DOT STANDARD EXAMS ANSWERS AND QUESTIONS
SET A+
✔✔The driver reports a history of a TIA and is taking Clopidogrel for history of atrial
fibrillation. The Medical Examiner should:
a. Disqualify the driver.
b. Refer the driver for a cardiology evaluation.
c. Require that the driver provide evidence of monthly INR checks.
d. Place the driver in Determination Pending - ✔✔Disqualify the driver
- FMCSA guidance (not regulatory) recommendations include disqualification of drivers
with neurologic conditions who are on blood thinning medications. Since this is a
guidance recommendation, the Medical Examiner could (and should) obtain a detailed
medical history of both the driver's neurologic and cardiac conditions and could consider
referral for neurologic and cardiac evaluations
✔✔The driver reports a recent diagnosis of atrial fibrillation 6 weeks ago. He is taking
warfarin (Coumadin). What is the most appropriate next step for the Medical Examiner?
a. Disqualify pending receipt of INR testing results.
b. Qualify for 1 year with monthly INR checks.
c. Qualify 3 months to assess INR stability.
d. Consider Determination Pending - ✔✔Disqualify pending receipt of INR testing
results
- Drivers who are on warfarin are required to have monthly INR checks. When warfarin
treatment is started, measurements of INR function should be required to assure that
INR treatment is therapeutic and stable. After this is established, FMCSA guidance
recommendations are for monthly INR testing
,✔✔The driver gives a recent history of a right wrist fusion. Grip strength is 10# on the
right and 60# on the left. The most appropriate Medical Examiner next step is:
a. Qualify the driver for 1 year.
b. Disqualify the driver.
c. Place the driver in Determination Pending and refer for an orthopedic evaluation.
d. Qualify the driver with a requirement that the driver wear a wrist brace - ✔✔Disqualify
the driver
The measured grip strength on the right is significant and likely to be functionally
impairing with respect to the many driver duties that require firm grasping.
✔✔The driver fails an Ishihara color test. The next step for the Medical Examiner
should:
a. Refer the driver for an ophthalmology evaluation.
b. Disqualify the driver.
c. Test the driver for the ability to recognize red, amber, and green.
d. Qualify the driver for 1 year. - ✔✔Test the driver for the ability to recognize red,
amber, and green
FMCSA requirements are that a driver is able to recognize the colors of a stoplight (and
warning signs): red, green, amber. An Ishihara test is a relatively sophisticated color
vision test and many drivers who fail an Ishihara test are able to still recognize and
distinguish between red, green, and amber
✔✔The driver describes a history of alcoholism last treated 2 years ago. He denies
alcohol use since that treatment. What is the most appropriate next step for the Medical
Examiner?
a. Refer the driver for evaluation by a substance abuse professional (SAP).
b. Perform an alcohol test.
c. Qualify the driver for 1 year.
d. Confirm that the driver was evaluated by a substance abuse professional and has
followed any follow-up recommendations made. - ✔✔Confirm that the driver was
evaluated by a substance abuse professional and has followed any follow-up
recommendations made.
✔✔The driver describes recent back pain and on examination the Medical Examiner
detects a bruit and pulsatile mass in the abdomen. The most important next step for the
Medical Examiner should be to:
,a. Document a probable aortic aneurysm and disqualify the driver.
b. Place the driver in Determination Pending.
c. Certify the driver for 1 year.
d. Recommend that the driver have an abdominal ultrasound - ✔✔Document a probable
aortic aneurysm and disqualify the driver
✔✔When audiometric testing is performed, what is the standard that should be
used?
a. ISO - International Organization for Standards.
b. ANSI - American National Standards Institute.
c. OSHA - Occupational Safety and Health Administration.
d. SDHE - Standard Diagnostic Hearing Evaluation. - ✔✔ANSI - American National
Standards Institute.
✔✔The driver has a history of a lumbar laminectomy. What finding would raise
concern?
a. Hip ROM.
b. Mild lumbar tenderness.
c. Positive Lasegue's sign.
d. Quadriceps stretch sign. - ✔✔Positive Lasegue's sign
Lasegue's sign or straight leg raising test (SLRT) is a neurodynamic exam to assess
nerve root irritation in the lumbosacral area and it used to help identify the likelihood of
lumbar radiculopathy
✔✔The driver has a lipoma that is not impairing. The Medical Examiner should:
a. Refer the driver for surgical evaluation.
b. Place the driver in Determination Pending.
c. Assess driving risk related to the lipoma.
d. Document the examination finding. - ✔✔Document the examination finding.
