4. 8 kHz
20. Why are patients requested to record the time of bowel movements when wearing a Holter monitor?
    1. Valsalva Maneuver will cause a heart rate change
    2. To correlate the motion artifact on the recording
    3. For the systematic recording of all patient activity
    4. Breathing rate will delay conduction through AV node
21. Dr. Hager has ordered an echocardiogram of Mr. Finney for evaluation of left ventricular function. The patient’s history indicates that the left ventricle is enlarged. When reviewing the 12 lead ECG, you observe that the T wave is inverted in leads 1, AVL, V5 and V6. The ST segment is depressed. You realize that this finding is MOST consistent with:
    1. Pericarditis
    2. An old myocardial infarction
    3. Left ventricular hypertrophy
    4. Right ventricular hypertrophy
22. Which of the following is NOT an effect of exercise in the patient with a healthy heart? Increased:
    1. Stroke volume
    2. Ejection fraction
    3. End-systolic volume
    4. End-diastolic volume
23. Which of the following is NOT considered an indicator of coronary artery disease, during the performance of exercise stress testing?
    1. Sinus tachycardia
    2. ST segment elevation
    3. ST segment depression
    4. Increased in R wave amplitude
24. The first heart sound is associated with:
    1. preload
    2. afterload
    3. semilunar valve closure
    4. atrioventricular valve closure
25. The patient’s ECG indicates the presence of atrioventricular disassociation, without heart block. This condition may cause a significant drop in blood pressure and cardiac output. Which of the following would be the MOST effective treatment choice to control and increase heart rate?
    1. Atropine sulfate intravenously
    2. Temporary atrial or ventricular pacing
    3. Administration of approximately 500cc of normal saline
    4. Implantation of a permanent atrioventricular pacemaker

Answers
 1. d   2. d   3. b   4. b   5. d  6. a   7. b  8. d   9. c 10. c  11. d 12. a 13. b 14. c 15. d 16. b 17. a  18. d 19. d 20. a 21. c 22. c 23. a 24. d  25. b