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Exam (elaborations)

NRCME Exam 2024

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What are regulations? - Answer Laws that must be followed What are disqualifying medical conditions? - Answer Epilepsy monocular vision hearing loss What are guidelines? - Answer Recommendation to follow but can have raptor ale for variation FMCSA medical program responsibilities include: Oversee the Department of Transportation. Regulation of intrastate commercial motor vehicle operations. Conduct and oversee the agency's medical exemption and certificate programs. Provide commercial motor vehicle driver examinations. - Answer Conduct and oversee the agency's medical exemption and certificate programs. Which of the following is true? The FMCSA does not consider feasibility or impact in the rule-making process. Only the Medical Review Board can provide advice and opinions on FMCSA

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NRCME Exam 2023
What are regulations? - Answer Laws that must be followed

What are disqualifying medical conditions? - Answer Epilepsy
monocular vision
hearing loss

What are guidelines? - Answer Recommendation to follow but can have raptor ale
for variation

FMCSA medical program responsibilities include:
Oversee the Department of Transportation.
Regulation of intrastate commercial motor vehicle operations.
Conduct and oversee the agency's medical exemption and certificate programs.
Provide commercial motor vehicle driver examinations. - Answer Conduct and
oversee the agency's medical exemption and certificate programs.

Which of the following is true?
The FMCSA does not consider feasibility or impact in the rule-making process.
Only the Medical Review Board can provide advice and opinions on FMCSA
rulemaking.
FMCSA medical standards and guidelines are subject to public notice and comment
rulemaking.
The Code of Federal Regulations provide guidance that the medical examiner may
or may not follow.examiner may or may not follow. - Answer FMCSA medical
standards and guidelines are subject to public notice and comment rulemaking.

FMCSA content sources rules and regulations include
49 CFR Part 16 DOT Procedures for Drug and Alcohol Testing.
49 CFR 391.41 Physical Qualifications for Drivers.
49 CFR 391.82 Medical examination; certificate of physical qualification.
49 CFR Part 73: Medical Review Board procedures. - Answer 49 CFR 391.41
Physical Qualifications for Drivers.

Which of the following is true regarding why regulation is needed to protect public
safety?

There is little environmental risk from crashes involving hazardous materials.
There is greater risk of injury and fatalities to individuals in smaller vehicles from
crashes involving commercial motor vehicles.
The economic cost of crashes involving commercial vehicles is relatively low.
Commercial vehicles do not carry members of the public. - Answer There is greater
risk of injury and fatalities to individuals in smaller vehicles from crashes involving
commercial motor vehicles.

Which of the following is true?
By May 21, 2015, medical providers that perform medical examinations for
commercial motor vehicle drivers must have completed an approved training
program and passed a national certification examination.
The Medical Examiner may request that an appropriate specialist provider make the
driver certification determination.

,NRCME Exam 2023
The purpose of the commercial motor vehicle driver examination is for treatment of
driver medical conditions.
FMCSA guidance recommendations may or may not be followed by the Medical
Examiner. - Answer FMCSA guidance recommendations may or may not be followed
by the Medical Examiner.`

What is the role of the medical examiner? - Answer to determine medical fitness for
duty.

What are the differences between the medical standards and the medical guidelines
- Answer Medical Standards - regulations that are non-discretionary - the medical
examiner cannot use judgment to certify a driver who does not meet a regulatory
standard
Medical Guidelines are discretionary - Medical Examiners may decide to certify
drivers who do not meet medical guidelines. Most recommendations related to
certification of specific medical conditions are guidance

What are some medical standards for certifications that need to be done? - Answer
Vision requirements, including distant visual acuity, horizontal vision, and color
vision. Drivers who do not meet standards cannot be certified unless accompanied
by a vision exemption/waiver.
Diabetes requirements: drivers using insulin cannot be certified unless special
procedures for evaluation and certification of such drivers are followed.
Epilepsy: drivers with a diagnosis of epilepsy cannot be certified unless
accompanied by an epilepsy waiver/exemption.
Hearing: drivers who cannot meet whisper test or audiometric test requirements
cannot be certified unless accompanied by a hearing waiver/exemption.

What are Turn around or short relay drivers? - Answer drivers return to their home
base each evening

what are Long relay drivers? - Answer drivers drive 9 to 11 hours and then have at
least a 10-hour off duty period)

What are Straight through haul drivers? - Answer cross country

What are Team drivers? - Answer drivers share the driving by alternating their 5-hour
driving periods and 5-hour rest periods

What are the instructions for completion of a DOT physical? - Answer Driver arrives
at medical examiner's office
Driver may bring paperwork
-Verify driver identification with photo ID
Driver completes formsMCSA 5875 - Medical Examination Report Form driver
history
-Confirm driver signature and date
-Recommend driver sign HIPAA compliant release form(s)
Driver testing then completed by medical examiner and/or staff
-Vision testing
-Hearing - whisper test or audiometry

, NRCME Exam 2023
-Dipstick urinalysis
-Blood pressure
- pulse
-Height and weight
Medical Examiner examination
=Review driver historyAcknowledge driver "Yes" answers and clarify with questions
and additional information
-Ask if driver has ever received less than a 2-year certification at any prior DOT
medical examination
Physical examination - driver should be in medical gown or equivalent
-Medical Examiner notes abnormal findings with comments
Medical Examiner completes forms (MCSA 5875 and MCSA 5876)
Provide copy of Driver Certificate to driver and, if requested, to employer
Complete online completion of driver certification information no later than midnight
(local time) of the calendar day following the date of the examination

When does the online completion of driver certification information have to be done?
- Answer no later than midnight (local time) of the calendar day following the date of
the examination

An individual diagnosed with Stage 1 hypertension (BP is 140/90-159/99) may be
certified for how long? - Answer 1 year

At recertification, an individual with a hx of HTN; BP is greater than 140/90 but less
than 160/100, - Answer 3 months

An individual diagnosed with Stage 2 (BP is 160/100-179/109) should be treated and
given certificate for how long? - Answer 3 months

An individual diagnosed with Stage 3 hypertension (BP equal to or greater than
180/110) should - Answer not be certified until his or her BP is reduced to 140/90 or
less, and may be recertified every 6 months

What are the four required tests for DOT exam? - Answer Vision
Hearing
Blood pressure/pulse
Urinalysis

What should you tell a driver with contact lenses and/or glasses? - Answer that he or
she should carry extra contacts/pairs of glasses while driving.

What should you tell a driver who wears a hearing aide? - Answer that he/she should
possess a spare power source for the device while driving.

What are some reasons to disqualify a driver? - Answer Who is currently using
methadone.
Who has a current clinical diagnosis of alcoholism or who uses a controlled
substance including a narcotic, an amphetamine, or another habit-forming drug
without a prescription from the treating physician.

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