ARDMS SPI Exam: The Complete Guide (2026)

Last Updated: January 2026 | Reading Time: 18 minutes

Written by Prepry Editorial Team, RDMS, RVTReviewed by Board-Certified Sonographers, RDMS (AB, OB/GYN)Last reviewed: January 2026

Quick Summary: The ARDMS SPI (Sonography Principles & Instrumentation) exam is a 110-question, 2-hour test required for every ARDMS credential. With a 71% first-time pass rate, proper preparation is essential. This guide covers everything you need: exam format, content domains, 10 free practice questions, registration steps, and proven study strategies.



What is the SPI Exam?

You did it! You've graduated from sonography school and are one step closer to becoming a registered sonographer. Now, there's just one hurdle to overcome before you can officially earn your ARDMS credentials (RDMS, RDCS, RVT, or RMSKS)—passing the ARDMS SPI Exam. The Sonography Principles & Instrumentation (SPI) exam is a standardized test administered by the American Registry for Diagnostic Medical Sonography (ARDMS). It evaluates your knowledge of ultrasound physics, instrumentation, and the scientific principles underlying diagnostic sonography. Unlike specialty exams that focus on specific body systems (like abdominal or OB/GYN sonography), the SPI exam tests the physics concepts that apply to all sonography specialties. This is why it's required for every ARDMS credential.

Why the SPI is Challenging

The SPI is often considered one of the more challenging exams because:


SPI Exam Format & Structure

Understanding the exam format helps you prepare strategically:

AspectDetails
Total QuestionsApproximately 110 multiple-choice
Time Limit2 hours (120 minutes)
Passing Score555 (on a 300-700 scale)
FormatMultiple choice and hotspot questions
Testing CentersPearson VUE (in-person or online proctoring)
Exam Fee$275 (as of 2026)

Understanding the 5 Content Domains

The SPI exam is divided into 5 content domains, each weighted differently. Knowing these weights helps you prioritize your study time.

Content Domain Weights

Apply Doppler Concepts
34%(37 questions)
Optimize Sonographic Images
26%(29 questions)
Perform Ultrasound Examinations
23%(25 questions)
Provide Clinical Safety & Quality Assurance
10%(11 questions)
Manage Ultrasound Transducers
7%(8 questions)

Question estimates based on total question count. Focus study time proportionally.

Study tip: Spend the most time on the largest domain—it makes up the biggest portion of your exam.

Domain 1: Perform Ultrasound Examinations (23%)

Approximately 25 questions

Domain 2: Manage Ultrasound Transducers (7%)

Approximately 8 questions

Domain 3: Optimize Sonographic Images (26%)

Approximately 29 questions

Domain 4: Apply Doppler Concepts (34%)

Approximately 37 questions

Domain 5: Provide Clinical Safety & Quality Assurance (10%)

Approximately 11 questions

Key formulas:
Speed = Frequency × Wavelength
c = 1540 m/s in soft tissue
Wavelength (mm) = 1.54 / Frequency (MHz)
Critical Doppler concepts:
1. Doppler shift = (2 × transmitted frequency × velocity × cos θ) / c
2. Nyquist limit = PRF/2
3. Aliasing occurs when Doppler shift > Nyquist limit
4. CW Doppler: No range resolution, no aliasing
5. PW Doppler: Has range resolution, subject to aliasing

Free SPI Practice Test Questions

Test your knowledge with these sample SPI exam questions. Answers and explanations are provided below.

Question 1

What is the speed of sound in soft tissue?

A) 1480 m/s
B) 1540 m/s
C) 1600 m/s
D) 330 m/s

Question 2

Which resolution is determined by pulse duration?

A) Lateral resolution
B) Elevational resolution
C) Axial resolution
D) Temporal resolution

Question 3

A sonographer increases the PRF. What effect does this have on aliasing?

A) Increases aliasing
B) Decreases aliasing
C) No effect on aliasing
D) Eliminates aliasing completely

Question 4

Which transducer type is best suited for cardiac imaging through the intercostal spaces?

A) Linear array
B) Curved array
C) Phased array
D) Annular array

Question 5

What does the Mechanical Index (MI) indicate?

A) Risk of thermal bioeffects
B) Risk of cavitation
C) Image resolution quality
D) Doppler sensitivity

Question 6

In pulsed wave Doppler, what determines the maximum detectable velocity without aliasing?

