The driver presents with a SPE Certificate. The Medical Examiner's next step should be:
- ANSWER-Proceed with the examination.
A 21-year-old driver presents with a history of ADHD for 10 years, taking stable dosing
of Adderall. He describes no side effects. Which of the following is true?
a. A significant percentage of individuals with adult ADHD show a moderate to marked
degree of improvement on central nervous system stimulant medication.
b. ADHD is a disqualifying condition.
c. Adderall is a Schedule 1 drug.
d. Medical Examiners should test for serum drug levels of Adderall. - ANSWER-A
significant percentage of individuals with adult ADHD show a moderate to marked
degree of improvement on central nervous system stimulant medication
Which of the following is the most important examination finding that requires additional
evaluation?
a. Acrochordon.
b. Hyperopia.
c. Palpable calf cords.
d. Verruca vulgaris. - ANSWER-Palpable calf cords
The driver reports taking Digoxin. What findings would raise the most significant
concerns regarding certification?
a. Arrhythmias.
b. Anorexia.
c. Nausea and vomiting.
d. Diarrhea. - ANSWER-Arrhythmias.
The driver is taking theophylline. Which of the following is not true?
a. Serum levels may be checked.
,b. The primary indication for theophylline is in the treatment of neurological conditions.
c. Cardiac toxicity is a significant risk of theophylline use.
d. Theophylline can be administered orally or intravenously (IV - ANSWER-The primary
indication for theophylline is in the treatment of neurological conditions.
The driver is taking Celexa and melatonin. The Medical Examiner should:
a. Advise the driver to only take these medications more than 12 hours before driving.
b. Advise the driver to stop melatonin as it can cause drowsiness.
c. Recommend an alternative to Celexa.
d. Advise the driver to discuss benzodiazepines as an alternative treatment. with the
driver's prescribing provider - ANSWER-Advise the driver to only take these
medications more than 12 hours before driving.
The driver tells the Medical Examiner he has recently been prescribed contact lenses.
He notes that after 3-4 hours of use the contacts cause irritation and he has to take
them out. The driver passes the vision test only with contacts and does not have
eyeglasses. The Medical Examiner should:
a. Advise the driver to carry a spare pair of contact lenses.
b. Certify the driver wearing corrective lenses.
c. Refer the driver for evaluation under the Alternative Vision Qualification standard.
d. Certify the driver without qualifications - ANSWER-Certify the driver wearing
corrective lenses.
The driver does not indicate any medical conditions on health history. During the exam
the Medical Examiner notes the presence of a hearing aid in one ear. The driver says
that he doesn't need the hearing aid to drive and doesn't think it should be required. The
next step for the Medical Examiner is:
a. Test the driver's hearing without the hearing aid.
b. Examine the driver's ears.
c. Refer the driver for hearing assessment by a specialist with specialized audiometric
testing capabilities for testing drivers while wearing a hearing aid. d. Certify the driver
with the qualification "wearing hearing aid - ANSWER-Test the driver's hearing without
the hearing aid.
A driver has an indication for obtaining a cardiac stress test. If the driver is not taking a
beta blocker, what is the percentage of maximum heart rate that the driver should meet
to indicate a satisfactory stress test:
a. 60%.
b. 75%.
c. 85%.
d. 100%. - ANSWER-85%
The driver is missing the 4th finger of his right hand. The Medical Examiner should:
a. Refer for orthopedic evaluation.
b. Indicate the driver will need a SPE Certificate.
c. Test the driver's grasp and prehension.
,d. Disqualify the driver - ANSWER-Test the driver's grasp and prehension.
The driver describes a history of dizzy spells. Which examination finding is not
indicated?
a. Test the driver for nystagmus.
b. Romberg testing.
c. Orthostatic blood pressure measurements.
d. Liver and spleen palpation - ANSWER-Liver and spleen palpation
Guidance (not regulatory) recommendations are that drivers with dizziness or vertigo
should not be qualified until the driver has achieved a 2-month symptom free interval
regardless of examination findings.
Vision testing may be performed by:
a. The Medical Examiner, an optometrist, or ophthalmologist.
b. Only an ophthalmologist.
c. Only the Medical Examiner.
d. Only an optometrist - ANSWER-The Medical Examiner, an optometrist, or
ophthalmologist
The driver has 1,000 ng/ml of glucose on urinalysis. What is the next appropriate step
for the Medical Examiner?
a. Disqualify the driver.
b. Refer the driver for evaluation by a kidney specialist.
c. Refer the driver for evaluation under the Insulin-Treated Diabetes Alternative
Qualification Standard.
d. Recommend the driver check blood glucose 4x per day. - ANSWER-Recommend the
driver check blood glucose 4x per day.
