FMCSA • NATIONAL REGISTRY OF CERTIFIED MEDICAL EXAMINERS
DOT CERTIFICATION EXAM A+
2026/2027
Medical Examiner Certification — Commercial Motor Vehicle Driver Physical Qualifications
A+ QUESTIONS 5 SECTIONS 100%
VERIFIED COMPLETE RATIONALES
CATEGORIES
■ 1. Vision, Hearing & Core Physical Examination Standards
■ 2. Cardiovascular Conditions & Certification Decisions
■ 3. Diabetes, Respiratory Conditions & Sleep Disorders
■ 4. Neurological, Mental Health & Musculoskeletal Conditions
■ 5. Medications, Substance Use, Documentation & Certification Process
STUVIAACTUALEXAM
Passing Score: 80% • 1 Mark per Question • Application / Analysis Level
, SECTION 1: Vision, Hearing & Core Physical Examination Standards
Q1. A commercial driver presents for certification. Distant visual acuity is 20/40 in the better eye and 20/60 in the other eye,
both corrected. Horizontal field of vision is 70 degrees in each eye. The medical examiner’s correct determination regarding
the basic vision standard is that the driver:
A. Meets the basic vision standard without restriction
B. Does not meet the basic distant acuity standard of at least 20/40 in each eye and requires evaluation under the alternative
vision standard process
C. Does not meet the basic vision standard because field of vision is less than 70 degrees in each eye is incorrect; the minimum
is 70 degrees
D. May be certified for two years without further documentation
Correct Answer: B
Rationale: The basic vision standard requires distant visual acuity of at least 20/40 in each eye (with or without corrective lenses) and field
of vision of at least 70 degrees in each eye. Failure in either eye triggers the alternative vision standard pathway (Form MCSA-5871)
rather than automatic qualification under the basic standard.
Q2. During a DOT physical, a driver fails the whispered voice test at 5 feet in both ears. The examiner then performs
audiometric testing. To meet the hearing standard, the average hearing loss in the better ear must not be greater than:
A. 40 dB at 500, 1000, and 2000 Hz
B. 25 dB at 500, 1000, and 2000 Hz
C. 55 dB at any single frequency
D. 70 dB across the speech frequencies
Correct Answer: A
Rationale: When the forced whispered voice test is failed, pure-tone audiometry is required. The average hearing loss in the better ear
must not exceed 40 dB at 500, 1000, and 2000 Hz (with or without a hearing aid).
Q3. A driver reports monocular vision and brings a completed Vision Evaluation Report (MCSA-5871) from an
ophthalmologist stating the driver is safe to drive. The medical examiner’s next required action under the alternative vision
standard is to:
A. Automatically certify the driver for two years without further review
B. Disqualify the driver permanently because monocular vision is never permitted
C. Review the specialist’s findings, complete the medical examination, and determine whether the driver can be certified under
the alternative vision standard
D. Require the driver to obtain a federal vision exemption before any certification decision
Correct Answer: C
Rationale: Under the alternative vision standard, the medical examiner reviews the Vision Evaluation Report, performs the remainder of
the examination, and decides certification. A federal exemption is no longer required for monocular vision that meets the alternative
standard criteria.
Q4. A driver presents with a blood pressure of 168/108 mm Hg on initial measurement and 164/106 mm Hg on repeat. The
driver has no prior hypertension history documented. According to FMCSA hypertension guidelines, the medical examiner
should:
A. Certify the driver for two years because the elevation is mild
B. Disqualify the driver permanently without the option for short-term certification
C. Ignore the reading if the driver is asymptomatic
D. Certify the driver for a maximum of three months (Stage 2 hypertension) and advise the driver to seek treatment and
re-evaluation
Correct Answer: D
Rationale: Blood pressure ≥160/100 mm Hg but <180/110 mm Hg is Stage 2 hypertension. The driver may receive a one-time certification
for up to three months to allow treatment and recheck. Certification for a full year requires controlled blood pressure.
