NRCME (DOT) FINAL TEST 2026
QUESTIONS WITH CORRECT
ANSWERS GRADED A+
◍ What minimum PaO2 level is recommended if the driver has an ABG due to
a chronic respiratory disorder? a. 70 mm Hg b. 55 mm Hgc. 60 mm Hgd. 65
mm Hg.
Answer: D.To be qualified, the driver should meet a minimum arterial blood
gas (PaO2) greater than 65.
◍ A driver first perceives a whispered voice at 5 feet in his right ear and 4 feet
in his left ear. All other aspects of his physical examination are
unremarkable. The examiner should:a. Disqualify the driver because he
"failed" the whispered voice test. b. Certify the driver for 2 years. c. Certify
the driver for 1 year. d. Require an audiometric test to determine the extent
of hearing loss in his left ear..
Answer: B.The driver is qualified to drive without restriction as long as he is
able to perceive a whispered voice at 5 feet in 1 ear.
◍ What percentage of NRCME exam questions focus on driver's medical info
& exam?.
Answer: 70%
◍ What percentage of NRCME exam questions focus on determining
qualification & disposition?.
Answer: 30%
◍ Which regulations govern the NRCME exam?.
Answer: 49 CFR 391.41-391.49
◍ What is the maximum certification interval for a fully qualified driver?.
Answer: 2 years
,◍ What is the minimum blood pressure for a 2-year certification?.
Answer: ≤ 140/90
◍ What blood pressure range typically results in a 1-year certification?.
Answer: Stage 2 Hypertension (160--109)
◍ A driver reports for an examination 6 weeks after suffering a mild heart
attack and presents a note from his cardiologist stating that he is able to
return to work immediately without restriction. Included within the note, the
cardiologist provides recent testing information showing that the driver had
an ETT that showed he was able to reach 12 METS during the test. His
echocardiogram showed an ejection fraction of 65%. The examination of the
driver is unremarkable. The examiner should: a. Disqualify the driver. b.
Qualify the driver for 1 year. c. Qualify the driver for 2 years. d. Consult
with the cardiologist to determine if the driver suffers from angina..
Answer: A.The driver has not completed the recommended 2-month waiting
period, but all other requirements for medical clearance and required testing
have been met. The driver would be certified for 1 year at the completion of
the waiting period.
◍ What is the required vision standard for NRCME certification?.
Answer: At least 20/40 in each eye and both eyes together
◍ What is the required horizontal field of vision for NRCME certification?.
Answer: ≥ 70° in each eye
◍ A driver provides an audiometric test documenting the following: 1. 500 Hz:
35 Right ear; 40 Left ear 2. 1000 HZ: 40 Right ear; 45 Left ear 3. 2000 HZ:
40 Right ear; 45 Left ear 4. 4000 Hz: 50 Right ear; 50 Left ear The medical
examiner should:a. Disqualify the driver because he does not meet minimum
hearing requirementsto drive. b. Certify the driver for 2years. c. Certify the
driver for 1 year. d. Require the driver to obtain a hearing exemption.
Answer: B. The examiner would average the results from 500 Hz, 1000 Hz
and 2000 Hz. This average is 38.33 in the Right and 43.33 in the Left ear. A
driver must have an average hearing loss of less than or equal to 40 in the
, better ear. This does not have to be met in both ears.
◍ During the examination of a commercial driver, the examiner notices that
the driver's peripheral vision is 70 degrees to the left and 80 degrees to the
right. The examiner should: a. Qualify the driver for 2years. b. Require the
driver to obtain a vision exemption because of the limitation in the driver's
left peripheral field. c. Disqualify the driver. d. Have the driver consult with
an Ophthalmologist to determine if the driver's peripheral vision meets
minimum standards..
Answer: A.A driver must exhibit a minimum peripheral vision of 70 degrees
bilaterally.
◍ What is the hearing standard for NRCME certification using the forced
whisper test?.
Answer: Hear forced whisper ≥ 5 feet in one ear
◍ What must be documented if a driver leaves before completing the vision
portion of the exam?.
Answer: The incomplete exam must be documented and submitted as
incomplete/temporarily disqualified.
◍ During examination, the medical examiner notices that the driver is distant,
lacks eye contact and shows absolutely no emotional response during the
exam. The examiner's best response should be:a. Provide the driver with a
"CAGE" questionnaire to determine if he suffers from alcoholism. b.
