NRCME DOT EXAM QUESTIONS AND
ANSWERS
1.Upon examination of a 46 y/o male smoker, you detect an irregularly ir-
regular heart rythm. The rate is 140 bpm. This is unknown to the driver and
he denies any symptoms of lightheadedness, shortness of breath,
dizziness, palpitations, nor any cardiac history. You would
Answer Disqualify and refer to his PMD or cardiologist for further
evaluation.
2.Concerning the medical certificate, which is false?
Answer Provide the original to the driver being examined. Retain a copy
for at least 3 years.
You may not provide a copy to the current or prospective employer,
they must get it from the driver. The driver must carry the original
certificate during operation of a CMV.
3.How soon may a driver be certified after coronary artery bypass grafting
(CABG) surgery?
Answer 3 months with clearance by cardiologist, resting echocardiogram
with an LVEF >40% after CABG, and asymptomatic status with no
angina.
4.FMCSA defines a severe hypoglycemic reaction as one that results in
,Answer Need of assistance from another person, loss of consciousness,
any period of impaired cognitive function that occurs without warning,
or seizure
5.Medical fitness for duty includes the ability to perform strenuous labor
and to have good judgment, impulse control, and .
Answer Prob- lem solving skills
6.All of the following may perform and certify vision test results except
Answer A chiropractor
Ophthalmologist
Optometrist
or Registered Nurse
7.The grace period for the expiration of a Medical Examiner's Certification
is
Answer There is no grace period, the certification expires at midnight
on the date listed
8.A 28 year old female presents for her CDL physical exam. She indicates
she has been enrolled in a Methadone program for three months secondary
to
a previous substance abuse issue in the recent past. She presents a letter
from the administrator of the program documenting her compliance with
the program and absence of any history of prior violations of their agree-
, ment. According to medical guidance, can a driver be certified while taking
methadone.
Answer No, since Methadone is a habit-forming narcotic that can
produce drug dependence. Methadone is not an allowable drug for CMV
operators.
9.Arriving for a recertification exam, a 48 y/o male non-smoker is 5'4",
275lbs. His supervisor calls you ahead of time stating he recently went off
the side of the road crashing into a guard rail. There were no injuries and the
truck sustained only minor damage. When the medical assistant goes to
bring
him back, he is found asleep, snoring in the waiting room and she needs to
wake him by gently shaking him by the shoulder. She reports this to you.
When you arrive in the exam room the patient appears to be nodding off
while sitting on the exam table. Upon further questioning, he admits that his
wife frequently elbows him because of his snoring and that he gasps and
snorts in his sleep. When asked, he denies nodding off while driving. His
exam is notable for obesity, Mallampati 4 oropharynx, HTN controlled with 2
medications, otherwise normal. Appropriate next steps
Answer Disqualify and refer to PMD for sleep study.
10.You examine a 37 male driver with missing fingers on his left hand, you
must evaluate and do all of the following,
Answer Document the effect that the deficit has on the ability of the
driver to safely operate a CMV Provide a copy of the Medical
ANSWERS
1.Upon examination of a 46 y/o male smoker, you detect an irregularly ir-
regular heart rythm. The rate is 140 bpm. This is unknown to the driver and
he denies any symptoms of lightheadedness, shortness of breath,
dizziness, palpitations, nor any cardiac history. You would
Answer Disqualify and refer to his PMD or cardiologist for further
evaluation.
2.Concerning the medical certificate, which is false?
Answer Provide the original to the driver being examined. Retain a copy
for at least 3 years.
You may not provide a copy to the current or prospective employer,
they must get it from the driver. The driver must carry the original
certificate during operation of a CMV.
3.How soon may a driver be certified after coronary artery bypass grafting
(CABG) surgery?
Answer 3 months with clearance by cardiologist, resting echocardiogram
with an LVEF >40% after CABG, and asymptomatic status with no
angina.
4.FMCSA defines a severe hypoglycemic reaction as one that results in
,Answer Need of assistance from another person, loss of consciousness,
any period of impaired cognitive function that occurs without warning,
or seizure
5.Medical fitness for duty includes the ability to perform strenuous labor
and to have good judgment, impulse control, and .
Answer Prob- lem solving skills
6.All of the following may perform and certify vision test results except
Answer A chiropractor
Ophthalmologist
Optometrist
or Registered Nurse
7.The grace period for the expiration of a Medical Examiner's Certification
is
Answer There is no grace period, the certification expires at midnight
on the date listed
8.A 28 year old female presents for her CDL physical exam. She indicates
she has been enrolled in a Methadone program for three months secondary
to
a previous substance abuse issue in the recent past. She presents a letter
from the administrator of the program documenting her compliance with
the program and absence of any history of prior violations of their agree-
, ment. According to medical guidance, can a driver be certified while taking
methadone.
Answer No, since Methadone is a habit-forming narcotic that can
produce drug dependence. Methadone is not an allowable drug for CMV
operators.
9.Arriving for a recertification exam, a 48 y/o male non-smoker is 5'4",
275lbs. His supervisor calls you ahead of time stating he recently went off
the side of the road crashing into a guard rail. There were no injuries and the
truck sustained only minor damage. When the medical assistant goes to
bring
him back, he is found asleep, snoring in the waiting room and she needs to
wake him by gently shaking him by the shoulder. She reports this to you.
When you arrive in the exam room the patient appears to be nodding off
while sitting on the exam table. Upon further questioning, he admits that his
wife frequently elbows him because of his snoring and that he gasps and
snorts in his sleep. When asked, he denies nodding off while driving. His
exam is notable for obesity, Mallampati 4 oropharynx, HTN controlled with 2
medications, otherwise normal. Appropriate next steps
Answer Disqualify and refer to PMD for sleep study.
10.You examine a 37 male driver with missing fingers on his left hand, you
must evaluate and do all of the following,
Answer Document the effect that the deficit has on the ability of the
driver to safely operate a CMV Provide a copy of the Medical
