NRCME Study Sheet
Latest Updated Guide 2025/2026
vision requirements - ansDistant vision 20/40 each eye and 20/40 both eyes, Peripheral vision
at least 70 degrees, Ability to recognize and distinguish betwen the colors of traffic signals
and devices.
If the driver presents a valid vision exemption, how long can he be certified? - ans1 year
The driver with a vision exemption must present what 2 things before receiving the medical
examiner's certificate. - ansValid vision exemption and copy of the specialist eye examination
report.
When applying for a vision exemption, the driver should include a copy of the Medical
Examination Report form and the medical examiner's certification with what marked? -
ansThe "accompanied by" exemption checkbox and write "vision" to identify the type of
exemption.
If the driver is qualified by operation of 49 CFR 391.64 due to participation in the vision
study program, what must the driver present to qualify for certification? - ansLetter
identifying the driver as a participant and copy of the specialist eye examination.
How long can a driver who is qualified by operation of 49 CFR 391.64 be certified. - ans1
year
hearing requirements - ansWhisper at not less than 5 feet in 1 ear, or average hearing loss no
greater than 40 dB at 500Hz, 1000Hz, 2000 Hz in 1 ear.
What is the waiting period for vertigo caused by benign positional vertigo or acute/chronic
peripheral vestibulopathy? - ans3 months
Name 4 otic conditions that are automatic disqualification - ansMeniere's, uncontrolled
vertigo, labyrinthine fistula, nonfunctioning labyrinth
Apnea-hypopnea index of [blank] or more episodes per hour is diagnostic of OSA - ans30
3 requirements for a passing ETT - ans1. increased SBP of at least 20 without angina
2. workload capacity >6 METs
3. no significant ST depression
Examiners must retain records for how many years? - ans3
Regulation that describes the physical qualifications of drivers. - ans49 CFR 391.41
Regulation that describes the responsibilities of the medical examiner. - ans49 CFR 391.43
Regulation that describes the process for conflict resolution when there is a disagreement
between the primary care provider for the driver and the medical examiner for the motor
carrier concerning driving qualifications. - ans49 CFR 391.47
Regulation that describes the Skill Performance Evaluation (SPE) Certification Program. -
ans49 CFR 391.49
Regulation that describes limited exemptions for intra-city zone drivers. - ans49 CFR 391.62
Regulation that describes grandfathering for certain drivers who participated in vision and
diabetes waiver study programs. - ans49 CFR 391.64
Regulation that includes regulations for medical review officers and substance abuse
professionals, including drug and alcohol testing procedures. - ans49 CFR 40
Define Stage I Hypertension - ansBP greater than or equal to 140/90
What is the maximum certification period for stage I hypertension if this is the 1st
examination at which the driver has BP equivalent to stage I hypertension and has no history
of hypertension? - ans1 year
What is the maximum certification period for untreated known or inadequately controlled
stage I hypertension? - ans3 months
, NRCME Study Sheet
Latest Updated Guide 2025/2026
What is the maximum certification period for blood pressure >140/90 and the following:
follow-up 3 months certificate or history of stage III hypertension - ansNone, driver is
disqualified
Define Stage II hypertension. - ansBP is ≥ 160 to <180 SYSTOLIC, and is ≥100 to < 110
Diastolic
What is the maximum certification period for Stage II hypertension with blood pressure
>140/90? - ans3 months
What is the maximum certification period for Stage II hypertension with blood pressure
</140/90? - ans1 year
Define Stage III hypertension. - ansBP >180 Systolic and > 110 Diastolic
What is the maximum certification period for Stage III hypertension with blood pressure
>140/90? - ans1 time certificate for 3 months in accordance with stage 1 or 2 HTN
guidelines, as determined by a case by case basis.
What is the maximum certification period for a driver with a history of Stage III hypertension
but t exam his BP is at or less 140/90 and treatment is well tolerated? - ans6 months
What is the maximum certification period for Stage III hypertension with blood pressure
>180/110? - ansNone, driver is disqualified.
What is the waiting period and maximum certification period for surgical correction of
secondary hypertension? - ans3 months and 1 year post surgical correction
What is the waiting period and maximum certification period for driver on anticoagulants for
cardiovascular cause? - ans1 month stabilized and 1 year with monthly INRs
What is the waiting period and maximum certification period for driver on anticoagulants for
neurlogical condition? - ansNone, driver is disqualified.
5 reasons to disqualify a driver with AAA - ans1. Symptomatic
2. AAA >5cm
3. AAA 4-5 cm and does not have clearance from a cardiologist
4. AAA increased in size 0.5cm in 6 months
5. Surgical repair was recommended but not done
Maximum certification period for driver with AAA that is asymptomatic or <4cm, >4cm and
<5cm but has clearance from cardiologist - ans1 year
Maximum certification period for Acute DVT - ans1 year
Maximum certification period for Chronic DVT - ans2 years
Waiting period and maximum certification period for intermittent claudication if driver has
no resting pain. - ans3 months for post-surgical repair and 1 year
Waiting period and maximum certification for aneurysms of visceral, peripheral arteries or
venous vessels - ans3 months post-surgical repair and 1 year with clearance from cardiologist
Waiting period and maximum certification for peripheral vascular disease - ans3 months
post-surgical repair and 1 year without resting pain
Waiting period and maximum certification for pulmonary emboli - ans3 months with no
pulmonary embolism and 1 year if asymptomatic
Maximum certification period for superficial phlebitis - ans2 years
Waiting period and maximum certification for thoracic aneurysm <3.5cm - ans3 months post
surgical repair and 1 year
True or false: having an ICD is automatic disqualification - anstrue
Min waiting period for pacemaker implantation for sinus node dysfunction or AV block -
ans1 month
Latest Updated Guide 2025/2026
vision requirements - ansDistant vision 20/40 each eye and 20/40 both eyes, Peripheral vision
at least 70 degrees, Ability to recognize and distinguish betwen the colors of traffic signals
and devices.
