NRCME TESTBAK LATEST VERSION EXAM WITH ACTUAL
170 QUESTION AND CORRECT DETAILED ANSWERS
WITH RATIONALES.
A driver previously diagnosed and treated for hypertension presents on April 4, 2014 with blood
pressure of 150/84. The driver is given a three-month certification until July 4, 2014. At follow-up two
months later, on June 4, 2014, a complete driver examination is performed, and the driver's blood
pressure is 124/74. The driver should be certified for _______________________.
A) Three months until September 4, 2014
B) One year until April 4, 2015
C) One year until June 4, 2015
D) Two years until April 4, 2016 - answer : ;Which of the following is true with respect to drivers with
psychological disorders?
A) With some exceptions (e.g. schizophrenia), exclusion from CMV driving is not based solely on
diagnosis.
B) Recommendations related to effects and/or side effects of medication use the degree of impairment
produced by a 0.08 percent blood alcohol concentration as a benchmark.
C) Medical examiners may not request medical records related to treatment of psychological disorders
due to HIPAA regulation.
D) Treatment with antipsychotic medications is disqualifying
A) The degree of of impairment produced by a 0.04 percent blood alcohol level is considered the
impairment benchmark by the FMCSA. HIPAA regulations do not preclude a medical examiner from
requesting records related to treatment of psychological disorders. The medical examiner requesting
such records should have the driver sign a HIPAA-compliant consent form for the release of such
records. Treatment with antipsychotic medications is not in and of itself disqualifying, although the
underlying diagnosis for which such medications are used may be disqualifying.
,Which of the following is true with respect to drivers with psychological disorders?
A) Drivers with chronic schizophrenia must be evaluated at least yearly by a qualified specialist such as a
psychiatrist or psychologist who understands the function and demands of CMV driving.
B) The waiting period for a brief reactive psychosis or schizophreniform disorder is three months
C) Alcohol and drug dependency and abuse are profound risk factors in the presence of personality
disorders
D) The waiting period following electroconvulsive therapy for treatment of depression is one year -
answer : ;C) Drivers with chronic schizophrenia are disqualified. The waiting period for a brief reactive
psychosis or schizophreniform disorder is six months as is the waiting period for electroconvulsive
therapy treatment.
Which of the following is true with respect to bipolar disorder?
A) Treatment with lithium has not been shown to increase risk for CMV accidents
B) The maximum certification interval is six months
C) The Drivers should be advised to report manic or sever depressive episodes within 10 days of onset to
the driver's employer, medical examiner, or appropriate health professional and to seek medical
intervention
D) Onset of manic episodes is uniformly sudden. - answer : ;A) Treatment with lithium has not been
shown to increase CMV driving risk. The maximum certification interval for a driver with bipolar disorder
is one year. The driver should be advised to report manic or depressive episodes within 30 days. Manic
episode onset may be gradual or sudden.
Categories of risk associated with psychological disorders include:
1) The mental disorder including symptoms and/or disturbances in performance that are in integral part
of the disorder and may pose hazards fro driving
2) The type of treatment provider who is treating the condition.
3) Psychopharmacology, as many psychotropic medications can comprise performance to the degree
that CMV driving would be hazardous
4) Physical disorders which may be compromised by the mental disorder and may increase risk of CMV
accidents
A) 1, 2, and 3 only
,B) 1 and 3 only
C) 2 and 4 only
D) 4 only
E) All of the above - answer : ;B) Type of treatment provider is unrelated to driving risk. Physical
disorders are not noted by the FMCSA to increase risk related to psychological disorders.
Which of the following is true with regard to Adult Attention Deficit Hyperactivity Disorder?
A) The maximum certification interval is two years.
B) The driver should be disqualified if the driver has another psychological disorder, such as depression.
C) Risk related to adult ADHD include comorbid antisocial or borderline personality disorders and a high
incidence of substance abuse
D) Treatment with amphetamines and amphetamine derivatives is disqualifying - answer : ;C) The
maximum certification interval is one year. As long as other psychological conditions are stable, a driver
with adult ADHD may be certified. Treatment with amphetamines and amphetamine derivatives is not
disqualifying.
