NRCME Test Questions 100% ACCURATE GRADE A+ GUARANTEED

What minimum PaO2 level is necessary if the driver has an ABG due to a chronic respiratory disorder? a.70mmHg b.55mmHg c.60mmHg d.65mmHg Correct answer is "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.Permanently 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. Correct answer is "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. 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. Temporarily 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. Correct answer is "A". The driver has not completed the required 2-monthwaiting 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. The date of the certification would be from the date of the original examination. A driver provides an audiometric test documenting the following: 1. 500 Hz: 2. 1000 HZ: 3. 2000 HZ: 4. 4000 Hz: 35 Right ear; 40 Left ear 40 Right ear; 45 Left ear 40 Right ear; 45 Left ear 50 Right ear; 50 Left ear 5. 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. Correct answer is "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 2 years. 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. Correct answer is "A". A driver must exhibit a minimum peripheral vision of 70 degrees bilaterally. 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. 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 CMV. d. Require a skill performance evaluation to ascertain if the driver has any limitations with driving. Correct answer is "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. Correct answer is "A". Use of marijuana is prohibited by Federal law while driving a CMV and trumps State law in this matter. 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. Correct answer is "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.Temporarily disqualify the driver until he obtains written clearance for the depression and the medication from the treating provi 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. Correct answer is "A". Medical clearance is required for all mental health disorders. Celexa is an SSRI or 2nd Generation anti-depressant and is acceptable. A driver reports that he had a hunting accident wherein he suffered a left orbital fracture. He presents a note at the time of the examination from an ophthalmologist stating "may drive". His exam is unremarkable except for a limitation in peripheral vision in his left eye, which was inconclusive. His distance vision was 20/20 right and 20/40 left. The medical examiner should? a. Council the driver on the need for a vision exemption. b. Disqualify the driver pending vision exam to determine if it meets peripheral vision requirements. c. Certify the driver for 1 year. d. Certify the driver for 2 years. Correct answer is "B". The driver must have a peripheral vision of 70 degrees bilaterally to certify to drive a CMV. What minimum PaO2 level on an ABG performed for a chronic respiratory disorder is necessary to certify a commercial driver? a. 55 mm Hg. b. 60 mm Hg. c. 65 mm Hg. d. 70 mm Hg. Correct answer is "C". Blood oxygen saturation must be a minimum of 65 mm Hg for the driver to certify. A driver is taking Topamax for the treatment of migraine headaches. He reports good management of his headaches and they never seem to interfere with his driving ability with the medication. The medical examiner should? a. Obtain medical clearance for the condition and the medication. b. Disqualify the driver because he is taking an anti-seizure medication. c. Certify the driver for 1 year. d. Certify the driver for 2 years. Correct answer is "A". Topamax is a medication that is used for seizure control. The examiner should confirm with the prescribing provider that the driver does not take it to control seizures, and he is capable of driving a CMV. A 26 year-old driver presents for a first-time certification. He has a long-standing history of ADHD and is taking methylphenidate. You have verified his diagnosis and obtained clearance from his treating psychiatrist. As the certified examiner, you: a. Should disqualify the driver, explaining that use of such stimulants is cause for disqualification. b. May certify for a maximum of 6 months. c. May certify for a maximum of 12 months. d. May certify for a maximum of 2 years. c. May certify for a maximum of 12 months. A driver has a blood pressure of 168/112 mm Hg confirmed during the examination. The driver should be: a. Disqualified. b. Certified for 6 months. c. Certified for 1 year. d. Certified for 2 years. Correct answer is "A". This is Stage 3 hypertension. The driver is disqualified until his blood pressure is less than 140/90 mm Hg at which time he will have a maximum certification of 6 months. For how long would a driver be certified if he is taking Micardis HCT for hypertension, and has a confirmed blood pressure of 148/96 mm Hg at the time of the examination? a. 3 months b. 6 months c. 1 year d. 2 years Correct answer is "A". Because the driver has a history of hypertension (he is taking medication), and he had Stage 1 hypertension during his exam, he would be provided a 1- time, 3-month certificate in order to lower his blood pressure to an acceptable level during that time. During the examination, a driver is found to have a positive "Babinski" reflex. The examiner should: a. Certify the driver for 1 year. b. Certify the driver for 2 years. c. Council the driver to obtain an SPE. d. Disqualify the driver until s/he has a neurological consultation. Correct answer is "D". A positive Babinski reflex is indicative of abnormalities in the motor control pathways leading from the cerebral cortex and is widely used as a diagnostic aide in disorders of the central nervous system. The examiner should obtain clearance from a neurologist prior to reconsidering the driver for certification. All of the following are required components of all DOT medical examinations EXCEPT? a. Vision b. Hearing c. Blood Pressure d. Ophthalmoscopic examination Correct answer is "D". There are four required components of every examination: vision, hearing, blood pressure and urinalysis. Ophthalmoscopic examination is not required but may be done if deemed necessary. A driver reports in his history that he was treated for epilepsy 14 years ago but stopped taking anti-epileptic medication on his own since his move to your area 11 years ago. He has not seen a neurologist nor a health care provider in over 10 years and reports no seizures during this period. The examiner should: a. Request medical clearance, and