NRCME DOT Medical Examiner Certification Exam
Preparation Guide: Comprehensive Test Bank with 400
Practice Questions, Verified Answers, and Detailed
Rationales
What are the 3 points of contact when entering/exiting a cab? - Answer - -hands
-arms
-leg
What is the minimum passing grip strength required when using a dynamometer? -
Answer - -58 lbs
-26.3 kgs
Can those with peripheral neuropathy be certified? - Answer - -do not certify!
-inform the patient they can submit an appeal which will require evaluation by a
physiatrist or neurologist
Can those with autonomic neuropathy be certified? - Answer - -if they have resting
tachycardia do not certify!
-if no resting tachycardia they can be certified for up to 2 years once etiology is
confirmed and treatment is safe/effective
Can those who are taking nitroglycerin be certified? - Answer - -only if angina is
stable
-requires cardiology evaluation
Can those with menieres disease be certified? - Answer - -no!
,What are 3 neurologic conditions that are always disqualifying? - Answer - -
myotonia
-Isaac's syndrome
-stiff person syndrome
What 3 factors are considered as part of the Council for Psychiatric Disease and
Commercial Driving? - Answer - -psychopharmacology
-counseling
-mental disorders
The sedative effects of psychotropic medications are compared to what blood
alcohol content? - Answer - -0.04
Which psychiatric condition is most likely to be disqualifying? - Answer - -
schizophrenia
What are the elements of the CAGE assessment? - Answer - -cut down (do you
feel the need to?)
-annoyed (are you annoyed by the response of others?)
-guilt (do you feel guilty about drinking?)
-eye opener (do you need one?)
What should you do if a candidate is visibley drunk on exam? - Answer - -contact
FMCSA or employer
-should not certify if you suspect alcoholism
Can you certify a driver who is actively in a 12-step or recovery program? -
Answer - -yes!
,When should you submit a candidate to drug/alcohol testing? - Answer - -not part
of the standard DOT exam
-only performed if required by the employer or another regulatory agency
What is the 1st indication of diabetic nephropathy? - Answer - -persistent
proteinuria on urine dipstick
-can certify for 2 years if etiology confirmed and treatment is safe and effective
How often does a candidate with a hernia require examination? - Answer - -
requires at least biennial medical exam
-must check for visceral/GU/abdominal hernia(s) on exam
-if painful they require further evaluation but can then be certified for up to 2 years
if appropriate
What should you do with a candidate who has abnormal urine dipstick findings? -
Answer - -refer back to primary care for evaluation and treatment
Can you certify a candidate who is using medial marijuana? - Answer - -no!
What should you do with a candidate who is using a disqualifying medication? -
Answer - -refer back to primary care
-they can still be qualified if approved by primary care but the ultimate decision is
left up to the medical examiner
-can certify for any time period you deem appropriate
Can a patient on anticoagulants be certified? - Answer - -if taking for
neurovascular condition then no!
, -if taking for cardiovascular condition then yes
-requires monthly INR checks to maintain certification
Can a patient with migraines be certified? - Answer - -yes they can be certified for
up to 2 years
-depends on the severity of symptoms and any associated symptoms they are
having (e.g. visual disturbances)
-must tolerate treatment
Can a patient taking antacids be certified? - Answer - -yes
-ensure there are no acute incapacitating events associated with the underlying
disease (e.g. IBD)
Can a patient taking anticonvulsants for seizures be certified? - Answer - -no!
Can a patient taking Provigil (modafinil) be certified? - Answer - -yes but only for
1 year max and only after a 6 week monitoring period
What 3 environmental factors are candidates exposed to? - Answer - -whole body
vibration
-temperature extremes
-excessive noise
What are the ETT qualification standards? - Answer - -workload >6 METS
-% predicated max HR >85%
-increase SBP >20 mmHg
-no angina
Preparation Guide: Comprehensive Test Bank with 400
Practice Questions, Verified Answers, and Detailed
Rationales
What are the 3 points of contact when entering/exiting a cab? - Answer - -hands
-arms
-leg
What is the minimum passing grip strength required when using a dynamometer? -
Answer - -58 lbs
-26.3 kgs
Can those with peripheral neuropathy be certified? - Answer - -do not certify!
-inform the patient they can submit an appeal which will require evaluation by a
physiatrist or neurologist
Can those with autonomic neuropathy be certified? - Answer - -if they have resting
tachycardia do not certify!
-if no resting tachycardia they can be certified for up to 2 years once etiology is
confirmed and treatment is safe/effective
Can those who are taking nitroglycerin be certified? - Answer - -only if angina is
stable
-requires cardiology evaluation
Can those with menieres disease be certified? - Answer - -no!
,What are 3 neurologic conditions that are always disqualifying? - Answer - -
myotonia
-Isaac's syndrome
-stiff person syndrome
What 3 factors are considered as part of the Council for Psychiatric Disease and
Commercial Driving? - Answer - -psychopharmacology
-counseling
-mental disorders
The sedative effects of psychotropic medications are compared to what blood
alcohol content? - Answer - -0.04
Which psychiatric condition is most likely to be disqualifying? - Answer - -
schizophrenia
What are the elements of the CAGE assessment? - Answer - -cut down (do you
feel the need to?)
-annoyed (are you annoyed by the response of others?)
-guilt (do you feel guilty about drinking?)
-eye opener (do you need one?)
What should you do if a candidate is visibley drunk on exam? - Answer - -contact
FMCSA or employer
-should not certify if you suspect alcoholism
Can you certify a driver who is actively in a 12-step or recovery program? -
Answer - -yes!
,When should you submit a candidate to drug/alcohol testing? - Answer - -not part
of the standard DOT exam
-only performed if required by the employer or another regulatory agency
What is the 1st indication of diabetic nephropathy? - Answer - -persistent
proteinuria on urine dipstick
-can certify for 2 years if etiology confirmed and treatment is safe and effective
How often does a candidate with a hernia require examination? - Answer - -
requires at least biennial medical exam
-must check for visceral/GU/abdominal hernia(s) on exam
-if painful they require further evaluation but can then be certified for up to 2 years
if appropriate
What should you do with a candidate who has abnormal urine dipstick findings? -
Answer - -refer back to primary care for evaluation and treatment
Can you certify a candidate who is using medial marijuana? - Answer - -no!
What should you do with a candidate who is using a disqualifying medication? -
Answer - -refer back to primary care
-they can still be qualified if approved by primary care but the ultimate decision is
left up to the medical examiner
-can certify for any time period you deem appropriate
Can a patient on anticoagulants be certified? - Answer - -if taking for
neurovascular condition then no!
, -if taking for cardiovascular condition then yes
-requires monthly INR checks to maintain certification
Can a patient with migraines be certified? - Answer - -yes they can be certified for
up to 2 years
-depends on the severity of symptoms and any associated symptoms they are
having (e.g. visual disturbances)
-must tolerate treatment
Can a patient taking antacids be certified? - Answer - -yes
-ensure there are no acute incapacitating events associated with the underlying
disease (e.g. IBD)
Can a patient taking anticonvulsants for seizures be certified? - Answer - -no!
Can a patient taking Provigil (modafinil) be certified? - Answer - -yes but only for
1 year max and only after a 6 week monitoring period
What 3 environmental factors are candidates exposed to? - Answer - -whole body
vibration
-temperature extremes
-excessive noise
What are the ETT qualification standards? - Answer - -workload >6 METS
-% predicated max HR >85%
-increase SBP >20 mmHg
-no angina
