DOT Exam Questions and Answers Rated A+

DOT Exam Questions and Answers Rated A+ Who sets the qualification standards for DOT exam? Federal Motor Carrier Safety Administration (FMCSA) What is required for drivers? MUST undergo a history and physical by a licensed Physician, Physician Assistant, Advanced Nurse Practitioner, DO, or Chiropractor What liability do we have? Examiner bears legal liability for exam accuracy What is the max cert length? 2 years What does DOT stand for? Department of Transportation What does CDL stand for? CDL: Commercial Drivers license Commercial motor vehicle: vehicle used for commercial purposes that...(at least 1) 1. Has a weight rating of >10,000 lbs. 2. Is used to transport hazardous materials 3. Can carry at least 16 passengers What is the primary goal of the DOT exam? public safety What is the 3rd highest mortality rate amoung US occupations? truck driving What are the vision requirements of DOT-testing? -demonstrate at least 20/40 visual acuity in each eye with or w/o correction -demonstrate at least 70 degrees peripheral vision in each eye -demonstrate ability to distinguish b/w red/green/amber colors (Ishihara test) -demonstrate binocular vision -use of corrective lenses MUST be noted on certificate* What test assesses for color blindness? Ishihara Test What are the hearing requirements for DOT-testing? -must first perceive a whispered voice > or = 5 ft. from the provider (with or w/o a hearing aid) OR -demonstrates average hearing loss in the better ear < or = 40 dB at 500, 1000, and 2000 Hz -use of a hearing aid MUST be noted on certificate* What are the BP requirements for DOT-testing? -Take at least 2 BP readings to confirm* -Reading must be < or = to 160/90 to qualify on initial exam What are the pulse requirements for DOT-testing? regular pulse pattern What does the PE of the DOT-testing consist of? vitals -abdomen -general appearance -vascular system -eyes -genitourinary -ears -extremities -mouth/throat -spine/MS -heart -neurological system -lungs (not breast) What is the purpose/focus of the PE on DOT-testing? Focus lies in assessing functional ability to control a large MV, move heavy cargo, load/unload vehicle etc. What are factors noted in the general appearance of the DOT PE? obesity, tremor, signs of alcohol or drug use What are factors noted in the eyes of the DOT PE? PERRLA, nystagmus (inv. mvmt), exophthalmos (popping out eyes), retinopathy, cataracts, glaucoma, macular degeneration What are factors noted in the ears of the DOT PE? ear disease, occlusion of canal, perforated TM What are factors noted in the mouth and throat of the DOT PE? deformities interfering w/breathing or swallowing What are factors noted in the heart of the DOT PE? murmurs, extra sounds, enlarged heart, pacemaker What are factors noted in the lungs/chest of the DOT PE? abnormal RR, abnormal breath sounds (wheezes, rales, rhonchi), dyspnea, cyanosis What are factors noted in the abdomen of the DOT PE? enlarged liver/spleen, masses, bruits, hernia, abd weakness What are factors noted in the abdomen of the DOT PE? ... What are factors noted in the abdomen of the DOT PE? Vascular: -abnormal pulse, bruits, varicosities Genitourinary: -hernias Spine: -previous surgery, deformities, decreased ROM, tenderness What are factors noted in the abdomen of the DOT PE? slide 14 and 15 What are factors noted in the abdomen of the DOT PE? slide 14 and 15 What are factors noted in the abdomen of the DOT PE? ... What are factors noted in the abdomen of the DOT PE? ... Only lab test needed for all applicants UA (to screen for diabetes) How do you deal with limb impairment? SPE (specific disease states) Certification Program allows persons w/loss of foot or limb to potentially qualify w/use of prosthetic devices or equipment modifications -additional restrictions may be placed -driver must have current SPE certificate in vehicle Regulation of diabetics stringent waiver program now available -Non-insulin dependent diabetics can qualify if controlled by diet an oral meds Individuals w/NIDDM (non insulin dependent diabetes mellitus) are eligible: 1. If DM is controlled AND 2. No evidence of organ damage Acceptable control: (per ADA) -Fasting plasma glucose < 140 -2 hr postprandial (after