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Exam (elaborations)

2019 Dot: Comprehensive Review For Nrcme Exam

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2019 DOT: COMPREHENSIVE REVIEW FOR NRCME EXAM

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Atrial Flutter - Certify if:


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, Asymptomatic.
Isthmus ablation performed and at least one month after procedure.
Arrhythmia successfully treated.
Cleared by electrophysiologist.
Rate/rhythm control deemed adequate.
Maximum certification period: one-year.




monocular vision


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requires driver disqualification




brain stroke area at risk for seizure?


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cortical or subcortical deficits




disqualifying ear conditions and waiting periods


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, Drivers with conditions affecting the inner ear and balance should not be
certified. The minimum symptom free waiting period for drivers with
dizziness or vertigo is two months.
Guidance recommends a two-month, symptom-free waiting period for
diagnoses of:
a) Acute and chronic peripheral vestibulopathy.

b) Benign positional vertigo.

Guidance recommends not to certify with diagnoses of:
a) Uncontrolled vertigo.


b) Ménière's disease.

c) Nonfunctioning labyrinth.

d) Nonfunctioning fistula.




Certification/Recertification - CNS Stimulant Therapy


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Waiting period: No recommended time frame.

Do not certify the driver until medication has been shown
adequate/effective, safe, and stable.

Maximum certification - one year.

Recommend to certify if driver has:


Non-disqualifying underlying condition (e.g., adult ADHD).

No drug-induced impairment.

No tendency to increase the dose.

Recommend not to certify if the driver has:

, Disqualifying underlying condition (e.g., narcolepsy).

Treatment side effects that interfere with safe driving.

Monitoring/Testing: On a case-by-case basis obtain additional tests and/or
consult with a mental health specialist who understands demands of CMV
driving.

Evaluate:


Dose, plasma concentration, and duration of drug therapy.

Severity of the underlying mental disorder.

Follow-up: The driver should have annual medical examinations.




A driver with a history of major depression should be evaluated at least every __________
by an appropriate mental health specialist, such as a psychiatrist or psychologist, who
understands the functions and demands of commercial motor vehicle driving.


Six months.
One year.
Two years.
Such evaluation is not required.


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Correct Answer: Two years.


Explanation: The maximum certification interval for a driver with a history of
major depression is one year. Regulatory guidance requires evaluation
every two years by a specialist, such as psychiatrist or psychologist, who
understands the functions and demands of commercial driving.

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