Disqualify the driver and refer him to a mental health professional prior to
consideration for certification. c. Certify the driver with a 1-time, 3-month
certificate to determine if there is any effect on the driver's ability to drive a
CM
V. d. Require a skill performance evaluation to ascertain if the driver has
any limitations with driving.
Answer: B.The driver exhibits what may be considered a "flat affect" which
is seen in schizophrenia and in severe depression. The driver should be
evaluated by a mental health expert to make a diagnosis prior to
certification.
, ◍ A driver admits to the use of marijuana for the treatment of his glaucoma,
which is legal in the State in which he lives. He provides medical
documentation for the glaucoma indicating he is able to drive a truck. He
began using the marijuana about three months ago. His current medical card
has no limitations listed and is for 2 years. His certification examination is
within normal limits. The medical examiner should:a. Disqualify the
driver.b. Perform a urine drug collection and provide the release from the
testing provider.c. Certify the driver for 1 year.d. Certify the driver for 2
years..
Answer: A.Use of marijuana is prohibited by Federal law while driving a
CMV and trumps State law in this matter.
◍ What is the waiting period after a single provoked seizure for certification?.
Answer: Typically, a waiting period is required based on the underlying
cause and recurrence risk.
◍ A driver has a blood pressure of 136/92 mm Hg. This is: a. Within normal
limits and would not affect the driver's certification. b. Stage 1
Hypertension. c. Stage 2 Hypertension. d. Stage 3 Hypertension..
Answer: B.This is Stage 1 Hypertension, which is defined as 140-159/90 -
99.
◍ A driver is taking Celexa for the treatment of what he calls a "mild
depression." He reports he has not considered or attempted suicide. The
examiner should:a. Certify only after obtaining written clearance for the
depression from the treating mental health professional.b. Certify the driver
for a period of 1 year.c. Certify the driver for a period of 2 years.d.
Disqualify the driver until he is no longer requiring medication for the
treatment of depression..
Answer: A.Medical clearance is recommended for all mental health
disorders. Celexa is an SSRI or 2nd Generation anti-depressant and is
acceptable.
◍ What form must an insulin-treated diabetic driver complete?.
Answer: Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870)
QUESTIONS WITH CORRECT
ANSWERS GRADED A+
◍ What minimum PaO2 level is recommended if the driver has an ABG due to
a chronic respiratory disorder? a. 70 mm Hg b. 55 mm Hgc. 60 mm Hgd. 65
mm Hg.
Answer: D.To be qualified, the driver should meet a minimum arterial blood
gas (PaO2) greater than 65.
◍ A driver first perceives a whispered voice at 5 feet in his right ear and 4 feet
in his left ear. All other aspects of his physical examination are
unremarkable. The examiner should:a. Disqualify the driver because he
"failed" the whispered voice test. b. Certify the driver for 2 years. c. Certify
the driver for 1 year. d. Require an audiometric test to determine the extent
of hearing loss in his left ear..
Answer: B.The driver is qualified to drive without restriction as long as he is
able to perceive a whispered voice at 5 feet in 1 ear.
◍ What percentage of NRCME exam questions focus on driver's medical info
& exam?.
Answer: 70%
◍ What percentage of NRCME exam questions focus on determining
qualification & disposition?.
Answer: 30%
◍ Which regulations govern the NRCME exam?.
Answer: 49 CFR 391.41-391.49
◍ What is the maximum certification interval for a fully qualified driver?.
Answer: 2 years
,◍ What is the minimum blood pressure for a 2-year certification?.
Answer: ≤ 140/90
◍ What blood pressure range typically results in a 1-year certification?.
Answer: Stage 2 Hypertension (160--109)
◍ A driver reports for an examination 6 weeks after suffering a mild heart
attack and presents a note from his cardiologist stating that he is able to
return to work immediately without restriction. Included within the note, the
cardiologist provides recent testing information showing that the driver had
an ETT that showed he was able to reach 12 METS during the test. His
echocardiogram showed an ejection fraction of 65%. The examination of the
driver is unremarkable. The examiner should: a. Disqualify the driver. b.
Qualify the driver for 1 year. c. Qualify the driver for 2 years. d. Consult
with the cardiologist to determine if the driver suffers from angina..
Answer: A.The driver has not completed the recommended 2-month waiting
period, but all other requirements for medical clearance and required testing
have been met. The driver would be certified for 1 year at the completion of
the waiting period.
