NRCME Test Bank Questions with
Complete Solutions
Which of the following is a requirement for drivers with a diabetes exemption?
A) Possess a rapidly absorbable form of glucose while driving
B) Self—monitor blood glucose one hour before driving and at least once every 2 hours while
driving
C) Plan to submit blood glucose monitoring logs every 6 months
D) Maintain a Hemoglobin A1C value less than 7 - ANSWERS-A. Drivers with diabetes should self
monitor blood glucose before driving and every 4 hours while driving. Blood glucose monitoring
logs should be submitted annually. There is no specific requirement for HgA1C level.
Drivers with insulin dependent diabetes:
A) May be certified for a maximum of 6 months
B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certification
C) Cannot be certified if they have a history of myocardial infarction
D) May be eligible for a diabetes exemption - ANSWERS-D) Drivers with insulin dependent
diabetes cannot be certified but may be eligible for a diabetes exemption
Which of the following is true?
A) A driver with diabetes who uses insulin does not meet the minimum requirements of 49 CFR
Part 391.41
B) The most important concert related to medication use for treating diabetes is hyperglycemia
C) Peripheral neuropathy is not a disqualifying condition
D) Diabetes is not a coronary heart disease (CHD) equivalent condition - ANSWERS-A) The
greatest risk for medication use for drivers with diabetes in hypoglycemia, not hyperglycemia.
Peripheral neuropathy is disqualifying condition. Diabetes is a CHD equivalent condition.
,What is the recommended certification interval for a driver with diabetes mellituse who does
not use insulin?
A) Three months
B) Six months
C) One year
D) Two years - ANSWERS-C) Drivers with non-insulin dependent diabetes should be certified for
a maximum of one year
A diabetes exemption may be issued by:
A) An endocrinologist
B) The Medical Examiner
C) The driver's personal physician
D) The FMCSA - ANSWERS-D) Only the FMCSA can grant exemptions
A driver with diabetes mellliktus who uses insulin is determined to be otherwise medically
qualified. The medical examiner must indicate that a diabetes exemption is required on the :
A) Medical Examination Report status section and Medical Examiners Certificate
B) Letter to the FMCSA
C) Employer authorization form
D) Endocrinology consultation form - ANSWERS-A) Exemption requirements must be noted on
the Medical Examination Report status section and the Medical Examiners Certificate
If glucose is detected on urinalysis in a driver with no history of diabetes, an appropriate next
step is:
A) Endocrinology consultation
B) One year clearance and recommendation to see personal physician
C) Fingerstick or blood glucose determination
,D) Temporary disqualification - ANSWERS-C) The medical examiner should first determine blood
glucose and then make an appropriate certification determination and referral
Drivers with a history of _____________ severe hypoglycemic reactions in the past year or
_____________ severe hypoglycemic reactions in the past five years should not be certifed.
A) one, three
B) one, two
C) two, three
D) two, five - ANSWERS-B) A driver should not be certified if the driver has had one
hypoglycemic reaction in the past year or two in the past five years.
Which of the following is not a criteria that the FMCSA uses to define a severe hypoglycemic
reaction?
A) Seizure
B) Dizziness
C) Need of assistance from another person
D) Period of impaired cognitive function that occurred without warning - ANSWERS-B) FMCSA
defines severe hypoglycemia as reactions that result in seizure, loss of consciousness, need of
assistance from another person, and a period of impaired congitive function that occurred
without warning
Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy - ANSWERS-C) Although hyperglycemia, peripheral neuropathy,
and metabolic encephalopathy all pose significant risks for safe driving, hypoglycemia poses the
greatest risk. The risk is particularly pronounced in drivers who use insulin. FMCSA defines a
hypoglycemia episode as one that results in seizure, loss of consciousness, need of assistance
from another person, or a period of impaired cognitive function that occurs without warning.
, A driver with a diabetes exemption should check glucose levels when?
A) One hour before driving and at least once every four hours while driving
B) One hour before driving and at least every eight hours while driving
C) Once after four hours of driving
D) Once a day after driving period has ended - ANSWERS-A) Driver's with diabetes exemption
should check glucose values one hour before driving and once every four hours while driving
Which of the following is true for diagnosis of a hernia?
A) The driver should be referred to a surgeon to determine whether repair of a hernia is
necessary
B) The waiting period following hernia surgery is two weeks
C) Inguinal hernias have been associated with an increased risk for CMV accidents
D) The maximum certification interval for a driver with a hernia is two years - ANSWERS-D) The
medical examiner can use his/her judgment as to whether a driver should be referred to a
surgeon or other specialist. There is no specified waiting period following hernia surgery - the
driver should not be certified until the medical examiner determines that treatment is safe and
effective, and that the condition is stable. No evidence has linked hernias of any type to
increased CMV accident risk.
Which of the following is true of nephropathy?
A) Nephropathy is a disqualifying condition
B) The maximum certification interval for nephropathy is two years
C) A driver with 3+ proteinuria should not be certified
D) A renal specialist should make the certification determination for a driver with nephropathy -
ANSWERS-B) Nephropathy is considered on a case-by-case basis. The medical examiner
determines what evaluation or monitoring is necessary for a driver with 3+ proteinuria and may
disqualify the driver. The certification is always made by the medical examiner and cannot be
deferred to a specialist.