meal)glucose < 200 -HA1C (hemoglobin A1C = 3 mo average) < 8 Individuals should be asked about hypoglycemic episodes Cardiovascular disease Current CV disease accompanied by or likely to cause sxs of syncope, dyspnea, collapse, or CHF should be disqualified -However...depending on severity, guidelines exist to help certify these individuals, obtain eval by Cardiologist -If pt has established CV disease must undergo resting and stress EKG -CABG, pacemakers, Coumadin-not disqualifying ***refer to cardiologist for clearance Hypertension Algorithm -BP 161-180/91-104 qualify x 3 mos -BP < or = to 160 and/or 90 w/in 3 mos then qualify x 1 year (document Rx, BP control) -BP > 180 and/or 104 disqualified* until reduced to <180/104 then qualify x 3 mos -BP < or = 160 and/or 90 w/in 3 mos qualify x 6 mos (document Rx, BP control) ***recheck follow closely, don't qualify for full 2 years or if too high initially disqualified until figured out further Respiratory concerns If any conditions suspected that are not controlled and could interfere with oxygen exchange (i.e.-COPD, chronic asthma, Tb, sleep apnea etc.) REFER for additional testing ***referred if poorly controlled or concerned epilepsy Any pt with a hx of epilepsy, current diagnosis of epilepsy, or taking antiseizure medication disqualified -If sudden LOC or sz of unknown cause which did not require antiseizure med 6 month waiting period/Neuro exam. If Neuro exam normal and driver is not prescribed antiseizure meds qualified -If LOC or sz resulted from known medical condition-defer until fully recovered mental disorders Individuals highly susceptible to frequent or severe episodes of emotional instability (schizophrenia, psychoses, paranoia, anxiety, depression etc.) consider disqualification -Adverse effects and interactions of psychotropic meds should also be reviewed Rheumatic, Orthopedic, Muscular, Neuromuscular or Vascular Disease Once individual has been diagnosed w/ one of the above conditions, the examiner must consider the following... 1. severity (loss of sensation or strength) 2. degree of limited ROM 3. likelihood of progressive limitation 4. likelihood of sudden incapacitation If severe functional impairment disqualified vision Individuals w/color perception deficiency may be qualified if able to distinguish among traffic control signals (red, yellow, amber) -Use of contact lenses in 1 eye for distance and 1 eye for near vision disqualified -If visual acuity normal only while wearing corrective lenses the pt must wear them in order to qualify ***mention if they are wearing contacts to pass test hearing Refer to previous slide on DOT testing -If individual passes the hearing exam only while wearing a hearing aid he/she must wear the aid in order to qualify drug use Disqualifying medications: Schedule 1 (heroine, marijuana), amphetamines, narcotics, any other habit-forming drugs -*Exception*...driver may use an above med if prescribed by licensed provider familiar w/pt's hx/duties and has been told it will not interfere w/safe driving -Exception excludes methadone Are there drug testing requirements? Drug testing is not required for screening but if individual has a positive test disqualified until free from use (documented) Recertification may include successful completion of a drug rehab program Examiner may opt to certify for < 2 yrs if more frequent monitoring is desired alcoholism If an individual has not fully stabilized, is not completely sober, or shows signs of current abuse = Disqualified-Refer for counseling/tx -After achieving sobriety (no specific time limit) the individual may be considered Legal aspets of the DOT exam Upon completion the Provider records the final results including: -qualification or disqualification status -duration of certification -waiver status -accommodations Providers must clearly document and make decisions based on objective data Completed DOT form must be kept on file Driver must sign certificate confirming accuracy Confidentiality is maintained Driver is given the certificate (if qualified) Employers can request to obtain copies of the full DOT form Providers should obtain a signed release from the patient The Americans With Disabilities Act does not override safety requirements under federal law