2025 DOT: Comprehensive Review for
NRCME Exam
"Lone atrial fibrillation" - ANS-is atrial fibrillation in the absence of other risk factors for stroke,
such as previous stroke or TIA, diabetes mellitus, hypertension, heart failure, age greater than
75 years, or valvular heart disease. ___ is the only anti-thrombotic therapy required for patients
with lone atrial fibrillation.
2. Pulse oximetry O2 saturation = 90%. Arterial blood gas (ABG): PaO2 = 60 mm Hg, PaCO2 =
42 mm Hg. What is the certification determination?
Do not certify.
Certify three months pending additional testing.
Certify for one year.
Certification depends on whether testing is conducted at altitudes above or below 5,000 feet. -
ANS-Correct Answer: Certification depends on whether testing is conducted at altitudes above
or below 5,000 feet.
Explanation: The certification determination related to arterial blood gas (ABG) testing depends
on the altitude at which testing is performed. A PaO2 of less than 65 mm Hg is disqualifying at
altitudes of less than 5,000 feet; a PaO2 of less than 60 mm Hg is disqualifying at altitudes of
greater than 5,000 feet.
A commercial motor vehicle (CMV) is defined as... - ANS-* A vehicle with a gross weight over
26,001 lbs
* A vehicle transporting hazardous materials
* A vehicle transporting 16 or more passengers
A current clinical diagnosis of drug abuse or alcoholism cert period? - ANS-disqualifying.
A driver experienced a pneumothorax four weeks ago. The medical examiner tests the driver's
respiratory function and the forced vital capacity (FVC) is 58% of predicted. What should the
certification decision be?
Do not certify pending additional testing.
Certify for three months, pending driver follow up with personal physician and/or specialist.
Certify one year.
Certify two years. - ANS-Correct Answer: Do not certify pending additional testing.
,Explanation: The driver may not be certified until FVC is > 60% predicted or additional testing
reveals acceptable respiratory parameters - e.g., pulse oximetry with O2 > 92%.
A driver has loss of hearing in the better ear of 25 dB loss at 500 Hz, 40 dB loss at 1000 Hz,
and 60 dB loss at 2000 Hz. With respect to the hearing requirement for medical certification, the
driver __________.
May be certified for one year.
May be certified for two years.
May not be certified.
May be certified if examined by an otolaryngologist who is familiar with the CMV driving duties
who certifies the driver as medically qualified to drive a CMV. - ANS-May not be certified.
Explanation: An average hearing loss of 41.7 decibels averaged across 500, 1000, and 2000 Hz
in the better ear is disqualifying. The driver should be referred to obtain a hearing aid and may
be certified if the driver passes while wearing a hearing aid. A specialist cannot determine
certification, and a specialist cannot override medical qualification standards such as the
minimum hearing requirement.
A driver underwent surgical repair of a 6 cm abdominal aortic aneurysm three months ago. The
driver may be certified for __________.
Three months.
One year.
Two years.
The driver should be medically disqualified. - ANS-One year.
Explanation: The minimum waiting period for surgical repair of an abdominal aneurysm is three
months. The maximum certification interval is one year.
A driver who wears contact lenses which correct farsightedness in one eye and
nearsightedness in the other, but has no other visual impairments can be certified under what
additional conditions?
Only if the driver wears prescription glasses which provide the same correction as the contact
lenses.
FMCSA guidance indicates that a driver should not be certified under these circumstances.
Only by federal exemption.
The driver is always certifiable under these conditions. - ANS-FMCSA guidance indicates that a
driver should not be certified under these circumstances.
Explanation: FMCSA guidance indicates that contact lenses that correct one eye for distance
and one eye for near vision are not acceptable.
,A driver with a history of bacterial meningitis with early seizures or a single unprovoked seizure
requires a waiting period of __________ seizure free and off anticonvulsant medications.
One year.
Two years.
Five years.
Ten years. - ANS-Correct Answer: Five years.
Explanation: The waiting period for a history of bacterial meningitis with early seizures or single
unprovoked seizure is five years seizure free and off anticonvulsant medications.
A driver with a history of kidney disease with or without transplant __________.
Is medically disqualified.
Must be assessed regarding severity, stability, medication use and medication side
effects/adverse reactions.
Should not be assessed for functional ability to operate a CMV safely.