◍ What is the required vision standard for NRCME certification?.
Answer: At least 20/40 in each eye and both eyes together
◍ What is the required horizontal field of vision for NRCME certification?.
Answer: ≥ 70° in each eye
◍ A driver provides an audiometric test documenting the following: 1. 500 Hz:
35 Right ear; 40 Left ear 2. 1000 HZ: 40 Right ear; 45 Left ear 3. 2000 HZ:
40 Right ear; 45 Left ear 4. 4000 Hz: 50 Right ear; 50 Left ear The medical
examiner should:a. Disqualify the driver because he does not meet minimum
hearing requirementsto drive. b. Certify the driver for 2years. c. Certify the
driver for 1 year. d. Require the driver to obtain a hearing exemption.
Answer: B. The examiner would average the results from 500 Hz, 1000 Hz
and 2000 Hz. This average is 38.33 in the Right and 43.33 in the Left ear. A
driver must have an average hearing loss of less than or equal to 40 in the
, better ear. This does not have to be met in both ears.
◍ During the examination of a commercial driver, the examiner notices that
the driver's peripheral vision is 70 degrees to the left and 80 degrees to the
right. The examiner should: a. Qualify the driver for 2years. b. Require the
driver to obtain a vision exemption because of the limitation in the driver's
left peripheral field. c. Disqualify the driver. d. Have the driver consult with
an Ophthalmologist to determine if the driver's peripheral vision meets
minimum standards..
Answer: A.A driver must exhibit a minimum peripheral vision of 70 degrees
bilaterally.
◍ What is the hearing standard for NRCME certification using the forced
whisper test?.
Answer: Hear forced whisper ≥ 5 feet in one ear
◍ What must be documented if a driver leaves before completing the vision
portion of the exam?.
Answer: The incomplete exam must be documented and submitted as
incomplete/temporarily disqualified.
◍ During examination, the medical examiner notices that the driver is distant,
lacks eye contact and shows absolutely no emotional response during the
exam. The examiner's best response should be:a. Provide the driver with a
"CAGE" questionnaire to determine if he suffers from alcoholism. b.
Disqualify the driver and refer him to a mental health professional prior to
consideration for certification. c. Certify the driver with a 1-time, 3-month
certificate to determine if there is any effect on the driver's ability to drive a
CM
V. d. Require a skill performance evaluation to ascertain if the driver has
any limitations with driving.
Answer: B.The driver exhibits what may be considered a "flat affect" which
is seen in schizophrenia and in severe depression. The driver should be
evaluated by a mental health expert to make a diagnosis prior to
certification.
, ◍ A driver admits to the use of marijuana for the treatment of his glaucoma,
which is legal in the State in which he lives. He provides medical
documentation for the glaucoma indicating he is able to drive a truck. He
began using the marijuana about three months ago. His current medical card
has no limitations listed and is for 2 years. His certification examination is
within normal limits. The medical examiner should:a. Disqualify the
driver.b. Perform a urine drug collection and provide the release from the
testing provider.c. Certify the driver for 1 year.d. Certify the driver for 2
years..
Answer: A.Use of marijuana is prohibited by Federal law while driving a
CMV and trumps State law in this matter.
◍ What is the waiting period after a single provoked seizure for certification?.
Answer: Typically, a waiting period is required based on the underlying
cause and recurrence risk.
◍ A driver has a blood pressure of 136/92 mm Hg. This is: a. Within normal
limits and would not affect the driver's certification. b. Stage 1
Hypertension. c. Stage 2 Hypertension. d. Stage 3 Hypertension..
Answer: B.This is Stage 1 Hypertension, which is defined as 140-159/90 -
99.
◍ A driver is taking Celexa for the treatment of what he calls a "mild
depression." He reports he has not considered or attempted suicide. The
examiner should:a. Certify only after obtaining written clearance for the
depression from the treating mental health professional.b. Certify the driver
for a period of 1 year.c. Certify the driver for a period of 2 years.d.
Disqualify the driver until he is no longer requiring medication for the
treatment of depression..
Answer: A.Medical clearance is recommended for all mental health
disorders. Celexa is an SSRI or 2nd Generation anti-depressant and is
acceptable.
◍ What form must an insulin-treated diabetic driver complete?.
Answer: Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870)
