NRCME (DOT) PRACTICE
EXAMINATION 2026 QUESTIONS
WITH ANSWERS GRADED A+
◍ What is the mission of FMCSA?.
Answer: FMCSA is focused on reducing crashes, injuries, and fatalities
involving large trucks and buses.
◍ Who and what does the FMCSA regulate?.
Answer: Interstate commercial operation, including the driver, vehicle,
motor carrier, and the transport of hazardous materials.
◍ VertigoWaiting PeriodCertification Time.
Answer: 2 months
◍ Examples of CMV driver stress factors.
Answer: Interruption of normal sleep, exercising, eating pattern, and access
to social support networks resulting in fatigue, obesity, and or/alienation of
affection. Environment that may have excessive vibration, noise, and
extremes in temperature and or/adverse road or traffic conditions that can
interfere with driver ability to recognize a driving hazard, cause temporary
or permanent physical damage to sensory perception or affect driver
behavior. Increased potential for injury and fatalities should there be a crash
when driver is responsible for passenger safety or hazardous cargo.
◍ Meniere's DiseaseLabyrinthe FistulaNonfunctioning LabryrinthsWaiting
PeriodCertification Time.
Answer: DO NOT CERTIFY
◍ What are the differences between the medical standards and medical
guidelines?.
Answer: Regulations are law and are mandatory. The ME must use
, standards to determine interstate CMV driver medical fitness for duty.
Medical guidelines are not regulatory and the ME may choose not to follow
the medical guidance.
◍ CADHow often exam?.
Answer: Annually
◍ In which regulations are the driver physical qualification standards and
Medical Examiners cited?.
Answer: Driver physical qualification standards are found in 49 CFR
391.41. ME responsibilities are found in 49 CFR 391.43
◍ What objective tests and measurements are required as part of the driver
physical examination?.
Answer: Height & weightVisionHearingBP & pulseUrinalysis (spec gravity,
protein, blood, glucose)
◍ What are the possible outcomes of the driver physical examination?.
Answer: CertificationDisqualificationDetermination pending
◍ What date is used to determine medical examiners certificate expiration?.
Answer: The date of the exam is used as the basis for certificate expiration,
except when determination pending is chosen.When determination pending
is chosen, if the driver returns with the necessary information prior to the
expiration of the driver's current certificate and the driver is qualified based
on that information provided, the date used for the basis of the certification
timeframe is the date the driver returned with the necessary information.
◍ What is the ME certificate expiration date for the following drivers?A -
Exam 4/16/2011, meets standards in 49 CFR 391.41, qualifies for 2 year
certificate.B - Exam 4/16/2011, meets standards, but periodic monitoring
required due to HTN, qualifies for 1 year certificate.C - Exam 4/16/2011,
determination pending due to not having results of post-CABG stress test, pt
returns and provides that info on 4/25/2011, driver is qualified for 1 year. D
- Exam 4/16/2011, disqualified due to benign position vertigo on 3/15/2011,
returned to ME for certification examination on 5/20/11. He has been
, asymptomatic since 3/11/2011. Qualified for two years..
Answer: A: 4/16/2013B: 4/16/2012C: 4/25/2012D: 5/20/2013
◍ Patient example:Karen, recertification exam42 y/o femaleNo health history,
no medications. Vision acuity: right 20/20, left 20/30. Both 20/20.
Horizontal field of vision Rt 80 degrees, Lt 80 degrees. Not corrected
vision.No monocular vision.No hearing aids, Whisper test 5' bilaterally. N/A
audiometric testingUA: spec grav 1.020, protein 1+, blood 4+, glucose
neg.Hgb 12.4BP 134/88, P 80, regular.PE: on 4th day of menses with heavy
bleeding. Advised to consult PCP or GYN for eval of excessive bleeding
that could lead to anemia, leading to fatigue that would affect her driving..
Answer: Two year certification - no disqualifying health history or PE
abnormalities. Ask about medication use, including OTC medications.ME
obtained hemoglobin testing based on PE findings. (not required)The ME
should correctly note the body system in which there was an abnormal
finding. The note reflects inquiry as to the affect on driving ability and is
also supported by Hgb test results. ME also documented medical follow up
advice.
◍ Who can perform the vision portion of the interstate CMV driver physical
examination?.
Answer: The certified ME, optometrist, or an opthalmologist. If the
specialist provider performs the exam, they should complete and sign the
provider's information on the report form and provide the results.
