NRCME ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED
A+
◍ 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%
◍ Corrective lenses that are prohibited by the FMCSA, including:.
Answer: lenses that correct distance vision in one eye and near vision in the
other.telescopic lenses
◍ Medical guidelines for the driver with diabetes mellitus include:.
Answer: Annual medical examination.Annual ophthalmologist or
optometrist eye evaluation.Disqualification for a diagnosis of unstable
proliferative retinopathy.
◍ 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
◍ Monocular Vision.
Answer: Monocular vision is disqualifying.However, the driver who has
monocular vision that with the better eye meets all vision qualification
requirements may be considered for a Federal Vision Exemption if the
Medical Examiner finds the driver otherwise medically fit for
, duty.Monocular vision is defined as vision that is at least 20/40 for distance
in one eye with or without correction and vision that is less than 20/40 for
distance in one eye with or without correction.The driver must meet other
vision requirements in each eye, including visual fields (horizontal field of
vision).Federal Vision Exemption: the driver with monocular vision who is
applying for or has a federal exemption or is qualified by operation of 49
CFR 391.64 must have an annual physical examination.Drivers with vision
loss who meet standards may be certified for up to two years.
◍ A driver who wears contact lenses which correct farsightedness in one eye
and nearsightedness in the other, but has no other visual impairments can be
certified under what additional conditions?Only if the driver wears
prescription glasses which provide the same correction as the contact
lenses.FMCSA guidance indicates that a driver should not be certified under
these circumstances.Only by federal exemption.The driver is always
certifiable under these conditions..
Answer: FMCSA guidance indicates that a driver should not be certified
under these circumstances.Explanation: FMCSA guidance indicates that
contact lenses that correct one eye for distance and one eye for near vision
are not acceptable.
◍ Guidance recommends not to certify with ear problem diagnoses of:.
Answer: a) Uncontrolled vertigo. b) Ménière's disease. c) Nonfunctioning
labyrinth. d) Nonfunctioning fistula.
◍ What is the minimum blood pressure for a 2-year certification?.
Answer: ≤ 140/90
◍ The medical examiner's role in the exemption process includes
_________.Issuing the exemption.Issuing the prescription for the driver's
contact lenses and/or glasses.Providing the driver with contact information
for the Federal Vision Exemption Program.Assuring that the driver has
peripheral vision of at least 110 degrees in each eye..
Answer: Providing the driver with contact information for the Federal
Vision Exemption Program.Explanation: The medical examiner's role in the
, exemption process is limited to performing the driver examination and
providing the driver with contact information for the FMCSA related to the
exemption process.
◍ What blood pressure range typically results in a 1-year certification?.
Answer: Stage 2 Hypertension (160--109)
◍ 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
◍ An audiometric test produces the following results: Left ear: 500 Hz, 35dB
Loss; 1,000 Hz, 35 dB loss; 2,000 Hz 45 dB loss. Right ear: 500 Hz, 40 dB
loss; 1,000 Hz, 45 dB loss; 2,000 40 dB loss. What is the
certification?Certify for one year.Certify for two years.Do not certify.Certify
only when accompanied by hearing aid..
Answer: Certify for two years.Explanation: Drivers with an average hearing
loss of < 40 decibels averaged across 500, 1000, and 2000 Hz in the better
ear may be certified for two years.
◍ What eye conditions must the medical examiner ask the driver
about?Cataracts, color deficiencies, retinitis pigmentosa, aphakia,
glaucoma.Lazy eye, cataracts, aphakia, floaters, retinopathy.Glaucoma,
macular degeneration, retinitis pigmentosa, color deficiencies.Retinopathy,
cataracts, aphakia, glaucoma, macular degeneration..
Answer: Retinopathy, cataracts, aphakia, glaucoma, macular
degeneration.Explanation: These are the "ask about" vision conditions. The
medical examiner may ask the driver about any eye conditions, but should
ask the driver about these specified conditions.
◍ 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.
◍ Which of the following drivers' tests meet hearing certification
standards?Whisper test 4 feet right ear, 3 feet left ear.Whisper test 5 feet
right ear with hearing aid, 3 feet left ear without hearing aid.Audiogram left
30/500 Hz, 40/1000 Hz, 60/2000 Hz; right 25/500 Hz, 35/1000 Hz, 80/2000
Hz.Audiogram left 35/500 Hz, 50/1000 Hz, 40/3000 Hz; right 35/500 Hz,
35/1000 Hz, 60/3000 Hz..
Answer: Whisper test 5 feet right ear with hearing aid, 3 feet left ear without
hearing aid.Explanation: Whisper test results require 5 feet in at least one
ear for passing, with or without a hearing aid. Audiometric testing results
require an average of 40 dB loss in the better ear for results averaged across
500, 1000, and 2000 Hz. Although testing may be performed at 3000 Hz,
results obtained are not used to determine whether the driver meets hearing
requirements.
◍ 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.
◍ What form must an insulin-treated diabetic driver complete?.
Answer: Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870)
◍ A driver has loss of hearing in the better ear of 25 dB loss at 500 Hz, 40 dB
loss at 1000 Hz, and 60 dB loss at 2000 Hz. With respect to the hearing
requirement for medical certification, the driver __________.May be
certified for one year.May be certified for two years.May not be
certified.May be certified if examined by an otolaryngologist who is familiar
with the CMV driving duties who certifies the driver as medically qualified
to drive a CM
V. .
Answer: May not be certified.Explanation: An average hearing loss of 41.7
decibels averaged across 500, 1000, and 2000 Hz in the better ear is
QUESTIONS WITH ANSWERS GRADED
A+
◍ 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%
◍ Corrective lenses that are prohibited by the FMCSA, including:.
