NRCME Test Questions with 100% Complete Answers| Graded to Pass

Def CMV - Wt =/ 10,001 8 passengers if for hire 15 passengers (any) Non-discretionary conditions - MUST follow regulation standards and disqualify: Hearing Vision Epilepsy Form MCSA-5850 - To maintain certification, the examiner must submit monthly with the following for all drivers examined for the month - CMV driver's Name - Date of birth - Driver's license number and state - Date of examination - Indication of examination outcome - Whether intrastate driver only Recert/refresher how often? - Refresher every 5 years Recertifcation test every 10 Who publishes guidelines? - FMCSA Parameters tested in UA - SG, glucose, pro, blood What's being determined by examination? - Whether the CMV driver has a fixed deficit that interferes with safe driving or a condition that may cause sudden death or incapacitation. When is fitness for duty exam performed outside of expiration of current certification and who decides it needs to be done? - A driver whose ability to perform his/her normal duties has been impaired by a physical or mental injury or disease (391.45). The carrier decides if the driver's illness was severe enough to require recertification The only condition for which formal medical exemption is available - Monocular vision How long must the examiner retain copies of the examination form and card. - 3 years When can Medical Examination Report form be revised - CANNOT be revised after final determination or after the examination has been in "determination pending" status for more than 45 days. Medical conditions for which a certification interval has been recommended - Hypertension Heart disease (both one year-considered best practice) MAY disqualify drive if: - Does not meet medical guideline recommendation Does not meet FMCSA Medical Advisory Criteria Recommendations Uncertain or unknown clinical course (Disqualify or limit certification until information obtained) Unable to follow up and condition may disqualify Until additional evaluation is completed Can the examiner give the driver's medical examination report to the employer - Yes, with the driver's consent What should the examiner comment on? - All findings, even if not disqualifying Vision standard - At least 20/40 (Snellen) in each eye and together Field of vision of 70 degrees in horizontal meridian Eye exam should include - -Pupillary equality -Reaction to light and accommodation -Ocular motility -Ocular muscle imbalance -Extraocular movements -Nystagmus -Exophthalmos Conditions that could require ophthalmology evaluation - Retinopathy Cataracts Aphakia Glaucoma Macular degeneration Disqualifying forms of vision correction - Monovision contacts (one eye corrected for near, one eye for far) Telescopic lenses to compensate for loss of central vision Monocular vision WAIVER - Drivers who participated in study grandfathered, as long as they meet other medical requirements. Must be seen by opthalmologist annually and present waiver letter Federal Vision Exemption Program - Driver sees medical examiner first and is cleared for other medical conditions, then takes examination form and certificate to ophthalmologist. After eye exam, driver sends paperwork including ophthalmologists report to FMCSA, who grants exemption. Driver must carry vision exemption and certificate card. Vision exemption maximum recertification - 1 year Hearing standards - Forced whisper at 5 feet, or Average hearing loss not greater than 40 dB at 500, 1000 and 2000 Hz Health history questions related to hearing loss - Ear disorders Loss of hearing Loss of balance Dizziness Tinnitus Menieres Cochlear implant Standard used for audiometry - ANSI Exemption for hearing impairment - Issued by FMCSA on defacto basis Mark "Valid only with exemption" and write "hearing" in the space Certification recommendation for acute/chronic peripheral vestibulopathy or benign positional vertigo - 2 month symptom free waiting period Certification recommendation for uncontrolled vertigo, meniere's disease, labyrinthine fistula or nonfunctioning labyrinthes - do not certify Ear exam findings that should be documented - Scarring of the tympanic membrane Occlusion of the external canal Perforated eardrums How forced whisper test is performed - Examiner stands at examinee's side five feet away. Examinee covers other ear. EAt the end of exhalation, whispers a series of words, numbers or colors. Examiner determines how many times test is attempted or what percentage of correct responses is adequate. Audiometry requirement - Average loss of equal to/less than 40 dB at 500, 1000 and 2000 Hz Audiometry requirement - Average loss of equal to/less than 40 dB at 500, 1000 and 2000 Hz Cochlear implants - No specific recommendation from MEP. Do not certify if experiencing vestibular sx. Vertigo or dizziness: do not certify if sx interfere with: - Cognitive abilities Judgment Attention Concentration Sensory or motor function Cardiovascular physical exam should include - - Heart murmurs, extra sounds, - Enlarged heart - Pacemaker, implantable cardiac defibrillator - Blood pressure and pulse (rate and rhythm) ---- Abnormal pulse and amplitude, - Carotid or arterial bruits, varicose veins - Additional signs of disease (e.g., edema) - Abnormal respiratory breath sounds including wheezes and rales Most important prognostic factor in patients with CAD - Left ventricular function (ejection fraction 40 percent or more is the major predictor of health). Indicators which suggest increased risk in CAD - - Severity of coronary disease - Arrhythmias (four to six fold increased risk of fatal ventricular arrhythmias) ] - General health - Age - Angina pectoris - Vascular disease