NRCME DOT Certification
UPDATED ACTUAL Exam Questions and CORRECT Answers
Question 1.
Examples of CMV driver stress factors
Correct 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.
Question 2.
What are the differences between the medical standards and medical guidelines?
Correct 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.
Question 3.
In which regulations are the driver physical qualification standards and Medical
Examiners cited?
Correct Answer: Driver physical qualification standards are found in 49 CFR
391.41. ME responsibilities are found in 49 CFR 391.43
Question 4.
What objective tests and measurements are required as part of the driver physical
examination?
Correct Answer: Height & weight Vision Hearing BP & pulse Urinalysis (spec
gravity, protein, blood, glucose)
Question 5.
What are the possible outcomes of the driver physical examination?
Correct Answer: Certification Disqualification Determination pending
Question 6.
What date is used to determine medical examiners certificate expiration?
,Correct 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.
Question 7.
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.
Correct Answer: A: 4/16/2013 B: 4/16/2012 C: 4/25/2012 D: 5/20/2013
Question 8.
Patient example: Karen, recertification exam 42 y/o female No 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 testing UA: spec grav 1.020, protein
1+, blood 4+, glucose neg. Hgb 12.4 BP 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.
Correct 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.
Question 9.
Who can perform the vision portion of the interstate CMV driver physical examination?
Correct 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.
Question 10.
To pass the interstate CMV driver vision exam, a visual acuity of ___/___corrected or
uncorrected is required.
, Correct Answer: 20/40 on Snellen chart in each eye individually AND in both
eyes combined.
Question 11.
What eye conditions must the ME ask the driver about and if indicated, request
specialist evaluation?
Correct Answer: Retinopathy, cataracts, aphakia, glaucoma, and macular
degeneration.
Question 12.
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.
Correct 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.
Question 13.
What is the purpose of the interstate CMV driver physical examination?
Correct Answer: To detect the presence of physical, mental, or organic
conditions of such character and extent as to affect the driver ability to
operate a CMV safely. This exam is for public safety determination and is
considered by FMCSA to be a "medical fitness for duty" examination.
• Examples of "yes" answers for hearing and ears on the health history that
may require further examination before a certification decision can be made
-✓✓Ear disorders Loss of hearing Loss of balance
Question 14.
Pt example: Pt has hearing of 4' in left and right ears. Do they meet the hearing
standards?
Correct Answer: No, hearing minimum for whisper test is equal or greater than
5' in the better ear. This driver needs an audiometric hearing test.
UPDATED ACTUAL Exam Questions and CORRECT Answers
Question 1.
Examples of CMV driver stress factors
Correct 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.
Question 2.
What are the differences between the medical standards and medical guidelines?
Correct 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.
Question 3.
In which regulations are the driver physical qualification standards and Medical
Examiners cited?
Correct Answer: Driver physical qualification standards are found in 49 CFR
391.41. ME responsibilities are found in 49 CFR 391.43
Question 4.
What objective tests and measurements are required as part of the driver physical
examination?
Correct Answer: Height & weight Vision Hearing BP & pulse Urinalysis (spec
gravity, protein, blood, glucose)
Question 5.
What are the possible outcomes of the driver physical examination?
Correct Answer: Certification Disqualification Determination pending
Question 6.
What date is used to determine medical examiners certificate expiration?
,Correct 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.
Question 7.
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.
Correct Answer: A: 4/16/2013 B: 4/16/2012 C: 4/25/2012 D: 5/20/2013
Question 8.
Patient example: Karen, recertification exam 42 y/o female No 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 testing UA: spec grav 1.020, protein
1+, blood 4+, glucose neg. Hgb 12.4 BP 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.
Correct 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.
Question 9.
Who can perform the vision portion of the interstate CMV driver physical examination?
Correct 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.
Question 10.
To pass the interstate CMV driver vision exam, a visual acuity of ___/___corrected or
uncorrected is required.
, Correct Answer: 20/40 on Snellen chart in each eye individually AND in both
eyes combined.
Question 11.
What eye conditions must the ME ask the driver about and if indicated, request
specialist evaluation?
Correct Answer: Retinopathy, cataracts, aphakia, glaucoma, and macular
degeneration.
Question 12.
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.
Correct 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.
Question 13.
What is the purpose of the interstate CMV driver physical examination?
Correct Answer: To detect the presence of physical, mental, or organic
conditions of such character and extent as to affect the driver ability to
operate a CMV safely. This exam is for public safety determination and is
considered by FMCSA to be a "medical fitness for duty" examination.
• Examples of "yes" answers for hearing and ears on the health history that
may require further examination before a certification decision can be made
-✓✓Ear disorders Loss of hearing Loss of balance
Question 14.
Pt example: Pt has hearing of 4' in left and right ears. Do they meet the hearing
standards?
Correct Answer: No, hearing minimum for whisper test is equal or greater than
5' in the better ear. This driver needs an audiometric hearing test.
