NRCME PRACTICE EXAMINATION
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ Which of the following is a requirement for drivers with a diabetes
exemption?A) Possess a rapidly absorbable form of glucose while drivingB)
Self—monitor blood glucose one hour before driving and at least once every
2 hours while drivingC) Plan to submit blood glucose monitoring logs every
6 monthsD) Maintain a Hemoglobin A1C value less than 7.
Answer: A. 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.
◍ FMCSA Mission Statement.
Answer: To reduce crashes, injuries, fatalities involving large trucks/buses
◍ Drivers with insulin dependent diabetes:A) May be certified for a maximum
of 6 monthsB) Must maintain a hemoglobin A1C level of less than 7 to
qualify for certificationC) Cannot be certified if they have a history of
myocardial infarctionD) May be eligible for a diabetes exemption.
Answer: D) Drivers with insulin dependent diabetes cannot be certified but
may be eligible for a diabetes exemption
◍ Which of the following is true?A) A driver with diabetes who uses insulin
does not meet the minimum requirements of 49 CFR Part 391.41B) The
most important concert related to medication use for treating diabetes is
hyperglycemiaC) Peripheral neuropathy is not a disqualifying conditionD)
Diabetes is not a coronary heart disease (CHD) equivalent condition.
Answer: A) The greatest risk for medication use for drivers with diabetes in
hypoglycemia, not hyperglycemia. Peripheral neuropathy is disqualifying
, condition. Diabetes is a CHD equivalent condition.
◍ What is the recommended certification interval for a driver with diabetes
mellituse who does not use insulin?A) Three monthsB) Six monthsC) One
yearD) Two years.
Answer: C) Drivers with non-insulin dependent diabetes should be certified
for a maximum of one year
◍ A diabetes exemption may be issued by:A) An endocrinologistB) The
Medical ExaminerC) The driver's personal physicianD) The FMCSA.
Answer: D) Only the FMCSA can grant exemptions
◍ A driver with diabetes mellliktus 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 Examiners CertificateB) Letter to the FMCSAC)
Employer authorization formD) Endocrinology consultation form.
Answer: A) Exemption requirements must be noted on the Medical
Examination Report status section and the Medical Examiners Certificate
◍ If glucose is detected on urinalysis in a driver with no history of diabetes, an
appropriate next step is:A) Endocrinology consultationB) One year
clearance and recommendation to see personal physicianC) Fingerstick or
blood glucose determinationD) Temporary disqualification.
Answer: C) The medical examiner should first determine blood glucose and
then make an appropriate certification determination and referral
◍ 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
◍ FMCSA.
Answer: Federal Motor Carrier Safety Administration
◍ Drivers with a history of _____________ severe hypoglycemic reactions in
the past year or _____________ severe hypoglycemic reactions in the past
, five years should not be certifed.A) one, threeB) one, twoC) two, threeD)
two, five.
Answer: B) 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.
◍ Which of the following is not a criteria that the FMCSA uses to define a
severe hypoglycemic reaction?A) SeizureB) DizzinessC) Need of assistance
from another personD) Period of impaired cognitive function that occurred
without warning.
Answer: B) FMCSA defines severe hypoglycemia as reactions that result in
seizure, loss of consciousness, need of assistance from another person, and a
period of impaired congitive function that occurred without warning
◍ 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
◍ Which diabetes mellitus risk poses the greatest threat to public safetyA)
HyperglycemiaB) Peripheral neuropathyC) HypoglycemiaD) Metabolic
encephalopathy.
Answer: C) Although hyperglycemia, peripheral neuropathy, and metabolic
encephalopathy all pose significant risks for safe driving, hypoglycemia
poses the greatest risk. The risk is particularly pronounced in drivers who
use insulin. FMCSA defines a hypoglycemia episode as one that results in
seizure, loss of consciousness, need of assistance from another person, or a
period of impaired cognitive function that occurs without warning.
◍ A driver with a diabetes exemption should check glucose levels when?A)
One hour before driving and at least once every four hours while drivingB)
One hour before driving and at least every eight hours while drivingC) Once
after four hours of drivingD) Once a day after driving period has ended.
Answer: A) Driver's with diabetes exemption should check glucose values
, one hour before driving and once every four hours while driving
◍ Interstate commercevs. Intrastate commerce.
Answer: Interstate: multiple states or internationalIntrastate: within 1 state
◍ Which of the following is true for diagnosis of a hernia?A) The driver
should be referred to a surgeon to determine whether repair of a hernia is
necessaryB) The waiting period following hernia surgery is two weeksC)
Inguinal hernias have been associated with an increased risk for CMV
accidentsD) The maximum certification interval for a driver with a hernia is
two years.
Answer: D) The medical examiner can use his/her judgment as to whether a
driver should be referred to a surgeon or other specialist. There is no
specified waiting period following hernia surgery - the driver should not be
certified until the medical examiner determines that treatment is safe and
effective, and that the condition is stable. No evidence has linked hernias of
any type to increased CMV accident risk.
◍ Who regulates treatment/management and aftercare of substance abuse for
drivers?.
Answer: SAP (Substance Abuse Professional)
◍ Who determines the origin of abnormal drug test results, determining
whether the driver has violated drug use regulations?.
Answer: Medical Review Officer
◍ 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
◍ Which of the following is true of nephropathy?A) Nephropathy is a
disqualifying conditionB) The maximum certification interval for
nephropathy is two yearsC) A driver with 3+ proteinuria should not be
certifiedD) A renal specialist should make the certification determination for
a driver with nephropathy.
