DOT UPDATED REVIEW QUESTIONS AND
ANSWERS SET A+
✔✔A driver presents for a certification exam and notes that he chews tobacco. On
examination you find several oral lesions. You should:
a. Disqualify the driver.
b. Place the driver in determination pending.
c. Certify the driver, recommending a referral to a dentist and noting this on the chart.
d. Certify the driver only if he agrees to stop chewing tobacco. - ✔✔The presence of
oral lesions does not compromise safe driving so you may certify the driver, but you
should ensure that the driver is referred to a dentist or oral surgeon to evaluate for the
possibility of oral cancer.
✔✔On dipstick urinalysis performed as part of the DOT exam, a driver is found to have
1+ proteinuria. A reasonable next test would be:
a. Fingerstick glucose.
b. Serum creatinine.
c. Complete Blood Count.
d. Urine culture. - ✔✔B. serum creatinine
This is another general knowledge question; the FMCSA is just making sure the
examiner is aware of that the first sign of nephropathy commonly is the development of
proteinuria.
✔✔A driver with no prior medical history and on no medications, is found to have
moderate glycosuria on urine dipstick. What is your next step?
a. Referral to endocrinologist.
b. Referral to primary care provider.
c. Obtain a hemoglobin A1C.
d. Perform a fingerstick glucose. - ✔✔Glycosuria should prompt a blood glucose test to
determine if the driver actually has hyperglycemia.
✔✔How often is a driver with stage 3 hypertension recertified?
a. Every 3 months.
,b. Every 6 months.
c. Every 12 months.
d. Every 2 years. - ✔✔A driver with a history of stage 3 hypertension may be certified
for a maximum of 6 months.
✔✔On an exercise tolerance test the driver should be able to exercise to a workload
capacity of at least:
a. 4 Metabolic Equivalents.
b. 6 Metabolic Equivalents.
c. 8 Metabolic Equivalents.
d. 10 Metabolic Equivalents. - ✔✔b. 6 Metabolic Equivalents.
The exercise tolerance test is the most common test used to evaluate workload capacity
and detect cardiac abnormalities. Driver should be able to exercise to a workload
capacity greater than 6 Metabolic Equivalents (METs) (through Bruce protocol stage II
or equivalent).
✔✔A driver sustained a shoulder injury at work two years earlier. He has developed
significant pain in the shoulder which is severely limiting use of the arm. He is now
presenting for his certification exam. You should:
a. Have the driver apply for a Skill Performance Certificate.
b. Certify the driver for only 3 months.
c. Disqualify the driver.
d. Certify the driver, but with work restrictions. - ✔✔C. Disqualify the driver
It would appear that the driver's shoulder injury prevents him from safely performing all
tasks of a CMV. An SPE would not have role here, as it is used for a fixed deficit of an
extremity. DOT certification is an "all or none" proposition, so work restrictions have no
place in DOT certification.
✔✔Which of the following clinical symptoms poses a significant risk to public safety
when present in a Commercial Motor Vehicle driver?
a. Vertigo.
b. Cough.
c. Nausea.
d. All of the above. - ✔✔A. VERTIGO
The presence of
uncontrolled vertigo/dizziness is disqualifying.
✔✔Which of the following lab values warrants disqualification?
a. Serum Sodium = 128 mEq/L.
b. Hemoglobin A1C = 11.
c. Serum creatinine = 9 mg/dL.
, d. Serum potassium = 3.1 mEq/L - ✔✔C. A serum creatinine of 9 mg/dL indicates renal
failure to a degree that dialysis is likely warranted. Dialysis is disqualifying, per FMCSA
guidance.
✔✔A driver with a recent myocardial infarction requires which of the following tests? a.
Echocardiogram. b. Holter monitor (or equivalent). c. Coronary CT scan. d. Any one of
the above. - ✔✔An echocardiogram demonstrating a post-MI ejection fraction of at least
40% is required for certification.
✔✔Which of the following medications is considered potentially disqualifying?
a. Diphenhydramine.
b. Prednisone.
c. Insulin.
d. Verapamil. - ✔✔First generation antihistamines such as diphenhydramine are quite
sedating; The driver should abstain from the medication for 12 hours prior to operating a
CMV. If this is not possible, the driver should not be certified.
✔✔A driver is found to have leukocytes on a urine dipstick. As the medical examiner,
you should:
a. Disqualify the driver.
b. Obtain a urine culture.
c. Refer the driver to his primary care provider.
d. Give the driver a prescription for antibiotics. - ✔✔The purpose of questions such as
this is to emphasize the role of the examiner is not to act as the driver's PCP.
✔✔A Romberg test is used to investigate the cause of:
a. Ataxia.
b. Paresthesias.
c. Hyperesthesia.
d. Diplopia. - ✔✔This is another example of a general knowledge question often asked
on the NRCME exam. The Romberg test is a test of the body's sense of proprioception,
which requires healthy functioning of the dorsal columns of the spinal cord.
✔✔Which of the following must be included on the Medical Examination Report Form?
a. The Medical Examiner's office address. b. The Medical Examiner's phone number. c.
The Medical Examiner's state license. d. All of the above. - ✔✔Review the components
of the MER before taking the NRCME exam.
✔✔. On an exercise tolerance test, the driver must attain a heart rate of what level
(assuming he is not taking a beta-blocker):
a. At least 50% of predicted maximum.
b. At least 65% of predicted maximum.
c. At least 75% of predicted maximum.