✔✔The driver resides in Canada and does not have a US driver's license. What is
the Medical Examiner required to confirm?
a. Where the driver is domiciled.
b. The driver's identity.
, c. The driver's application for a US driver's license.
d. The driver's international driver's license number. - ✔✔The driver's identity
✔✔The driver has swollen tonsils. What is the Medical Examiner's best next action?
a. Determine if the driver is under the care of an ENT specialist.
b. Treat the driver for infection.
c. Place the driver in Determination Pending.
d. Document abnormal findings and assess whether the condition affects the
driver's risk of gradual or sudden incapacitation. - ✔✔Document abnormal findings and
assess whether the condition affects the driver's risk of gradual or sudden
incapacitation.
✔✔The driver had a stroke 3 months ago. He has a medical clearance letter from a
neurologist to return to driving without restrictions. What is most important for the
Medical Examiner to consider?
a. The driver's physical examination findings.
b. Whether the neurologist is aware of the driving responsibilities of a
commercial motor vehicle driver.
c. The highest risk of stroke is within the first year of a prior stroke.
d. The State guidelines for return to driving after a stroke. - ✔✔The highest risk of stroke
is within the first year of a prior stroke
✔✔The driver has a history of L4-5 lumbar laminectomy 2 years ago. Which of the
following is the most important for the Medical Examiner to assess:
a. Knee flexion.
b. Ankle dorsiflexion.
c. Hip ROM.
d. Lumbar subluxations. - ✔✔Knee flexion
Knee flexion weakness could limit driver use of the lower extremity and can occur with
compression of the L5 nerve which is associated with L4-5- disc herniation.
✔✔The driver reports a recent concussion. Which of the following is most important for
the Medical Examiner to assess:
a. Nystagmus.
b. Hearing loss.
c. Patellar and ankle reflexes.
SET A+
✔✔The driver reports a history of a TIA and is taking Clopidogrel for history of atrial
fibrillation. The Medical Examiner should:
a. Disqualify the driver.
b. Refer the driver for a cardiology evaluation.
c. Require that the driver provide evidence of monthly INR checks.
d. Place the driver in Determination Pending - ✔✔Disqualify the driver
- FMCSA guidance (not regulatory) recommendations include disqualification of drivers
with neurologic conditions who are on blood thinning medications. Since this is a
guidance recommendation, the Medical Examiner could (and should) obtain a detailed
medical history of both the driver's neurologic and cardiac conditions and could consider
referral for neurologic and cardiac evaluations
✔✔The driver reports a recent diagnosis of atrial fibrillation 6 weeks ago. He is taking
warfarin (Coumadin). What is the most appropriate next step for the Medical Examiner?
a. Disqualify pending receipt of INR testing results.
b. Qualify for 1 year with monthly INR checks.
c. Qualify 3 months to assess INR stability.
d. Consider Determination Pending - ✔✔Disqualify pending receipt of INR testing
results
- Drivers who are on warfarin are required to have monthly INR checks. When warfarin
treatment is started, measurements of INR function should be required to assure that
INR treatment is therapeutic and stable. After this is established, FMCSA guidance
recommendations are for monthly INR testing
,✔✔The driver gives a recent history of a right wrist fusion. Grip strength is 10# on the
right and 60# on the left. The most appropriate Medical Examiner next step is:
a. Qualify the driver for 1 year.
b. Disqualify the driver.
c. Place the driver in Determination Pending and refer for an orthopedic evaluation.
d. Qualify the driver with a requirement that the driver wear a wrist brace - ✔✔Disqualify
the driver
The measured grip strength on the right is significant and likely to be functionally
impairing with respect to the many driver duties that require firm grasping.