Complete Solutions
Which of the following is a requirement for drivers with a diabetes exemption?
A) Possess a rapidly absorbable form of glucose while driving
B) Self—monitor blood glucose one hour before driving and at least once every 2 hours while
driving
C) Plan to submit blood glucose monitoring logs every 6 months
D) Maintain a Hemoglobin A1C value less than 7 - ANSWERS-A. Drivers with diabetes should self
monitor blood glucose before driving and every 4 hours while driving. Blood glucose monitoring
logs should be submitted annually. There is no specific requirement for HgA1C level.
Drivers with insulin dependent diabetes:
A) May be certified for a maximum of 6 months
B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certification
C) Cannot be certified if they have a history of myocardial infarction
D) May be eligible for a diabetes exemption - ANSWERS-D) Drivers with insulin dependent
diabetes cannot be certified but may be eligible for a diabetes exemption
Which of the following is true?
A) A driver with diabetes who uses insulin does not meet the minimum requirements of 49 CFR
Part 391.41
B) The most important concert related to medication use for treating diabetes is hyperglycemia
C) Peripheral neuropathy is not a disqualifying condition
D) Diabetes is not a coronary heart disease (CHD) equivalent condition - ANSWERS-A) The
greatest risk for medication use for drivers with diabetes in hypoglycemia, not hyperglycemia.
Peripheral neuropathy is disqualifying condition. Diabetes is a CHD equivalent condition.
,What is the recommended certification interval for a driver with diabetes mellituse who does
not use insulin?
A) Three months
B) Six months
C) One year
D) Two years - ANSWERS-C) Drivers with non-insulin dependent diabetes should be certified for
a maximum of one year
A diabetes exemption may be issued by:
A) An endocrinologist
B) The Medical Examiner
C) The driver's personal physician
D) The FMCSA - ANSWERS-D) Only the FMCSA can grant exemptions
A driver with diabetes mellliktus who uses insulin is determined to be otherwise medically
qualified. The medical examiner must indicate that a diabetes exemption is required on the :
A) Medical Examination Report status section and Medical Examiners Certificate
B) Letter to the FMCSA
C) Employer authorization form
D) Endocrinology consultation form - ANSWERS-A) Exemption requirements must be noted on
the Medical Examination Report status section and the Medical Examiners Certificate
If glucose is detected on urinalysis in a driver with no history of diabetes, an appropriate next
step is:
A) Endocrinology consultation
B) One year clearance and recommendation to see personal physician
C) Fingerstick or blood glucose determination
,D) Temporary disqualification - ANSWERS-C) The medical examiner should first determine blood
glucose and then make an appropriate certification determination and referral
Drivers with a history of _____________ severe hypoglycemic reactions in the past year or
_____________ severe hypoglycemic reactions in the past five years should not be certifed.
A) one, three
B) one, two
C) two, three
D) two, five - ANSWERS-B) A driver should not be certified if the driver has had one
hypoglycemic reaction in the past year or two in the past five years.
Which of the following is not a criteria that the FMCSA uses to define a severe hypoglycemic
reaction?
A) Seizure
B) Dizziness
C) Need of assistance from another person
D) Period of impaired cognitive function that occurred without warning - ANSWERS-B) FMCSA
defines severe hypoglycemia as reactions that result in seizure, loss of consciousness, need of
assistance from another person, and a period of impaired congitive function that occurred
without warning
Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy - ANSWERS-C) Although hyperglycemia, peripheral neuropathy,
and metabolic encephalopathy all pose significant risks for safe driving, hypoglycemia poses the
greatest risk. The risk is particularly pronounced in drivers who use insulin. FMCSA defines a
hypoglycemia episode as one that results in seizure, loss of consciousness, need of assistance
from another person, or a period of impaired cognitive function that occurs without warning.
, A driver with a diabetes exemption should check glucose levels when?
A) One hour before driving and at least once every four hours while driving
B) One hour before driving and at least every eight hours while driving
C) Once after four hours of driving
D) Once a day after driving period has ended - ANSWERS-A) Driver's with diabetes exemption
should check glucose values one hour before driving and once every four hours while driving
Which of the following is true for diagnosis of a hernia?
A) The driver should be referred to a surgeon to determine whether repair of a hernia is
necessary
B) The waiting period following hernia surgery is two weeks
C) Inguinal hernias have been associated with an increased risk for CMV accidents
D) The maximum certification interval for a driver with a hernia is two years - ANSWERS-D) The
medical examiner can use his/her judgment as to whether a driver should be referred to a
surgeon or other specialist. There is no specified waiting period following hernia surgery - the
driver should not be certified until the medical examiner determines that treatment is safe and
effective, and that the condition is stable. No evidence has linked hernias of any type to
increased CMV accident risk.
Which of the following is true of nephropathy?
A) Nephropathy is a disqualifying condition
B) The maximum certification interval for nephropathy is two years
C) A driver with 3+ proteinuria should not be certified
D) A renal specialist should make the certification determination for a driver with nephropathy -
ANSWERS-B) Nephropathy is considered on a case-by-case basis. The medical examiner
determines what evaluation or monitoring is necessary for a driver with 3+ proteinuria and may
disqualify the driver. The certification is always made by the medical examiner and cannot be
deferred to a specialist.
