DOT exam - NRCME Training Institute Material [ACTUAL
EXAM] LATEST VERSION [QUESTIONS AND ANSWERS]
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A (BRAND NEW!!)
What are the differences between the medical standards and medical guidelines? -
CORRECT ANSWER ✔✔✔✔✔ Regulations are law and are mandatory. The ME must
use standards to determine interstate CMV driver medical fitness for duty. Medical
guidelines are not regulatory and the ME may choose not to follow the medical
guidance.
In which regulations are the driver physical qualification standards and Medical
Examiners cited? - CORRECT ANSWER ✔✔✔✔✔ Driver physical qualification
standards are found in 49 CFR 391.41. ME responsibilities are found in 49 CFR 391.43
What objective tests and measurements are required as part of the driver physical
examination? - CORRECT ANSWER ✔✔✔✔✔ Height & weight
Vision
Hearing
BP & pulse
Urinalysis (spec gravity, protein, blood, glucose)
What are the possible outcomes of the driver physical examination? - CORRECT
ANSWER ✔✔✔✔✔ Certification
Disqualification
Determination pending
What date is used to determine medical examiners certificate expiration? - CORRECT
ANSWER ✔✔✔✔✔ The date of the exam is used as the basis for certificate
expiration, except when determination pending is chosen.
When determination pending is chosen, if the driver returns with the necessary
information prior to the expiration of the driver's current certificate and the driver is
qualified based on that information provided, the date used for the basis of the
certification timeframe is the date the driver returned with the necessary information.
What is the ME certificate expiration date for the following drivers?
A - Exam 4/16/2011, meets standards in 49 CFR 391.41, qualifies for 2 year certificate.
B - Exam 4/16/2011, meets standards, but periodic monitoring required due to HTN,
qualifies for 1 year certificate.
,C - Exam 4/16/2011, determination pending due to not having results of post-CABG
stress test, pt returns and provides that info on 4/25/2011, driver is qualified for 1 year.
D - Exam 4/16/2011, disqualified due to benign position vertigo on 3/15/2011, returned
to ME for certification examination on 5/20/11. He has been asymptomatic since
3/11/2011. Qualified for two years. - CORRECT ANSWER ✔✔✔✔✔ A: 4/16/2013
B: 4/16/2012
C: 4/25/2012
D: 5/20/2013
Patient example:
Karen, recertification exam
42 y/o female
No health history, no medications.
Vision acuity: right 20/20, left 20/30. Both 20/20. Horizontal field of vision Rt 80 degrees,
Lt 80 degrees. Not corrected vision.
No monocular vision.
No hearing aids, Whisper test 5' bilaterally. N/A audiometric testing
UA: spec grav 1.020, protein 1+, blood 4+, glucose neg.
Hgb 12.4
BP 134/88, P 80, regular.
PE: on 4th day of menses with heavy bleeding. Advised to consult PCP or GYN for eval
of excessive bleeding that could lead to anemia, leading to fatigue that would affect her
driving. - CORRECT ANSWER ✔✔✔✔✔ Two year certification - no disqualifying
health history or PE abnormalities.
Ask about medication use, including OTC medications.
ME obtained hemoglobin testing based on PE findings. (not required)
The ME should correctly note the body system in which there was an abnormal finding.
The note reflects inquiry as to the affect on driving ability and is also supported by Hgb
test results. ME also documented medical follow up advice.
Who can perform the vision portion of the interstate CMV driver physical examination? -
CORRECT ANSWER ✔✔✔✔✔ The certified ME, optometrist, or an opthalmologist. If
the specialist provider performs the exam, they should complete and sign the provider's
information on the report form and provide the results.
To pass the interstate CMV driver vision exam, a visual acuity of ___/___corrected or
uncorrected is required. - CORRECT ANSWER ✔✔✔✔✔ 20/40 on Snellen chart in
each eye individually AND in both eyes combined.
What eye conditions must the ME ask the driver about and if indicated, request
specialist evaluation? - CORRECT ANSWER ✔✔✔✔✔ Retinopathy, cataracts,
aphakia, glaucoma, and macular degeneration.
Pt example:
Mr. Brown, 48 y/o male. No current meds, injury 5 years ago. Hunting accident 2 years
ago with facial trauma and left orbital fracture. Presented a "may drive" note from eye
, surgeon (dated 3 months prior to examination). Uncorrected vision, right eye 20/20. left
eye 20/40. Both 20/20. Horizontal field of vision Right 80 degrees, left eye is
inconclusive. No monocular vision. No hearing aids. Whisper test 5' bilaterally. N/A
audiometric test. UA normal. BP 122/74, p 80, regular. - CORRECT ANSWER
✔✔✔✔✔ Exam findings: Left eye muscles do not move eye to the left, discussed
disqualification pending eye exam by specialist. Explained the specialist will get precise
visual field measurements. Provided driver with appropriate medical release and copy of
medical exam report with vision section highlighted.
