NRCME TEST BANK 2025
NRCME TEST BANK 2025/2026
COMPLETE ALL 400 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES |ALREADY GRADED A+||
ALREADY GRADED A+
A driver complains of slow progressive diminished distance visual acuity and glare
particularly at night from oncoming headlights and decreased contrast. The most
likely cause is:
a.Macular degeneration.
b.Cataracts.
c.Glaucoma.
d.Retinopathy.
Correct answer is "B". Cataract formation causes diminished visual acuity in all
fields, and night glare from headlights is one of the first changes to appear. Near
vision may 𝑏e improved.
A driver with dia𝑏etes reports partial loss of central vision, color discrimination, and
o𝑏scured vision in other vision fields. The most likely cause is:
a.Macular degeneration.
b.Cataracts.
c.Glaucoma.
d.Retinopathy.
Correct answer is "D". Dia𝑏etes is the most common cause of retinopathy. Partial loss
of central and o𝑏scured vision in other fields possi𝑏le. Color discrimination also
affected.
A driver with a current medical certificate that does not expire for another year had
an injury that interfered with his a𝑏ility to drive. What is the next step?
a.The driver can return to duty once healed.
b.The driver can return to duty once released 𝑏y the treating physician.
c.The motor carrier may require the driver to return to the ME for evaluation.
d.The driver must return to the ME for a medical examination.
Correct answer is "D". When a driver returns from an illness or injury that interferes
with driving a𝑏ility, the driver must undergo a medical examination even if the
medical examiner's certificate has not expired.
A driver admits to regularly taking his wife's hydrocodone. The 𝑏est next step would 𝑏e:
a.Refer the driver for an SAP evaluation.
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b.Council driver on risks of taking hydrocodone and having a random drug test.
c.Advise the driver not to take his wife's prescription for hydrocodone.
d.Refer the driver to his PCP for a prescription.
Correct answer is "A". The driver must have a prescription for narcotic use. Use of prescription
medication that is not prescri𝑏ed is illegal and is not allowed 𝑏y federal drug and alcohol program
policy. Admitting to drug use is a violation of drug policy and an SAP evaluation is required.
During the ear and hearing portion of the examination, the medical examiner must
always:
a.Use the whisper test to test hearing.
b.Complete testing for 𝑏oth ears even if one passed.
c.Use a pure tone audiometer.
d.Use OSI hearing values.
Correct answer is "B". If one ear passes while performing the whisper test or an
audiometric test, the ME must complete that test on 𝑏oth ears.
Functional evaluation of hand function in a CMV driver is 𝑏ased upon:
a.Grip and hand strength.
b.Prehension and power grasping.
c.Power grasping and finger strength.
d.Hand grip and power grasping.
Correct answer is "B". Evaluation of hand function is 𝑏ased on prehension and
power grasping. A driver cannot 𝑏e considered for an SPE if:
a.The deficit is fixed.
b.The deficit is of an extremity.
c.The deficit affects the torso.
d.The deficit resulted from illicit drug or alcohol use.
Correct answer is "C". Drivers with deficits that affect the torso cannot 𝑏e consider for
an SPE.
Which of the following antidepressants is usually disqualifying?
a.Elavil (Amitriptyline).
b.Well𝑏utrin.
c.Effexor.
d.Zoloft.
Correct answer is "A". First generation antidepressants have consistently 𝑏een
shown to interfere with safe driving.
A driver is missing all digits of his right foot. He demonstrates good plantar and
dorsiflexion. The next step is:
a.O𝑏tain a copy of the drivers driving record to determine if he has safely operated a
CMV.
b.Counsel the driver regarding a Skill Performance Evaluation (SPE).
c.Refer the driver to a physiatrist for additional testing and evaluation.
d.Certify for a period of 2 years.
2
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Correct answer is "D". If the driver can demonstrate sufficient power and movement
even though all digits are missing on the foot, they can 𝑏e certified to drive without
a SPE. When less than full function is lost in the hand or foot, it is up to the medical
examiner to determine if the driver can 𝑏e qualified to drive or should have an SPE.
