NRCME TEST EXAM 2024/2025 LATEST UPDATE

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 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. - CORRECT ANSWER 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 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 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 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. Provide the driver with a "CAGE" questionnaire to determine if he suffers from alcoholism. b. c. Certify the driver with a 1-time, 3-month certificate to determine if there is any effect on the driver's ability to drive a CMV. d. Require a skill performance evaluation to ascertain if the driver has any limitations with driving. - CORRECT ANSWER Correct answer is "B". The driver exhibits what may be considered a "flat affect" which is seen in schizophrenia and in severe depression. The driver should be evaluated by a mental health expert to make a diagnosis prior to certification. A driver admits to the use of marijuana for the treatment of his glaucoma, which is legal in the State in which he lives. He provides medical documentation for the glaucoma indicating he is able to drive a truck. He began using the marijuana about three months ago. His current medical card has no limitations listed and is for 2 years. His certification examination is within normal limits. The medical examiner should: a. Disqualify the driver. b. Perform a urine drug collection and provide the release from the testing provider. c. Certify the driver for 1 year. d. Certify the driver for 2 years. - CORRECT ANSWER Correct answer is "A". Use of marijuana is prohibited by Federal law while driving a CMV and trumps State law in this matter. A driver has a blood pressure of 136/92 mm Hg. This is: a. Within normal limits and would not affect the driver's certification. b. Stage 1 Hypertension. c. Stage 2 Hypertension. d. Stage 3 Hypertension. - CORRECT ANSWER Correct answer is "B". This is Stage 1 Hypertension, which is defined as 140-159/90 - 99. A driver is taking Celexa for the treatment of what he calls a "mild depression." He reports he has not considered or attempted suicide. The examiner should? a.Temporarily disqualify the driver until he obtains written clearance for the depression and the medication from the treating provi b. Certify the driver for a period of 1 year. c. Certify the driver for a period of 2 years. d. Disqualify the driver until he is no longer requiring medication for the treatment of depression. - CORRECT ANSWER Correct answer is "A". Medical clearance is required for all mental health disorders. Celexa is an SSRI or 2nd Generation anti-depressant and is acceptable. A driver reports that he had a hunting accident wherein he suffered a left orbital fracture. He presents a note at the time of the examination from an ophthalmologist stating "may drive". His exam is unremarkable except for a limitation in peripheral vision in his left eye, which was inconclusive. His distance vision was 20/20 right and 20/40 left. The medical examiner should? a. Council the driver on the need for a vision exemption.