DOT practice questions {Answered Distinction Level Exam}

DOT practice questions {Answered Distinction Level Exam} Fatigue is a major concern. What do current FMCSA regulations allow from drivers? driver presents with a heart attack 1 month previous. He is following up with his MD again in 1 week. He is unsure of his prescriptions, but is asymptomatic. Should he be certified today? Driver has been trying to stop smoking for 10 years without success. 1 month ago, she began taking Chantix. She reports no blackout, suicidal thoughts, or change in mood. The rest of the exam is normal. Can she be qualified? Which of the following diagnoses is NOT always disqualifying? (narcolepsy, type 1 diabetes, meniere's disease, current alcoholism, bipolar disorder) when asked about seizures, a driver reports several febrile seizures as a young child. Is this disqualifying? What does the acronym FMCSA stand for? What is NOT a mission of the FMCSA? -develop and enforce data-driven regulations that balance motor carrier (truck and bus companies) safety with industry efficiency -target educational messages to carriers, commercial drivers, and the public -partner with stakeholders including federal, state, and local enforcement agencies, the motor carrier industry, safety groups, and organized labor on efforts to reduce bus and truck-related crashes -oversee the prosecution of criminally negligent cases of motor carrier safety breaches who is NOT eligible to be a medical examiner? (APNs, DC, MD, PharmD, DO, PA, PT) what is the role of the medical examiner? -assess the driver for medical fitness to safely perform all driver duties -ensure the driver is properly following up on any potentially dangerous conditions -treat the driver for health conditions -council the driver on health conditions and consequences -diagnose new health concerns of the driver what is ensured as a part of the NRCME's medical oversight mission? -individuals performing medical examinations are qualified to do so and are educated about occupational issues for drivers -a tracking mechanism that ensures that every prior application by an individual for medical certification is recorded and reviewed -medical certification regulations are updated periodically -a review process that prevents or identifies and corrects the inappropriate issuance of medical certification -all of the above according to the DOT, the AVERAGE driver falls into all of these categories, EXCEPT: (male, between 25 and 39 years of age, sedentary, overweight, smoker, poor eating habits, less healthy than the average person, more than 2 medical conditions, cardiovascular disease prevalent) what of these abilities is NOT required of a driver to safely perform his/her duties? -perceptual skills to monitor sometimes complex driving situations -judgment skills to make quick decisions when necessary -manipulative/manual skills to control his vehicle -social sills to act kindly to interpersonal activities on the road fatigue is a major concern. what do current FMCSA regulations allow from drivers? the motor carrier is required to make sure drivers meet certain requirements. EXCEPT which of the following, the driver must: -be at least 21 years old -speak and read English well enough to understand highway/traffic signals and converse -have a current medical examiner's certificate on file -provide their full medical examiner's report (long form) to the motor carrier -have provided the motor carrier with required background and violations information -have successfully completed a driver's road test or equivalent what should be done if the driver presents for his/her exam without a government issued ID? for any affirmative response on the health history section, what are reasonable follow ups? -ask about history, diagnosis, treatment, and response to treatment -explore underlying cause, precipitating events, and other pertinent facts -obtain additional tests or consultations, as necessary, to adequately assess medical fitness -review and discuss driver response to treatment and medications currently or recently used -all of the above in addition to asking the driver about any affirmatives in the health history section, which of the following should be asked about every time? -any past hospitalizations or surgeries -any recent changes in health status -any medical conditions or current complaints -incidents of disability/physical limitations -whether they smoke -all of the above the driver presents with a previous diagnosis of type 2 diabetes. it is controlled by metformin, but not insulin. what is the maximum time period he should be given for certification? driver presents with a type 2 diabetes diagnosis. he has controlled it for 10 years with oral medication. he brings his most recent lab work from 2 months previous. A1c is at 7.3%. what is normal HbA1c? driver presents with a type 2 diabetes diagnosis. he has controlled it for 10 years with oral medication. he brings