The driver presents after having had a PCI procedure 3 days prior. The driver indicates
no symptoms and has a letter from his cardiologist indicating he is cleared to drive. The
Medical Examiner should:
a. Have the driver return for evaluation at least 3 weeks after the date of the PCI.
b. Refer the driver for a cardiac stress test.
c. Certify the driver for 6 months.
d. Certify the driver for 2 years - ANSWER-Have the driver return for evaluation at least
3 weeks after the date of the PCI
- Current FMCSA guidelines in the reference table in the 2022 Draft version of the
Medical Examiner's Handbook include: Asymptomatic; Minimum 3 weeks after elective
procedure; LVEF > 40%; Adherence to cardiovascular specialist-recommended
appropriate medical therapy for a minimum of 1 year after receiving drug-eluting stent;
Clearance by cardiologist.
The driver describes alcohol use including 2 drinks a night during the week and a 6
pack on the weekends. The Medical Examiner's next step should be to:
, a. Refer the driver for evaluation by a substance abuse professional.
b. Further assess the driver's history of and current use of alcohol.
c. Disqualify the driver.
d. Test the driver for drugs and alcohol - ANSWER-Further assess the driver's history of
and current use of alcohol
What is the driver required to sign for on MCSA-5875?
a. Health history.
b. Release of information.
c. Acknowledgement of testing results.
d. Acceptance of the Medical Examiner's certification determination - ANSWER-Health
history.
What is appropriate preparation for the physical examination?
a. Dress and stockings.
b. Examination gown and underwear.
c. Shorts and tennis shoes.
d. Loose fitting clothing. - ANSWER-Examination gown and underwear
The driver has a history of coronary artery bypass grafting (CABG) 3 years ago. He is
now describing shortness of breath. The Medical Examiner's next step is:
a. Refer the driver for cardiac stress testing.
b. Refer the driver for cardiology evaluation.
c. Disqualify the driver.
d. Assess cardiac risk factors and further characterize the driver's symptoms -
ANSWER-Assess cardiac risk factors and further characterize the driver's symptoms
Which of the following should raise the greatest concern for the Medical Examiner's
assessment?
a. History of lumbar fusion 2 years ago.
b. Grade 1 ankle sprain 1 month ago.
c. Prepatellar bursitis 3 months ago.
d. Rotator cuff injury 6 months ago. - ANSWER-Grade 1 ankle sprain 1 month ago.
The driver smokes and describes long hours of prolonged driving. Which of the
following is the most important condition or symptom that the Medical Examiner should
discuss with the driver?
a. Fatigue.
b. COPD.
c. Deep vein thrombosis and possible pulmonary embolus.
d. Acute cardiac conditions - ANSWER-Deep vein thrombosis and possible pulmonary
embolus
- ANSWER-Proceed with the examination.
A 21-year-old driver presents with a history of ADHD for 10 years, taking stable dosing
of Adderall. He describes no side effects. Which of the following is true?
a. A significant percentage of individuals with adult ADHD show a moderate to marked
degree of improvement on central nervous system stimulant medication.
b. ADHD is a disqualifying condition.
c. Adderall is a Schedule 1 drug.
d. Medical Examiners should test for serum drug levels of Adderall. - ANSWER-A
significant percentage of individuals with adult ADHD show a moderate to marked
degree of improvement on central nervous system stimulant medication
Which of the following is the most important examination finding that requires additional
evaluation?
a. Acrochordon.
b. Hyperopia.
c. Palpable calf cords.
d. Verruca vulgaris. - ANSWER-Palpable calf cords
The driver reports taking Digoxin. What findings would raise the most significant
concerns regarding certification?
a. Arrhythmias.
b. Anorexia.
c. Nausea and vomiting.
d. Diarrhea. - ANSWER-Arrhythmias.
The driver is taking theophylline. Which of the following is not true?
a. Serum levels may be checked.
,b. The primary indication for theophylline is in the treatment of neurological conditions.
c. Cardiac toxicity is a significant risk of theophylline use.
d. Theophylline can be administered orally or intravenously (IV - ANSWER-The primary
indication for theophylline is in the treatment of neurological conditions.
The driver is taking Celexa and melatonin. The Medical Examiner should:
a. Advise the driver to only take these medications more than 12 hours before driving.
b. Advise the driver to stop melatonin as it can cause drowsiness.
c. Recommend an alternative to Celexa.
d. Advise the driver to discuss benzodiazepines as an alternative treatment. with the
driver's prescribing provider - ANSWER-Advise the driver to only take these
medications more than 12 hours before driving.
The driver tells the Medical Examiner he has recently been prescribed contact lenses.
He notes that after 3-4 hours of use the contacts cause irritation and he has to take
them out. The driver passes the vision test only with contacts and does not have
eyeglasses. The Medical Examiner should:
a. Advise the driver to carry a spare pair of contact lenses.
b. Certify the driver wearing corrective lenses.
c. Refer the driver for evaluation under the Alternative Vision Qualification standard.
d. Certify the driver without qualifications - ANSWER-Certify the driver wearing
corrective lenses.