Should have the medical certification determination made by a renal specialist. - ANS-Correct
Answer: Must be assessed regarding severity, stability, medication use and medication side
effects/adverse reactions.
Explanation: Assessment for kidney disease must be made on a case-by-case basis. Dialysis of
any kind is disqualifying. The medical examiner may choose to test the driver for functional
ability to operate a CMV safely. The medical certification decision must be made by the medical
examiner.
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. - ANS-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.
A driver with a history of recent drug abuse must - ANS-be evaluated by a substance abuse
professional (SAP) and must complete a rehabilitation program as recommended by the SAP.
A driver with a history of recent drug abuse must pass a DOT return-to-work drug test and is
then subject to follow-up random drug testing at a frequency determined by the SAP.
, A driver with an impairment of an arm, leg, hand, or foot who is otherwise medically qualified,
may be certified if the driver does what? - ANS-gets an SPE certificate.
Driver must apply for the SPE certificate from the FMCSA and the FMCSA determines if driver
is qualified for the SPE certificate.
A driver with congestive heart failure (CHF) recently had an echocardiogram demonstrating an
ejection fraction of 44%. The driver may be certified for __________ if the driver meets all other
qualifications for CHF.
One year.
Two years.
Six months.
The driver should not be certified. - ANS-One year.
Explanation: The minimum left ventricular ejection fraction (LVEF) for certification with any
cardiovascular condition is 40%. The maximum certification interval for drivers with CHF is one
year.
A driver with history of moderate traumatic brain injury with early seizures, stroke with risk for
seizures, or intracerebral or subarachnoid hemorrhage with risk for seizures requires a waiting
period of __________ seizure free and off anticonvulsant medications.
One year.
Two years.
Five years.
Ten years. - ANS-Correct Answer: Five years.
Explanation: Each of these conditions requires a symptom-free waiting period of five years.
A driver with peripheral neuropathy __________.
May be certified for one year.
Should not be certified by regulation.
Should not be certified by guidance.
May be certified for three months pending specialist evaluation. - ANS-Correct Answer: Should
not be certified by guidance.
Explanation: Peripheral neuropathy is a disqualifying condition. However, this is a guidance
recommendation, not a regulatory requirement, so Medical Examiners may consider
qualification for a driver with peripheral neuropathy.
NRCME Exam
"Lone atrial fibrillation" - ANS-is atrial fibrillation in the absence of other risk factors for stroke,
such as previous stroke or TIA, diabetes mellitus, hypertension, heart failure, age greater than
75 years, or valvular heart disease. ___ is the only anti-thrombotic therapy required for patients
with lone atrial fibrillation.
2. Pulse oximetry O2 saturation = 90%. Arterial blood gas (ABG): PaO2 = 60 mm Hg, PaCO2 =
42 mm Hg. What is the certification determination?
Do not certify.
Certify three months pending additional testing.
Certify for one year.
Certification depends on whether testing is conducted at altitudes above or below 5,000 feet. -
ANS-Correct Answer: Certification depends on whether testing is conducted at altitudes above
or below 5,000 feet.
Explanation: The certification determination related to arterial blood gas (ABG) testing depends
on the altitude at which testing is performed. A PaO2 of less than 65 mm Hg is disqualifying at
altitudes of less than 5,000 feet; a PaO2 of less than 60 mm Hg is disqualifying at altitudes of
greater than 5,000 feet.
A commercial motor vehicle (CMV) is defined as... - ANS-* A vehicle with a gross weight over
26,001 lbs
* A vehicle transporting hazardous materials
* A vehicle transporting 16 or more passengers
A current clinical diagnosis of drug abuse or alcoholism cert period? - ANS-disqualifying.
A driver experienced a pneumothorax four weeks ago. The medical examiner tests the driver's
respiratory function and the forced vital capacity (FVC) is 58% of predicted. What should the
certification decision be?
Do not certify pending additional testing.
Certify for three months, pending driver follow up with personal physician and/or specialist.
Certify one year.
Certify two years. - ANS-Correct Answer: Do not certify pending additional testing.
,Explanation: The driver may not be certified until FVC is > 60% predicted or additional testing
reveals acceptable respiratory parameters - e.g., pulse oximetry with O2 > 92%.
A driver has loss of hearing in the better ear of 25 dB loss at 500 Hz, 40 dB loss at 1000 Hz,
and 60 dB loss at 2000 Hz. With respect to the hearing requirement for medical certification, the
driver __________.