ANSWERS SET A+
✔✔A driver presents for a certification exam and notes that he chews tobacco. On
examination you find several oral lesions. You should:
a. Disqualify the driver.
b. Place the driver in determination pending.
c. Certify the driver, recommending a referral to a dentist and noting this on the chart.
d. Certify the driver only if he agrees to stop chewing tobacco. - ✔✔The presence of
oral lesions does not compromise safe driving so you may certify the driver, but you
should ensure that the driver is referred to a dentist or oral surgeon to evaluate for the
possibility of oral cancer.
✔✔On dipstick urinalysis performed as part of the DOT exam, a driver is found to have
1+ proteinuria. A reasonable next test would be:
a. Fingerstick glucose.
b. Serum creatinine.
c. Complete Blood Count.
d. Urine culture. - ✔✔B. serum creatinine
This is another general knowledge question; the FMCSA is just making sure the
examiner is aware of that the first sign of nephropathy commonly is the development of
proteinuria.
✔✔A driver with no prior medical history and on no medications, is found to have
moderate glycosuria on urine dipstick. What is your next step?
a. Referral to endocrinologist.
b. Referral to primary care provider.
c. Obtain a hemoglobin A1C.
d. Perform a fingerstick glucose. - ✔✔Glycosuria should prompt a blood glucose test to
determine if the driver actually has hyperglycemia.
✔✔How often is a driver with stage 3 hypertension recertified?
a. Every 3 months.
,b. Every 6 months.
c. Every 12 months.
d. Every 2 years. - ✔✔A driver with a history of stage 3 hypertension may be certified
for a maximum of 6 months.
✔✔On an exercise tolerance test the driver should be able to exercise to a workload
capacity of at least:
a. 4 Metabolic Equivalents.
b. 6 Metabolic Equivalents.
c. 8 Metabolic Equivalents.
d. 10 Metabolic Equivalents. - ✔✔b. 6 Metabolic Equivalents.
The exercise tolerance test is the most common test used to evaluate workload capacity
and detect cardiac abnormalities. Driver should be able to exercise to a workload
capacity greater than 6 Metabolic Equivalents (METs) (through Bruce protocol stage II
or equivalent).
✔✔A driver sustained a shoulder injury at work two years earlier. He has developed
significant pain in the shoulder which is severely limiting use of the arm. He is now
presenting for his certification exam. You should:
a. Have the driver apply for a Skill Performance Certificate.
b. Certify the driver for only 3 months.
c. Disqualify the driver.
d. Certify the driver, but with work restrictions. - ✔✔C. Disqualify the driver
It would appear that the driver's shoulder injury prevents him from safely performing all
tasks of a CMV. An SPE would not have role here, as it is used for a fixed deficit of an
extremity. DOT certification is an "all or none" proposition, so work restrictions have no
place in DOT certification.
✔✔Which of the following clinical symptoms poses a significant risk to public safety
when present in a Commercial Motor Vehicle driver?
a. Vertigo.
b. Cough.
c. Nausea.
d. All of the above. - ✔✔A. VERTIGO
The presence of
uncontrolled vertigo/dizziness is disqualifying.
✔✔Which of the following lab values warrants disqualification?
a. Serum Sodium = 128 mEq/L.
b. Hemoglobin A1C = 11.
c. Serum creatinine = 9 mg/dL.
, d. Serum potassium = 3.1 mEq/L - ✔✔C. A serum creatinine of 9 mg/dL indicates renal
failure to a degree that dialysis is likely warranted. Dialysis is disqualifying, per FMCSA
guidance.
✔✔A driver with a recent myocardial infarction requires which of the following tests? a.
Echocardiogram. b. Holter monitor (or equivalent). c. Coronary CT scan. d. Any one of
the above. - ✔✔An echocardiogram demonstrating a post-MI ejection fraction of at least
40% is required for certification.
✔✔Which of the following medications is considered potentially disqualifying?
a. Diphenhydramine.
b. Prednisone.
c. Insulin.
d. Verapamil. - ✔✔First generation antihistamines such as diphenhydramine are quite
sedating; The driver should abstain from the medication for 12 hours prior to operating a
CMV. If this is not possible, the driver should not be certified.
✔✔A driver is found to have leukocytes on a urine dipstick. As the medical examiner,
you should:
a. Disqualify the driver.
b. Obtain a urine culture.
c. Refer the driver to his primary care provider.
d. Give the driver a prescription for antibiotics. - ✔✔The purpose of questions such as
this is to emphasize the role of the examiner is not to act as the driver's PCP.
✔✔A Romberg test is used to investigate the cause of:
a. Ataxia.
b. Paresthesias.
c. Hyperesthesia.
d. Diplopia. - ✔✔This is another example of a general knowledge question often asked
on the NRCME exam. The Romberg test is a test of the body's sense of proprioception,
which requires healthy functioning of the dorsal columns of the spinal cord.
✔✔Which of the following must be included on the Medical Examination Report Form?
a. The Medical Examiner's office address. b. The Medical Examiner's phone number. c.
The Medical Examiner's state license. d. All of the above. - ✔✔Review the components
of the MER before taking the NRCME exam.
✔✔. On an exercise tolerance test, the driver must attain a heart rate of what level
(assuming he is not taking a beta-blocker):
a. At least 50% of predicted maximum.
b. At least 65% of predicted maximum.
c. At least 75% of predicted maximum.
