NRCME DOT Medical Examiner Certification
Exam Review | Complete Practice Question Bank
with Verified Answers & Rationales | Latest
Update 2026/2027
Question 1
How often is a driver with stage 3 hypertension recertified?
A. Every 3 months
B. Every 6 months
C. Every 12 months
D. Every 2 years
Answer: B
Rationale: A driver with a history of stage 3 hypertension may be certified for a
maximum of 6 months.
Question 2
What minimum PaO2 level is necessary if the driver has an ABG due to a chronic
respiratory disorder?
A. 70 mm Hg
B. 55 mm Hg
C. 60 mm Hg
D. 65 mm Hg
Answer: D
Rationale: To be qualified, the driver should meet a minimum arterial blood gas
(PaO2) greater than 65 mm Hg.
Question 3
A driver reports for an examination 6 weeks after suffering a mild heart attack and
presents a note from his cardiologist stating that he is able to return to work
immediately without restriction. Included within the note, the cardiologist provides
recent testing information showing that the driver had an ETT that showed he was able
to reach 12 METS during the test. His echocardiogram showed an ejection fraction of
65%. The examination of the driver is unremarkable. The examiner should:
pg. 1
,A. Disqualify the driver
B. Qualify the driver for 1 year
C. Qualify the driver for 2 years
D. Consult with the cardiologist to determine if the driver suffers from angina
Answer: A
Rationale: The driver has not completed the required 2-month waiting period, but all
other requirements for medical clearance and required testing have been met. The
driver would be certified for 1 year at the completion of the waiting period. The date of
the certification would be from the date of the original examination.
Question 4
A driver provides an audiometric test documenting the following:
1. 500 Hz: 35 Right ear; 40 Left ear
2. 1000 Hz: 40 Right ear; 45 Left ear
3. 2000 Hz: 40 Right ear; 45 Left ear
4. 4000 Hz: 50 Right ear; 50 Left ear
The medical examiner should:
A. Disqualify the driver because he does not meet minimum hearing requirements to
drive
B. Certify the driver for 2 years
C. Certify the driver for 1 year
D. Require the driver to obtain a hearing exemption
Answer: B
Rationale: The examiner would average the results from 500 Hz, 1000 Hz and 2000
Hz. This average is 38.33 in the Right and 43.33 in the Left ear. A driver must have an
average hearing loss of less than or equal to 40 in the better ear. This does not have to be
met in both ears.
Question 5
During the examination of a commercial driver, the examiner notices that the driver's
peripheral vision is 70 degrees to the left and 80 degrees to the right. The examiner
should:
A. Qualify the driver for 2 years
B. Require the driver to obtain a vision exemption because of the limitation in the
pg. 2
,driver's left peripheral field
C. Disqualify the driver
D. Have the driver consult with an Ophthalmologist to determine if the driver's
peripheral vision meets minimum standards
Answer: A
Rationale: A driver must exhibit a minimum peripheral vision of 70 degrees
bilaterally.
Question 6
During examination, the medical examiner notices that the driver is distant, lacks eye
contact and shows absolutely no emotional response during the exam. The examiner's
best response should be:
A. Provide the driver with a "CAGE" questionnaire to determine if he suffers from
alcoholism
B. Disqualify the driver and refer him to a mental health professional prior to
consideration for certification
C. Certify the driver with a 1-time, 3-month certificate to determine if there is any effect
on the driver's ability to drive a CMV
D. Require a skill performance evaluation to ascertain if the driver has any limitations
with driving
Answer: B
Rationale: The driver exhibits what may be considered a "flat affect" which is seen in
schizophrenia and in severe depression. The driver should be evaluated by a mental
health expert to make a diagnosis prior to certification.
Question 7
A driver admits to the use of marijuana for the treatment of his glaucoma, which is legal
in the State in which he lives. He provides medical documentation for the glaucoma
indicating he is able to drive a truck. He began using the marijuana about three months
ago. His current medical card has no limitations listed and is for 2 years. His
certification examination is within normal limits. The medical examiner should:
A. Disqualify the driver
B. Perform a urine drug collection and provide the release from the testing provider
C. Certify the driver for 1 year
D. Certify the driver for 2 years
Answer: A
pg. 3
, Rationale: Use of marijuana is prohibited by Federal law while driving a CMV and
trumps State law in this matter.
Question 8
A driver has a blood pressure of 136/92 mm Hg. This is:
A. Within normal limits and would not affect the driver's certification
B. Stage 1 Hypertension
C. Stage 2 Hypertension
D. Stage 3 Hypertension
Answer: B
Rationale: This is Stage 1 Hypertension, which is defined as 140-159/90-99.
Question 9
A driver is taking Celexa for the treatment of what he calls a "mild depression." He
reports he has not considered or attempted suicide. The examiner should:
A. Certify only after obtaining written clearance for the depression and the medication
from the treating provider
B. Certify the driver for a period of 1 year
C. Certify the driver for a period of 2 years
D. Disqualify the driver until he is no longer requiring medication for the treatment of
depression
Answer: A
Rationale: Medical clearance is recommended for all mental health disorders. Celexa
is an SSRI or 2nd Generation anti-depressant and is acceptable.
Question 10
For a driver with insulin-treated diabetes mellitus, the medical examiner can only accept
Form MCSA-5870 if it has been properly completed within the last:
A. 25 days
B. 30 days
C. 45 days
D. 60 days
Answer: C
Rationale: The medical examiner must receive the form and begin the medical
examination no later than 45 days after the date signed on the form; however, the
pg. 4
Exam Review | Complete Practice Question Bank
with Verified Answers & Rationales | Latest
Update 2026/2027
Question 1
How often is a driver with stage 3 hypertension recertified?