his most recent lab work from 2 months previous. A1c is at 7.3%. what is the level of HbA1c for diabetes diagnosis? driver presents with a type 2 diabetes diagnosis. he has controlled it for 10 years with oral medication. he brings his most recent lab work from 2 months previous. A1c is at 7.3%. what is the target range of HbA1c for those with a diabetes diagnosis? driver presents with a type 2 diabetes diagnosis. he has controlled it for 10 years with oral medication. he brings his most recent lab work from 2 months previous. A1c is at 7.3%. In this case, what would be an appropriate action? -certify for 2 years -certify for 1 year and discuss glucose control, diet, prognosis, etc. -temporarily defer decision or give a 1-month certification. contact treating physician regarding insulin control before deciding on further action -disqualify a driver presents with an 8 year history of type 2 diabetes mellitus. he reports that he has not changed his diet nor activity level. he moved 9 months ago and has not found a new treating physician since. weight is 325 lbs and height is 72 inches. BMI = 44.1. there is a significant amount of glucose in his urine. A1c is ordered and found to be 15.4. Driver doesn't seem concerned. What do you do? once a diabetic driver has to take insulin to control his blood sugar, how long should his re-certification period be to make sure he is stable and controlling the disease? a driver presents for her first DOT medical exam. she is 48 years old and starting truck-driving school as a second career. she has no previous diagnosis of HTN, but BP today is 176/124. she is obese. what time period is appropriate for certification? a driver presents with a BP of 118/72. pulse is 66. he previously was on HTN medication, but stopped taking it 6 months ago. in the last year, he lost 55 pounds, stopped smoking, and began exercising regularly. can he be given a 2 year card? driver has no previous diagnosis of HTN. today his BP is 146/88. all else is clear. what certificate time should be given? driver has been on HTN Rx for 3 years. he is inconsistent about taking his Rx. today BP is read at 146/96. what should be done? which of the following should be considered for a sleep study (but given a certificate of up to 2 months to get the study done)? -driver admits loud snoring and score of 13 on ESS -BMI of 38 and neck circumference of 18 inches -BMI of 40 and new diagnosis of HTN -driver falls asleep during the exam -previous diagnosis and CPAP, but non-compliant -all of the above -A and C driver has been blind in 1 eye since a childhood accident. he previously got his certificate from his family doctor and always was certified for 2 years. what is the proper time period for certification? driver presents with a heart attack 1 month previous. he is following up with his MD again in 1 week. he is unsure of his prescriptions, but is asymptomatic. should he be certified today? driver had heart surgery 6 months ago. he reports recovering well and is asymptomatic. documentation from his MD shows he is indeed recovering well and tolerating his medication. surgery included installation of an implantable cardioverter defibrillator (ICD). can he be qualified today? driver claims to be on no illegal drugs, but he looks haggard and has fresh needle sticks on his forearm. can you order lab testing for drugs? driver hears a forced whisper at 8 feet out of his right ear with no aid. he is deaf in his left ear. is this adequate? driver is missing the distal half of his left 4th and 5th fingers. dynamometer shows grip strength to be a comparable to the right at 77 lbs. is this disqualifying? driver tells you that he is red/green colorblind. he is unable to pick out the numbers in an Ishihara color blindness test. however, he is able to identify red, green, and amber stoplights. does he meet vision standards? which of the following is NOT a non-discretionary disqualifier? (epilepsy, insulin dependent diabetes, use of medical marijuana, hypertension) driver has no glasses. her visual acuity is 20/20 with her left eye alone, 20/50 in her right eye, and 20/30 with both eyes together. what is the proper course of action? driver is evasive when asked about alcohol use, but upon further pressing admits to drinking every day of the week, but not on the job. he has never been diagnosed as an alcoholic. what is a proper course of action? -check for signs of alcoholism in exam. inquire further using alcohol abuse questionnaire. -refer to a substance abuse professional or chemical dependency center for evaluation. temporarily disqualify- possibly longer depending on outcomes -disqualify -qualify. drinking is not affecting his job/safety driver has been trying to stop smoking for 10 years without success. 1 month ago, she began taking Chantix. she reports no blackout, suicidal thoughts, or change in mood. the rest of the exam is normal. can she be qualified? a morbidly obese driver comes for a DOT