Driver does not meet requirements. He is pending specialist vision exam. Diminished
vision in left eye noted. Pt could be functionally monocular.
What is the purpose of the interstate CMV driver physical examination? - CORRECT
ANSWER ✔✔✔✔✔ To detect the presence of physical, mental, or organic conditions
of such character and extent as to affect the driver ability to operate a CMV safely. This
exam is for public safety determination and is considered by FMCSA to be a "medical
fitness for duty" examination.
Examples of "yes" answers for hearing and ears on the health history that may require
further examination before a certification decision can be made - CORRECT ANSWER
✔✔✔✔✔ Ear disorders
Loss of hearing
Loss of balance
Pt example:
Pt has hearing of 4' in left and right ears. Do they meet the hearing standards? -
CORRECT ANSWER ✔✔✔✔✔ No, hearing minimum for whisper test is equal or
greater than 5' in the better ear. This driver needs an audiometric hearing test.
Pt example:
Does this driver meet hearing standards for interstate CMV driver certification?
Audiometric test results - [Hearing loss in decibles 500 Hz, 1,000 Hz, 2,000 Hz]
Right ear: 30, 45, 40
Left ear: 45, 45, 35 - CORRECT ANSWER ✔✔✔✔✔ Yes, the average hearing loss in
the right ear is less than 40 dB.
Rt ear average is 38.33 = pass
Lt ear average is 41.67 = fail
*only one ear has to meet requirement of less than 40 dB of hearing loss
Pt example:
Mr. Chin, 54 y/o male
Admits loss of hearing. No medications.
History of frequent ear infections in childhood, multiple TM ruptures and infections in
elementary and middle school. He has "always been hard of hearing" in his left ear.
Uncorrected vision acuity, right eye 20/30. left eye 20/30. Both 20/30. Horizontal field of
vision 90 degrees bilaterally. No monocular vision.
No hearing aids used for test.
EXAM] LATEST VERSION [QUESTIONS AND ANSWERS]
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A (BRAND NEW!!)
What are the differences between the medical standards and medical guidelines? -
CORRECT ANSWER ✔✔✔✔✔ Regulations are law and are mandatory. The ME must
use standards to determine interstate CMV driver medical fitness for duty. Medical
guidelines are not regulatory and the ME may choose not to follow the medical
guidance.
In which regulations are the driver physical qualification standards and Medical
Examiners cited? - CORRECT ANSWER ✔✔✔✔✔ Driver physical qualification
standards are found in 49 CFR 391.41. ME responsibilities are found in 49 CFR 391.43
What objective tests and measurements are required as part of the driver physical
examination? - CORRECT ANSWER ✔✔✔✔✔ Height & weight
Vision
Hearing
BP & pulse
Urinalysis (spec gravity, protein, blood, glucose)
What are the possible outcomes of the driver physical examination? - CORRECT
ANSWER ✔✔✔✔✔ Certification
Disqualification
Determination pending
What date is used to determine medical examiners certificate expiration? - CORRECT
ANSWER ✔✔✔✔✔ The date of the exam is used as the basis for certificate
expiration, except when determination pending is chosen.
When determination pending is chosen, if the driver returns with the necessary
information prior to the expiration of the driver's current certificate and the driver is
qualified based on that information provided, the date used for the basis of the
certification timeframe is the date the driver returned with the necessary information.
What is the ME certificate expiration date for the following drivers?
A - Exam 4/16/2011, meets standards in 49 CFR 391.41, qualifies for 2 year certificate.
B - Exam 4/16/2011, meets standards, but periodic monitoring required due to HTN,
qualifies for 1 year certificate.
,C - Exam 4/16/2011, determination pending due to not having results of post-CABG
stress test, pt returns and provides that info on 4/25/2011, driver is qualified for 1 year.
D - Exam 4/16/2011, disqualified due to benign position vertigo on 3/15/2011, returned
to ME for certification examination on 5/20/11. He has been asymptomatic since
3/11/2011. Qualified for two years. - CORRECT ANSWER ✔✔✔✔✔ A: 4/16/2013
B: 4/16/2012
C: 4/25/2012
D: 5/20/2013
Patient example:
Karen, recertification exam
42 y/o female
No health history, no medications.
