NRCME TEST BANK 2025
NRCME TEST BANK 2025/2026
COMPLETE ALL 400 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES |ALREADY GRADED
A+||ALREADY GRADED A+
A driver complains of slow progressive diminished distance visual acuity and glare particularly at
night from oncoming headlights and decreased contrast. The most likely cause is:
a. Macular degeneration.
b. Cataracts.
c. Glaucoma.
d. Retinopathy.
Correct answer is "B". Cataract formation causes diminished visual acuity in all fields, and night glare
from headlights is one of the first changes to appear. Near vision may be improved.
A driver with diabetes reports partial loss of central vision, color discrimination, and obscured vision
in other vision fields. The most likely cause is:
a. Macular degeneration.
b. Cataracts.
c. Glaucoma.
d. Retinopathy.
Correct answer is "D". Diabetes is the most common cause of retinopathy. Partial loss of central and
obscured vision in other fields possible. Color discrimination also affected.
A driver with a current medical certificate that does not expire for another year had an injury that
interfered with his ability to drive. What is the next step?
a. The driver can return to duty once healed.
b. The driver can return to duty once released by the treating physician.
c. The motor carrier may require the driver to return to the ME for evaluation.
d. The driver must return to the ME for a medical examination.
Correct answer is "D". When a driver returns from an illness or injury that interferes with driving
ability, the driver must undergo a medical examination even if the medical examiner's certificate has
not expired.
A driver admits to regularly taking his wife's hydrocodone. The best next step would be:
a. Refer the driver for an SAP evaluation.
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b. Council driver on risks of taking hydrocodone and having a random drug test.
c. Advise the driver not to take his wife's prescription for hydrocodone.
d. Refer the driver to his PCP for a prescription.
Correct answer is "A". The driver must have a prescription for narcotic use. Use of prescription
medication that is not prescribed is illegal and is not allowed by federal drug and alcohol program
policy. Admitting to drug use is a violation of drug policy and an SAP evaluation is required.
During the ear and hearing portion of the examination, the medical examiner must always:
a. Use the whisper test to test hearing.
b. Complete testing for both ears even if one passed.
c. Use a pure tone audiometer.
d. Use OSI hearing values.
Correct answer is "B". If one ear passes while performing the whisper test or an audiometric test, the
ME must complete that test on both ears.
Functional evaluation of hand function in a CMV driver is based upon:
a. Grip and hand strength.
b. Prehension and power grasping.
c. Power grasping and finger strength.
d. Hand grip and power grasping.
Correct answer is "B". Evaluation of hand function is based on prehension and power grasping.
A driver cannot be considered for an SPE if:
a. The deficit is fixed.
b. The deficit is of an extremity.
c. The deficit affects the torso.
d. The deficit resulted from illicit drug or alcohol use.
Correct answer is "C". Drivers with deficits that affect the torso cannot be consider for an SPE.
Which of the following antidepressants is usually disqualifying?
a. Elavil (Amitriptyline).
b. Wellbutrin.
c. Effexor.
d. Zoloft.
Correct answer is "A". First generation antidepressants have consistently been shown to interfere
with safe driving.
A driver is missing all digits of his right foot. He demonstrates good plantar and dorsiflexion. The
next step is:
a. Obtain a copy of the drivers driving record to determine if he has safely operated a CMV.
b. Counsel the driver regarding a Skill Performance Evaluation (SPE).
c. Refer the driver to a physiatrist for additional testing and evaluation.
d. Certify for a period of 2 years.
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Correct answer is "D". If the driver can demonstrate sufficient power and movement even though all
digits are missing on the foot, they can be certified to drive without a SPE. When less than full
function is lost in the hand or foot, it is up to the medical examiner to determine if the driver can be
qualified to drive or should have an SPE. In this case, the driver appears to have sufficient ability to
drive.
Who gets the original copy of the exam report form that is used during medical exam?
a. The Driver.
b. The Motor Carrier.
c. The Medical Examiner.
d. It doesn't matter.
Correct answer is "D". The original copy of the Medical Examination Report form, which is the copy
used during the examination, is kept by the medical examiner. This can be either a paper or
electronic copy.
A driver currently does not meet the visual acuity requirement but states that he is going to have
lasik surgery in the next month. What is the next best step?
a. Complete the physical exam and disqualify the driver.
b. Complete the physical exam and qualify the driver for one year.
c. Discontinue the physical exam and tell the driver to return after Lasik surgery.
d. Complete the physical exam and qualify the driver for one month with instructions to return
after Lasik surgery.
Correct answer is "A". The correct answer is to complete the physical exam and disqualify the driver
because the vision standard is a non-discretionary standard. The driver can return after the
procedure for another certification exam.
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 first perceives a whispered voice at 5 feet in his right ear and 4 feet in his left ear. All other
aspects of his physical examination are unremarkable. The examiner should:
a.Permanently disqualify the driver because he "failed" the whispered voice test.
b.Certify the driver for 2 years.
c.Certify the driver for 1 year.
d.Require an audiometric test to determine the extent of hearing loss in his left ear.
