NRCME Exam 65 Questions with Correct Answers

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 do what? - Temporarily disqualify the driver until he obtains written clearance for the depression and the medication from the treating provider. Can hearing aids be worn during the forced whisper test? - NO A driver with a history of diabetes, who is taking Metformin, provides a note from his primary care provider that lists his A1c level as 10. His exam is essentially normal including laboratory analysis, except he is very overweight. The medical examiner should: - A driver with a history of diabetes, who is taking Metformin, provides a note from his primary care provider that lists his A1c level as 10. His exam is essentially normal including laboratory analysis, except he is very overweight. The medical examiner should: - certify for 1 year A driver has had his second spontaneous pneumothorax on the same side 3 months ago. There has been no surgical intervention. The FVC is 68%. The correct determination in this case is: - Do not certify until the condition has been corrected surgically. The driver reports a suicide attempt 6 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? - disqualify the driver A driver with an Abnormal Aortic Aneurysm (AAA) can be certified: - For 1 year if between 4 and 5 cm, asymptomatic, with a recommendation from a cardiovascular specialist who understands the functions and demands of commercial driving. If a driver responds yes to the history section of the exam form, what details must he include? - 1. date of onset 2. diagnosis 3. PCP contact info 4. any limitations 5. medications including prescription, OTC and herbal supplements Upon examination of a 46 year-old male smoker, you detect an irregularly irregular heart rhythm. The rate is 140 bpm. This is unknown to the driver and he denies any symptoms of lightheadedness, shortness of breath, dizziness, palpitations, nor any cardiac history. You would: - Disqualify and refer to his PMD or cardiologist for further evaluation. Which of the following best describes the length of time to certify a driver who has non-insulin diabetes mellitus treated with oral medication and no other medical issues? - While such drivers may be certified for 2 years, the FMCSA prefers that such drivers should have annual re-certification examinations. A driver was discharged from the hospital 10 weeks ago after an MI. He is asymptomatic and has a note from the cardiologist that he had a satisfactory in office ETT the week prior to your examination and that he may drive. His pre-discharge ECHO shows an EF of 45%. His examination is normal. Your determination: - certify for 1 year because waiting period is at least 2 months after MI, no sypmtoms, ETT pass, LVEF greater than 40 and no ECG changes What are the 3 things that ME and driver must do with the certificate? - 1. ME must retain copy for at least 3 years 2. ME must provide a copy to prospective or current employer upon request 3. driver must carry certificate while operating CMV A 69 year-old male driver had a femoral-popliteal bypass 4 months ago with resolution of chronic leg pain due to claudication. His surgeon clears him for driving. He is on coumadin with INRs consistently in the therapeutic range since discharge. The correct determination is: - Meets standards, qualified for one year. What physical abilities must drivers have? - grip strength, upper body strength and balance and flexibility A driver returns to work after a two week absence due to a respiratory illness. He presents a note from his physician that he was unable to work as a truck driver because of the illness and is now cleared for returning to work. His medical certificate expires in 3 months. The driver: - should undergo a new examination A driver is found to have diminished central acuity during Snellen chart acuity testing. This is suggestive of: - macular degeneration As the medical examiner you notice a patient's urinalysis is positive for 3+ protein. You should: - Determine if additional evaluation is required and request or recommend primary care provider follow-up. What are the regulatory non-discretionary standards? - E-HIV Epilepsy, Hearing, Insulin, Vison