A driver with bipolar disorder must meet a waiting period of ______________ following a nonpsychotic
episode of major depression unaccompanied by suicidal behavior or a waiting period of
__________________ following a nonpsychotic episode of major depression with suicidal behavior.
A) One year, two years
B) Six months, one year
C) Three months, six months
D) Three months, one year - answer : ;B) Whatever the underlying medical condition, nonpsychotic
episodes of major depression unaccompanied by suicidal behavior require a waiting period of six
months and nonpsychotic episodes of major depression with suicidal behavior require a one year
waiting period.
A driver with a history of major depression should be evaluated at least every _______________ by an
appropriate mental health specialist who understands the functions and demands of commercial motor
vehicle driving.
A) Six months
B) One year
C) Two years
, D) Such evaluation is not required - answer : ;B) The maximum certification interval for a driver with a
history of major depression is one year. Regulatory guidance is somewhat confusing: guidance
recommends annual evaluation by a mental health professional who understands the functions and
demands of commercial driving, but requires evaluation every two years by a specialist, such as
psychiatrist or psychologist who understands the functions and demands of comical driving
Drivers with schizophreniform disorder, brief reactive psychosis, schizoaffective disorder, or delusional
disorder may be certified after a _____________________ waiting period for a brief reactive psychosis
or schizophreniform disorder and after a _________________ waiting period for any other psychotic
disorder.
A) Six weeks, three months
B) Three months, six months
C) Six months, one year
D) One year, two years - answer : ;C) The waiting period is six on this for a brief reactive psychosis or
schizophreniform disorder and one year for any other psychotic disorder
Which of the following is true?
A) Bipolar disorder effects usually manifest immediately after disease onset
B) Manic or depression symptoms may impair judgment or function and make it impossible for the
driver to function effectively
C) Rapid onset of debilitating symptoms of depression are unlikely to be triggered by personal, social,
financial, or job-related difficulties
D) Schizophrenia is not a progressive condition - answer : ;B) Symptoms of bipolar disorder often do not
manifest for months or years but can be progressive and severe symptoms may then occur with
relatively sudden onset. Debilitating symptoms associated with depression may be triggered by a variety
of conditions or circumstances. Schizophrenia is usually a progressive condition, so certification of a
driver even with mild symptoms is usually not warranted.
Which of the following is an adverse effect of neuroleptic?
A) Hyperactivity
B) Motor dysfunction that affects coordination and response time
C) Auditory hallucinations
170 QUESTION AND CORRECT DETAILED ANSWERS
WITH RATIONALES.
A driver previously diagnosed and treated for hypertension presents on April 4, 2014 with blood
pressure of 150/84. The driver is given a three-month certification until July 4, 2014. At follow-up two
months later, on June 4, 2014, a complete driver examination is performed, and the driver's blood
pressure is 124/74. The driver should be certified for _______________________.
A) Three months until September 4, 2014
B) One year until April 4, 2015
C) One year until June 4, 2015
D) Two years until April 4, 2016 - answer : ;Which of the following is true with respect to drivers with
psychological disorders?
A) With some exceptions (e.g. schizophrenia), exclusion from CMV driving is not based solely on
diagnosis.
B) Recommendations related to effects and/or side effects of medication use the degree of impairment
produced by a 0.08 percent blood alcohol concentration as a benchmark.
C) Medical examiners may not request medical records related to treatment of psychological disorders
due to HIPAA regulation.
D) Treatment with antipsychotic medications is disqualifying
A) The degree of of impairment produced by a 0.04 percent blood alcohol level is considered the
impairment benchmark by the FMCSA. HIPAA regulations do not preclude a medical examiner from
requesting records related to treatment of psychological disorders. The medical examiner requesting
such records should have the driver sign a HIPAA-compliant consent form for the release of such
records. Treatment with antipsychotic medications is not in and of itself disqualifying, although the
underlying diagnosis for which such medications are used may be disqualifying.
,Which of the following is true with respect to drivers with psychological disorders?
A) Drivers with chronic schizophrenia must be evaluated at least yearly by a qualified specialist such as a
psychiatrist or psychologist who understands the function and demands of CMV driving.
B) The waiting period for a brief reactive psychosis or schizophreniform disorder is three months
C) Alcohol and drug dependency and abuse are profound risk factors in the presence of personality
disorders
D) The waiting period following electroconvulsive therapy for treatment of depression is one year -
answer : ;C) Drivers with chronic schizophrenia are disqualified. The waiting period for a brief reactive
psychosis or schizophreniform disorder is six months as is the waiting period for electroconvulsive
therapy treatment.
