NRCME (DOT) Exam Prep 2026 Medical
Examiner Certification – 200 Practice Questions
with Detailed Explanation FMCSA National
Registry Review Guide
Overview
This comprehensive 200-question NRCME (DOT) Exam Prep guide is designed to fully
prepare medical professionals for the National Registry of Certified Medical Examiners
(NRCME) Certification Exam. Each question is written in true FMCSA/NRCME style,
covering all domains tested on the exam, and includes bolded correct answers with concise
rationales for rapid review and reinforcement of key concepts.
The guide is organized into eight core sections:
1. FMCSA Regulations & NRCME Responsibilities (Questions 1–30)
o Examines certification requirements, registry rules, exam documentation, and
examiner duties.
2. DOT Physical Examination Standards (Questions 31–50)
o Covers vision, hearing, BP, urinalysis, height/weight, medications, and functional
assessment.
3. Cardiovascular Conditions (Questions 51–80)
o Includes hypertension, coronary artery disease, post-MI, arrhythmias,
pacemakers, and heart failure.
4. Respiratory Disorders & Sleep Apnea (Questions 81–105)
o Covers COPD, asthma, OSA, hypoxia, CPAP compliance, and other pulmonary
conditions.
5. Diabetes & Metabolic Disorders (Questions 106–115)
o Addresses insulin-treated and oral diabetes, hypoglycemia, neuropathy, and
certification considerations.
6. Neurological Conditions (Questions 116–130)
o Covers seizures, stroke, TIA, Parkinson’s, dementia, vertigo, migraines, and CNS
effects of medications.
7. Mental Health Conditions (Questions 131–155)
o Includes depression, anxiety, bipolar disorder, psychosis, PTSD, ADHD, and
functional assessment for driving.
8. Substance Use, Vision, Hearing & Administrative Rules (Questions 156–200)
o Covers alcohol, drugs, vision/hearing standards, certification forms, electronic
reporting, record retention, examiner responsibilities, and FMCSA compliance.
,SECTION 1: FMCSA REGULATIONS & NRCME RESPONSIBILITIES
(Start of the 200-question exam)
1. The primary purpose of the NRCME program is to ensure
that:
A. Drivers receive free medical exams
B. Employers determine driver fitness
C. Medical examiners apply uniform FMCSA medical standards
D. Drivers self-report medical conditions
Correct Answer: C
Rationale: The NRCME ensures consistent application of FMCSA
medical standards nationwide.
2. How often must a certified medical examiner renew NRCME
certification?
A. Every year
B. Every 5 years
C. Every 10 years
D. Only once
Correct Answer: C
Rationale: FMCSA requires NRCME recertification every 10
years with periodic training updates.
,3. A DOT medical certificate (MEC) may be issued for a
maximum of:
A. 6 months
B. 12 months
C. 24 months
D. 36 months
Correct Answer: C
Rationale: The maximum certification period allowed by
FMCSA is 24 months if no disqualifying conditions exist.
4. Who is ultimately responsible for determining medical
fitness for duty?
A. The employer
B. The driver
C. The certified medical examiner
D. FMCSA headquarters
Correct Answer: C
Rationale: The certified medical examiner makes the final
certification decision based on FMCSA guidelines.
5. Which form documents the results of the DOT physical
exam?
A. DOT-5
B. MCSA-5875
, C. MCSA-5880
D. CDL-FMCSA
Correct Answer: B
Rationale: Form MCSA-5875 is the Medical Examination Report
(MER).
6. The Medical Examiner’s Certificate is documented on which
form?
A. MCSA-5875
B. MCSA-5876
C. DOT-201
D. NRCME-10
Correct Answer: B
Rationale: MCSA-5876 is the official Medical Examiner’s
Certificate (MEC).
7. True or False:
Medical examiners must transmit exam results to FMCSA by
midnight of the next calendar day.
Answer: True
Rationale: FMCSA requires electronic submission within 24
hours.
