NRCME (DOT) COMPREHENSIVE
STUDY GUIDE 2026 FULL QUESTIONS
AND SOLUTIONS GRADED A+
◍ FMCSA Mission Statement.
Answer: To reduce crashes, injuries, fatalities involving large trucks/buses
◍ Medical Examiner.
Answer: Licensed, certified, registered provider who can perform PEs in
accordance with laws and regulations ; registered through NRS ; has unique
identifier ; passes MEC test
◍ NRCME exam length.
Answer: 2 hours
◍ FMCSA.
Answer: Federal Motor Carrier Safety Administration
◍ Total NRCME questions.
Answer: 120
◍ Pilot questions.
Answer: 20 do not count toward score
◍ Passing score requirement.
Answer: Greater than 70 percent
◍ NRCME.
Answer: National Registry of Certified Medical Examiners
◍ Commerical Motor Vehicle.
Answer: Weight >1000 lb ; or transports >8 people for compensation ; or
>15 people without compensation ; transports hazardous materials requiring
placarding
,◍ Primary examiner role.
Answer: DOT medical examiner not a primary care provider
◍ Interstate commercevs. Intrastate commerce.
Answer: Interstate: multiple states or internationalIntrastate: within 1 state
◍ Who regulates treatment/management and aftercare of substance abuse for
drivers?.
Answer: SAP (Substance Abuse Professional)
◍ Most tested exam mindset.
Answer: What should the examiner do NEXT
◍ Safer answer rule.
Answer: Choose the answer that protects public safety
◍ Who determines the origin of abnormal drug test results, determining
whether the driver has violated drug use regulations?.
Answer: Medical Review Officer
◍ Minimum distant vision standard.
Answer: 20/40 each eye with or without correction
◍ Peripheral vision requirement.
Answer: 70 degrees in each eye
◍ Title 49 CFR 391.41.
Answer: Medical Examiner Report Form- Paperwork completed during
DOT physical- Physical exam requirements for driver- Determines if
Certificate is granted
◍ Color vision requirement.
Answer: Must distinguish red amber and green
◍ Corrective lens rule.
Answer: Allowed if standards met
◍ Title 49 CFR 391.43.
Answer: Describes responsibilities of Medical Examiner, instructions for
, exam, and requirements for medical certification- Supporting information to
explain 391.41
◍ Forced whisper test distance.
Answer: 5 feet
◍ When was DOT established?.
Answer: 1966Became separate entity on Jan 1, 2000
◍ If whisper test failed.
Answer: Audiometric testing required
◍ Hearing aid use.
Answer: Allowed if standards met
◍ Hearing aid advice.
Answer: Carry spare power source
◍ Motor Carrier Safety Improvement Act of 1999.
Answer: Established DOT as separate federal entity
◍ Pulse oximetry threshold for ABG.
Answer: Less than 92 percent
◍ Omnibus Transportation Employee Testing Act of 1991.
Answer: Required drug testing for drivers
◍ The driver must always keep a copy of ____________________ with them
while driving.
Answer: Medical CertificateSPE if applicable
◍ FEV1 threshold requiring evaluation.
Answer: Less than 65 percent
◍ FEV1/FVC threshold.
Answer: Less than 65 percent
◍ FVC threshold.
Answer: Less than 60 percent
STUDY GUIDE 2026 FULL QUESTIONS
AND SOLUTIONS GRADED A+
◍ FMCSA Mission Statement.
Answer: To reduce crashes, injuries, fatalities involving large trucks/buses
◍ Medical Examiner.
Answer: Licensed, certified, registered provider who can perform PEs in
accordance with laws and regulations ; registered through NRS ; has unique
identifier ; passes MEC test
◍ NRCME exam length.
Answer: 2 hours
◍ FMCSA.
Answer: Federal Motor Carrier Safety Administration
◍ Total NRCME questions.
Answer: 120
◍ Pilot questions.
Answer: 20 do not count toward score
◍ Passing score requirement.
Answer: Greater than 70 percent
◍ NRCME.
Answer: National Registry of Certified Medical Examiners
◍ Commerical Motor Vehicle.
Answer: Weight >1000 lb ; or transports >8 people for compensation ; or
>15 people without compensation ; transports hazardous materials requiring
placarding
,◍ Primary examiner role.
Answer: DOT medical examiner not a primary care provider
◍ Interstate commercevs. Intrastate commerce.
Answer: Interstate: multiple states or internationalIntrastate: within 1 state
◍ Who regulates treatment/management and aftercare of substance abuse for
drivers?.
Answer: SAP (Substance Abuse Professional)
◍ Most tested exam mindset.
Answer: What should the examiner do NEXT
◍ Safer answer rule.
Answer: Choose the answer that protects public safety
◍ Who determines the origin of abnormal drug test results, determining
whether the driver has violated drug use regulations?.
Answer: Medical Review Officer
◍ Minimum distant vision standard.
Answer: 20/40 each eye with or without correction
◍ Peripheral vision requirement.
Answer: 70 degrees in each eye
◍ Title 49 CFR 391.41.
Answer: Medical Examiner Report Form- Paperwork completed during
DOT physical- Physical exam requirements for driver- Determines if
Certificate is granted
◍ Color vision requirement.
Answer: Must distinguish red amber and green
◍ Corrective lens rule.
Answer: Allowed if standards met
◍ Title 49 CFR 391.43.
Answer: Describes responsibilities of Medical Examiner, instructions for
, exam, and requirements for medical certification- Supporting information to
explain 391.41
◍ Forced whisper test distance.
Answer: 5 feet
◍ When was DOT established?.
Answer: 1966Became separate entity on Jan 1, 2000
◍ If whisper test failed.
Answer: Audiometric testing required
◍ Hearing aid use.
Answer: Allowed if standards met
◍ Hearing aid advice.
Answer: Carry spare power source
◍ Motor Carrier Safety Improvement Act of 1999.
Answer: Established DOT as separate federal entity
◍ Pulse oximetry threshold for ABG.
Answer: Less than 92 percent
◍ Omnibus Transportation Employee Testing Act of 1991.
Answer: Required drug testing for drivers
◍ The driver must always keep a copy of ____________________ with them
while driving.
Answer: Medical CertificateSPE if applicable
◍ FEV1 threshold requiring evaluation.
Answer: Less than 65 percent
◍ FEV1/FVC threshold.
Answer: Less than 65 percent
◍ FVC threshold.
Answer: Less than 60 percent
