NRCME exam questions with complete
solutions
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? - correct answer ✔✔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? - correct answer ✔✔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: - correct answer ✔✔
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: - correct answer ✔✔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: - correct answer
✔✔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? - correct answer ✔✔disqualify the driver
A driver with an Abnormal Aortic Aneurysm (AAA) can be certified: - correct answer ✔✔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? - correct
answer ✔✔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: - correct answer
✔✔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? - correct answer ✔✔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: - correct answer ✔✔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? - correct answer ✔✔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: - correct answer ✔✔Meets
standards, qualified for one year.
What physical abilities must drivers have? - correct answer ✔✔grip strength, upper body strength and
balance and flexibility
solutions
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? - correct answer ✔✔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? - correct answer ✔✔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: - correct answer ✔✔
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: - correct answer ✔✔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: - correct answer
✔✔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? - correct answer ✔✔disqualify the driver
A driver with an Abnormal Aortic Aneurysm (AAA) can be certified: - correct answer ✔✔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? - correct
answer ✔✔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: - correct answer
✔✔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? - correct answer ✔✔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: - correct answer ✔✔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? - correct answer ✔✔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: - correct answer ✔✔Meets
standards, qualified for one year.
What physical abilities must drivers have? - correct answer ✔✔grip strength, upper body strength and
balance and flexibility
