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MRO Practice Questions and Answers
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 Ans: 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 Ans: A
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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 Ans: 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?
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A.Lab checker
B.SAP advisor
C.Gatekeeper
D.Mediator
E.Substance Abuse Identifier Ans: 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 Ans: 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
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B.Review appropriateness of medications donor is taking
C.Verify prescriptions with PCP/pharmacy
D.Assess safety risks from medications Ans: 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 Ans: 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?
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MRO Practice Questions and Answers
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 Ans: 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 Ans: A
© 2025 All rights reserved
, 2 | Page
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 Ans: 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?
© 2025 All rights reserved
, 3 | Page
A.Lab checker
B.SAP advisor
C.Gatekeeper
D.Mediator
E.Substance Abuse Identifier Ans: 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 Ans: 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
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, 4 | Page
B.Review appropriateness of medications donor is taking
C.Verify prescriptions with PCP/pharmacy
D.Assess safety risks from medications Ans: 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 Ans: 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?
© 2025 All rights reserved
