NRCME 2025 ACTUAL TEST QUESTIONS WITH WELL EXPLAINED SOLUTIONS
What minimum PaO2 level is necessary if the driver has an ABG due to a chronic
respiratory disorder?
a.70mmHg
b.55mmHg
c.60mmHg
d.65mmHg
Correct answer is "D". To be qualified, the driver should meet a minimum arterial blood gas
(PaO2) greater than 65.
A driver has a history of a moderate Traumatic Brain Injury that occurred 3 years ago as a
result of a car accident. He reports he has fully recovered and provides a note from his
neurologist stating that he suffered no seizures and that he is able to return to driving. He
does not list any medications in his history. The examiner should:
a. Disqualify the driver.
b. Require the driver to take a "Folstein's mini mental state exam."
c. Certify the driver for one year.
d. Certify the driver for two years.
Correct answer is "C". The driver suffered no seizures from the TBI, has completed the
required waiting period (2 years), and has medical clearance. If the rest of the examination
is unremarkable, the driver could be certified for 1 year.
A driver reports a suicide attempt 10 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:
a. Disqualify the driver.
,b. Require a CAGE questionnaire.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years.
Correct answer is "A". The driver is temporarily disqualified because he has not completed
the mandatory waiting period for suicide attempt of 1 year. Once he has completed this, he
may be certified for 1 year due to the continued treatment of depression (taking an SSRI).
The certification is from the date of the original examination.
The driver lists Synthroid for the treatment of hypothyroidism. He has been taking it for
about 6 months and feels fine now. His examination is essentially normal. The examiner's
best course of action is to?
a. Request medical clearance for the medication prior to certification.
b. Certify the driver for 1 year.
c. Certify the driver for 2 years.
d. Counsel the driver that he needs to apply for an endocrine exemption.
Correct answer is "C". The driver's hypothyroidism is well managed and he is
asymptomatic. The driver may be certified for 2 years.
A 48-year-old male driver presents for a certification examination. He reports in his history
a back injury that had occurred 4 years earlier. He states that he was out of work following
back surgery for over a year, but since has returned to driving and his last certification was
good for 2 years. He lists as his only medication Oxycodone, which he takes only as
needed. He reports seeing his "pain doctor" every few months for evaluation. He also
reports he has had a steroid injection (series of 3) about a year ago, which "helped a lot."
The examiner should:
a. Request medical clearance.
b. Certify the driver for 1 year.
c. Certify the driver for 2 years.
,d. Disqualify the driver.
Correct answer is "A". The driver suffers a chronic pain condition which may inhibit his
ability to perform all essential functions associated with driving a CMV. He is also taking a
narcotic medication. Both of these will need clearance from a treating provider prior to
making a decision regarding certification.
A driver should not be certified when an ABG reveals a PaO2 of less than 65 at altitudes
below:
a. 2,000 feet
b. 3,000 feet
c. 5,000 feet
d. 7,000 feet
Correct answer "C" The threshold changes to 60 mm Hg at altitudes above 5,000 feet.
A driver presents for certification after a myocardial infarction. What is theminimum waiting
period status post myocardial infarction?
2 months
6 months
1 year
2 years
Correct answer is "A". There is a 2-month waiting period from the date of the MI.
A driver presents for certification 6 weeks after suffering a myocardial infarction. She
presents a note from her cardiologist, clearing her to drive a CMV without restrictions. Her
, post MI echocardiogram shows an EF of 50%. Her EKG shows no ischemia. Her ETT
exceeds FMCSA standards. The medical examiner should:
Certify the driver for 3 months.
Certify the driver for 1 year.
Certify the driver for 2 years
Disqualify the driver.
Correct answer is "D". The driver should be disqualified because she has not met the
minimum wait time of 2 months (8 weeks) after suffering a myocardial infarction. The driver
can return for certification in two more weeks.
A driver presents for certification. He checks "yes" for "Anxiety, depression, nervousness,
and other mental health problems" for the Driver Health History portion of the Medical
Examiner Report Form. He clarifies he has depression which is controlled with medications
and electroconvulsive therapy (ECT). Following ECT, the driver should be symptoms free for
how long before being certified?
a. 3 months
b. 6 months
c. 12 months
d. 24 months
Correct answer is "B". Following ECT, the waiting period is 6 months. Maintenance or
ongoing ECT for depression is not certifiable.