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ Which of the following is a requirement for drivers with a diabetes
exemption?A) Possess a rapidly absorbable form of glucose while drivingB)
Self—monitor blood glucose one hour before driving and at least once every
2 hours while drivingC) Plan to submit blood glucose monitoring logs every
6 monthsD) Maintain a Hemoglobin A1C value less than 7.
Answer: A. 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.
◍ FMCSA Mission Statement.
Answer: To reduce crashes, injuries, fatalities involving large trucks/buses
◍ Drivers with insulin dependent diabetes:A) May be certified for a maximum
of 6 monthsB) Must maintain a hemoglobin A1C level of less than 7 to
qualify for certificationC) Cannot be certified if they have a history of
myocardial infarctionD) May be eligible for a diabetes exemption.
Answer: D) Drivers with insulin dependent diabetes cannot be certified but
may be eligible for a diabetes exemption
◍ Which of the following is true?A) A driver with diabetes who uses insulin
does not meet the minimum requirements of 49 CFR Part 391.41B) The
most important concert related to medication use for treating diabetes is
hyperglycemiaC) Peripheral neuropathy is not a disqualifying conditionD)
Diabetes is not a coronary heart disease (CHD) equivalent condition.
Answer: A) The greatest risk for medication use for drivers with diabetes in
hypoglycemia, not hyperglycemia. Peripheral neuropathy is disqualifying
, condition. Diabetes is a CHD equivalent condition.
◍ What is the recommended certification interval for a driver with diabetes
mellituse who does not use insulin?A) Three monthsB) Six monthsC) One
yearD) Two years.
Answer: C) Drivers with non-insulin dependent diabetes should be certified
for a maximum of one year
◍ A diabetes exemption may be issued by:A) An endocrinologistB) The
Medical ExaminerC) The driver's personal physicianD) The FMCSA.
Answer: D) Only the FMCSA can grant exemptions
◍ A driver with diabetes mellliktus 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 Examiners CertificateB) Letter to the FMCSAC)
Employer authorization formD) Endocrinology consultation form.
Answer: A) Exemption requirements must be noted on the Medical
Examination Report status section and the Medical Examiners Certificate
◍ If glucose is detected on urinalysis in a driver with no history of diabetes, an
appropriate next step is:A) Endocrinology consultationB) One year
clearance and recommendation to see personal physicianC) Fingerstick or
blood glucose determinationD) Temporary disqualification.
Answer: C) The medical examiner should first determine blood glucose and
then make an appropriate certification determination and referral
◍ 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
◍ FMCSA.
Answer: Federal Motor Carrier Safety Administration
◍ Drivers with a history of _____________ severe hypoglycemic reactions in
the past year or _____________ severe hypoglycemic reactions in the past
, five years should not be certifed.A) one, threeB) one, twoC) two, threeD)
two, five.
Answer: B) 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.
◍ Which of the following is not a criteria that the FMCSA uses to define a
severe hypoglycemic reaction?A) SeizureB) DizzinessC) Need of assistance
from another personD) Period of impaired cognitive function that occurred
without warning.
Answer: B) FMCSA defines severe hypoglycemia as reactions that result in
seizure, loss of consciousness, need of assistance from another person, and a
period of impaired congitive function that occurred without warning
◍ 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
◍ Which diabetes mellitus risk poses the greatest threat to public safetyA)
HyperglycemiaB) Peripheral neuropathyC) HypoglycemiaD) Metabolic
encephalopathy.
Answer: C) Although hyperglycemia, peripheral neuropathy, and metabolic
encephalopathy all pose significant risks for safe driving, hypoglycemia
poses the greatest risk. The risk is particularly pronounced in drivers who
use insulin. FMCSA defines a hypoglycemia episode as one that results in
seizure, loss of consciousness, need of assistance from another person, or a
period of impaired cognitive function that occurs without warning.
◍ A driver with a diabetes exemption should check glucose levels when?A)
One hour before driving and at least once every four hours while drivingB)
One hour before driving and at least every eight hours while drivingC) Once
after four hours of drivingD) Once a day after driving period has ended.
Answer: A) Driver's with diabetes exemption should check glucose values
, one hour before driving and once every four hours while driving
◍ Interstate commercevs. Intrastate commerce.
Answer: Interstate: multiple states or internationalIntrastate: within 1 state
◍ Which of the following is true for diagnosis of a hernia?A) The driver
should be referred to a surgeon to determine whether repair of a hernia is
necessaryB) The waiting period following hernia surgery is two weeksC)
Inguinal hernias have been associated with an increased risk for CMV
accidentsD) The maximum certification interval for a driver with a hernia is
two years.
Answer: D) The medical examiner can use his/her judgment as to whether a
driver should be referred to a surgeon or other specialist. There is no
specified waiting period following hernia surgery - the driver should not be
certified until the medical examiner determines that treatment is safe and
effective, and that the condition is stable. No evidence has linked hernias of
any type to increased CMV accident risk.
◍ Who regulates treatment/management and aftercare of substance abuse for
drivers?.
Answer: SAP (Substance Abuse Professional)
◍ Who determines the origin of abnormal drug test results, determining
whether the driver has violated drug use regulations?.
Answer: Medical Review Officer
◍ 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
◍ Which of the following is true of nephropathy?A) Nephropathy is a
disqualifying conditionB) The maximum certification interval for
nephropathy is two yearsC) A driver with 3+ proteinuria should not be
certifiedD) A renal specialist should make the certification determination for
a driver with nephropathy.