◍ To pass the interstate CMV driver vision exam, a visual acuity of
___/___corrected or uncorrected is required..
Answer: 20/40 on Snellen chart in each eye individually AND in both eyes
combined.
◍ What eye conditions must the ME ask the driver about and if indicated,
request specialist evaluation?.
Answer: Retinopathy, cataracts, aphakia, glaucoma, and macular
degeneration.
◍ Acute MIWaiting PeriodCertification TimeHow often exam?.
, Answer: 2 months1 year1 year
◍ Pt example:Mr. Brown, 48 y/o male. No current meds, injury 5 years ago.
Hunting accident 2 years ago with facial trauma and left orbital fracture.
Presented a "may drive" note from eye surgeon (dated 3 months prior to
examination). Uncorrected vision, right eye 20/20. left eye 20/40. Both
20/20. Horizontal field of vision Right 80 degrees, left eye is inconclusive.
No monocular vision. No hearing aids. Whisper test 5' bilaterally. N/A
audiometric test. UA normal. BP 122/74, p 80, regular..
Answer: Exam findings: Left eye muscles do not move eye to the left,
discussed disqualification pending eye exam by specialist. Explained the
specialist will get precise visual field measurements. Provided driver with
appropriate medical release and copy of medical exam report with vision
section highlighted. Driver does not meet requirements. He is pending
specialist vision exam. Diminished vision in left eye noted. Pt could be
functionally monocular.
◍ Angina PectorisWaiting PeriodCertification TimeHow often exam?.
Answer: 3 months1 year-
◍ CABGWaiting PeriodCertification TimeHow often exam?.
Answer: 3 months1 year-
◍ Percutaneous Coronary Intervention (Post-op)Waiting PeriodCertification
TimeHow often exam?.
Answer: 1 week1 yearBiannually
◍ Implantable Cardioverter-Defibrilllators (ICDs)Waiting PeriodCertification
TimeHow often exam?.
Answer: DO NOT CERTIFY
◍ Pacemaker (Sinus Node Dysfunction or AV Block) (post-op)Waiting
PeriodCertification TimeHow often exam?.
Answer: 1 month1 year-
◍ Pacemaker (Hypersensitive Carotid Sinus w/ Syncope)Waiting
PeriodCertification TimeHow often exam?.
EXAMINATION 2026 QUESTIONS
WITH ANSWERS GRADED A+
◍ What is the mission of FMCSA?.
Answer: FMCSA is focused on reducing crashes, injuries, and fatalities
involving large trucks and buses.
◍ Who and what does the FMCSA regulate?.
Answer: Interstate commercial operation, including the driver, vehicle,
motor carrier, and the transport of hazardous materials.
◍ VertigoWaiting PeriodCertification Time.
Answer: 2 months
◍ Examples of CMV driver stress factors.
Answer: Interruption of normal sleep, exercising, eating pattern, and access
to social support networks resulting in fatigue, obesity, and or/alienation of
affection. Environment that may have excessive vibration, noise, and
extremes in temperature and or/adverse road or traffic conditions that can
interfere with driver ability to recognize a driving hazard, cause temporary
or permanent physical damage to sensory perception or affect driver
behavior. Increased potential for injury and fatalities should there be a crash
when driver is responsible for passenger safety or hazardous cargo.
◍ Meniere's DiseaseLabyrinthe FistulaNonfunctioning LabryrinthsWaiting
PeriodCertification Time.
Answer: DO NOT CERTIFY
◍ What are the differences between the medical standards and medical
guidelines?.
Answer: Regulations are law and are mandatory. The ME must use
, standards to determine interstate CMV driver medical fitness for duty.
Medical guidelines are not regulatory and the ME may choose not to follow
the medical guidance.
◍ CADHow often exam?.
Answer: Annually
◍ In which regulations are the driver physical qualification standards and
Medical Examiners cited?.
Answer: Driver physical qualification standards are found in 49 CFR
391.41. ME responsibilities are found in 49 CFR 391.43
◍ What objective tests and measurements are required as part of the driver
physical examination?.
Answer: Height & weightVisionHearingBP & pulseUrinalysis (spec gravity,
protein, blood, glucose)
◍ What are the possible outcomes of the driver physical examination?.
Answer: CertificationDisqualificationDetermination pending
◍ What date is used to determine medical examiners certificate expiration?.