DOT CERTIFICATION EXAM | Page 2
DOT CERTIFICATION EXAM A+
2026/2027
Medical Examiner Certification — Commercial Motor Vehicle Driver Physical Qualifications
A+ QUESTIONS 5 SECTIONS 100%
VERIFIED COMPLETE RATIONALES
CATEGORIES
■ 1. Vision, Hearing & Core Physical Examination Standards
■ 2. Cardiovascular Conditions & Certification Decisions
■ 3. Diabetes, Respiratory Conditions & Sleep Disorders
■ 4. Neurological, Mental Health & Musculoskeletal Conditions
■ 5. Medications, Substance Use, Documentation & Certification Process
STUVIAACTUALEXAM
Passing Score: 80% • 1 Mark per Question • Application / Analysis Level
, SECTION 1: Vision, Hearing & Core Physical Examination Standards
Q1. A commercial driver presents for certification. Distant visual acuity is 20/40 in the better eye and 20/60 in the other eye,
both corrected. Horizontal field of vision is 70 degrees in each eye. The medical examiner’s correct determination regarding
the basic vision standard is that the driver:
A. Meets the basic vision standard without restriction
B. Does not meet the basic distant acuity standard of at least 20/40 in each eye and requires evaluation under the alternative
vision standard process
C. Does not meet the basic vision standard because field of vision is less than 70 degrees in each eye is incorrect; the minimum
is 70 degrees
D. May be certified for two years without further documentation
Correct Answer: B
Rationale: The basic vision standard requires distant visual acuity of at least 20/40 in each eye (with or without corrective lenses) and field
of vision of at least 70 degrees in each eye. Failure in either eye triggers the alternative vision standard pathway (Form MCSA-5871)
rather than automatic qualification under the basic standard.
Q2. During a DOT physical, a driver fails the whispered voice test at 5 feet in both ears. The examiner then performs
audiometric testing. To meet the hearing standard, the average hearing loss in the better ear must not be greater than:
A. 40 dB at 500, 1000, and 2000 Hz
B. 25 dB at 500, 1000, and 2000 Hz
C. 55 dB at any single frequency
D. 70 dB across the speech frequencies
Correct Answer: A
Rationale: When the forced whispered voice test is failed, pure-tone audiometry is required. The average hearing loss in the better ear
must not exceed 40 dB at 500, 1000, and 2000 Hz (with or without a hearing aid).
Q3. A driver reports monocular vision and brings a completed Vision Evaluation Report (MCSA-5871) from an
ophthalmologist stating the driver is safe to drive. The medical examiner’s next required action under the alternative vision
standard is to:
A. Automatically certify the driver for two years without further review
B. Disqualify the driver permanently because monocular vision is never permitted
C. Review the specialist’s findings, complete the medical examination, and determine whether the driver can be certified under
the alternative vision standard
D. Require the driver to obtain a federal vision exemption before any certification decision
Correct Answer: C
Rationale: Under the alternative vision standard, the medical examiner reviews the Vision Evaluation Report, performs the remainder of
the examination, and decides certification. A federal exemption is no longer required for monocular vision that meets the alternative
standard criteria.
Q4. A driver presents with a blood pressure of 168/108 mm Hg on initial measurement and 164/106 mm Hg on repeat. The
driver has no prior hypertension history documented. According to FMCSA hypertension guidelines, the medical examiner
should:
A. Certify the driver for two years because the elevation is mild
B. Disqualify the driver permanently without the option for short-term certification
C. Ignore the reading if the driver is asymptomatic
D. Certify the driver for a maximum of three months (Stage 2 hypertension) and advise the driver to seek treatment and
re-evaluation
Correct Answer: D
Rationale: Blood pressure ≥160/100 mm Hg but <180/110 mm Hg is Stage 2 hypertension. The driver may receive a one-time certification
for up to three months to allow treatment and recheck. Certification for a full year requires controlled blood pressure.
DOT CERTIFICATION EXAM | Page 2