Answer: lenses that correct distance vision in one eye and near vision in the
other.telescopic lenses
◍ Medical guidelines for the driver with diabetes mellitus include:.
Answer: Annual medical examination.Annual ophthalmologist or
optometrist eye evaluation.Disqualification for a diagnosis of unstable
proliferative retinopathy.
◍ 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
◍ Monocular Vision.
Answer: Monocular vision is disqualifying.However, the driver who has
monocular vision that with the better eye meets all vision qualification
requirements may be considered for a Federal Vision Exemption if the
Medical Examiner finds the driver otherwise medically fit for
, duty.Monocular vision is defined as vision that is at least 20/40 for distance
in one eye with or without correction and vision that is less than 20/40 for
distance in one eye with or without correction.The driver must meet other
vision requirements in each eye, including visual fields (horizontal field of
vision).Federal Vision Exemption: the driver with monocular vision who is
applying for or has a federal exemption or is qualified by operation of 49
CFR 391.64 must have an annual physical examination.Drivers with vision
loss who meet standards may be certified for up to two years.
◍ A driver who wears contact lenses which correct farsightedness in one eye
and nearsightedness in the other, but has no other visual impairments can be
certified under what additional conditions?Only if the driver wears
prescription glasses which provide the same correction as the contact
lenses.FMCSA guidance indicates that a driver should not be certified under
these circumstances.Only by federal exemption.The driver is always
certifiable under these conditions..
Answer: FMCSA guidance indicates that a driver should not be certified
under these circumstances.Explanation: FMCSA guidance indicates that
contact lenses that correct one eye for distance and one eye for near vision
are not acceptable.
◍ Guidance recommends not to certify with ear problem diagnoses of:.
Answer: a) Uncontrolled vertigo. b) Ménière's disease. c) Nonfunctioning
labyrinth. d) Nonfunctioning fistula.
◍ What is the minimum blood pressure for a 2-year certification?.
Answer: ≤ 140/90
◍ The medical examiner's role in the exemption process includes
_________.Issuing the exemption.Issuing the prescription for the driver's
contact lenses and/or glasses.Providing the driver with contact information
for the Federal Vision Exemption Program.Assuring that the driver has
peripheral vision of at least 110 degrees in each eye..
Answer: Providing the driver with contact information for the Federal
Vision Exemption Program.Explanation: The medical examiner's role in the
, exemption process is limited to performing the driver examination and
providing the driver with contact information for the FMCSA related to the
exemption process.
◍ What blood pressure range typically results in a 1-year certification?.
Answer: Stage 2 Hypertension (160--109)
◍ 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
◍ An audiometric test produces the following results: Left ear: 500 Hz, 35dB
Loss; 1,000 Hz, 35 dB loss; 2,000 Hz 45 dB loss. Right ear: 500 Hz, 40 dB
loss; 1,000 Hz, 45 dB loss; 2,000 40 dB loss. What is the
certification?Certify for one year.Certify for two years.Do not certify.Certify
only when accompanied by hearing aid..
Answer: Certify for two years.Explanation: Drivers with an average hearing
loss of < 40 decibels averaged across 500, 1000, and 2000 Hz in the better
ear may be certified for two years.
◍ What eye conditions must the medical examiner ask the driver
about?Cataracts, color deficiencies, retinitis pigmentosa, aphakia,
glaucoma.Lazy eye, cataracts, aphakia, floaters, retinopathy.Glaucoma,
macular degeneration, retinitis pigmentosa, color deficiencies.Retinopathy,
cataracts, aphakia, glaucoma, macular degeneration..
Answer: Retinopathy, cataracts, aphakia, glaucoma, macular
degeneration.Explanation: These are the "ask about" vision conditions. The
medical examiner may ask the driver about any eye conditions, but should
ask the driver about these specified conditions.
◍ 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.
◍ Which of the following drivers' tests meet hearing certification
standards?Whisper test 4 feet right ear, 3 feet left ear.Whisper test 5 feet
right ear with hearing aid, 3 feet left ear without hearing aid.Audiogram left
30/500 Hz, 40/1000 Hz, 60/2000 Hz; right 25/500 Hz, 35/1000 Hz, 80/2000
Hz.Audiogram left 35/500 Hz, 50/1000 Hz, 40/3000 Hz; right 35/500 Hz,
35/1000 Hz, 60/3000 Hz..
Answer: Whisper test 5 feet right ear with hearing aid, 3 feet left ear without
hearing aid.Explanation: Whisper test results require 5 feet in at least one
ear for passing, with or without a hearing aid. Audiometric testing results
require an average of 40 dB loss in the better ear for results averaged across
500, 1000, and 2000 Hz. Although testing may be performed at 3000 Hz,
results obtained are not used to determine whether the driver meets hearing
requirements.
◍ 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.
◍ What form must an insulin-treated diabetic driver complete?.
Answer: Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870)
◍ A driver has loss of hearing in the better ear of 25 dB loss at 500 Hz, 40 dB
loss at 1000 Hz, and 60 dB loss at 2000 Hz. With respect to the hearing
requirement for medical certification, the driver __________.May be
certified for one year.May be certified for two years.May not be
certified.May be certified if examined by an otolaryngologist who is familiar
with the CMV driving duties who certifies the driver as medically qualified
to drive a CM
V. .
Answer: May not be certified.Explanation: An average hearing loss of 41.7
decibels averaged across 500, 1000, and 2000 Hz in the better ear is