A) Transducer frequency
B) Pulse repetition frequency
C) Sample volume size
D) Wall filter setting

Question 7

Which artifact results from sound traveling through a fluid-filled structure?

A) Shadowing
B) Posterior acoustic enhancement
C) Reverberation
D) Mirror image

Question 8

The piezoelectric effect describes:

A) The conversion of heat to sound
B) The conversion of electrical energy to mechanical energy
C) The absorption of sound by tissue
D) The reflection of sound at interfaces

Question 9

What happens to axial resolution when frequency is increased?

A) Axial resolution improves (gets smaller)
B) Axial resolution worsens (gets larger)
C) Axial resolution remains unchanged
D) Axial resolution becomes equal to lateral resolution

Question 10

A Doppler angle of 90 degrees results in:

A) Maximum Doppler shift
B) Zero Doppler shift
C) Aliasing
D) Increased penetration

Answer Key with Explanations

Question 1: B) 1540 m/s

The assumed speed of sound in soft tissue is 1540 m/s (or 1.54 mm/μs). This value is used by ultrasound machines to calculate depth. Sound travels at 330 m/s in air and about 1480 m/s in water.

Question 2: C) Axial resolution

Axial resolution equals spatial pulse length divided by 2 (SPL/2). Since SPL depends on wavelength (and thus frequency) and number of cycles in the pulse, axial resolution is determined by pulse characteristics. Lateral resolution depends on beam width.

Question 3: B) Decreases aliasing

Increasing PRF raises the Nyquist limit (PRF/2), allowing higher Doppler shifts to be detected without aliasing. This is a primary method for reducing aliasing in pulsed wave Doppler.

Question 4: C) Phased array

Phased array transducers have a small footprint, making them ideal for imaging through narrow acoustic windows like intercostal spaces. They electronically steer the beam to create a sector-shaped image.

Question 5: B) Risk of cavitation

The Mechanical Index indicates the likelihood of cavitation (mechanical bioeffects). Higher MI values suggest greater cavitation risk. The Thermal Index (TI) indicates thermal bioeffect risk.

Question 6: B) Pulse repetition frequency

The Nyquist limit equals PRF/2. This is the maximum Doppler shift that can be accurately measured without aliasing in pulsed wave Doppler. Higher PRF = higher velocity detection capability.

Question 7: B) Posterior acoustic enhancement

When sound passes through a low-attenuation structure (like a cyst), more sound reaches deeper tissues, causing them to appear brighter. Shadowing occurs behind highly attenuating or reflective structures.

Question 8: B) The conversion of electrical energy to mechanical energy

Piezoelectric crystals convert electrical signals to mechanical vibrations (sound waves) and vice versa. This bidirectional conversion is fundamental to ultrasound transducer operation.

Question 9: A) Axial resolution improves (gets smaller)

Higher frequency = shorter wavelength = shorter spatial pulse length = better (smaller) axial resolution. The tradeoff is decreased penetration at higher frequencies.

Question 10: B) Zero Doppler shift

When the Doppler angle is 90°, cos(90°) = 0, making the Doppler shift equation equal zero. This is why Doppler imaging requires angles less than 90° (ideally 30-60°) to the direction of flow.


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SPI Exam Scoring & Pass Rate

Current Pass Rates

According to official data, the SPI first-time pass rate is approximately 71%. This makes it one of the more challenging exams.

Why Pass Rates May Be Lower

  1. Underestimation: Students focus on specialty exams and don't dedicate enough time to physics
  2. Abstract concepts: Physics is less intuitive than anatomy-based exams
  3. Math component: Calculations can be time-consuming and error-prone
  4. Broad scope: The exam covers a wide range of topics

Understanding Your Score Report

Your score report includes:

What If You Don't Pass?

First, know that you're not alone—many examinees don't pass on their first attempt.

Retake Policy:
  • Waiting period: 60 days before you can retake
  • Maximum attempts: 3 attempts per 12-month period
  • Re-application: You must submit a new application and fee for each attempt

How to Register for the SPI Exam

Step 1: Create an ARDMS Account

Visit myARDMS.org, create a new account or log in, and complete your profile information.