If the driver presents a valid vision exemption, how long can he be certified? - ans1 year
The driver with a vision exemption must present what 2 things before receiving the medical
examiner's certificate. - ansValid vision exemption and copy of the specialist eye examination
report.
When applying for a vision exemption, the driver should include a copy of the Medical
Examination Report form and the medical examiner's certification with what marked? -
ansThe "accompanied by" exemption checkbox and write "vision" to identify the type of
exemption.
If the driver is qualified by operation of 49 CFR 391.64 due to participation in the vision
study program, what must the driver present to qualify for certification? - ansLetter
identifying the driver as a participant and copy of the specialist eye examination.
How long can a driver who is qualified by operation of 49 CFR 391.64 be certified. - ans1
year
hearing requirements - ansWhisper at not less than 5 feet in 1 ear, or average hearing loss no
greater than 40 dB at 500Hz, 1000Hz, 2000 Hz in 1 ear.
What is the waiting period for vertigo caused by benign positional vertigo or acute/chronic
peripheral vestibulopathy? - ans3 months
Name 4 otic conditions that are automatic disqualification - ansMeniere's, uncontrolled
vertigo, labyrinthine fistula, nonfunctioning labyrinth
Apnea-hypopnea index of [blank] or more episodes per hour is diagnostic of OSA - ans30
3 requirements for a passing ETT - ans1. increased SBP of at least 20 without angina
2. workload capacity >6 METs
3. no significant ST depression
Examiners must retain records for how many years? - ans3
Regulation that describes the physical qualifications of drivers. - ans49 CFR 391.41
Regulation that describes the responsibilities of the medical examiner. - ans49 CFR 391.43
Regulation that describes the process for conflict resolution when there is a disagreement
between the primary care provider for the driver and the medical examiner for the motor
carrier concerning driving qualifications. - ans49 CFR 391.47
Regulation that describes the Skill Performance Evaluation (SPE) Certification Program. -
ans49 CFR 391.49
Regulation that describes limited exemptions for intra-city zone drivers. - ans49 CFR 391.62
Regulation that describes grandfathering for certain drivers who participated in vision and
diabetes waiver study programs. - ans49 CFR 391.64
Regulation that includes regulations for medical review officers and substance abuse
professionals, including drug and alcohol testing procedures. - ans49 CFR 40
Define Stage I Hypertension - ansBP greater than or equal to 140/90
What is the maximum certification period for stage I hypertension if this is the 1st
examination at which the driver has BP equivalent to stage I hypertension and has no history
of hypertension? - ans1 year
What is the maximum certification period for untreated known or inadequately controlled
stage I hypertension? - ans3 months
, NRCME Study Sheet
Latest Updated Guide 2025/2026
What is the maximum certification period for blood pressure >140/90 and the following:
follow-up 3 months certificate or history of stage III hypertension - ansNone, driver is
disqualified
Define Stage II hypertension. - ansBP is ≥ 160 to <180 SYSTOLIC, and is ≥100 to < 110
Diastolic
What is the maximum certification period for Stage II hypertension with blood pressure
>140/90? - ans3 months
What is the maximum certification period for Stage II hypertension with blood pressure
</140/90? - ans1 year
Define Stage III hypertension. - ansBP >180 Systolic and > 110 Diastolic
What is the maximum certification period for Stage III hypertension with blood pressure
>140/90? - ans1 time certificate for 3 months in accordance with stage 1 or 2 HTN
guidelines, as determined by a case by case basis.
What is the maximum certification period for a driver with a history of Stage III hypertension
but t exam his BP is at or less 140/90 and treatment is well tolerated? - ans6 months
What is the maximum certification period for Stage III hypertension with blood pressure
>180/110? - ansNone, driver is disqualified.
What is the waiting period and maximum certification period for surgical correction of
secondary hypertension? - ans3 months and 1 year post surgical correction
What is the waiting period and maximum certification period for driver on anticoagulants for
cardiovascular cause? - ans1 month stabilized and 1 year with monthly INRs
What is the waiting period and maximum certification period for driver on anticoagulants for
neurlogical condition? - ansNone, driver is disqualified.
5 reasons to disqualify a driver with AAA - ans1. Symptomatic
2. AAA >5cm
3. AAA 4-5 cm and does not have clearance from a cardiologist
4. AAA increased in size 0.5cm in 6 months
5. Surgical repair was recommended but not done
Maximum certification period for driver with AAA that is asymptomatic or <4cm, >4cm and
<5cm but has clearance from cardiologist - ans1 year
Maximum certification period for Acute DVT - ans1 year
Maximum certification period for Chronic DVT - ans2 years
Waiting period and maximum certification period for intermittent claudication if driver has
no resting pain. - ans3 months for post-surgical repair and 1 year
Waiting period and maximum certification for aneurysms of visceral, peripheral arteries or
venous vessels - ans3 months post-surgical repair and 1 year with clearance from cardiologist
Waiting period and maximum certification for peripheral vascular disease - ans3 months
post-surgical repair and 1 year without resting pain
Waiting period and maximum certification for pulmonary emboli - ans3 months with no
pulmonary embolism and 1 year if asymptomatic
Maximum certification period for superficial phlebitis - ans2 years
Waiting period and maximum certification for thoracic aneurysm <3.5cm - ans3 months post
surgical repair and 1 year
True or false: having an ICD is automatic disqualification - anstrue
Min waiting period for pacemaker implantation for sinus node dysfunction or AV block -
ans1 month