The driver does not indicate any medical conditions on health history. During the exam
the Medical Examiner notes the presence of a hearing aid in one ear. The driver says
that he doesn't need the hearing aid to drive and doesn't think it should be required. The
next step for the Medical Examiner is:
a. Test the driver's hearing without the hearing aid.
b. Examine the driver's ears.
c. Refer the driver for hearing assessment by a specialist with specialized audiometric
testing capabilities for testing drivers while wearing a hearing aid. d. Certify the driver
with the qualification "wearing hearing aid - ANSWER-Test the driver's hearing without
the hearing aid.
A driver has an indication for obtaining a cardiac stress test. If the driver is not taking a
beta blocker, what is the percentage of maximum heart rate that the driver should meet
to indicate a satisfactory stress test:
a. 60%.
b. 75%.
c. 85%.
d. 100%. - ANSWER-85%
The driver is missing the 4th finger of his right hand. The Medical Examiner should:
a. Refer for orthopedic evaluation.
b. Indicate the driver will need a SPE Certificate.
c. Test the driver's grasp and prehension.
,d. Disqualify the driver - ANSWER-Test the driver's grasp and prehension.
The driver describes a history of dizzy spells. Which examination finding is not
indicated?
a. Test the driver for nystagmus.
b. Romberg testing.
c. Orthostatic blood pressure measurements.
d. Liver and spleen palpation - ANSWER-Liver and spleen palpation
Guidance (not regulatory) recommendations are that drivers with dizziness or vertigo
should not be qualified until the driver has achieved a 2-month symptom free interval
regardless of examination findings.
Vision testing may be performed by:
a. The Medical Examiner, an optometrist, or ophthalmologist.
b. Only an ophthalmologist.
c. Only the Medical Examiner.
d. Only an optometrist - ANSWER-The Medical Examiner, an optometrist, or
ophthalmologist
The driver has 1,000 ng/ml of glucose on urinalysis. What is the next appropriate step
for the Medical Examiner?
a. Disqualify the driver.
b. Refer the driver for evaluation by a kidney specialist.
c. Refer the driver for evaluation under the Insulin-Treated Diabetes Alternative
Qualification Standard.
d. Recommend the driver check blood glucose 4x per day. - ANSWER-Recommend the
driver check blood glucose 4x per day.
The driver presents after having had a PCI procedure 3 days prior. The driver indicates
no symptoms and has a letter from his cardiologist indicating he is cleared to drive. The
Medical Examiner should:
a. Have the driver return for evaluation at least 3 weeks after the date of the PCI.
b. Refer the driver for a cardiac stress test.
c. Certify the driver for 6 months.
d. Certify the driver for 2 years - ANSWER-Have the driver return for evaluation at least
3 weeks after the date of the PCI
- Current FMCSA guidelines in the reference table in the 2022 Draft version of the
Medical Examiner's Handbook include: Asymptomatic; Minimum 3 weeks after elective
procedure; LVEF > 40%; Adherence to cardiovascular specialist-recommended
appropriate medical therapy for a minimum of 1 year after receiving drug-eluting stent;
Clearance by cardiologist.
The driver describes alcohol use including 2 drinks a night during the week and a 6
pack on the weekends. The Medical Examiner's next step should be to:
, a. Refer the driver for evaluation by a substance abuse professional.
b. Further assess the driver's history of and current use of alcohol.
c. Disqualify the driver.
d. Test the driver for drugs and alcohol - ANSWER-Further assess the driver's history of
and current use of alcohol
What is the driver required to sign for on MCSA-5875?
a. Health history.
b. Release of information.
c. Acknowledgement of testing results.
d. Acceptance of the Medical Examiner's certification determination - ANSWER-Health
history.
What is appropriate preparation for the physical examination?
a. Dress and stockings.
b. Examination gown and underwear.
c. Shorts and tennis shoes.
d. Loose fitting clothing. - ANSWER-Examination gown and underwear
The driver has a history of coronary artery bypass grafting (CABG) 3 years ago. He is
now describing shortness of breath. The Medical Examiner's next step is:
a. Refer the driver for cardiac stress testing.
b. Refer the driver for cardiology evaluation.
c. Disqualify the driver.
d. Assess cardiac risk factors and further characterize the driver's symptoms -
ANSWER-Assess cardiac risk factors and further characterize the driver's symptoms
Which of the following should raise the greatest concern for the Medical Examiner's
assessment?
a. History of lumbar fusion 2 years ago.
b. Grade 1 ankle sprain 1 month ago.
c. Prepatellar bursitis 3 months ago.
d. Rotator cuff injury 6 months ago. - ANSWER-Grade 1 ankle sprain 1 month ago.
The driver smokes and describes long hours of prolonged driving. Which of the
following is the most important condition or symptom that the Medical Examiner should
discuss with the driver?
a. Fatigue.
b. COPD.
c. Deep vein thrombosis and possible pulmonary embolus.
d. Acute cardiac conditions - ANSWER-Deep vein thrombosis and possible pulmonary
embolus
