NRCME (DOT) EXAM 2026 REVISED
VERSION WITH ANSWERS
FMCSA Mission Statement - ANSWER- To reduce crashes, injuries, fatalities involving large
trucks/buses
Medical Examiner - ANSWER- Licensed, certified, registered provider who can perform PEs in
accordance with laws and regulations ; registered through NRS ; has unique
identifier ; passes MEC test
FMCSA - ANSWER- Federal Motor Carrier Safety Administration
NRCME - ANSWER- National Registry of Certified Medical Examiners
Commerical Motor Vehicle - ANSWER- Weight >1000 lb ; or transports >8 people for
compensation ; or >15 people without compensation ; transports hazardous materials
requiring placarding Interstate commerce
vs.
Intrastate commerce - ANSWER- Interstate: multiple states or international
Intrastate: within 1 state
Who regulates treatment/management and aftercare of substance abuse for drivers?
ANSWER-SAP (Substance Abuse Professional)
Who determines the origin of abnormal drug test results, determining
whether the driver has violated ANSWER- drug use regulations? -Medical Review Officer
Title 49 CFR 391.41 - ANSWER- Medical Examiner Report Form
- Paperwork completed during DOT physical
- Physical exam requirements for driver
- Determines if Certificate is granted
Title 49 CFR 391.43 - ANSWER- Describes responsibilities of Medical Examiner, instructions
for exam, and requirements for
medical certification - Supporting information to
explain 391.41
When was DOT established? - ANSWER- 1966
Became separate entity on Jan 1, 2000
ANSWER-
, Motor Carrier Safety Improvement Act of 1999 - Established DOT as
separate federal entity ANSWER-
Omnibus Transportation Employee Testing Act of 1991 - Required drug testing for
drivers
The driver must always keep a copy of ____________________ with them while driving
ANSWER-Medical Certificate
SPE if applicable
Does the driver need to sign a medical release before you release their Medical
ANSWER- Certification? -No. Certificate is provided to employer.
(Release is required for a copy of medical report form)
How many standards are used to determine driver fitness for duty? - ANSWER- 13
How many standards of "driver fitness for duty" are *discretionary*? - ANSWER- 9
(according to my review course)
- Other sources say 10 and say that T2DM is discretionary
How many standards of "driver fitness for duty" are *NON- discretionary*? - ANSWER- 4
- Vision
- Hearing
- Epilepsy
- T2DM
(Some sources say 3 and do not include T2DM)
Age requirement for drivers - ANSWER- 21+
Language requirement for drivers - ANSWER- Must be able to read/speak English well
enough to read signs, communicate
Height/weight requirement for drivers - ANSWER- There is none
What is tested for in urine? - ANSWER- USG
PRO
BLO
GLU
How long are you (the provider) required to keep a copy of a driver's Medical Certificate?
ANSWER-3 years
After a reading of Stage 3 hypertension, how often can a driver be certified? - ANSWER- Only
every 6 months max
- Disqualify until BP <140/90
- 3 month cert if <160/100 and they are initiating treatment for the first time - May
certify Q1 year post surgical correction of secondary HTN
VERSION WITH ANSWERS
FMCSA Mission Statement - ANSWER- To reduce crashes, injuries, fatalities involving large
trucks/buses
Medical Examiner - ANSWER- Licensed, certified, registered provider who can perform PEs in
accordance with laws and regulations ; registered through NRS ; has unique
identifier ; passes MEC test
FMCSA - ANSWER- Federal Motor Carrier Safety Administration
NRCME - ANSWER- National Registry of Certified Medical Examiners
Commerical Motor Vehicle - ANSWER- Weight >1000 lb ; or transports >8 people for
compensation ; or >15 people without compensation ; transports hazardous materials
requiring placarding Interstate commerce
vs.
Intrastate commerce - ANSWER- Interstate: multiple states or international
Intrastate: within 1 state
Who regulates treatment/management and aftercare of substance abuse for drivers?
ANSWER-SAP (Substance Abuse Professional)
Who determines the origin of abnormal drug test results, determining
whether the driver has violated ANSWER- drug use regulations? -Medical Review Officer
Title 49 CFR 391.41 - ANSWER- Medical Examiner Report Form
- Paperwork completed during DOT physical
- Physical exam requirements for driver
- Determines if Certificate is granted
Title 49 CFR 391.43 - ANSWER- Describes responsibilities of Medical Examiner, instructions
for exam, and requirements for
medical certification - Supporting information to
explain 391.41
When was DOT established? - ANSWER- 1966
Became separate entity on Jan 1, 2000
ANSWER-
, Motor Carrier Safety Improvement Act of 1999 - Established DOT as
separate federal entity ANSWER-
Omnibus Transportation Employee Testing Act of 1991 - Required drug testing for
drivers
The driver must always keep a copy of ____________________ with them while driving
ANSWER-Medical Certificate
SPE if applicable
Does the driver need to sign a medical release before you release their Medical
ANSWER- Certification? -No. Certificate is provided to employer.
(Release is required for a copy of medical report form)
How many standards are used to determine driver fitness for duty? - ANSWER- 13
How many standards of "driver fitness for duty" are *discretionary*? - ANSWER- 9
(according to my review course)
- Other sources say 10 and say that T2DM is discretionary
How many standards of "driver fitness for duty" are *NON- discretionary*? - ANSWER- 4
- Vision
- Hearing
- Epilepsy
- T2DM
(Some sources say 3 and do not include T2DM)
Age requirement for drivers - ANSWER- 21+
Language requirement for drivers - ANSWER- Must be able to read/speak English well
enough to read signs, communicate
Height/weight requirement for drivers - ANSWER- There is none
What is tested for in urine? - ANSWER- USG
PRO
BLO
GLU
How long are you (the provider) required to keep a copy of a driver's Medical Certificate?
ANSWER-3 years
After a reading of Stage 3 hypertension, how often can a driver be certified? - ANSWER- Only
every 6 months max
- Disqualify until BP <140/90
- 3 month cert if <160/100 and they are initiating treatment for the first time - May
certify Q1 year post surgical correction of secondary HTN