Which of the following is true with respect to bipolar disorder?
A) Treatment with lithium has not been shown to increase risk for CMV accidents
B) The maximum certification interval is six months
C) The Drivers should be advised to report manic or sever depressive episodes within 10 days of onset to
the driver's employer, medical examiner, or appropriate health professional and to seek medical
intervention
D) Onset of manic episodes is uniformly sudden. - answer : ;A) Treatment with lithium has not been
shown to increase CMV driving risk. The maximum certification interval for a driver with bipolar disorder
is one year. The driver should be advised to report manic or depressive episodes within 30 days. Manic
episode onset may be gradual or sudden.
Categories of risk associated with psychological disorders include:
1) The mental disorder including symptoms and/or disturbances in performance that are in integral part
of the disorder and may pose hazards fro driving
2) The type of treatment provider who is treating the condition.
3) Psychopharmacology, as many psychotropic medications can comprise performance to the degree
that CMV driving would be hazardous
4) Physical disorders which may be compromised by the mental disorder and may increase risk of CMV
accidents
A) 1, 2, and 3 only
,B) 1 and 3 only
C) 2 and 4 only
D) 4 only
E) All of the above - answer : ;B) Type of treatment provider is unrelated to driving risk. Physical
disorders are not noted by the FMCSA to increase risk related to psychological disorders.
Which of the following is true with regard to Adult Attention Deficit Hyperactivity Disorder?
A) The maximum certification interval is two years.
B) The driver should be disqualified if the driver has another psychological disorder, such as depression.
C) Risk related to adult ADHD include comorbid antisocial or borderline personality disorders and a high
incidence of substance abuse
D) Treatment with amphetamines and amphetamine derivatives is disqualifying - answer : ;C) The
maximum certification interval is one year. As long as other psychological conditions are stable, a driver
with adult ADHD may be certified. Treatment with amphetamines and amphetamine derivatives is not
disqualifying.
A driver with bipolar disorder must meet a waiting period of ______________ following a nonpsychotic
episode of major depression unaccompanied by suicidal behavior or a waiting period of
__________________ following a nonpsychotic episode of major depression with suicidal behavior.
A) One year, two years
B) Six months, one year
C) Three months, six months
D) Three months, one year - answer : ;B) Whatever the underlying medical condition, nonpsychotic
episodes of major depression unaccompanied by suicidal behavior require a waiting period of six
months and nonpsychotic episodes of major depression with suicidal behavior require a one year
waiting period.
A driver with a history of major depression should be evaluated at least every _______________ by an
appropriate mental health specialist who understands the functions and demands of commercial motor
vehicle driving.
A) Six months
B) One year
C) Two years
, D) Such evaluation is not required - answer : ;B) The maximum certification interval for a driver with a
history of major depression is one year. Regulatory guidance is somewhat confusing: guidance
recommends annual evaluation by a mental health professional who understands the functions and
demands of commercial driving, but requires evaluation every two years by a specialist, such as
psychiatrist or psychologist who understands the functions and demands of comical driving
Drivers with schizophreniform disorder, brief reactive psychosis, schizoaffective disorder, or delusional
disorder may be certified after a _____________________ waiting period for a brief reactive psychosis
or schizophreniform disorder and after a _________________ waiting period for any other psychotic
disorder.
A) Six weeks, three months
B) Three months, six months
C) Six months, one year
D) One year, two years - answer : ;C) The waiting period is six on this for a brief reactive psychosis or
schizophreniform disorder and one year for any other psychotic disorder
Which of the following is true?
A) Bipolar disorder effects usually manifest immediately after disease onset
B) Manic or depression symptoms may impair judgment or function and make it impossible for the
driver to function effectively
C) Rapid onset of debilitating symptoms of depression are unlikely to be triggered by personal, social,
financial, or job-related difficulties
D) Schizophrenia is not a progressive condition - answer : ;B) Symptoms of bipolar disorder often do not
manifest for months or years but can be progressive and severe symptoms may then occur with
relatively sudden onset. Debilitating symptoms associated with depression may be triggered by a variety
of conditions or circumstances. Schizophrenia is usually a progressive condition, so certification of a
driver even with mild symptoms is usually not warranted.
Which of the following is an adverse effect of neuroleptic?
A) Hyperactivity
B) Motor dysfunction that affects coordination and response time
C) Auditory hallucinations