if obtained the driver may be certified for 1 year. b. Request medical clearance, and if obtained the driver may be certified for 2 years. c. Refer the driver to the epilepsy/seizure exemption program. d. Disqualify the driver. D. Disqualify Comment: Even though the driver reports exceeding the 10-year waiting period, it was not under medical supervision and the driver discontinued medication use and treatment outside of medical oversight. Since the driver cannot a documented medical history this driver does not meet the non- discretionary epilepsy standard until it is established that the driver is 10 years seizure-free while off anti-convulsants. A driver reports for a re-certification examination 8 weeks after having triple coronary artery bypass surgery. He presents a note from his treating provider stating that he is able to return to driving without restriction. Additionally, the note mentions that the driver's results of his ETT were normal, and his echo showed a left ventricular ejection fraction of 75%. The examiner should? a. Temporarily disqualify the driver until he has completed the required waiting period. b. Permanently disqualify the driver because his ejection fraction is too low. c. Certify the driver for 1 year only. d. Certify the driver for 2 years because he has medical clearance. Correct answer "A". Following CABG, there is a 3-month waiting period. Since the driver is only at 8 weeks post-op, he would have to wait 4 more weeks until he can certify. Once he completes his waiting period, he would be certified for 1 year from the date of the original examination. What is the maximum number of hours a CMV driver can drive in 7 consecutive days? a. 50. b. 60. c. 70. d. 80. Correct answer "B". 60-70 Hour Limit: A driver may not drive after 60/70 hours of duty in 7/8 consecutive days. Many versions of the NRCME exam will have one question about the 60/70 rule. A blood pressure of 166/92 mm Hg would be? a. Considered normal b. Stage 1 hypertension. c. Stage 2 hypertension. d. Stage 3 hypertension. Correct answer is "C". The driver has Stage 2 hypertension (160 - 179/100 - 109). The driver is taking "Sinemet" for the treatment of Parkinson's disease. The medical examiner should: a. Disqualify the driver. b. Obtain medical clearance from a neurologist. c. Counsel the driver to obtain a neurologist waiver. d. Certify the driver for 1 year. Correct answer is "A". A driver who is diagnosed with Parkinson's is permanently disqualified. The driver uses hearing aids during the whisper test. He is able to hear at 5 feet on the right and 4 feet on the left. a. Send the driver for an audiometric test. b. Disqualify the driver. c. Certify the driver for 1 year. d. Certify the driver for 2 years. Correct answer is "D". The driver is able to use hearing aids during the whisper test (and this should be marked on the form). A driver must only qualify in 1 ear to certify and there is no limitation of certification time. The minimum acceptable spirometry values required to certify a driver are: a. FEV1 70%, FVC 65%, FEV1/FVC ratio 65% b. FEV1 65%, FVC 60%, FEV1/FVC ratio 65% c. FEV1 65%, FVC 65%, FEV1/FVC ratio 65% d. FEV1 60%, FVC 60%, FEV1/FVC ratio 60% Correct answer is "B". The minimum acceptable values are 65%, 60%, and 65% (FEV1, FVC, FEV1/FVC ratio). A driver presenting to your office marks down that he is taking "nitroglycerin" for angina and he has been doing so for a few years. Upon questioning he indicates that he has needed more nitroglycerin recently because his episodes have become more frequent. Your best course of action is to: a. Council the driver to increase his dose of medication. b. Certify the driver for 1 year. c. Provide a 1-time, 3-month certificate to monitor his condition. d. Disqualify the driver and refer him to his cardiologist for further evaluation. Correct answer is "D". Disqualify the driver because his angina is not stable. The longest the medical examiner would certify a driver with a history of Stage 3 hypertension is: a. 3 months b. 6 months c. 12 months d. 24 months Correct answer is "B". The driver may only be certified for a maximum of 6 months for the rest of his/her driving career. A driver is taking Wellbutrin to help him stop smoking. He has provided a note from his PCP stating that he has no side effects and confirms that he is taking the medication for smoking cessation.The examiner would? a. Certify the driver for 2 years. b. Certify the driver for 1 year. c. Disqualify the driver because the medication is not allowed. d. Council the driver to only take the medication at night. Correct answer is "A". The driver is not being treated for a psychiatric condition such as anxiety or depression, and he has clearance. He would be able to be certified for 2 years. During the history, the driver admits to taking Benadryl for seasonal allergies. The examiner should? a. Counsel the driver to not take the medication for 12 hours prior to driving. b. Obtain medical clearance from the driver's PCP that he/she can drive. c. Disqualify the driver until he/she is no longer taking Benadryl. d. Provide a 1-time, 3-month certificate to determine the medication's effect on the driver. Correct answer is "A". Counsel the driver concerning use of over-the-counter anti- histamines, and anti-tussives (both cause drowsiness and should not be taken while driving) and about the 12- hour rule. A driver has a history of a moderate Traumatic Brain Injury that occurred 3 years ago as a result of a car accident. He reports he has fully recovered and provides a note from his neurologist stating that he suffered no seizures and that he is able to return to driving. He does not list any medications in his history. The examiner should: a. Disqualify the driver. b. Require the driver to take a "Folstein's mini mental state exam." c. Certify the driver for one year. d. Certify the driver for two years. Correct answer is "C". The driver suffered no seizures from the TBI, has completed the required waiting period (2 years), and has medical clearance. If the rest of the examination is unremarkable, the driver could be certified for 1 year. A driver reports a suicide attempt 10 months earlier, following the break-up of his marriage. He noted seeing a psychiatrist and he takes Citalopram daily and he reports he feels fine now and is moving on with his life. He provides a release from his doctor that he may return to work without restrictions. The medical examiner should: a. Disqualify the driver. CONTINUED.......