A. Every 3 months
B. Every 6 months
C. Every 12 months
D. Every 2 years
Answer: B
Rationale: A driver with a history of stage 3 hypertension may be certified for a
maximum of 6 months.
Question 2
What minimum PaO2 level is necessary if the driver has an ABG due to a chronic
respiratory disorder?
A. 70 mm Hg
B. 55 mm Hg
C. 60 mm Hg
D. 65 mm Hg
Answer: D
Rationale: To be qualified, the driver should meet a minimum arterial blood gas
(PaO2) greater than 65 mm Hg.
Question 3
A driver reports for an examination 6 weeks after suffering a mild heart attack and
presents a note from his cardiologist stating that he is able to return to work
immediately without restriction. Included within the note, the cardiologist provides
recent testing information showing that the driver had an ETT that showed he was able
to reach 12 METS during the test. His echocardiogram showed an ejection fraction of
65%. The examination of the driver is unremarkable. The examiner should:
pg. 1
,A. Disqualify the driver
B. Qualify the driver for 1 year
C. Qualify the driver for 2 years
D. Consult with the cardiologist to determine if the driver suffers from angina
Answer: A
Rationale: The driver has not completed the required 2-month waiting period, but all
other requirements for medical clearance and required testing have been met. The
driver would be certified for 1 year at the completion of the waiting period. The date of
the certification would be from the date of the original examination.
Question 4
A driver provides an audiometric test documenting the following:
1. 500 Hz: 35 Right ear; 40 Left ear
2. 1000 Hz: 40 Right ear; 45 Left ear
3. 2000 Hz: 40 Right ear; 45 Left ear
4. 4000 Hz: 50 Right ear; 50 Left ear
The medical examiner should:
A. Disqualify the driver because he does not meet minimum hearing requirements to
drive
B. Certify the driver for 2 years
C. Certify the driver for 1 year
D. Require the driver to obtain a hearing exemption
Answer: B
Rationale: The examiner would average the results from 500 Hz, 1000 Hz and 2000
Hz. This average is 38.33 in the Right and 43.33 in the Left ear. A driver must have an
average hearing loss of less than or equal to 40 in the better ear. This does not have to be
met in both ears.
Question 5
During the examination of a commercial driver, the examiner notices that the driver's
peripheral vision is 70 degrees to the left and 80 degrees to the right. The examiner
should:
A. Qualify the driver for 2 years
B. Require the driver to obtain a vision exemption because of the limitation in the
pg. 2
,driver's left peripheral field
C. Disqualify the driver
D. Have the driver consult with an Ophthalmologist to determine if the driver's
peripheral vision meets minimum standards
Answer: A
Rationale: A driver must exhibit a minimum peripheral vision of 70 degrees
bilaterally.
Question 6
During examination, the medical examiner notices that the driver is distant, lacks eye
contact and shows absolutely no emotional response during the exam. The examiner's
best response should be:
A. Provide the driver with a "CAGE" questionnaire to determine if he suffers from
alcoholism
B. Disqualify the driver and refer him to a mental health professional prior to
consideration for certification
C. Certify the driver with a 1-time, 3-month certificate to determine if there is any effect
on the driver's ability to drive a CMV
D. Require a skill performance evaluation to ascertain if the driver has any limitations
with driving
Answer: B
Rationale: The driver exhibits what may be considered a "flat affect" which is seen in
schizophrenia and in severe depression. The driver should be evaluated by a mental
health expert to make a diagnosis prior to certification.
Question 7
A driver admits to the use of marijuana for the treatment of his glaucoma, which is legal
in the State in which he lives. He provides medical documentation for the glaucoma
indicating he is able to drive a truck. He began using the marijuana about three months
ago. His current medical card has no limitations listed and is for 2 years. His
certification examination is within normal limits. The medical examiner should:
A. Disqualify the driver
B. Perform a urine drug collection and provide the release from the testing provider
C. Certify the driver for 1 year
D. Certify the driver for 2 years
Answer: A
pg. 3
, Rationale: Use of marijuana is prohibited by Federal law while driving a CMV and
trumps State law in this matter.
Question 8
A driver has a blood pressure of 136/92 mm Hg. This is:
A. Within normal limits and would not affect the driver's certification
B. Stage 1 Hypertension
C. Stage 2 Hypertension
D. Stage 3 Hypertension
Answer: B
Rationale: This is Stage 1 Hypertension, which is defined as 140-159/90-99.
Question 9
A driver is taking Celexa for the treatment of what he calls a "mild depression." He
reports he has not considered or attempted suicide. The examiner should:
A. Certify only after obtaining written clearance for the depression and the medication
from the treating provider
B. Certify the driver for a period of 1 year
C. Certify the driver for a period of 2 years
D. Disqualify the driver until he is no longer requiring medication for the treatment of
depression
Answer: A
Rationale: Medical clearance is recommended for all mental health disorders. Celexa
is an SSRI or 2nd Generation anti-depressant and is acceptable.
Question 10
For a driver with insulin-treated diabetes mellitus, the medical examiner can only accept
Form MCSA-5870 if it has been properly completed within the last:
A. 25 days
B. 30 days
C. 45 days
D. 60 days
Answer: C
Rationale: The medical examiner must receive the form and begin the medical
examination no later than 45 days after the date signed on the form; however, the
pg. 4