✔✔The driver fails an Ishihara color test. The next step for the Medical Examiner
should:
a. Refer the driver for an ophthalmology evaluation.
b. Disqualify the driver.
c. Test the driver for the ability to recognize red, amber, and green.
d. Qualify the driver for 1 year. - ✔✔Test the driver for the ability to recognize red,
amber, and green
FMCSA requirements are that a driver is able to recognize the colors of a stoplight (and
warning signs): red, green, amber. An Ishihara test is a relatively sophisticated color
vision test and many drivers who fail an Ishihara test are able to still recognize and
distinguish between red, green, and amber
✔✔The driver describes a history of alcoholism last treated 2 years ago. He denies
alcohol use since that treatment. What is the most appropriate next step for the Medical
Examiner?
a. Refer the driver for evaluation by a substance abuse professional (SAP).
b. Perform an alcohol test.
c. Qualify the driver for 1 year.
d. Confirm that the driver was evaluated by a substance abuse professional and has
followed any follow-up recommendations made. - ✔✔Confirm that the driver was
evaluated by a substance abuse professional and has followed any follow-up
recommendations made.
✔✔The driver describes recent back pain and on examination the Medical Examiner
detects a bruit and pulsatile mass in the abdomen. The most important next step for the
Medical Examiner should be to:
,a. Document a probable aortic aneurysm and disqualify the driver.
b. Place the driver in Determination Pending.
c. Certify the driver for 1 year.
d. Recommend that the driver have an abdominal ultrasound - ✔✔Document a probable
aortic aneurysm and disqualify the driver
✔✔When audiometric testing is performed, what is the standard that should be
used?
a. ISO - International Organization for Standards.
b. ANSI - American National Standards Institute.
c. OSHA - Occupational Safety and Health Administration.
d. SDHE - Standard Diagnostic Hearing Evaluation. - ✔✔ANSI - American National
Standards Institute.
✔✔The driver has a history of a lumbar laminectomy. What finding would raise
concern?
a. Hip ROM.
b. Mild lumbar tenderness.
c. Positive Lasegue's sign.
d. Quadriceps stretch sign. - ✔✔Positive Lasegue's sign
Lasegue's sign or straight leg raising test (SLRT) is a neurodynamic exam to assess
nerve root irritation in the lumbosacral area and it used to help identify the likelihood of
lumbar radiculopathy
✔✔The driver has a lipoma that is not impairing. The Medical Examiner should:
a. Refer the driver for surgical evaluation.
b. Place the driver in Determination Pending.
c. Assess driving risk related to the lipoma.
d. Document the examination finding. - ✔✔Document the examination finding.
✔✔The driver resides in Canada and does not have a US driver's license. What is
the Medical Examiner required to confirm?
a. Where the driver is domiciled.
b. The driver's identity.
, c. The driver's application for a US driver's license.
d. The driver's international driver's license number. - ✔✔The driver's identity
✔✔The driver has swollen tonsils. What is the Medical Examiner's best next action?
a. Determine if the driver is under the care of an ENT specialist.
b. Treat the driver for infection.
c. Place the driver in Determination Pending.
d. Document abnormal findings and assess whether the condition affects the
driver's risk of gradual or sudden incapacitation. - ✔✔Document abnormal findings and
assess whether the condition affects the driver's risk of gradual or sudden
incapacitation.
✔✔The driver had a stroke 3 months ago. He has a medical clearance letter from a
neurologist to return to driving without restrictions. What is most important for the
Medical Examiner to consider?
a. The driver's physical examination findings.
b. Whether the neurologist is aware of the driving responsibilities of a
commercial motor vehicle driver.
c. The highest risk of stroke is within the first year of a prior stroke.
d. The State guidelines for return to driving after a stroke. - ✔✔The highest risk of stroke
is within the first year of a prior stroke
✔✔The driver has a history of L4-5 lumbar laminectomy 2 years ago. Which of the
following is the most important for the Medical Examiner to assess:
a. Knee flexion.
b. Ankle dorsiflexion.
c. Hip ROM.
d. Lumbar subluxations. - ✔✔Knee flexion
Knee flexion weakness could limit driver use of the lower extremity and can occur with
compression of the L5 nerve which is associated with L4-5- disc herniation.
✔✔The driver reports a recent concussion. Which of the following is most important for
the Medical Examiner to assess:
a. Nystagmus.
b. Hearing loss.
c. Patellar and ankle reflexes.
