MRO PRACTICE QUESTIONS WITH
CORRECT DETAILED ANSWERS
A driver's DOT drug test is positive. To ensure the right to have the split specimen
analyzed, the donor must request the additional analysis within:
A. 2 days
B. 3 days
C. 5 days
D. 7 days
E. There is no time limit - Answer-B
A split sample has reconfirmed the primary test result. The employee requests
reanalysis of the primary specimen. Under DOT regulations, the MRO should:
A. Direct a reanalysis if requested within 72 hours of the result being reported to the
donor
B. Deny the request for reanalysis
C. Order a test of the split sample only
D. Request a quantitative analysis of the split sample
E. None of these are correct - Answer-B
Which one of the following statements is true?
A. l-methamphetamine is metabolized to l-amphetamine.
B. d-amphetamine is metabolized to d-methamphetamine.
C. GC/MS methods cannot differentiate between d- and l- forms of methamphetamine.
D. The presence of l-methamphetamine rules out the illicit use of methamphetamine.
E. The presence of d-methamphetamine rules out the illicit use of methamphetamine. -
Answer-A
Which of the following can be a metabolite of morphine?
A. Hydromorphone
B. Diacetylmorphine
C. Monoacetylmorphine
D. Hydrocodone
E. Normorphine - Answer-A and E
Which of the following is/are true of alcohol testing?
A. Industrial exposure to certain solvents may cause some interference with the
determination of alcohol ingestion
B. Ingested food will generally hasten the absorption of alcohol.
,C. Assuming no post-accident consumption, a driver's blood alcohol concentration 45
minutes after an accident may overestimate his or her level at the time of the accident.
D. Assuming no post-accident consumption, a driver's blood alcohol concentration 45
minutes after an accident may underestimate his or her level at the time of the accident.
E. All of these are true statements - Answer-A, C, and D
Which of the following REQUIRE(S) an observed collection under DOT regulations?
A. Donor admits to illicit drug use.
B. Donor presents with clinical signs consistent with opiate abuse.
C. Donor states that he or she is unable to provide urine.
D. State law permits routine observed collections, and the employer's policy requires
this action.
E. Specimen temperature is 89.5 degrees Fahrenheit. - Answer-E
Under DOT regulations, which of the following is/are true?
A. If the primary specimen is negative, the lab may dispose of the split sample.
B. If the primary specimen is confirmed positive, the split specimen must be preserved
for at least one year.
C. If a split test is requested, the MRO must obtain and ship the split sample to another
DHHS Certified lab.
D. If the drug(s) is(are) not detected in the split sample, and validity testing is negative,
then the test is canceled. - Answer-A, B, and D
2. Which of the following drug tests is not required for federal employees under the
federal Drug-Free Workplace Program?
A.Preplacement
B.Post-accident
C.Return to duty
D.Unreasonable suspicion
E.Random - Answer-D
SAMHSA's Drug Free Workplace Program specifies "Reasonable Suspicion" as one of
the types of drug testing. This is found on the federal Custody and Control Form. The
incorrect answer was unreasonable suspicion.
3. Which of the following is the "weakest link" in drug testing, i.e., generally produces
the most frequent errors?
A.Specimen collection
B.Laboratory testing
C.MRO review - Answer-A
Among drug testing personnel, there are far more specimen collectors than laboratory
staff or MROs. Collectors receive the least amount of training, are paid the lowest
wages, and have the highest job turnover.
Quality reviews show that a substantially larger number of errors occur in collection and
properly completing the Custody and Control Form.
,4. MROs must pass a nationally recognized certifying examination for which of the
following activities?
A.All MRO work
B.All federally regulated MRO work
C.All DHHS and DOT MRO work
D.All states with provisions allowing medical marijuana - Answer-C
A. All MRO work - Incorrect: includes non-federally regulated drug testing, in which only
a handful of states require MRO certification
B. All federally-regulated MRO work - Incorrect: includes DOD, NRC and other
agencies, which do not require MRO certification
C. All DHHS and DOT MRO work - Correct Answer: Both SAMHSA and DOT clearly
specify this requirement for MROs.
D. All states with provisions allowing medical marijuana - Incorrect: state Marijuana laws
make no reference to MROs, and only allow medical authorization or recommendation
permitting marijuana use. Health care professions do not "prescribe" marijuana.
5. Which of the following roles is primary for the MRO?
A.Lab checker
B.SAP advisor
C.Gatekeeper
D.Mediator
E.Substance Abuse Identifier - Answer-c
Although each of these monikers identify occasional, peripheral roles of the MRO, the
DOT has clearly earmarked the role of the MRO as a gatekeeper.
6. After completing review of drug test results, interviewing the donor and documenting
findings, an MRO must do which of the following?
