NRCME DOT Exam Study Guide With Complete Solution

Solution 5 Feet - Answer A CMV driver must perceive a forced whispered voice in the better eat at not less than ___ with or w/o a hearing aid Audiogram - Answer This test is performed only when the Forced Whisper Test is failed in both ears 40 decibels - Answer If tested by the use of an audiometric device, they must not have an AVERAGE hearing loss in the better ear greater than ____ at 500Hz, 1000Hz, and 2000Hz One - Answer ___ ear and two eyes certifies! Audiologist - Answer A driver with a hearing aid usually must go to an ____ or a hearing aid center for audiometry testing 2 Years - Answer How long can a driver who meets the hearing requirements in one ear be certified? Acute and Peripheral Vesitbulopathy - Answer Inflammation of the inner ear that causes a sudden onset of vertigo. This requires a 2 month waiting period. Benign Positional Vertigo - Answer This occurs when a small piece of bone-like calcium breaks free and floats inside the Eustachian tube sending confusing messages to your brain about your body's position. This requires a 2-month waiting period. False - Answer T/F It is OK to certify someone with Uncontrolled Vertigo, Meniere's Disease, Labrythine Fistula, or Non-Functioning Labryinthes Meniere's Disease - Answer An inner ear disorder that affects balance and hearing. Labrythine Fistula - Answer An abnormal opening in the bony capsule of the inner ear resulting in the leakage of the peri lymph from the semicircular canals of the middle ear. Non-Functioning Labryinths - Answer Loss of vestibular function in both Labryinths leading to characteristic dysfunction in vision and balance. These symptoms reflect how crucial our Labryinth sense is for generating proper reflexes so that we can see clearly when we are moving and not lose our balance when we are standing or walking. Inner Ear - Answer Another name for the Labryinth Elevated Blood Pressure - Answer 1 or 2 readings greater than or equal to 140/90 on the same day Hypertension - Answer Two readings greater than or equal to 140/90 on consecutive exams on two different days The examiner - Answer Who should remeasure abnormal BP and or pulse rate or rhythm, especially if they are significant factors in determining certification? Even with the Sternum or right atrium of the driver - Answer When measuring a driver's BP they should sit in the chair for at least 5 min, back is supported, legs are uncrossed, and feet are touching the ground. Support the drivers arm at the elbow so the midpoint of the BP cuff is... 140-159/90-99 - Answer Stage 1 HTN 1 year - Answer How long can you certify someone who comes in for certification for the first time and has Stage 1 HTN? 1 year on BP meds - Answer If someone with Stage 1 HTN comes into the clinic for recertification how long can you certify them for if they are on BP meds and their BP is less than 140/90? 1-2 years if not on any BP meds - Answer If someone with Stage 1 HTN comes into the clinic for recertification how long can you certify them for if they are not on any BP meds? 1 time, 3 month certification card - Answer If a patient with Stage 1 HTN comes in for recertification and their BP is 140-159/90-99 what type of certification would they receive? 1 year from the date of the of the complete exam - Answer If a patient with Stage one HTN who comes back in for a 3-month recheck and their BP is 140/90 how long can they be certified for? 160-179/100-109 - Answer What is Stage 2 HTN? 3 months - Answer When does a person need to come back to be seen with Stage 2 HTN after their first exam for recertification? 1 year from the date of the complete exam - Answer A person with Stage 2 HTN returns for their recheck exam after 3 months. How long can they be certified if their BP is 140/90 and they are on BP meds? 1-2 years from the date of the complete exam - Answer A person with Stage 2 HTN returns for their recheck exam after 3 months. How long can they be certified if their BP is 140/90 and they are not on BP meds? Providers discretion - Answer A person with Stage 2 HTN returns for their recheck exam after 3 months. How long can they be certified if their BP is 140/90? 180/11 - Answer Stage 3 HTN Disqualified - Answer If a person comes in for an exam and their BP is 180/110 then they should be ...? Certify for 6 months with recertification every six months - Answer Stage 3 HTN patient returns for a recheck. How long can they be certified and how often should they be recertified? The patient should be disqualified. - Answer What should happen if a Stage 3 HTN patient comes in for a recheck and their BP is greater than 140/90?? One Time 3 month card - Answer This certificate is included in the annual certification interval and is not an extension of the certification period. It can not be used in consecutive increments. Drivers who must be tested for drugs and alcohol - Answer Drivers who operate CMVs of 26,001 pounds or more, transport 16 or more passengers, or who carry placarded hazardous material on the public roadway -- All drivers operating CMVs in interstate commerce --- All drivers required to have a CDL If they were in a testing program within the last 30 days and was tested within the last 6 months or a was a program for the previous 12 months - Answer When is a driver exempt from Pre-Employment testing? 