NRCME (DOT) Exam 2023/2024 Questions with Complete Solutions Rated A+

FMCSA Mission Statement - To reduce crashes, injuries, fatalities involving large trucks/buses Medical Examiner - Licensed, certified, registered provider who can perform PEs in accordance with laws and regulations ; registered through NRS ; has unique identifier ; passes MEC test FMCSA - Federal Motor Carrier Safety Administration NRCME - National Registry of Certified Medical Examiners Commerical Motor Vehicle - Weight 1000 lb ; or transports 8 people for compensation ; or 15 people without compensation ; transports hazardous materials requiring placarding Interstate commerce vs. Intrastate commerce - Interstate: multiple states or international Intrastate: within 1 state Who regulates treatment/management and aftercare of substance abuse for drivers? - SAP (Substance Abuse Professional) Who determines the origin of abnormal drug test results, determining whether the driver has violated drug use regulations? - Medical Review Officer Title 49 CFR 391.41 - Medical Examiner Report Form - Paperwork completed during DOT physical - Physical exam requirements for driver - Determines if Certificate is granted Title 49 CFR 391.43 - Describes responsibilities of Medical Examiner, instructions for exam, and requirements for medical certification - Supporting information to explain 391.41 When was DOT established? - 1966 Became separate entity on Jan 1, 2000 Motor Carrier Safety Improvement Act of 1999 - Established DOT as separate federal entity Omnibus Transportation Employee Testing Act of 1991 - Required drug testing for drivers The driver must always keep a copy of ____________________ with them while driving - Medical Certificate SPE if applicable Does the driver need to sign a medical release before you release their Medical Certification? - No. Certificate is provided to employer. (Release is required for a copy of medical report form) How many standards are used to determine driver fitness for duty? - 13 How many standards of "driver fitness for duty" are *discretionary*? - 9 (according to my review course) - Other sources say 10 and say that T2DM is discretionary How many standards of "driver fitness for duty" are *NON- discretionary*? - 4 - Vision - Hearing - Epilepsy - T2DM (Some sources say 3 and do not include T2DM) Age requirement for drivers - 21+ Language requirement for drivers - Must be able to read/speak English well enough to read signs, communicate Height/weight requirement for drivers - There is none What is tested for in urine? - USG PRO BLO GLU How long are you (the provider) required to keep a copy of a driver's Medical Certificate? - 3 years After a reading of Stage 3 hypertension, how often can a driver be certified? - Only every 6 months max - Disqualify until BP 140/90 - 3 month cert if 160/100 and they are initiating treatment for the first time - May certify Q1 year post surgical correction of secondary HTN Which generation of antihistamines should be used for drivers? - 2nd gen - Nonsedating A driver must wait ___ hours after taking a sedating med before driving - 12+ hours Urine drug testing includes: - MJ Tobacco Amphetamines Cocaine Opiates Which type of stroke only requires a 1 year waiting period? - Cerebellar or brainstem, which has low risk for seizures - And NO hx of seizure - + Neuro clearance and normal neuro exam What is the A1C requirement for drivers with T2DM? - There is not one Vision requirements - 20/40 in each eye and both eyes (or better) Field 70 degrees Can see amber, red, green colors Exam: Fundoscopic, PERRLA, ocular movements Hearing requirements - Whisper at not less than 5 feet in 1 ear, or average hearing loss no greater than 40 dB at 500Hz, 1000Hz, 2000 Hz in 1 ear. - Can use hearing aids - mark on paperwork - Only 1 ear required ("the better ear") Blood pressure requirement for 2-year certification - 140/90 with no HTN therapy No previous diagnosis of HTN Blood pressure requirement for 1-year certification - First finding of Stage 1 hypertension (140-159/90-99) or History of Hypertension or taking 1+ HTN med and BP is controlled at 140/90 BP requirement for 3-month certification - - Has not yet had antihypertensive therapy - Previously had a 1-year certificate for uncontrolled Stage 1 BP - OR: first finding of Stage 2 HTN Required Echocardiography criteria - - LVEF 40% - No Pulm HTN (Right heart pressure 50 mmHg) When is Echo required? - - Aortic Regurg - Aortic stenosis (Q1 year moderate, Q5 years mild) - Mitral stenosis (annual) - MVP (annual) One time: Eval of CHF, CHD Post CABG, MI Which conditions require an annual Echo? - - Mitral stenosis - MVP - Moderate aortic stenosis