A.Confirm laboratory results
B.Reconfirm laboratory results
C.Verify drug test results
D.Report findings to laboratory and employer - Answer-C
The determination of an MRO is called a "verification" decision. Laboratories confirm lab
results though performing a second test using a different analytical method and
performing internal quality control measures. A laboratory to which a split specimen is
send reconfirms or fails to reconfirm the original laboratory's findings. MROs report
findings to employers, but do not routinely report to laboratories.
7. The MRO safety duties include all but which of the following activities?
A.Consider essential job functions
B.Review appropriateness of medications donor is taking
C.Verify prescriptions with PCP/pharmacy
D.Assess safety risks from medications - Answer-B
A, C and D are all part of the considerations of an MRO in assessing workplace safety.
However, the DOT has made it explicitly clear that while an MRO may express safety
, concerns to the donor and discuss them with prescribing health care professional, the
MRO is admonished NOT to determine whether the medication was appropriately
prescribed.
The one exception for federal employees is mentioned the SAMHSA MRO Guidance
Manual, which does allow MROs to "use reasonable medical judgement to make the
decision that the provided prescription was generated in response to the donor's current
medical condition
8. At what age does use of illicit drugs peak in the U.S.?
A.12-17
B.18-24
C.25-3
D.33-50
E.51 and older - Answer-B
The National Survey on Drug Use and Health has consistently shown in all its surveys
from 2000-2018 that illicit drug use peaks at ages 18-24.
9. The greatest increase in U.S. drug overdose deaths is due to which of the following
categories of drugs?
A.Cocaine
B.Heroin
C.Methamphetamine
D.Natural and semi-synthetic opioids
E.Synthetic opioids other than methadone (e.g., fentanyl) - Answer-E
The Centers for Disease Control and Prevention (CDC) National Center for Health
Statistics has tracked drug overdose deaths from 1999-2017. Overdose deaths from
many different drug classes have risen, including heroin, natural and semisynthetic
opioids, cocaine, and methamphetamine. But none have risen so dramatically as
synthetic opioids other than methadone
9a. What are the most frequent sources of pain relievers that are misused in the U.S.?
A.Drug dealers
B.Health care providers
C.Friends or relatives - Answer-A. Drug dealers or other stranger - 6.5%
B. Prescriptions or stone from a health care provider - 37.6%
C. Given by, bought from or took from friend or relative - 51.3%
10. Which type of drug tests are non-DOT employers most likely to require?
A.Post-accident
B.Reasonable Suspicion
C.Return to Duty
D.Pre-placement
E.Random - Answer-D
CORRECT DETAILED ANSWERS
A driver's DOT drug test is positive. To ensure the right to have the split specimen
analyzed, the donor must request the additional analysis within:
A. 2 days
B. 3 days
C. 5 days
D. 7 days
E. There is no time limit - Answer-B
A split sample has reconfirmed the primary test result. The employee requests
reanalysis of the primary specimen. Under DOT regulations, the MRO should:
A. Direct a reanalysis if requested within 72 hours of the result being reported to the
donor
B. Deny the request for reanalysis
C. Order a test of the split sample only
D. Request a quantitative analysis of the split sample
E. None of these are correct - Answer-B
Which one of the following statements is true?
A. l-methamphetamine is metabolized to l-amphetamine.
B. d-amphetamine is metabolized to d-methamphetamine.
C. GC/MS methods cannot differentiate between d- and l- forms of methamphetamine.
D. The presence of l-methamphetamine rules out the illicit use of methamphetamine.
E. The presence of d-methamphetamine rules out the illicit use of methamphetamine. -
Answer-A
Which of the following can be a metabolite of morphine?
A. Hydromorphone
B. Diacetylmorphine
C. Monoacetylmorphine
D. Hydrocodone
E. Normorphine - Answer-A and E
Which of the following is/are true of alcohol testing?
A. Industrial exposure to certain solvents may cause some interference with the
determination of alcohol ingestion
B. Ingested food will generally hasten the absorption of alcohol.
,C. Assuming no post-accident consumption, a driver's blood alcohol concentration 45
minutes after an accident may overestimate his or her level at the time of the accident.
D. Assuming no post-accident consumption, a driver's blood alcohol concentration 45
minutes after an accident may underestimate his or her level at the time of the accident.
E. All of these are true statements - Answer-A, C, and D
Which of the following REQUIRE(S) an observed collection under DOT regulations?
A. Donor admits to illicit drug use.
B. Donor presents with clinical signs consistent with opiate abuse.
C. Donor states that he or she is unable to provide urine.
D. State law permits routine observed collections, and the employer's policy requires
this action.
E. Specimen temperature is 89.5 degrees Fahrenheit. - Answer-E
Under DOT regulations, which of the following is/are true?
A. If the primary specimen is negative, the lab may dispose of the split sample.
B. If the primary specimen is confirmed positive, the split specimen must be preserved
for at least one year.