Examiner Certification – 200 Practice Questions
with Detailed Explanation FMCSA National
Registry Review Guide
Overview
This comprehensive 200-question NRCME (DOT) Exam Prep guide is designed to fully
prepare medical professionals for the National Registry of Certified Medical Examiners
(NRCME) Certification Exam. Each question is written in true FMCSA/NRCME style,
covering all domains tested on the exam, and includes bolded correct answers with concise
rationales for rapid review and reinforcement of key concepts.
The guide is organized into eight core sections:
1. FMCSA Regulations & NRCME Responsibilities (Questions 1–30)
o Examines certification requirements, registry rules, exam documentation, and
examiner duties.
2. DOT Physical Examination Standards (Questions 31–50)
o Covers vision, hearing, BP, urinalysis, height/weight, medications, and functional
assessment.
3. Cardiovascular Conditions (Questions 51–80)
o Includes hypertension, coronary artery disease, post-MI, arrhythmias,
pacemakers, and heart failure.
4. Respiratory Disorders & Sleep Apnea (Questions 81–105)
o Covers COPD, asthma, OSA, hypoxia, CPAP compliance, and other pulmonary
conditions.
5. Diabetes & Metabolic Disorders (Questions 106–115)
o Addresses insulin-treated and oral diabetes, hypoglycemia, neuropathy, and
certification considerations.
6. Neurological Conditions (Questions 116–130)
o Covers seizures, stroke, TIA, Parkinson’s, dementia, vertigo, migraines, and CNS
effects of medications.
7. Mental Health Conditions (Questions 131–155)
o Includes depression, anxiety, bipolar disorder, psychosis, PTSD, ADHD, and
functional assessment for driving.
8. Substance Use, Vision, Hearing & Administrative Rules (Questions 156–200)
o Covers alcohol, drugs, vision/hearing standards, certification forms, electronic
reporting, record retention, examiner responsibilities, and FMCSA compliance.
,SECTION 1: FMCSA REGULATIONS & NRCME RESPONSIBILITIES
(Start of the 200-question exam)
1. The primary purpose of the NRCME program is to ensure
that:
A. Drivers receive free medical exams
B. Employers determine driver fitness
C. Medical examiners apply uniform FMCSA medical standards
D. Drivers self-report medical conditions
Correct Answer: C
Rationale: The NRCME ensures consistent application of FMCSA
medical standards nationwide.
2. How often must a certified medical examiner renew NRCME
certification?
A. Every year
B. Every 5 years
C. Every 10 years
D. Only once
Correct Answer: C
Rationale: FMCSA requires NRCME recertification every 10
years with periodic training updates.
,3. A DOT medical certificate (MEC) may be issued for a
maximum of:
A. 6 months
B. 12 months
C. 24 months
D. 36 months
Correct Answer: C
Rationale: The maximum certification period allowed by
FMCSA is 24 months if no disqualifying conditions exist.
4. Who is ultimately responsible for determining medical
fitness for duty?
A. The employer
B. The driver
C. The certified medical examiner
D. FMCSA headquarters
Correct Answer: C
Rationale: The certified medical examiner makes the final
certification decision based on FMCSA guidelines.
5. Which form documents the results of the DOT physical
exam?
A. DOT-5
B. MCSA-5875
, C. MCSA-5880
D. CDL-FMCSA
Correct Answer: B
Rationale: Form MCSA-5875 is the Medical Examination Report
(MER).
6. The Medical Examiner’s Certificate is documented on which
form?
A. MCSA-5875
B. MCSA-5876
C. DOT-201
D. NRCME-10
Correct Answer: B
Rationale: MCSA-5876 is the official Medical Examiner’s
Certificate (MEC).
7. True or False:
Medical examiners must transmit exam results to FMCSA by
midnight of the next calendar day.
Answer: True
Rationale: FMCSA requires electronic submission within 24
hours.