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Correct answer is "B". The driver is qualified to drive without restriction as long as he is able to
perceive a whispered voice at 5 feet in 1 ear.
A driver reports for an examination 6 weeks after suffering a mild heart attack and presents a note
from his cardiologist stating that he is able to return to work immediately without restriction.
Included within the note, the cardiologist provides recent testing information showing that the
driver had an ETT that showed he was able to reach 12 METS during the test. His echocardiogram
showed an ejection fraction of 65%. The examination of the driver is unremarkable. The examiner
should:
a. Temporarily disqualify the driver.
b. Qualify the driver for 1 year.
c. Qualify the driver for 2 years.
d. Consult with the cardiologist to determine if the driver suffers from angina.
Correct answer is "A". The driver has not completed the required 2-monthwaiting period, but all
other requirements for medical clearance and required testing have been met. The driver would be
certified for 1 year at the completion of the waiting period. The date of the certification would be
from the date of the original examination.
A driver provides an audiometric test documenting the following:
1. 500 Hz: 2. 1000 HZ: 3. 2000 HZ: 4. 4000 Hz:
35 Right ear; 40 Left ear 40 Right ear; 45 Left ear 40 Right ear; 45 Left ear 50 Right ear; 50 Left ear
5.
The medical examiner should:
a. Disqualify the driver because he does not meet minimum hearing requirementsto drive.
b. Certify the driver for 2years.
c. Certify the driver for 1 year.
d. Require the driver to obtain a hearing exemption.
Correct answer is "B". The examiner would average the results from 500 Hz, 1000 Hz and 2000 Hz.
This average is 38.33 in the Right and 43.33 in the Left ear. A driver must have an average hearing loss
of less than or equal to 40 in the better ear. This does not have to be met in both ears.
During the examination of a commercial driver, the examiner notices that the driver's peripheral
vision is 70 degrees to the left and 80 degrees to the right. The examiner should:
a. Qualify the driver for 2 years.
b. Require the driver to obtain a vision exemption because of the limitation in the driver's
left peripheral field.
c. Disqualify the driver.
d. Have the driver consult with an Ophthalmologist to determine if the driver's peripheral vision
meets minimum standards.
Correct answer is "A". A driver must exhibit a minimum peripheral vision of 70 degrees bilaterally.
During examination, the medical examiner notices that the driver is distant, lacks eye contact and
shows absolutely no emotional response during the exam. The examiner's best response should be:
A+ TEST BANK 4
NRCME TEST BANK 2025/2026
COMPLETE ALL 400 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES |ALREADY GRADED
A+||ALREADY GRADED A+
A driver complains of slow progressive diminished distance visual acuity and glare particularly at
night from oncoming headlights and decreased contrast. The most likely cause is:
a. Macular degeneration.
b. Cataracts.
c. Glaucoma.
d. Retinopathy.
Correct answer is "B". Cataract formation causes diminished visual acuity in all fields, and night glare
from headlights is one of the first changes to appear. Near vision may be improved.
A driver with diabetes reports partial loss of central vision, color discrimination, and obscured vision
in other vision fields. The most likely cause is:
a. Macular degeneration.
b. Cataracts.
c. Glaucoma.
d. Retinopathy.
Correct answer is "D". Diabetes is the most common cause of retinopathy. Partial loss of central and
obscured vision in other fields possible. Color discrimination also affected.
A driver with a current medical certificate that does not expire for another year had an injury that
interfered with his ability to drive. What is the next step?
a. The driver can return to duty once healed.
b. The driver can return to duty once released by the treating physician.
c. The motor carrier may require the driver to return to the ME for evaluation.
d. The driver must return to the ME for a medical examination.
Correct answer is "D". When a driver returns from an illness or injury that interferes with driving
ability, the driver must undergo a medical examination even if the medical examiner's certificate has
not expired.
A driver admits to regularly taking his wife's hydrocodone. The best next step would be:
a. Refer the driver for an SAP evaluation.
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b. Council driver on risks of taking hydrocodone and having a random drug test.
c. Advise the driver not to take his wife's prescription for hydrocodone.
d. Refer the driver to his PCP for a prescription.
Correct answer is "A". The driver must have a prescription for narcotic use. Use of prescription
medication that is not prescribed is illegal and is not allowed by federal drug and alcohol program
policy. Admitting to drug use is a violation of drug policy and an SAP evaluation is required.
During the ear and hearing portion of the examination, the medical examiner must always:
a. Use the whisper test to test hearing.
b. Complete testing for both ears even if one passed.
c. Use a pure tone audiometer.
d. Use OSI hearing values.
Correct answer is "B". If one ear passes while performing the whisper test or an audiometric test, the
ME must complete that test on both ears.
Functional evaluation of hand function in a CMV driver is based upon:
a. Grip and hand strength.
b. Prehension and power grasping.
c. Power grasping and finger strength.
d. Hand grip and power grasping.
Correct answer is "B". Evaluation of hand function is based on prehension and power grasping.
