NRCME Test BaNK exam complete questions and verified answers
1. Which of the following is a requirement for drivers with a diabetes exemp-
tion?
A) Possess a rapidly absorbable form of glucose while driving
B) Self—monitor blood glucose one hour before driving and at least once every
2 hours while driving
C) Plan to submit blood glucose monitoring logs every 6 months
D) Maintain a Hemoglobin A1C value less than 7: A. Drivers with diabetes should self monitor
blood glucose before driving and every 4 hours while driving. Blood glucose monitoring logs should be submitted
annually. There is no specific requirement for HgA1C level.
2. Drivers with insulin dependent diabetes:
A) May be certified for a maximum of 6 months
B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certifica-
tion
C) Cannot be certified if they have a history of myocardial infarction
D) May be eligible for a diabetes exemption: D) Drivers with insulin dependent diabetes cannot
be certified but may be eligible for a diabetes exemption
3. Which of the following is true?
A) A driver with diabetes who uses insulin does not meet the minimum require-
ments of 49 CFR Part 391.41
B) The most important concert related to medication use for treating diabetes
is hyperglycemia
C) Peripheral neuropathy is not a disqualifying condition
D) Diabetes is not a coronary heart disease (CHD) equivalent condition: A) The
greatest risk for medication use for drivers with diabetes in hypoglycemia, not hyperglycemia. Peripheral neuropathy
is disqualifying condition. Diabetes is a CHD equivalent condition.
4. What is the recommended certification interval for a driver with diabetes
mellituse who does not use insulin?
A) Three months
B) Six months
C) One year
D) Two years: C) Drivers with non-insulin dependent diabetes should be certified for a maximum of one year
, NRCME Test BaNK exam complete questions and verified answers
5. A diabetes exemption may be issued by:
A) An endocrinologist
B) The Medical Examiner
C) The driver's personal physician
D) The FMCSA: D) Only the FMCSA can grant exemptions
6. A driver with diabetes mellliktus who uses insulin is determined to be other-
wise medically qualified. The medical examiner must indicate that a diabetes
exemption is required on the :
A) Medical Examination Report status section and Medical Examiners Certifi-
cate
B) Letter to the FMCSA
C) Employer authorization form
D) Endocrinology consultation form: A) Exemption requirements must be noted on the Medical
Examination Report status section and the Medical Examiners Certificate
7. If glucose is detected on urinalysis in a driver with no history of diabetes, an
appropriate next step is:
A) Endocrinology consultation
B) One year clearance and recommendation to see personal physician
C) Fingerstick or blood glucose determination
D) Temporary disqualification: C) The medical examiner should first determine blood glucose and then
make an appropriate certification determination and referral
8. Drivers with a history of severe hypoglycemic reactions in the
past year or severe hypoglycemic reactions in the past five years
should not be certifed.
A) one, three
B) one, two
C) two, three
D) two, five: B) A driver should not be certified if the driver has had one hypoglycemic reaction in the past year
or two in the past five years.
9. Which of the following is not a criteria that the FMCSA uses to define a severe
hypoglycemic reaction?
A) Seizure
, NRCME Test BaNK exam complete questions and verified answers
B) Dizziness
C) Need of assistance from another person
D) Period of impaired cognitive function that occurred without warning: B) FMCSA
defines severe hypoglycemia as reactions that result in seizure, loss of consciousness, need of assistance from another
person, and a period of impaired congitive function that occurred without warning
10. Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy: C) Although hyperglycemia, peripheral neuropathy, and metabolic en-
cephalopathy all pose significant risks for safe driving, hypoglycemia poses the greatest risk. The risk is particularly
pronounced in drivers who use insulin. FMCSA defines a hypoglycemia episode as one that results in seizure, loss of
consciousness, need of assistance from another person, or a period of impaired cognitive function that occurs without
warning.
11. A driver with a diabetes exemption should check glucose levels when?
A) One hour before driving and at least once every four hours while driving
B) One hour before driving and at least every eight hours while driving
C) Once after four hours of driving
D) Once a day after driving period has ended: A) Driver's with diabetes exemption should check
glucose values one hour before driving and once every four hours while driving
12. Which of the following is true for diagnosis of a hernia?
A) The driver should be referred to a surgeon to determine whether repair of
a hernia is necessary
B) The waiting period following hernia surgery is two weeks
C) Inguinal hernias have been associated with an increased risk for CMV acci-
dents
D) The maximum certification interval for a driver with a hernia is two years: D)
The medical examiner can use his/her judgment as to whether a driver should be referred to a surgeon or other
specialist. There is no specified waiting period following hernia surgery - the driver should not be certified until the
medical examiner determines that treatment is safe and ettective, and that the condition is stable. No evidence has
linked hernias of any type to increased CMV accident risk.
