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NRCME Study Sheet Actual Exam Questions and Verified Answers | Latest Version | Just Released | Graded A+

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Medical Conditions & Certification Guidelines Hypertension Stage 1: Certify for 1 year if controlled Stage 2: Certify for 3 months; recheck required Stage 3: Disqualify until BP is controlled Diabetes Insulin-treated drivers require FMCSA exemption Monitor for hypoglycemia risks and complications Vision & Hearing Must meet minimum standards (e.g., 20/40 vision in each eye) Hearing via audiometry or forced whisper test Cardiovascular Post-MI or stent: wait period + clearance Anticoagulant therapy: requires INR monitoring Neurological Seizure history: generally disqualifying unless exempted Stroke/TIA: waiting period + specialist clearance Medications & Substance Use Disqualifying Meds Benzodiazepines, opioids, amphetamines (unless cleared by treating provider) Psychotropic Drugs Must assess for side effects and stability Substance Abuse History of abuse requires documentation of treatment and abstinence Regulatory & Administrative Knowledge FMCSA Guidelines Know 49 CFR Part 391 for physical qualifications Understand waiver and exemption programs Documentation Proper use of Medical Examination Report (MER) and Medical Examiner’s Certificate (MEC) Exam Protocols Required tests: vision, hearing, BP, urinalysis Optional tests: EKG, lab work if indicated

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NRCME Study Sheet Actual Exam
Questions and Verified Answers | Latest
Version | Just Released | Graded A+




vision requirements - ANSWER-Distant 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? - ANSWER-1 year


The driver with a vision exemption must present what 2 things
before receiving the medical examiner's certificate. - ANSWER-Valid
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? - ANSWER-The
"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? - ANSWER-Letter 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. - ANSWER-1 year


hearing requirements - ANSWER-Whisper 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? - ANSWER-3
months


Name 4 otic conditions that are automatic disqualification -
ANSWER-Meniere's, uncontrolled vertigo, labyrinthine fistula,
nonfunctioning labyrinth


Apnea-hypopnea index of [blank] or more episodes per hour is
diagnostic of OSA - ANSWER-30


3 requirements for a passing ETT - ANSWER-1. 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? - ANSWER-3


Regulation that describes the physical qualifications of drivers. -
ANSWER-49 CFR 391.41


Regulation that describes the responsibilities of the medical
examiner. - ANSWER-49 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. - ANSWER-49 CFR 391.47


Regulation that describes the Skill Performance Evaluation (SPE)
Certification Program. - ANSWER-49 CFR 391.49


Regulation that describes limited exemptions for intra-city zone
drivers. - ANSWER-49 CFR 391.62


Regulation that describes grandfathering for certain drivers who
participated in vision and diabetes waiver study programs. -
ANSWER-49 CFR 391.64

, Regulation that includes regulations for medical review officers and
substance abuse professionals, including drug and alcohol testing
procedures. - ANSWER-49 CFR 40


Define Stage I Hypertension - ANSWER-BP 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? - ANSWER-
1 year


What is the maximum certification period for untreated known or
inadequately controlled stage I hypertension? - ANSWER-3 months


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 - ANSWER-None, driver is disqualified


Define Stage II hypertension. - ANSWER-BP 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? - ANSWER-3 months

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