DOT Exam NRCME Study Guide
A driver has a BP of 138 over 98. What stage is this? - ANS-Stage 1. The diastolic meets the
definition of Stage 1
A driver has a BP of 146/82. What stage is this? - ANS-Stage 1. The systolic meets the
definition of Stage 1
A driver has a BP of 164/92. What stage is this? - ANS-Stage 2. Even though there are 2 levels
for systolic and diastolic, the higher stage would determine the overall stage the driver is in.
Systolic is stage 2, diastolic is stage 1. The driver suffers from stage 2 Htn.
A driver has a glucose of 1000 in his UA with a history of DM. The rest of his exam is WNL. Can
this driver be certified even with a shortened certificate? - ANS-No, It is evident that the driver's
DM is not well managed.
A driver has a glucose reading of 250 in his UA with no history of diabetes. The rest of his exam
is WNL. Can this driver be certified to drive? - ANS-Yes, provide a 1 to 3 month shortened
certificate and refer for an evaluation by the drivers PCP to determine if the driver has a DM.
A driver has AAA. The ME view the sonogram indicating the diameter is 5.6. Can he be certified
to drive? - ANS-No. The diameter must be less than 5cm.
A driver has an audiometric test. His hearing loss in ANSI while wearing hearing aids is 40db
left ear; and 43 db right ear. Do he meet the standard? - ANS-Yes. Because one ear meets the
standard (40 in the left ear meets the requirement) his is capable of being certified to drive.
A driver is taking amitriptyline for depression, should he be certified to drive a CMV? -
ANS-According to guidance, drivers taking this should not be certified. However, in some cases
small dosages are Rx. (typically as a sleep aide.) If the ME obtains confirmation from the Tx
provider and medical clearance that there are no side effects and that the driver is safe to
operate a CMV, then the ME may consider certification (25 mg only at night for sleep)
A driver presents 6 weeks following carpal tunnel surgery. He has been provided a full release
without restrictions by his orthopedist. Can he certified and for how long? - ANS-Yes. There is
no waiting period for this surgery. The driver may be certified for 2 years.
A driver reports for examination with a history of pneumothorax last month. The records
provided indicate the episode reduced the drivers FVC to 58%. Can this driver be certified? If
not, when can the driver be certified? - ANS-DQ the driver. The driver may not be certified until
the ME has verified that the drivers recover is complete, with X-Rays, and an FVC of > 60%.
, A driver takes Benadryl, 25mg, 2 to 3 times per day to Tx nasal congestion. Discuss concerns, if
any, the ME may have. - ANS-a. the driver should abstain from antihistamines, with known
sedative side effects and narcotic-based antitussives, for 12 hours prior to driving.
b. The ME should council the drier concerning side effects of meds and need to consult with
PCP about chronic congestion.
A driver with a recent pneumothorax 3 months ago presents records that indicate that this was
the second pneumothorax on the same side. There is no surgical intervention. The clearance
letter indicates he may drive and his FEV is 68%. Certify or DQ? - ANS-DQ the driver. The
driver has had two pneumothorax on the same side it has not be corrected surgically.
A driver with exercise induced asthma controlled with an inhaler (albuterol, Proventil, Ventolin)
before any aerobic activity. What must their FEV1 be greater than in % of predicted FEVI to
qualify? - ANS-65%
A ME reports for an exam on a driver that is insulin dependent. The driver provided an MCSA
5870 form signed by the driver 52 days ago. The ME's best approach would be? - ANS-Tell the
driver that they cannot perform an exam because the MCSA 5870 form is greater than 45 days
old. The driver must return to the treating clinician and have another form filled out.. The DOT
exam MUST be completed by the TC within 45 days of the exam.
According the medical guidance, episodic neurological conditions that are disqualifying include?
- ANS-a. Extreme headaches, migraine, cluster neuralgia that affect driving.
b. Vertigo
C. Narcolepsy
d. Untreated Sleep Apnea requiring treatment
e. Idiopathic CNS hypersomnolence
f. Primary Alveolar Hyperventilation
g. Restless Legs associated with excessive somnolence syndrome
According to medical guidance, what would the three areas of concern be with a driver is
treated for mental disorder? - ANS-a. The condition and its symptoms
b. It's treatment including side effects associated with the treatment.
c. The episodic nature of any recurrent symptoms after a time-limited, reversible episode or
initial presentation.
Can a driver be certified while taking methadone for chronic pain managment? - ANS-Yes. The
ME can certify the driver if the Rx provider indicates that the driver is using this for the treatment
for chronic pain, if the condition does not cause any restrictions or limitations, and if taking
methadone will not cause side effects that might interfere with the safe operation of a CMV.