, NRCME Test BaNK exam complete questions and verified answers
13. Which of the following is true of nephropathy?
A) Nephropathy is a disqualifying condition
B) The maximum certification interval for nephropathy is two years
C) A driver with 3+ proteinuria should not be certified
D) A renal specialist should make the certification determination for a driver
with nephropathy: B) Nephropathy is considered on a case-by-case basis. The medical examiner determines
what evaluation or monitoring is necessary for a driver with 3+ proteinuria and may disqualify the driver. The certification
is always made by the medical examiner and cannot be deferred to a specialist.
14. Drivers with which of the following conditions should be disqualified?
A) Cancer requiring chemotherapy treatment
B) Umbilical hernia not surgically repaired
C) Renal failure on peritoneal dialysis
D) Hemochromatosis: C) Dialysis of any type is disqualifying
15. If a significant abnormal finding for urinalysis specific gravity, protein, or
blood is found, the medical examiner should:
A) Disqualify the driver
B) Request that a renal specialist determine if the driver is medically qualified
C) Use clinical expertise to determine a certification decision and to determine
if additional evaluation is required or recommended
D) Obtain blood chemistries for renal function: C) The medical examiner must determine
whether additional evaluation is needed and whether the certification decision should be postponed or limited
16. A driver with a history of kidney disease with or without transplant:
A) Is medically disqualified
B) Must be assessed regarding the severity, stability, medications used, and
medication side effects/adverse reactions
C) Should not be assessed for functional ability to operate a CMV safely
D) Should have the medical certificaton determination made by a renal special-
ist: B) ASsessment for kidney disease must be ade on a case-by-case basis. Dialysis of any kind is disqualifying. The
medical examiner may choose to test the driver for functional ability to operate a CMV safely. The medical certification
decision must be made by the medical examiner.
17. Which of the following is not a disqualifying condition?
A) Peritoneal dialysis
1. Which of the following is a requirement for drivers with a diabetes exemp-
tion?
A) Possess a rapidly absorbable form of glucose while driving
B) Self—monitor blood glucose one hour before driving and at least once every
2 hours while driving
C) Plan to submit blood glucose monitoring logs every 6 months
D) Maintain a Hemoglobin A1C value less than 7: A. Drivers with diabetes should self monitor
blood glucose before driving and every 4 hours while driving. Blood glucose monitoring logs should be submitted
annually. There is no specific requirement for HgA1C level.
2. Drivers with insulin dependent diabetes:
A) May be certified for a maximum of 6 months
B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certifica-
tion
C) Cannot be certified if they have a history of myocardial infarction
D) May be eligible for a diabetes exemption: D) Drivers with insulin dependent diabetes cannot
be certified but may be eligible for a diabetes exemption
3. Which of the following is true?
A) A driver with diabetes who uses insulin does not meet the minimum require-
ments of 49 CFR Part 391.41
B) The most important concert related to medication use for treating diabetes
is hyperglycemia
C) Peripheral neuropathy is not a disqualifying condition
D) Diabetes is not a coronary heart disease (CHD) equivalent condition: A) The
greatest risk for medication use for drivers with diabetes in hypoglycemia, not hyperglycemia. Peripheral neuropathy
is disqualifying condition. Diabetes is a CHD equivalent condition.
4. What is the recommended certification interval for a driver with diabetes
mellituse who does not use insulin?
A) Three months
B) Six months
C) One year
D) Two years: C) Drivers with non-insulin dependent diabetes should be certified for a maximum of one year
, NRCME Test BaNK exam complete questions and verified answers
5. A diabetes exemption may be issued by:
A) An endocrinologist
B) The Medical Examiner
C) The driver's personal physician
D) The FMCSA: D) Only the FMCSA can grant exemptions
6. A driver with diabetes mellliktus who uses insulin is determined to be other-
wise medically qualified. The medical examiner must indicate that a diabetes
exemption is required on the :
A) Medical Examination Report status section and Medical Examiners Certifi-
cate
B) Letter to the FMCSA
C) Employer authorization form
D) Endocrinology consultation form: A) Exemption requirements must be noted on the Medical
Examination Report status section and the Medical Examiners Certificate
7. If glucose is detected on urinalysis in a driver with no history of diabetes, an
appropriate next step is:
A) Endocrinology consultation
B) One year clearance and recommendation to see personal physician
C) Fingerstick or blood glucose determination
D) Temporary disqualification: C) The medical examiner should first determine blood glucose and then
make an appropriate certification determination and referral
8. Drivers with a history of severe hypoglycemic reactions in the
past year or severe hypoglycemic reactions in the past five years
should not be certifed.
