NRCME DOT EXAMINER TEST PRACTICE QUESTIONS WITH ACCURATE SOLUTIONS
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
D. Corneal thickness
Correct Response:
A. Pupil reactivity
Incorrect Responses:
B. Iris symmetry
This is incorrect because determining iris symmetry is not required by FMCSA.
C. Conjunctival injection
This is incorrect because most causes of conjunctival injection would not be disqualifying.
Causes that are suspicious for a disqualifying condition need additional evaluation. While
this abnormal finding should be explained, with determination of possible effects on safe
driving before making a certification decision, it is not a condition that is specified in
FMCSA regulations.
D. Corneal thickness
This is incorrect because it is not measured in an office examination except by an eye
specialist.
A 46-year-old male driver presents for recertification. He has a history of chronic gastro
esophageal reflux disease (GERD). He takes esomeprazole (Nexium) and over-the-counter
cimetidine (Tagamet). He states that he feels fine, but has trouble finding foods that do not
trigger his GERD when he is on the road. Which of the following should the medical
examiner do first?
,A. Disqualify the driver until he has a nutritional consultation.
B. Certify the driver and advise him to carry non-triggering foods in a cooler.
C. Contact the driver's physician and request an upper GI study.
D. Correlate the GI history findings with the abdominal examination.
Correct Response:
D. Correlate the GI history findings with the abdominal examination.
This is the correct response because given the information in the question; a medical
examiner would need to examine the driver before having sufficient information about the
health of the driver to consider any of the other options.
Incorrect Responses:
A. Disqualify the driver until he has a nutritional consultation.This is not the correct
response because until completion of the examination, there is insufficient information to
make a certification decision. In addition, there is no regulation or medical guideline that
requires a nutritional consultation in order to be certified.
B. Certify the driver and advise him to carry non-triggering foods in a cooler.
This is not the correct response because until completion of the examination, there is
insufficient information to make a certification decision.
C. Contact the driver's primary care provider and request an upper-GI study.
This is not the correct response because until completion of the examination, one does not
have sufficient information to make a referral decision.
A 25-year-old female driver denies a history of any medical problems. She is a non-smoker
who exercises regularly without symptoms. The medical examiner auscultates bilateral
wheezes during the examination. The driver's SpO2 is 90 percent in the medical examiner's
office. The rest of the examination is normal. The driver should be... ?
A. Temporarily disqualified pending results of a cardiac workup.
B. Qualified since she has no cardiac symptoms.
, C. Temporarily disqualified until further evaluation.
D. Qualified because her O2 saturation exceeds the minimum.
Correct Response:
C. Temporarily disqualified until further evaluation.
This is the correct response because the driver has a non-diagnosed respiratory or thoracic
illness that might interfere with the ability to safely operate a CMV. The driver should not be
certified until the etiology is confirmed and treatment has been shown to be effective, safe,
and stable. Also, according to FMCSA medical guidelines, a SpO2 of less than 92 percent
warrants obtaining an arterial blood gas analysis.
Which of the following stages of hypertension calls for a medical certificate that expires in
a year?
A. Stage 1
B. Stage 3
C. Stage 2
D. Stage 4
A. Stage 1
Medical certificates for drivers with Stage 1 hypertension expire after a year. Stage 2
hypertension results in a one-time, three-month medical certificate. Stage 3 corresponds
to a medical certificate, good for 6 months from date of examination if the reading is less
than or equal to 140/90. Lastly, Stage 4 hypertension doesn't exist.
The FMCSA provides exemption programs for which of the following?
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
D. Corneal thickness
Correct Response:
A. Pupil reactivity
Incorrect Responses:
B. Iris symmetry
This is incorrect because determining iris symmetry is not required by FMCSA.
C. Conjunctival injection
This is incorrect because most causes of conjunctival injection would not be disqualifying.
Causes that are suspicious for a disqualifying condition need additional evaluation. While
this abnormal finding should be explained, with determination of possible effects on safe
driving before making a certification decision, it is not a condition that is specified in
FMCSA regulations.
D. Corneal thickness
This is incorrect because it is not measured in an office examination except by an eye
specialist.
A 46-year-old male driver presents for recertification. He has a history of chronic gastro
esophageal reflux disease (GERD). He takes esomeprazole (Nexium) and over-the-counter
cimetidine (Tagamet). He states that he feels fine, but has trouble finding foods that do not
trigger his GERD when he is on the road. Which of the following should the medical
examiner do first?
,A. Disqualify the driver until he has a nutritional consultation.
B. Certify the driver and advise him to carry non-triggering foods in a cooler.
C. Contact the driver's physician and request an upper GI study.
D. Correlate the GI history findings with the abdominal examination.
Correct Response:
D. Correlate the GI history findings with the abdominal examination.
This is the correct response because given the information in the question; a medical
examiner would need to examine the driver before having sufficient information about the
health of the driver to consider any of the other options.
Incorrect Responses:
A. Disqualify the driver until he has a nutritional consultation.This is not the correct
response because until completion of the examination, there is insufficient information to
make a certification decision. In addition, there is no regulation or medical guideline that
requires a nutritional consultation in order to be certified.
B. Certify the driver and advise him to carry non-triggering foods in a cooler.
This is not the correct response because until completion of the examination, there is
insufficient information to make a certification decision.
C. Contact the driver's primary care provider and request an upper-GI study.
This is not the correct response because until completion of the examination, one does not
have sufficient information to make a referral decision.
A 25-year-old female driver denies a history of any medical problems. She is a non-smoker
who exercises regularly without symptoms. The medical examiner auscultates bilateral
wheezes during the examination. The driver's SpO2 is 90 percent in the medical examiner's
office. The rest of the examination is normal. The driver should be... ?
A. Temporarily disqualified pending results of a cardiac workup.
B. Qualified since she has no cardiac symptoms.
, C. Temporarily disqualified until further evaluation.
D. Qualified because her O2 saturation exceeds the minimum.
Correct Response:
C. Temporarily disqualified until further evaluation.
This is the correct response because the driver has a non-diagnosed respiratory or thoracic
illness that might interfere with the ability to safely operate a CMV. The driver should not be
certified until the etiology is confirmed and treatment has been shown to be effective, safe,
and stable. Also, according to FMCSA medical guidelines, a SpO2 of less than 92 percent
warrants obtaining an arterial blood gas analysis.
Which of the following stages of hypertension calls for a medical certificate that expires in
a year?
A. Stage 1
B. Stage 3
C. Stage 2
D. Stage 4
A. Stage 1
Medical certificates for drivers with Stage 1 hypertension expire after a year. Stage 2
hypertension results in a one-time, three-month medical certificate. Stage 3 corresponds
to a medical certificate, good for 6 months from date of examination if the reading is less
than or equal to 140/90. Lastly, Stage 4 hypertension doesn't exist.
The FMCSA provides exemption programs for which of the following?