Step 2: Verify Your Eligibility

ARDMS offers several pathways to SPI eligibility:

  • Pathway 1: Graduate from a CAAHEP-accredited sonography program
  • Pathway 2: Currently enrolled in final semester of accredited program
  • Pathway 3: Hold ARRT, CCI, or equivalent credential (or MD/DO with sonography training)
  • Pathway 4: Documented clinical sonography work experience

Step 3: Submit Your Application

Select 'SPI Examination' from available exams, choose your eligibility pathway, upload required documentation, and pay the application fee ($275 as of 2026).

Step 4: Receive Your Authorization to Test (ATT)

ARDMS reviews applications within 2-4 weeks. Upon approval, you'll receive an ATT via email. Your ATT is valid for 90 days.

Step 5: Schedule with Pearson VUE

Visit Pearson VUE, choose in-person or online proctoring, select your preferred date and time, and confirm your appointment.


What to Expect on Exam Day

For In-Person Testing

Before arrival:

At the testing center:

During the exam:

For Online Proctoring

System requirements:

Environment requirements:


How Long Should You Study?

The ideal study timeline depends on your background:

SituationRecommended Study Time
Currently in school (physics fresh)4-6 weeks
Recent graduate (< 1 year)6-8 weeks
Working sonographer (1-3 years)8-10 weeks
Returning after break (3+ years)10-12 weeks

Sample Study Schedule

Week 1-2: Foundation

  • Review basic physics: waves, sound properties
  • Study Domain 1 (Performing Examinations)
  • Complete 100-150 practice questions

Complete 100-150 practice questions

Week 3: Transducers & Image Optimization

  • Study Domain 2 (Transducers)
  • Study Domain 3 (Image Optimization)
  • Focus on artifact recognition

Complete 150-200 practice questions

Week 4: Doppler (Most Critical)

  • Dedicate full week to Domain 4
  • Master Doppler equation and Nyquist limit
  • Practice spectral and color Doppler concepts

Complete 200+ practice questions

Week 5: Safety & Comprehensive Review

  • Study Domain 5 (Safety)
  • Review weak areas from practice tests
  • Take first full-length mock exam

Complete 200 practice questions

Week 6: Final Preparation

  • Take 2-3 timed mock exams
  • Review missed questions
  • Light review of formulas and key concepts
  • Rest the day before your exam

Free Video Lessons

Free Video Lessons

Watch these free video lessons to help you prepare for the SPI.


Tips to Pass the SPI Exam

1. Understand, Don't Just Memorize

Physics concepts build on each other. Don't just memorize "higher frequency = better axial resolution." Understand WHY: Higher frequency → shorter wavelength → shorter SPL → better axial resolution.

2. Master Doppler First

Since Doppler accounts for 34% of the exam, start early and practice calculations repeatedly. Understand the relationships between PRF, Nyquist limit, and aliasing.

3. Practice Under Real Conditions

Complete 110 questions in 2 hours with no interruptions. Simulate the testing environment and review thoroughly to understand why you missed questions.

4. Focus on Weak Areas

After each practice test, calculate your accuracy by domain. Spend 60% of study time on your lowest-scoring domains.

5. Use Spaced Repetition

Don't cram. Review material at increasing intervals: Day 1 (learn), Day 3 (first review), Day 7 (second review), Day 14 (third review).

6. Don't Self-Evaluate During the Exam

Concentrate on one question at a time. Don't waste mental energy on "what if I fail" thoughts. Answer every question and keep moving.


FAQs

How many questions are on the SPI exam?

The SPI exam contains approximately 110 multiple-choice questions.

What is the passing score for the SPI exam?

You need a scaled score of 555 or higher (on a 300-700 scale) to pass.

How long is the SPI exam?

You have 2 hours (120 minutes) to complete the exam—approximately 65 seconds per question.

What is the SPI exam pass rate?

The current first-time pass rate is approximately 71%.

How much does the SPI exam cost?

The examination fee is $275 (as of 2026).

Can I take the SPI exam online?

Yes, ARDMS offers online proctoring through Pearson VUE if you meet technical and environmental requirements.

How many times can I take the SPI exam?

You can attempt the SPI exam up to 3 times within a 12-month period with a mandatory 60-day waiting period between attempts.

Should I study for SPI or my specialty exam first?

Most students benefit from taking the SPI first while physics concepts are fresh from school.

How do I know if I'm ready for the SPI exam?

Aim for 80-85% accuracy on practice exams under timed conditions before scheduling your test.



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This guide is updated regularly to reflect the latest ARDMS SPI exam information. Last reviewed: January 2026.