NRCME Test Bank Questions 2026/2027 – Commercial Driver Medical Certification | Verified Q&A with Rationales (Latest FMCSA Guidelines)

,NRCME Test Bank Questions 2026/2027 Latest
Update – Commercial Driver Medical
Certification | Verified Q&A with Rationales


Question 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
Rationale: 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.




Question 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
Rationale: Drivers with insulin dependent diabetes cannot be certified but may be
eligible for a diabetes exemption.




Question 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 concern 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
Rationale: The greatest risk for medication use for drivers with diabetes is
hypoglycemia, not hyperglycemia. Peripheral neuropathy is a disqualifying condition.
Diabetes is a CHD equivalent condition.




Question 4
What is the recommended certification interval for a driver with diabetes mellitus who
does not use insulin?
A) Three months
B) Six months
C) One year
D) Two years
Correct Answer: C
Rationale: Drivers with non-insulin dependent diabetes should be certified for a
maximum of one year.




Question 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
Rationale: Only the FMCSA can grant exemptions.




Question 6
A driver with diabetes mellitus 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 Examiner's Certificate
B) Letter to the FMCSA

, C) Employer authorization form
D) Endocrinology consultation form
Correct Answer: A
Rationale: Exemption requirements must be noted on the Medical Examination
Report status section and the Medical Examiner's Certificate.




Question 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
Rationale: The medical examiner should first determine blood glucose and then make
an appropriate certification determination and referral.




Question 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 certified.
A) one, three
B) one, two
C) two, three
D) two, five
Correct Answer: B
Rationale: 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.




Question 9
Which of the following is not a criteria that the FMCSA uses to define a severe
hypoglycemic reaction?
A) Seizure
B) Dizziness