May be certified for one year.
May be certified for two years.
May not be certified.
May be certified if examined by an otolaryngologist who is familiar with the CMV driving duties
who certifies the driver as medically qualified to drive a CMV. - ANS-May not be certified.
Explanation: An average hearing loss of 41.7 decibels averaged across 500, 1000, and 2000 Hz
in the better ear is disqualifying. The driver should be referred to obtain a hearing aid and may
be certified if the driver passes while wearing a hearing aid. A specialist cannot determine
certification, and a specialist cannot override medical qualification standards such as the
minimum hearing requirement.
A driver underwent surgical repair of a 6 cm abdominal aortic aneurysm three months ago. The
driver may be certified for __________.
Three months.
One year.
Two years.
The driver should be medically disqualified. - ANS-One year.
Explanation: The minimum waiting period for surgical repair of an abdominal aneurysm is three
months. The maximum certification interval is one year.
A driver who wears contact lenses which correct farsightedness in one eye and
nearsightedness in the other, but has no other visual impairments can be certified under what
additional conditions?
Only if the driver wears prescription glasses which provide the same correction as the contact
lenses.
FMCSA guidance indicates that a driver should not be certified under these circumstances.
Only by federal exemption.
The driver is always certifiable under these conditions. - ANS-FMCSA guidance indicates that a
driver should not be certified under these circumstances.
Explanation: FMCSA guidance indicates that contact lenses that correct one eye for distance
and one eye for near vision are not acceptable.
,A driver with a history of bacterial meningitis with early seizures or a single unprovoked seizure
requires a waiting period of __________ seizure free and off anticonvulsant medications.
One year.
Two years.
Five years.
Ten years. - ANS-Correct Answer: Five years.
Explanation: The waiting period for a history of bacterial meningitis with early seizures or single
unprovoked seizure is five years seizure free and off anticonvulsant medications.
A driver with a history of kidney disease with or without transplant __________.
Is medically disqualified.
Must be assessed regarding severity, stability, medication use and medication side
effects/adverse reactions.
Should not be assessed for functional ability to operate a CMV safely.
Should have the medical certification determination made by a renal specialist. - ANS-Correct
Answer: Must be assessed regarding severity, stability, medication use and medication side
effects/adverse reactions.
Explanation: Assessment for kidney disease must be made on a case-by-case basis. Dialysis of
any kind is disqualifying. The medical examiner may choose to test the driver for functional
ability to operate a CMV safely. The medical certification decision must be made by the medical
examiner.
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. - ANS-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.
A driver with a history of recent drug abuse must - ANS-be evaluated by a substance abuse
professional (SAP) and must complete a rehabilitation program as recommended by the SAP.
A driver with a history of recent drug abuse must pass a DOT return-to-work drug test and is
then subject to follow-up random drug testing at a frequency determined by the SAP.
, A driver with an impairment of an arm, leg, hand, or foot who is otherwise medically qualified,
may be certified if the driver does what? - ANS-gets an SPE certificate.
Driver must apply for the SPE certificate from the FMCSA and the FMCSA determines if driver
is qualified for the SPE certificate.
A driver with congestive heart failure (CHF) recently had an echocardiogram demonstrating an
ejection fraction of 44%. The driver may be certified for __________ if the driver meets all other
qualifications for CHF.
One year.
Two years.
Six months.
The driver should not be certified. - ANS-One year.
Explanation: The minimum left ventricular ejection fraction (LVEF) for certification with any
cardiovascular condition is 40%. The maximum certification interval for drivers with CHF is one
year.
A driver with history of moderate traumatic brain injury with early seizures, stroke with risk for
seizures, or intracerebral or subarachnoid hemorrhage with risk for seizures requires a waiting
period of __________ seizure free and off anticonvulsant medications.
One year.
Two years.
Five years.
Ten years. - ANS-Correct Answer: Five years.
Explanation: Each of these conditions requires a symptom-free waiting period of five years.
A driver with peripheral neuropathy __________.
May be certified for one year.
Should not be certified by regulation.
Should not be certified by guidance.
May be certified for three months pending specialist evaluation. - ANS-Correct Answer: Should
not be certified by guidance.
Explanation: Peripheral neuropathy is a disqualifying condition. However, this is a guidance
recommendation, not a regulatory requirement, so Medical Examiners may consider
qualification for a driver with peripheral neuropathy.