Vision acuity: right 20/20, left 20/30. Both 20/20. Horizontal field of vision Rt 80 degrees,
Lt 80 degrees. Not corrected vision.
No monocular vision.
No hearing aids, Whisper test 5' bilaterally. N/A audiometric testing
UA: spec grav 1.020, protein 1+, blood 4+, glucose neg.
Hgb 12.4
BP 134/88, P 80, regular.
PE: on 4th day of menses with heavy bleeding. Advised to consult PCP or GYN for eval
of excessive bleeding that could lead to anemia, leading to fatigue that would affect her
driving. - CORRECT ANSWER ✔✔✔✔✔ Two year certification - no disqualifying
health history or PE abnormalities.
Ask about medication use, including OTC medications.
ME obtained hemoglobin testing based on PE findings. (not required)
The ME should correctly note the body system in which there was an abnormal finding.
The note reflects inquiry as to the affect on driving ability and is also supported by Hgb
test results. ME also documented medical follow up advice.
Who can perform the vision portion of the interstate CMV driver physical examination? -
CORRECT ANSWER ✔✔✔✔✔ The certified ME, optometrist, or an opthalmologist. If
the specialist provider performs the exam, they should complete and sign the provider's
information on the report form and provide the results.
To pass the interstate CMV driver vision exam, a visual acuity of ___/___corrected or
uncorrected is required. - CORRECT ANSWER ✔✔✔✔✔ 20/40 on Snellen chart in
each eye individually AND in both eyes combined.
What eye conditions must the ME ask the driver about and if indicated, request
specialist evaluation? - CORRECT ANSWER ✔✔✔✔✔ Retinopathy, cataracts,
aphakia, glaucoma, and macular degeneration.
Pt example:
Mr. Brown, 48 y/o male. No current meds, injury 5 years ago. Hunting accident 2 years
ago with facial trauma and left orbital fracture. Presented a "may drive" note from eye
, surgeon (dated 3 months prior to examination). Uncorrected vision, right eye 20/20. left
eye 20/40. Both 20/20. Horizontal field of vision Right 80 degrees, left eye is
inconclusive. No monocular vision. No hearing aids. Whisper test 5' bilaterally. N/A
audiometric test. UA normal. BP 122/74, p 80, regular. - CORRECT ANSWER
✔✔✔✔✔ Exam findings: Left eye muscles do not move eye to the left, discussed
disqualification pending eye exam by specialist. Explained the specialist will get precise
visual field measurements. Provided driver with appropriate medical release and copy of
medical exam report with vision section highlighted.
Driver does not meet requirements. He is pending specialist vision exam. Diminished
vision in left eye noted. Pt could be functionally monocular.
What is the purpose of the interstate CMV driver physical examination? - CORRECT
ANSWER ✔✔✔✔✔ To detect the presence of physical, mental, or organic conditions
of such character and extent as to affect the driver ability to operate a CMV safely. This
exam is for public safety determination and is considered by FMCSA to be a "medical
fitness for duty" examination.
Examples of "yes" answers for hearing and ears on the health history that may require
further examination before a certification decision can be made - CORRECT ANSWER
✔✔✔✔✔ Ear disorders
Loss of hearing
Loss of balance
Pt example:
Pt has hearing of 4' in left and right ears. Do they meet the hearing standards? -
CORRECT ANSWER ✔✔✔✔✔ No, hearing minimum for whisper test is equal or
greater than 5' in the better ear. This driver needs an audiometric hearing test.
Pt example:
Does this driver meet hearing standards for interstate CMV driver certification?
Audiometric test results - [Hearing loss in decibles 500 Hz, 1,000 Hz, 2,000 Hz]
Right ear: 30, 45, 40
Left ear: 45, 45, 35 - CORRECT ANSWER ✔✔✔✔✔ Yes, the average hearing loss in
the right ear is less than 40 dB.
Rt ear average is 38.33 = pass
Lt ear average is 41.67 = fail
*only one ear has to meet requirement of less than 40 dB of hearing loss
Pt example:
Mr. Chin, 54 y/o male
Admits loss of hearing. No medications.
History of frequent ear infections in childhood, multiple TM ruptures and infections in
elementary and middle school. He has "always been hard of hearing" in his left ear.
Uncorrected vision acuity, right eye 20/30. left eye 20/30. Both 20/30. Horizontal field of
vision 90 degrees bilaterally. No monocular vision.
No hearing aids used for test.
