NRCME EXAM 2026 FINAL PREPARATION
COMPILATION
⫸ 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 Answer: 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
Answer: 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 Answer: 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 Answer: 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 Answer: 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 Answer: 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 Answer: 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
Answer: 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 Answer: 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 Answer: 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?
COMPILATION
⫸ 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 Answer: 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
Answer: 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 Answer: 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 Answer: 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 Answer: 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 Answer: 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 Answer: 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
Answer: 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 Answer: 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 Answer: 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?
