DOT Exam PEARLS|Complete Questions with Correct Answers

DOT Exam PEARLS|Complete Questions with Correct Answers True or false: One component of a satisfactory ETT includes a heart rate 75% of predicted maximum unless on beta blocker False 1) Must attain a HR 85% of predicted maximum unless on beta blocker 2) No significant ST segment depression or elevation 3) Increased diastolic BP greater than 20 mmHg without angina FMCSA mission statement The FMCSA is focused on reducing crashes, injuries, and fatalities involving large trucks and buses NRCME mission statement The NRCME is focused on improving highway safety by producing trained, certified medical examiners who can effectively determine if a CMV driver's health meets the FMCSA standards What "title, part, section" is used to described the 13 standards that are used to determine driver medical fitness for duty? Title 49, Part 391, Section 41 49 CFR 391.41 What are the 3 disqualifies that do not depend on medical clinical interpretation? 1) Vision 2) Hearing 3) Epilepsy True or false: Insulin dependent diabetes is a disqualifier that does not depend on medical clinical interpretation False - this used to be a disqualifier but is no longer the case as of 2018 Any self-propelled or towed motor vehicle used on a highway in interstate commerce to transport passengers or property when the vehicle: 1) Has a combined gross of weight or weight rating of 10,001 lbs 2) Is designed or used to transport 8 vehicles (including the driver) 3) Is used to transport 15 passengers (including the driver) 4) Transport hazardous materials Commercial Motor Vehicle Trade, traffic, or transportation: 1) Between a place in a State and a place outside such State 2) Between two places in a State through another State or a place outside of the US 3) Between two places in a State as part of trade, traffic, or transportation originating or terminating outside the State or US Interstate Commerce What act requires drug and alcohol testing of safety-sensitive transportation employees in transportation industries? The Omnibus Transportation Employee Testing Act of 1991 True or false: As the medical examiner, you are NOT diagnosing and treating person medical conditions True! It is your duty to educate and refer the driver for further evaluation if you suspect an undiagnosed or worsening medical problem, but you are not treating. "As the medical examiner, you are not treating the provider and do not treat or diagnose in this setting" Stage I HTN 140-159/90-99 Stage II HTN 160-179/100-109 Stage III HTN SBP ≥ 180 DBP ≥ 110 If a driver comes in with a BP of 144/92, what should you do? A BP 130/89 must be confirmed with a 2nd measurement taken later during the examination NOTE: When BP and pulse rate are significant factors in why you are not certifying a driver, if is crucial for you to re-measure them! If a driver has a confirmed BP of 158/98, what should your certifying decision be? The driver may be certified for one year. At recertification, if the BP is not under 160/100, the driver can be given a one-time certificate for 3 months. If BP is 140/90, the driver may be certified for another year If a driver has a confirmed BP of 181111, what should your certifying decision be? Disqualified - The driver should not be certified until his/her BP is reduced to 140/90. Once this is achieved, the driver can be certified for 6 months If a driver has a confirmed BP of 178/108, what should your certifying decision be? One-time 3 month certification. If BP is reduced to 140/90, the driver can be issued a one year certificate What are the two cases in which a one-time 3 month certificate is granted for HTN? 1) A driver who has a BP that is equivalent to stage 2 2) A driver who was given a 1 year certificate for a BP equivalent of stage 1 who has not yet achieved BP 140/90 True or false: Testing for controlled substances is NOT part of the physical qualifications for the driver examination process True - if you suspect the need for drug/alcohol testing, contact the FMCSA or the motor carrier directly What must distant visual acuity be in both eyes in order to pass vision testing? At least 20/40 What must field of vision in the horizontal meridian be in both eyes in order to pass vision testing? At least 70 degrees What colors must a driver be able to distinguish between in order to pass vision testing? Red, amber, green True or false: Use of telescopic lenses is disqualifying? True What are the four disqualifying factors for vision testing? 1) Monocular vision 2) Telescopic lenses 3) Use of contact lenses where one contact is for distant vision and one of for near vision 4) Failure to meet any part of the vision criteria with one or both eyes True or false: To meet the federal hearing standard, the driver must successfully complete one hearing test with both ears False - the driver must successfully complete one hearing test with only one ear True or false: The driver MUST have hearing loss 35 decibels in one ear order to pass False - The driver must have hearing loss 40 decibels in one ear in order to pass Whisper voice test rules for hearing testing Whisper voice in one ear at not less than 5 feet Audiometric test rules for hearing testing Average hearing loss in one ear less than 40 decibels at 500, 1000, and 2000 hz If a driver fails the initial hearing test (either whisper or audiometric) what is the next step? Administer the other hearing test! True of false: A driver may use a hearing aid to meet the hearing standards for certification True True or false: If the driver passes the initial hearing test, no other testing needs to be administered as they have already met the standard True What is the maximum time you can certify a driver? 2 years How long must the medical examiner keep the passing certificate on file in office from the day that the driver passes? 3 years When does a certificate officially expire? The certificate expires at midnight of the expiring date and no grace period is given When operating a CMV, a driver must carry what with them? The medical examiner's certificate which can either be the original, a copy of the original, or a reduced size copy of the original (wallet sized) When do medical examiners need to report results of each CMV drivers physical examination? By midnight of the next calendar day following examination What are the 3 federal exemption programs for drivers who do not meet the regulatory requirements? 1) The Vision Exemption - allows some drivers with monocular vision to operate CMV 2) The Hearing Exemption - allows some drivers who do not meet the hearing criteria to operate CMV 3) The Seizure Exemption - allows some drivers with a known history of epilepsy or known prior seizure to operate CMV What is the vision regulation? 49 CFR 391.41(b)(10) What must distant visual acuity be? At least 20/40 in both eyes with or without contact lenses What must horizontal field of vision be in each eye? At least 70 degrees True or false: Monocular vision is disqualifying unless with a vision exemption True! True or false: Drivers with colorblindness who cannot distinguish among the colors of traffic signals are disqualified unless with a vision exemption False! - there is no vision exemption for colorblindness, only for monocular vision How long is the federal vision exemption granted for? 2 years, but drivers require an annual certification, thus you may only certify the driver for one year True or false: Vision loss from glaucoma is irreversible True! True of false: Glaucoma affects peripheral vision True What is the leading cause of untreatable legal blindness in the US? Macular degeneration True or false: While telescopic lenses can be used to redirect unaffected peripheral vision to compensate for loss of central acuity in macular degeneration, these lenses are not acceptable for commercial driving True In regards to vision, what are disqualifying factors for patients with DM? 1) Severe, non-proliferative diabetic retinopathy 2) Proliferative diabetic retinopathy How long is the hearing exemption valid for? 2 years What is the hearing regulation? 49 CFR 391.41 (b)(11) True or false: A driver is disqualified when both the forced whisper test AND the audiometric test are failed True True or false: Uncontrolled vertigo is disqualifying True What 3 vertigo conditions are non-qualifying?