A driver has a BP of 138 over 98. What stage is this? - ANS-Stage 1. The diastolic meets the
definition of Stage 1
A driver has a BP of 146/82. What stage is this? - ANS-Stage 1. The systolic meets the
definition of Stage 1
A driver has a BP of 164/92. What stage is this? - ANS-Stage 2. Even though there are 2 levels
for systolic and diastolic, the higher stage would determine the overall stage the driver is in.
Systolic is stage 2, diastolic is stage 1. The driver suffers from stage 2 Htn.
A driver has a glucose of 1000 in his UA with a history of DM. The rest of his exam is WNL. Can
this driver be certified even with a shortened certificate? - ANS-No, It is evident that the driver's
DM is not well managed.
A driver has a glucose reading of 250 in his UA with no history of diabetes. The rest of his exam
is WNL. Can this driver be certified to drive? - ANS-Yes, provide a 1 to 3 month shortened
certificate and refer for an evaluation by the drivers PCP to determine if the driver has a DM.
A driver has AAA. The ME view the sonogram indicating the diameter is 5.6. Can he be certified
to drive? - ANS-No. The diameter must be less than 5cm.
A driver has an audiometric test. His hearing loss in ANSI while wearing hearing aids is 40db
left ear; and 43 db right ear. Do he meet the standard? - ANS-Yes. Because one ear meets the
standard (40 in the left ear meets the requirement) his is capable of being certified to drive.
A driver is taking amitriptyline for depression, should he be certified to drive a CMV? -
ANS-According to guidance, drivers taking this should not be certified. However, in some cases
small dosages are Rx. (typically as a sleep aide.) If the ME obtains confirmation from the Tx
provider and medical clearance that there are no side effects and that the driver is safe to
operate a CMV, then the ME may consider certification (25 mg only at night for sleep)
A driver presents 6 weeks following carpal tunnel surgery. He has been provided a full release
without restrictions by his orthopedist. Can he certified and for how long? - ANS-Yes. There is
no waiting period for this surgery. The driver may be certified for 2 years.
A driver reports for examination with a history of pneumothorax last month. The records
provided indicate the episode reduced the drivers FVC to 58%. Can this driver be certified? If
not, when can the driver be certified? - ANS-DQ the driver. The driver may not be certified until
the ME has verified that the drivers recover is complete, with X-Rays, and an FVC of > 60%.
, A driver takes Benadryl, 25mg, 2 to 3 times per day to Tx nasal congestion. Discuss concerns, if
any, the ME may have. - ANS-a. the driver should abstain from antihistamines, with known
sedative side effects and narcotic-based antitussives, for 12 hours prior to driving.
b. The ME should council the drier concerning side effects of meds and need to consult with
PCP about chronic congestion.
A driver with a recent pneumothorax 3 months ago presents records that indicate that this was
the second pneumothorax on the same side. There is no surgical intervention. The clearance
letter indicates he may drive and his FEV is 68%. Certify or DQ? - ANS-DQ the driver. The
driver has had two pneumothorax on the same side it has not be corrected surgically.
A driver with exercise induced asthma controlled with an inhaler (albuterol, Proventil, Ventolin)
before any aerobic activity. What must their FEV1 be greater than in % of predicted FEVI to
qualify? - ANS-65%
A ME reports for an exam on a driver that is insulin dependent. The driver provided an MCSA
5870 form signed by the driver 52 days ago. The ME's best approach would be? - ANS-Tell the
driver that they cannot perform an exam because the MCSA 5870 form is greater than 45 days
old. The driver must return to the treating clinician and have another form filled out.. The DOT
exam MUST be completed by the TC within 45 days of the exam.
According the medical guidance, episodic neurological conditions that are disqualifying include?
- ANS-a. Extreme headaches, migraine, cluster neuralgia that affect driving.
b. Vertigo
C. Narcolepsy
d. Untreated Sleep Apnea requiring treatment
e. Idiopathic CNS hypersomnolence
f. Primary Alveolar Hyperventilation
g. Restless Legs associated with excessive somnolence syndrome
According to medical guidance, what would the three areas of concern be with a driver is
treated for mental disorder? - ANS-a. The condition and its symptoms
b. It's treatment including side effects associated with the treatment.
c. The episodic nature of any recurrent symptoms after a time-limited, reversible episode or
initial presentation.
Can a driver be certified while taking methadone for chronic pain managment? - ANS-Yes. The
ME can certify the driver if the Rx provider indicates that the driver is using this for the treatment
for chronic pain, if the condition does not cause any restrictions or limitations, and if taking
methadone will not cause side effects that might interfere with the safe operation of a CMV.