A driver cannot be considered for an SPE if:
a. The deficit is fixed.
b. The deficit is of an extremity.
c. The deficit affects the torso.
d. The deficit resulted from illicit drug or alcohol use.
Correct answer is "C". Drivers with deficits that affect the torso cannot be consider for an SPE.
Which of the following antidepressants is usually disqualifying?
a. Elavil (Amitriptyline).
b. Wellbutrin.
c. Effexor.
d. Zoloft.
Correct answer is "A". First generation antidepressants have consistently been shown to interfere
with safe driving.
A driver is missing all digits of his right foot. He demonstrates good plantar and dorsiflexion. The
next step is:
a. Obtain a copy of the drivers driving record to determine if he has safely operated a CMV.
b. Counsel the driver regarding a Skill Performance Evaluation (SPE).
c. Refer the driver to a physiatrist for additional testing and evaluation.
d. Certify for a period of 2 years.
A+ TEST BANK 2
, NRCME TEST BANK 2025
Correct answer is "D". If the driver can demonstrate sufficient power and movement even though all
digits are missing on the foot, they can be certified to drive without a SPE. When less than full
function is lost in the hand or foot, it is up to the medical examiner to determine if the driver can be
qualified to drive or should have an SPE. In this case, the driver appears to have sufficient ability to
drive.
Who gets the original copy of the exam report form that is used during medical exam?
a. The Driver.
b. The Motor Carrier.
c. The Medical Examiner.
d. It doesn't matter.
Correct answer is "D". The original copy of the Medical Examination Report form, which is the copy
used during the examination, is kept by the medical examiner. This can be either a paper or
electronic copy.
A driver currently does not meet the visual acuity requirement but states that he is going to have
lasik surgery in the next month. What is the next best step?
a. Complete the physical exam and disqualify the driver.
b. Complete the physical exam and qualify the driver for one year.
c. Discontinue the physical exam and tell the driver to return after Lasik surgery.
d. Complete the physical exam and qualify the driver for one month with instructions to return
after Lasik surgery.
Correct answer is "A". The correct answer is to complete the physical exam and disqualify the driver
because the vision standard is a non-discretionary standard. The driver can return after the
procedure for another certification exam.
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 first perceives a whispered voice at 5 feet in his right ear and 4 feet in his left ear. All other
aspects of his physical examination are unremarkable. The examiner should:
a.Permanently disqualify the driver because he "failed" the whispered voice test.
b.Certify the driver for 2 years.
c.Certify the driver for 1 year.
d.Require an audiometric test to determine the extent of hearing loss in his left ear.
A+ TEST BANK 3
, NRCME TEST BANK 2025
Correct answer is "B". The driver is qualified to drive without restriction as long as he is able to
perceive a whispered voice at 5 feet in 1 ear.
A driver reports for an examination 6 weeks after suffering a mild heart attack and presents a note
from his cardiologist stating that he is able to return to work immediately without restriction.
Included within the note, the cardiologist provides recent testing information showing that the
driver had an ETT that showed he was able to reach 12 METS during the test. His echocardiogram
showed an ejection fraction of 65%. The examination of the driver is unremarkable. The examiner
should:
a. Temporarily disqualify the driver.
b. Qualify the driver for 1 year.
c. Qualify the driver for 2 years.
d. Consult with the cardiologist to determine if the driver suffers from angina.
Correct answer is "A". The driver has not completed the required 2-monthwaiting period, but all
other requirements for medical clearance and required testing have been met. The driver would be
certified for 1 year at the completion of the waiting period. The date of the certification would be
from the date of the original examination.
A driver provides an audiometric test documenting the following:
1. 500 Hz: 2. 1000 HZ: 3. 2000 HZ: 4. 4000 Hz:
35 Right ear; 40 Left ear 40 Right ear; 45 Left ear 40 Right ear; 45 Left ear 50 Right ear; 50 Left ear
5.
The medical examiner should:
a. Disqualify the driver because he does not meet minimum hearing requirementsto drive.
b. Certify the driver for 2years.
c. Certify the driver for 1 year.
d. Require the driver to obtain a hearing exemption.
Correct answer is "B". The examiner would average the results from 500 Hz, 1000 Hz and 2000 Hz.
This average is 38.33 in the Right and 43.33 in the Left ear. A driver must have an average hearing loss
of less than or equal to 40 in the better ear. This does not have to be met in both ears.
During the examination of a commercial driver, the examiner notices that the driver's peripheral
vision is 70 degrees to the left and 80 degrees to the right. The examiner should:
a. Qualify the driver for 2 years.
b. Require the driver to obtain a vision exemption because of the limitation in the driver's
left peripheral field.
c. Disqualify the driver.
d. Have the driver consult with an Ophthalmologist to determine if the driver's peripheral vision
meets minimum standards.
Correct answer is "A". A driver must exhibit a minimum peripheral vision of 70 degrees bilaterally.
During examination, the medical examiner notices that the driver is distant, lacks eye contact and
shows absolutely no emotional response during the exam. The examiner's best response should be:
A+ TEST BANK 4
