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National Registry of Certified Medical Examiners, FMCSA — NRCME test bank questions and answers for DOT medical examiner certification

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This document is a multiple-choice test bank with correct answers for the DOT medical examiner certification topics covered under the NRCME/Federal Motor Carrier Safety Administration guidance. It reviews high-yield certification rules and disqualifiers across conditions like diabetes (including exemptions and hypoglycemia risk), urinalysis findings, kidney disease and dialysis, substance use and DOT alcohol/drug regulations, vision and hearing standards, and hypertension staging and certification intervals. Each question includes the correct option and a brief rationale, making it useful for rapid review and exam-style self-testing.

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Institution
Nrcme
Course
Nrcme

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National-Registry-of-Certified-Medical-Examiners-(NRCME)-
TEST-BANK-QUESTIONS-&-ANSWERS
1. Which-of-the-following-is-a-requirement-for-drivers-with-a-diabetes-exemption?
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---CORRECT-ANSWER-
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-
certification
C) Cannot-be-certified-if-they-have-a-history-of-myocardial-infarction
D) May-be-eligible-for-a-diabetes-exemption---CORRECT-ANSWER-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-
requirements-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---
CORRECT-ANSWER-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---CORRECT-ANSWER-C)-Drivers-with-non-insulin-
dependent-diabetes-should-be-certified-for-a-maximum-of-one-year

,National-Registry-of-Certified-Medical-Examiners-(NRCME)-
TEST-BANK-QUESTIONS-&-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---CORRECT-ANSWER-D)-Only-the-FMCSA-can-grant-
exemptions

6. A-driver-with-diabetes-mellliktus-who-uses-insulin-is-determined-to-be-
otherwise-medically-qualified.-The-medical-examiner-must-indicate-that-a-
diabetes-exemption-is-required-on-the-:
A) Medical-Examination-Report-status-section-and-Medical-Examiners-
Certificate
B) Letter-to-the-FMCSA
C) Employer-authorization-form
D) Endocrinology-consultation-form---CORRECT-ANSWER-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---CORRECT-ANSWER-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---CORRECT-ANSWER-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

,National-Registry-of-Certified-Medical-Examiners-(NRCME)-
TEST-BANK-QUESTIONS-&-ANSWERS
B) Dizziness
C) Need-of-assistance-from-another-person
D) Period-of-impaired-cognitive-function-that-occurred-without-warning---
CORRECT-ANSWER-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---CORRECT-ANSWER-C)-Although-
hyperglycemia,-peripheral-neuropathy,-and-metabolic-encephalopathy-
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---CORRECT-ANSWER-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-
accidents
D) The-maximum-certification-interval-for-a-driver-with-a-hernia-is-two-
years---CORRECT-ANSWER-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-

, National-Registry-of-Certified-Medical-Examiners-(NRCME)-
TEST-BANK-QUESTIONS-&-ANSWERS
determines-that-treatment-is-safe-and-effective,-and-that-the-condition-is-
stable.-No-evidence-has-linked-hernias-of-any-type-to-increased-CMV-
accident-risk.

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---CORRECT-ANSWER-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---CORRECT-ANSWER-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---CORRECT-ANSWER-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

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Uploaded on
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Number of pages
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Written in
2025/2026
Type
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Questions & answers

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