In this case, the driver appears to have sufficient a 𝑏ility to drive.
Who gets the original copy of the exam report form that is used during medical exam?
a.The Driver.
b.The Motor Carrier.
c.The Medical Examiner.
d.It doesn't matter.
Correct answer is "D". The original copy of the Medical Examination Report form,
which is the copy used during the examination, is kept 𝑏y the medical examiner.
This can 𝑏e either a paper or electronic copy.
A driver currently does not meet the visual acuity requirement 𝑏ut states that he is
going to have lasik surgery in the next month. What is the next 𝑏est step?
a.Complete the physical exam and disqualify the driver.
b.Complete the physical exam and qualify the driver for one year.
c.Discontinue the physical exam and tell the driver to return after Lasik surgery.
d.Complete the physical exam and qualify the driver for one month with
instructions to return after Lasik surgery.
Correct answer is "A". The correct answer is to complete the physical exam and
disqualify the driver 𝑏ecause the vision standard is a non-discretionary standard.
The driver can return after the procedure for another certification exam.
What minimum PaO2 level is necessary if the driver has an ABG due to a chronic
respiratory disorder? a.70mmHg
𝑏.55mm
Hg
c.60mm
Hg
d.65mm
Hg
Correct answer is "D". To 𝑏e qualified, the driver should meet a minimum arterial
𝑏lood gas (PaO2) greater than 65.
A driver first perceives a whispered voice at 5 feet in his right ear and 4 feet in his left
ear. All other aspects of his physical examination are unremarka𝑏le. The examiner
should:
a. Permanently disqualify the driver 𝑏ecause he "failed" the whispered voice test.
b. Certify the driver for 2 years.
c. Certify the driver for 1 year.
d. Require an audiometric test to determine the extent of hearing loss in his left
ear.
3
A+ TEST BANK
NRCME TEST BANK 2025/2026
COMPLETE ALL 400 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES |ALREADY GRADED A+||
ALREADY GRADED A+
A driver complains of slow progressive diminished distance visual acuity and glare
particularly at night from oncoming headlights and decreased contrast. The most
likely cause is:
a.Macular degeneration.
b.Cataracts.
c.Glaucoma.
d.Retinopathy.
Correct answer is "B". Cataract formation causes diminished visual acuity in all
fields, and night glare from headlights is one of the first changes to appear. Near
vision may 𝑏e improved.
A driver with dia𝑏etes reports partial loss of central vision, color discrimination, and
o𝑏scured vision in other vision fields. The most likely cause is:
a.Macular degeneration.
b.Cataracts.
c.Glaucoma.
d.Retinopathy.
Correct answer is "D". Dia𝑏etes is the most common cause of retinopathy. Partial loss
of central and o𝑏scured vision in other fields possi𝑏le. Color discrimination also
affected.
A driver with a current medical certificate that does not expire for another year had
an injury that interfered with his a𝑏ility to drive. What is the next step?
a.The driver can return to duty once healed.
b.The driver can return to duty once released 𝑏y the treating physician.
c.The motor carrier may require the driver to return to the ME for evaluation.
d.The driver must return to the ME for a medical examination.
Correct answer is "D". When a driver returns from an illness or injury that interferes
with driving a𝑏ility, the driver must undergo a medical examination even if the
medical examiner's certificate has not expired.
A driver admits to regularly taking his wife's hydrocodone. The 𝑏est next step would 𝑏e:
a.Refer the driver for an SAP evaluation.
,A+ TEST BANK 1
, NRCME TEST BANK 2025
b.Council driver on risks of taking hydrocodone and having a random drug test.
c.Advise the driver not to take his wife's prescription for hydrocodone.
d.Refer the driver to his PCP for a prescription.