C. If a split test is requested, the MRO must obtain and ship the split sample to another
DHHS Certified lab.
D. If the drug(s) is(are) not detected in the split sample, and validity testing is negative,
then the test is canceled. - Answer-A, B, and D
2. Which of the following drug tests is not required for federal employees under the
federal Drug-Free Workplace Program?
A.Preplacement
B.Post-accident
C.Return to duty
D.Unreasonable suspicion
E.Random - Answer-D
SAMHSA's Drug Free Workplace Program specifies "Reasonable Suspicion" as one of
the types of drug testing. This is found on the federal Custody and Control Form. The
incorrect answer was unreasonable suspicion.
3. Which of the following is the "weakest link" in drug testing, i.e., generally produces
the most frequent errors?
A.Specimen collection
B.Laboratory testing
C.MRO review - Answer-A
Among drug testing personnel, there are far more specimen collectors than laboratory
staff or MROs. Collectors receive the least amount of training, are paid the lowest
wages, and have the highest job turnover.
Quality reviews show that a substantially larger number of errors occur in collection and
properly completing the Custody and Control Form.
,4. MROs must pass a nationally recognized certifying examination for which of the
following activities?
A.All MRO work
B.All federally regulated MRO work
C.All DHHS and DOT MRO work
D.All states with provisions allowing medical marijuana - Answer-C
A. All MRO work - Incorrect: includes non-federally regulated drug testing, in which only
a handful of states require MRO certification
B. All federally-regulated MRO work - Incorrect: includes DOD, NRC and other
agencies, which do not require MRO certification
C. All DHHS and DOT MRO work - Correct Answer: Both SAMHSA and DOT clearly
specify this requirement for MROs.
D. All states with provisions allowing medical marijuana - Incorrect: state Marijuana laws
make no reference to MROs, and only allow medical authorization or recommendation
permitting marijuana use. Health care professions do not "prescribe" marijuana.
5. Which of the following roles is primary for the MRO?
A.Lab checker
B.SAP advisor
C.Gatekeeper
D.Mediator
E.Substance Abuse Identifier - Answer-c
Although each of these monikers identify occasional, peripheral roles of the MRO, the
DOT has clearly earmarked the role of the MRO as a gatekeeper.
6. After completing review of drug test results, interviewing the donor and documenting
findings, an MRO must do which of the following?
A.Confirm laboratory results
B.Reconfirm laboratory results
C.Verify drug test results
D.Report findings to laboratory and employer - Answer-C
The determination of an MRO is called a "verification" decision. Laboratories confirm lab
results though performing a second test using a different analytical method and
performing internal quality control measures. A laboratory to which a split specimen is
send reconfirms or fails to reconfirm the original laboratory's findings. MROs report
findings to employers, but do not routinely report to laboratories.
7. The MRO safety duties include all but which of the following activities?
A.Consider essential job functions
B.Review appropriateness of medications donor is taking
C.Verify prescriptions with PCP/pharmacy
D.Assess safety risks from medications - Answer-B
A, C and D are all part of the considerations of an MRO in assessing workplace safety.
However, the DOT has made it explicitly clear that while an MRO may express safety
, concerns to the donor and discuss them with prescribing health care professional, the
MRO is admonished NOT to determine whether the medication was appropriately
prescribed.
The one exception for federal employees is mentioned the SAMHSA MRO Guidance
Manual, which does allow MROs to "use reasonable medical judgement to make the
decision that the provided prescription was generated in response to the donor's current
medical condition
8. At what age does use of illicit drugs peak in the U.S.?
A.12-17
B.18-24
C.25-3
D.33-50
E.51 and older - Answer-B
The National Survey on Drug Use and Health has consistently shown in all its surveys
from 2000-2018 that illicit drug use peaks at ages 18-24.
9. The greatest increase in U.S. drug overdose deaths is due to which of the following
categories of drugs?
A.Cocaine
B.Heroin
C.Methamphetamine
D.Natural and semi-synthetic opioids
E.Synthetic opioids other than methadone (e.g., fentanyl) - Answer-E
The Centers for Disease Control and Prevention (CDC) National Center for Health
Statistics has tracked drug overdose deaths from 1999-2017. Overdose deaths from
many different drug classes have risen, including heroin, natural and semisynthetic
opioids, cocaine, and methamphetamine. But none have risen so dramatically as
synthetic opioids other than methadone
9a. What are the most frequent sources of pain relievers that are misused in the U.S.?
A.Drug dealers
B.Health care providers
C.Friends or relatives - Answer-A. Drug dealers or other stranger - 6.5%
B. Prescriptions or stone from a health care provider - 37.6%
C. Given by, bought from or took from friend or relative - 51.3%
10. Which type of drug tests are non-DOT employers most likely to require?
A.Post-accident
B.Reasonable Suspicion
C.Return to Duty
D.Pre-placement
E.Random - Answer-D