Answer: The date of the exam is used as the basis for certificate expiration,
except when determination pending is chosen.When determination pending
is chosen, if the driver returns with the necessary information prior to the
expiration of the driver's current certificate and the driver is qualified based
on that information provided, the date used for the basis of the certification
timeframe is the date the driver returned with the necessary information.
◍ What is the ME certificate expiration date for the following drivers?A -
Exam 4/16/2011, meets standards in 49 CFR 391.41, qualifies for 2 year
certificate.B - Exam 4/16/2011, meets standards, but periodic monitoring
required due to HTN, qualifies for 1 year certificate.C - Exam 4/16/2011,
determination pending due to not having results of post-CABG stress test, pt
returns and provides that info on 4/25/2011, driver is qualified for 1 year. D
- Exam 4/16/2011, disqualified due to benign position vertigo on 3/15/2011,
returned to ME for certification examination on 5/20/11. He has been
, asymptomatic since 3/11/2011. Qualified for two years..
Answer: A: 4/16/2013B: 4/16/2012C: 4/25/2012D: 5/20/2013
◍ Patient example:Karen, recertification exam42 y/o femaleNo health history,
no medications. Vision acuity: right 20/20, left 20/30. Both 20/20.
Horizontal field of vision Rt 80 degrees, Lt 80 degrees. Not corrected
vision.No monocular vision.No hearing aids, Whisper test 5' bilaterally. N/A
audiometric testingUA: spec grav 1.020, protein 1+, blood 4+, glucose
neg.Hgb 12.4BP 134/88, P 80, regular.PE: on 4th day of menses with heavy
bleeding. Advised to consult PCP or GYN for eval of excessive bleeding
that could lead to anemia, leading to fatigue that would affect her driving..
Answer: Two year certification - no disqualifying health history or PE
abnormalities. Ask about medication use, including OTC medications.ME
obtained hemoglobin testing based on PE findings. (not required)The ME
should correctly note the body system in which there was an abnormal
finding. The note reflects inquiry as to the affect on driving ability and is
also supported by Hgb test results. ME also documented medical follow up
advice.
◍ Who can perform the vision portion of the interstate CMV driver physical
examination?.
Answer: The certified ME, optometrist, or an opthalmologist. If the
specialist provider performs the exam, they should complete and sign the
provider's information on the report form and provide the results.
◍ To pass the interstate CMV driver vision exam, a visual acuity of
___/___corrected or uncorrected is required..
Answer: 20/40 on Snellen chart in each eye individually AND in both eyes
combined.
◍ What eye conditions must the ME ask the driver about and if indicated,
request specialist evaluation?.
Answer: Retinopathy, cataracts, aphakia, glaucoma, and macular
degeneration.
◍ Acute MIWaiting PeriodCertification TimeHow often exam?.
, Answer: 2 months1 year1 year
◍ Pt example:Mr. Brown, 48 y/o male. No current meds, injury 5 years ago.
Hunting accident 2 years ago with facial trauma and left orbital fracture.
Presented a "may drive" note from eye surgeon (dated 3 months prior to
examination). Uncorrected vision, right eye 20/20. left eye 20/40. Both
20/20. Horizontal field of vision Right 80 degrees, left eye is inconclusive.
No monocular vision. No hearing aids. Whisper test 5' bilaterally. N/A
audiometric test. UA normal. BP 122/74, p 80, regular..
Answer: Exam findings: Left eye muscles do not move eye to the left,
discussed disqualification pending eye exam by specialist. Explained the
specialist will get precise visual field measurements. Provided driver with
appropriate medical release and copy of medical exam report with vision
section highlighted. Driver does not meet requirements. He is pending
specialist vision exam. Diminished vision in left eye noted. Pt could be
functionally monocular.
◍ Angina PectorisWaiting PeriodCertification TimeHow often exam?.
Answer: 3 months1 year-
◍ CABGWaiting PeriodCertification TimeHow often exam?.
Answer: 3 months1 year-
◍ Percutaneous Coronary Intervention (Post-op)Waiting PeriodCertification
TimeHow often exam?.
Answer: 1 week1 yearBiannually
◍ Implantable Cardioverter-Defibrilllators (ICDs)Waiting PeriodCertification
TimeHow often exam?.
Answer: DO NOT CERTIFY
◍ Pacemaker (Sinus Node Dysfunction or AV Block) (post-op)Waiting
PeriodCertification TimeHow often exam?.
Answer: 1 month1 year-
◍ Pacemaker (Hypersensitive Carotid Sinus w/ Syncope)Waiting
PeriodCertification TimeHow often exam?.