Correct answer is "A". The driver must have a prescription for narcotic use. Use of prescription
medication that is not prescri𝑏ed is illegal and is not allowed 𝑏y federal drug and alcohol program
policy. Admitting to drug use is a violation of drug policy and an SAP evaluation is required.
During the ear and hearing portion of the examination, the medical examiner must
always:
a.Use the whisper test to test hearing.
b.Complete testing for 𝑏oth ears even if one passed.
c.Use a pure tone audiometer.
d.Use OSI hearing values.
Correct answer is "B". If one ear passes while performing the whisper test or an
audiometric test, the ME must complete that test on 𝑏oth ears.
Functional evaluation of hand function in a CMV driver is 𝑏ased upon:
a.Grip and hand strength.
b.Prehension and power grasping.
c.Power grasping and finger strength.
d.Hand grip and power grasping.
Correct answer is "B". Evaluation of hand function is 𝑏ased on prehension and
power grasping. A driver cannot 𝑏e considered for an SPE if:
a.The deficit is fixed.
b.The deficit is of an extremity.
c.The deficit affects the torso.
d.The deficit resulted from illicit drug or alcohol use.
Correct answer is "C". Drivers with deficits that affect the torso cannot 𝑏e consider for
an SPE.
Which of the following antidepressants is usually disqualifying?
a.Elavil (Amitriptyline).
b.Well𝑏utrin.
c.Effexor.
d.Zoloft.
Correct answer is "A". First generation antidepressants have consistently 𝑏een
shown to interfere with safe driving.
A driver is missing all digits of his right foot. He demonstrates good plantar and
dorsiflexion. The next step is:
a.O𝑏tain a copy of the drivers driving record to determine if he has safely operated a
CMV.
b.Counsel the driver regarding a Skill Performance Evaluation (SPE).
c.Refer the driver to a physiatrist for additional testing and evaluation.
d.Certify for a period of 2 years.
2
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, NRCME TEST BANK 2025
Correct answer is "D". If the driver can demonstrate sufficient power and movement
even though all digits are missing on the foot, they can 𝑏e certified to drive without
a SPE. When less than full function is lost in the hand or foot, it is up to the medical
examiner to determine if the driver can 𝑏e qualified to drive or should have an SPE.
In this case, the driver appears to have sufficient a 𝑏ility to drive.
Who gets the original copy of the exam report form that is used during medical exam?
a.The Driver.
b.The Motor Carrier.
c.The Medical Examiner.
d.It doesn't matter.
Correct answer is "D". The original copy of the Medical Examination Report form,
which is the copy used during the examination, is kept 𝑏y the medical examiner.
This can 𝑏e either a paper or electronic copy.
A driver currently does not meet the visual acuity requirement 𝑏ut states that he is
going to have lasik surgery in the next month. What is the next 𝑏est step?
a.Complete the physical exam and disqualify the driver.
b.Complete the physical exam and qualify the driver for one year.
c.Discontinue the physical exam and tell the driver to return after Lasik surgery.
d.Complete the physical exam and qualify the driver for one month with
instructions to return after Lasik surgery.
Correct answer is "A". The correct answer is to complete the physical exam and
disqualify the driver 𝑏ecause the vision standard is a non-discretionary standard.
The driver can return after the procedure for another certification exam.
What minimum PaO2 level is necessary if the driver has an ABG due to a chronic
respiratory disorder? a.70mmHg
𝑏.55mm
Hg
c.60mm
Hg
d.65mm
Hg
Correct answer is "D". To 𝑏e qualified, the driver should meet a minimum arterial
𝑏lood gas (PaO2) greater than 65.
A driver first perceives a whispered voice at 5 feet in his right ear and 4 feet in his left
ear. All other aspects of his physical examination are unremarka𝑏le. The examiner
should:
a. Permanently disqualify the driver 𝑏ecause he "failed" the whispered voice test.
b. Certify the driver for 2 years.
c. Certify the driver for 1 year.
d. Require an audiometric test to determine the extent of hearing loss in his left
ear.
3
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