A) one, three
B) one, two
C) two, three
D) two, five: B) A driver should not be certified if the driver has had one hypoglycemic reaction in the past year
or two in the past five years.
9. Which of the following is not a criteria that the FMCSA uses to define a severe
hypoglycemic reaction?
A) Seizure
, NRCME Test BaNK exam complete questions and verified answers
B) Dizziness
C) Need of assistance from another person
D) Period of impaired cognitive function that occurred without warning: B) FMCSA
defines severe hypoglycemia as reactions that result in seizure, loss of consciousness, need of assistance from another
person, and a period of impaired congitive function that occurred without warning
10. Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy: C) Although hyperglycemia, peripheral neuropathy, and metabolic en-
cephalopathy all pose significant risks for safe driving, hypoglycemia poses the greatest risk. The risk is particularly
pronounced in drivers who use insulin. FMCSA defines a hypoglycemia episode as one that results in seizure, loss of
consciousness, need of assistance from another person, or a period of impaired cognitive function that occurs without
warning.
11. A driver with a diabetes exemption should check glucose levels when?
A) One hour before driving and at least once every four hours while driving
B) One hour before driving and at least every eight hours while driving
C) Once after four hours of driving
D) Once a day after driving period has ended: A) Driver's with diabetes exemption should check
glucose values one hour before driving and once every four hours while driving
12. Which of the following is true for diagnosis of a hernia?
A) The driver should be referred to a surgeon to determine whether repair of
a hernia is necessary
B) The waiting period following hernia surgery is two weeks
C) Inguinal hernias have been associated with an increased risk for CMV acci-
dents
D) The maximum certification interval for a driver with a hernia is two years: D)
The medical examiner can use his/her judgment as to whether a driver should be referred to a surgeon or other
specialist. There is no specified waiting period following hernia surgery - the driver should not be certified until the
medical examiner determines that treatment is safe and ettective, and that the condition is stable. No evidence has
linked hernias of any type to increased CMV accident risk.
, NRCME Test BaNK exam complete questions and verified answers
13. Which of the following is true of nephropathy?
A) Nephropathy is a disqualifying condition
B) The maximum certification interval for nephropathy is two years
C) A driver with 3+ proteinuria should not be certified
D) A renal specialist should make the certification determination for a driver
with nephropathy: B) Nephropathy is considered on a case-by-case basis. The medical examiner determines
what evaluation or monitoring is necessary for a driver with 3+ proteinuria and may disqualify the driver. The certification
is always made by the medical examiner and cannot be deferred to a specialist.
14. Drivers with which of the following conditions should be disqualified?
A) Cancer requiring chemotherapy treatment
B) Umbilical hernia not surgically repaired
C) Renal failure on peritoneal dialysis
D) Hemochromatosis: C) Dialysis of any type is disqualifying
15. If a significant abnormal finding for urinalysis specific gravity, protein, or
blood is found, the medical examiner should:
A) Disqualify the driver
B) Request that a renal specialist determine if the driver is medically qualified
C) Use clinical expertise to determine a certification decision and to determine
if additional evaluation is required or recommended
D) Obtain blood chemistries for renal function: C) The medical examiner must determine
whether additional evaluation is needed and whether the certification decision should be postponed or limited
16. A driver with a history of kidney disease with or without transplant:
A) Is medically disqualified
B) Must be assessed regarding the severity, stability, medications used, and
medication side effects/adverse reactions
C) Should not be assessed for functional ability to operate a CMV safely
D) Should have the medical certificaton determination made by a renal special-
ist: B) ASsessment for kidney disease must be ade on a case-by-case basis. Dialysis of any kind is disqualifying. The
medical examiner may choose to test the driver for functional ability to operate a CMV safely. The medical certification
decision must be made by the medical examiner.
17. Which of the following is not a disqualifying condition?
A) Peritoneal dialysis
