NRCME/ DOT Medical Examiner Exam
Study Guide s Exam Test Questions with
100% Correct Answers | Updated &
Verified 2026
There are 13 standards used to determine medical
fitness for duty. What 3 are "non-discretionary"? -
ANSWER -vision, hearing, and epilepsy
A commercial motor vehicle means any self-propelled or
towed motor vehicle used on a highway in interstate
commerce to transport passengers or property when the
,vehicle meets what 4 criteria? - ANSWER -1. Combined
weight of ≥ 10,001lbs
2. Transport >8 passengers including driver for
compensation
3. Transport >15 passengers including driver regardless
of compensation
4. Transport hazardous materials in quantities that
require hazardous placards
Acceptable Risk: Does the driver pose a risk to public
safety? If you answer yes to this question, what should
you do? - ANSWER -Do not certify as fit for duty
You get a question on the NRCME giving you a clinical
scenario and they ask the treatment you recommend.
What do you answer? - ANSWER -None! You are an
examining provider during the DOT physical, not a
treating provider. F/u with PCM or subspecialty
Can you use BP readings from anywhere (e.g. patient's
primary care from last week) and include it on the
,physical? What do you do if it is high? - ANSWER --No,
only what was obtained during the exam
-confirm with an additional reading later in the
examination
Does the provider have to obtain all vitals and tests
himself or can they use other qualified personnel? -
ANSWER --You may use qualified personnel for these
(e.g. BP, Snellen, etc.), but REMEMBER, the provider is
still responsible for these results and is attesting to their
accuracy. STRONG RECOMMEND to confirm any
abnormal results that would factor into your decision.
What are the 3 Stages of hypertension? (For this exam,
not the current ACC/AHA guidelines) - ANSWER -Stage 1:
140-159/90-99
Stage 2: 160-179/100-109
Stage 3: ≥180/110
An individual has stage 1 HTN. Can they be certified?
, What about recertification? - ANSWER --Yes, for 1 year (if
this is the first time the BP has been elevated and there
has been no prior BP tx)
-Can get another year if <140/90. If they are >140/90, but
less than 160/100, they can get a one-time 3 month
certificate
An individual has stage II HTN. Can they be certified?
What about recertification? - ANSWER --Yes, but they
should be treated and can get a one time certificate for 3
month certification.
-Once the driver has reduced his or her BP <140/90, he
may be recertified annually thereafter.
An individual has stage III HTN. Can they be certified?
What about recertification? - ANSWER --Should not be
certified until BP <140/90
-Can be recertified q6m
T/F: A one time certificate means per recertification
period. Not once per lifetime. - ANSWER -T: a one time
Study Guide s Exam Test Questions with
100% Correct Answers | Updated &
Verified 2026
There are 13 standards used to determine medical
fitness for duty. What 3 are "non-discretionary"? -
ANSWER -vision, hearing, and epilepsy
A commercial motor vehicle means any self-propelled or
towed motor vehicle used on a highway in interstate
commerce to transport passengers or property when the
,vehicle meets what 4 criteria? - ANSWER -1. Combined
weight of ≥ 10,001lbs
2. Transport >8 passengers including driver for
compensation
3. Transport >15 passengers including driver regardless
of compensation
4. Transport hazardous materials in quantities that
require hazardous placards
Acceptable Risk: Does the driver pose a risk to public
safety? If you answer yes to this question, what should
you do? - ANSWER -Do not certify as fit for duty
You get a question on the NRCME giving you a clinical
scenario and they ask the treatment you recommend.
What do you answer? - ANSWER -None! You are an
examining provider during the DOT physical, not a
treating provider. F/u with PCM or subspecialty
Can you use BP readings from anywhere (e.g. patient's
primary care from last week) and include it on the
,physical? What do you do if it is high? - ANSWER --No,
only what was obtained during the exam
-confirm with an additional reading later in the
examination
Does the provider have to obtain all vitals and tests
himself or can they use other qualified personnel? -
ANSWER --You may use qualified personnel for these
(e.g. BP, Snellen, etc.), but REMEMBER, the provider is
still responsible for these results and is attesting to their
accuracy. STRONG RECOMMEND to confirm any
abnormal results that would factor into your decision.
What are the 3 Stages of hypertension? (For this exam,
not the current ACC/AHA guidelines) - ANSWER -Stage 1:
140-159/90-99
Stage 2: 160-179/100-109
Stage 3: ≥180/110
An individual has stage 1 HTN. Can they be certified?
, What about recertification? - ANSWER --Yes, for 1 year (if
this is the first time the BP has been elevated and there
has been no prior BP tx)
-Can get another year if <140/90. If they are >140/90, but
less than 160/100, they can get a one-time 3 month
certificate
An individual has stage II HTN. Can they be certified?
What about recertification? - ANSWER --Yes, but they
should be treated and can get a one time certificate for 3
month certification.
-Once the driver has reduced his or her BP <140/90, he
may be recertified annually thereafter.
An individual has stage III HTN. Can they be certified?
What about recertification? - ANSWER --Should not be
certified until BP <140/90
-Can be recertified q6m
T/F: A one time certificate means per recertification
period. Not once per lifetime. - ANSWER -T: a one time