According to FMCSA regulations, which of the following must the medical examiner
evaluate when examining a driver's eyes?
a. Pupil reactivity
b. Iris symmetry
c. Conjunctival injection
What minimum PaO2 level is necessary if the driver has an ABG due to a chronic
respiratory disorder?
a.70mmHg
b.55mmHg
c.60mmHg
d.65mmHg
Correct answer is "D". To be qualified, the driver should meet a minimum arterial blood gas
(PaO2) greater than 65.
A driver has a history of a moderate Traumatic Brain Injury that occurred 3 years ago as a
result of a car accident. He reports he has fully recovered and provides a note from his
neurologist stating that he suffered no seizures and that he is able to return to driving. He
does not list any medications in his history. The examiner should:
a. Disqualify the driver.
b. Require the driver to take a "Folstein's mini mental state exam."
c. Certify the driver for one year.
d. Certify the driver for two years.
Correct answer is "C". The driver suffered no seizures from the TBI, has completed the
required waiting period (2 years), and has medical clearance. If the rest of the examination
is unremarkable, the driver could be certified for 1 year.
A driver reports a suicide attempt 10 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:
a. Disqualify the driver.
,b. Require a CAGE questionnaire.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years.
Correct answer is "A". The driver is temporarily disqualified because he has not completed
the mandatory waiting period for suicide attempt of 1 year. Once he has completed this, he
may be certified for 1 year due to the continued treatment of depression (taking an SSRI).
The certification is from the date of the original examination.
The driver lists Synthroid for the treatment of hypothyroidism. He has been taking it for
about 6 months and feels fine now. His examination is essentially normal. The examiner's
best course of action is to?
a. Request medical clearance for the medication prior to certification.
b. Certify the driver for 1 year.
c. Certify the driver for 2 years.
d. Counsel the driver that he needs to apply for an endocrine exemption.
Correct answer is "C". The driver's hypothyroidism is well managed and he is
asymptomatic. The driver may be certified for 2 years.
A 48-year-old male driver presents for a certification examination. He reports in his history
a back injury that had occurred 4 years earlier. He states that he was out of work following
back surgery for over a year, but since has returned to driving and his last certification was
good for 2 years. He lists as his only medication Oxycodone, which he takes only as
needed. He reports seeing his "pain doctor" every few months for evaluation. He also
reports he has had a steroid injection (series of 3) about a year ago, which "helped a lot."
The examiner should:
a. Request medical clearance.
b. Certify the driver for 1 year.
c. Certify the driver for 2 years.
,d. Disqualify the driver.
Correct answer is "A". The driver suffers a chronic pain condition which may inhibit his
ability to perform all essential functions associated with driving a CMV. He is also taking a
narcotic medication. Both of these will need clearance from a treating provider prior to
making a decision regarding certification.
A driver should not be certified when an ABG reveals a PaO2 of less than 65 at altitudes
below:
a. 2,000 feet
b. 3,000 feet
c. 5,000 feet
d. 7,000 feet
Correct answer "C" The threshold changes to 60 mm Hg at altitudes above 5,000 feet.
A driver presents for certification after a myocardial infarction. What is theminimum waiting
period status post myocardial infarction?
2 months
6 months
1 year
2 years
Correct answer is "A". There is a 2-month waiting period from the date of the MI.
A driver presents for certification 6 weeks after suffering a myocardial infarction. She
presents a note from her cardiologist, clearing her to drive a CMV without restrictions. Her
, post MI echocardiogram shows an EF of 50%. Her EKG shows no ischemia. Her ETT
exceeds FMCSA standards. The medical examiner should:
Certify the driver for 3 months.
Certify the driver for 1 year.
Certify the driver for 2 years
Disqualify the driver.
Correct answer is "D". The driver should be disqualified because she has not met the
minimum wait time of 2 months (8 weeks) after suffering a myocardial infarction. The driver
can return for certification in two more weeks.
A driver presents for certification. He checks "yes" for "Anxiety, depression, nervousness,
and other mental health problems" for the Driver Health History portion of the Medical
Examiner Report Form. He clarifies he has depression which is controlled with medications
and electroconvulsive therapy (ECT). Following ECT, the driver should be symptoms free for
how long before being certified?
a. 3 months
b. 6 months
c. 12 months
d. 24 months
Correct answer is "B". Following ECT, the waiting period is 6 months. Maintenance or
ongoing ECT for depression is not certifiable.
According to FMCSA regulations, which of the following must the medical examiner
evaluate when examining a driver's eyes?
a. Pupil reactivity
b. Iris symmetry
c. Conjunctival injection