8 hours for ETOH and 32 hours for drugs - Answer What is the time frames for ETOH and drug testing after a crash? Post-Accident Testing - Answer Testing that has to occur when the crash involves the loss of human life, the driver receives a citation within 8 hours of the accident, there is bodily injury to a person who immediately received medical treatment away from the scene, or if 1 or more MVs must be transported away by tow truck 6 drug tests within the first year - Answer When a driver returns to duty after violating drug and ETOH standards, how many f/u drug and ETOH tests would they need in the first year of returning to driving? Directly Observed Testing - Answer Employee must raise shirt and lower underpants to mid-thigh to show no device is being worn during what kind of urine testing? 2 drinks/day for men 1 drink/day for women - Answer Heavy drinking average for men and women? Binge Drinking - Answer A pattern of ETOH consumption that brings the Blood Alcohol Concentration (BAC) level to 0.08% or more in a 2-hour period - Men 5 or more drinks and Women 4 or more drinks Alcohol Abuse - Answer A pattern of drinking that results in harm to one's health, interpersonal relationships, or ability to work. Long term use can turn into dependence. Alcohol Dependence - Answer A chronic disease that includes a strong craving for ETOH despite repeated physical, psychological, or intepersonal problems; An inability to limit drinking SAP (Substance Abuse Professional) - Answer Evaluates employees who have violated DOT drug and ETOH regulations and makes recommendations concerning education, treatment, F/U testing, and aftercare MRO (Medical Review Officer) - Answer Licensed MD responsible for receiving and reviewing labs generated by a drug testing program, contacts the user when there is a positive result for an interview to determine if there is an alternate explanation for drug findings in the urine specimen DER (Designated Employee Representative) - Answer Individual who receives communications and test results from service agents, authorized to take immediate action to remove employees from safety sensitive duties, and to make required decisions in the testing and evaluation process-- Must be an employee of the company Alcoholism - Answer When in remission, _____ is not disabling unless transient or permanent neurological changes have occurred - Answer REVIEW MEDICATIONS AND IF THEY ARE SAFE FOR CMV DRIVERS Normal Labs - Answer A1C: 5% Fasting Glucose: 99 or below Oral GTT: 139 or Below Prediabetes - Answer A1C: 5.7-6.4% Fasting Glucose: 100-125 Oral GTT: 140-199 Diabetes - Answer A1C: 6.5% or greater Fasting Glucose: 126 or above Oral GTT: 200 or above Type 1 DM - Answer Lack of insulin production, must receive insulin, severely compromised counter-regulatory mechanisms Type 2 DM - Answer Adult Onset or Non-Insulin Taking, patient can produce insulin, treatment is diet and oral medication which preserves blood glucose mechanisms for years If the driver takes insulin - Answer Certification of a CMV driver with diabetes is based on what? Macrovascular Disease - Answer Accelerated atherosclerosis of coronary, cerebral, and peripheral vessels, higher risk for cardiovascular disease, can cause TIA or stroke, leading cause of death among diabetics Microvascular Disease - Answer Neuropathy, Nephropathy, Retinopathy, Macular Degeneration Neuropathy - Answer Disturbance in sensation and touch, loss of position sense, loss of vibratory sense, autonomic neuropathy Symptoms of Acute Hyperglycemia - Answer Fatigue, lethargy, sluggishness, transient cognitive disruption; Sudden onset unlikely; May begin around 280-300% but is more likely with a sustained plasma glucose of greater than 400% 10% - Answer The FMCSA Medical Examiner Handbook states that a Hgb A1C of ____ (275%) indicates poor glucose control Mild Hypoglycemia - Answer Rapid heart rate, sweating, weakness, and hunger Severe Hypoglycemia - Answer Seizure, loss of consciousness, need of assistance from another person, period of impaired cognitive function without warning Blood Glucose - Answer When performing a UA... A MA detects glycosuria. What should be the test that she performs? Glomerular Damage - Answer Diabetics with excessive proteinuria may be indicative of what? Annualy - Answer How often should diabetics be recertified because of the progressive nature of DM and the potential for complications? Transportation Equity Act of 1998 - Answer The act revised the authority of the Secretary of Transportation to grant waivers or exemptions and established procedures for pilot exemption programs SAFETEA-LU - Answer This 2005 act eliminated the 3-year driving requirement of driving a CMV while on insulin, adopted new waiting periods New Diabetic Waiting Periods because of the 2005 SAFETEA-LU - Answer Minimum 1-month if the driver was previously diagnosed and treated with oral mess but now requires insulin