NRCME QUESTION BANK REVIEW
cb cb cb
Drivercb6cbweekscbpost-
MI,cbhascbcardiocbclearedcbtocbreturncbtocbworkcbwithoutcbrestrictions.cbETTcb12cbMETs,cbec
hocbEFcb65%.cbExaminercbshould:cb-
correctcbanswer✔ ✔ temporarilycbdisqualifycbdrivercbuntilcbdrivercbmeetscbwaitingcbperi
cb
odcbofcb2cbmonths
drivercbiscbdistant,cblackscbeyecbcontactcbandcbshowscbabsolutelycbnocbemotionalcbresponse
duringcbthecbexam.cbThecbexaminer'scbbestcbresponsecbshouldcbbe:cb-cbcorrectcbanswer✔
cb
✔
disqualifycbandcbrefercbtocbSAPcbpriorcbtocbconsiderationcb(flatcbaffectcbseencbincbseverecbd
epressioncbandcbschizophrenia)
Acbdrivercbhascbacbbloodcbpressurecbofcb136/92cbmmcbHg.cbThiscbiscbwhatcbstagecbofcbHTN?c
- correctcbanswer✔ ✔ StagecbI.cbBPcb140-159/*90-99*
b cb
AcbdrivercbiscbtakingcbCelexacbforcbthecbtreatmentcbofcbwhatcbhecbcallscbacb"mildcbdepression
."cbHecbreportscbhecbhascbnotcbconsideredcborcbattemptedcbsuicide.cbThecbexaminercbshould
?cb-cbcorrectcbanswer✔ ✔
Temporarilycbdisqualifycbthecbdrivercbuntilcbhecbobtainscbwrittencbclearancecbforcbthecbdepr
essioncbandcbthecbmedicationcbfromcbthecbtreatingcbprovider.cb
Medicalcbclearancecbiscbrequiredcbforcballcbmentalcbhealthcbdisorders
Acbdrivercbreportscbthatcbhecbhadcbacbhuntingcbaccidentcbwhereincbhecbsufferedcbacbleftcborbit
alcbfracture.cbHecbpresentscbacbnotecbatcbthecbtimecbofcbthecbexaminationcbfromcbancbophthal
mologistcbstatingcb"maycbdrive".cbHiscbexamcbiscbunremarkablecbexceptcbforcbacblimitationcbi
ncbperipheralcbvisioncbincbhiscbleftcbeye,cbwhichcbwascbinconclusive.cbHiscbdistancecbvisioncb
,wascb20/20cbrightcbandcb20/40cbleft.cbThecbmedicalcbexaminercbshould?cb-cbcorrectcbanswer
✔ ✔
Disqualifycbthecbdrivercbpendingcbvisioncbexamcbtocbdeterminecbifcbmeetscbperipheralcbvisi
oncbrequirements
AcbdrivercbiscbtakingcbTopamaxcbforcbthecbtreatmentcbofcbmigrainecbheadaches.cbHecbreport
scbgoodcbmanagementcbofcbhiscbheadachescbandcbtheycbnevercbseemcbtocbinterferecbwithcbh
iscbdrivingcbabilitycbwithcbthecbmedication.cbThecbmedicalcbexaminercbshouldcb-
cb correctcbanswer✔ ✔
Obtaincbmedicalcbclearancecbforcbthecbconditioncbandcbthecbmedication
Topamaxcbiscbacbmedicationcbthatcbiscbusedcbforcbseizurecbcontrol.cbThecbexaminercbshouldc
bconfirmcbwithcbthecbprescribingcbprovidercbthatcbthecbdrivercbdoescbnotcbtakecbitcbtocbcontrolc
bseizures.
PositivecbBabinski"reflexcbindicatescbwhat?cbWhatcbiscbexaminer'scbnextcbstep?cb-
cb correctcbanswer✔ ✔
indicativecbofcbabnormalitiescbincbthecbmotorcbcontrolcbpathwayscbleadingcbfromcbthecbcer
ebralcbcortex;cbobtaincbclearancecbfromcbacbneurologistcbpriorcbtocbreconsideringcbthecbdrive
rcbforcbcertification
Epilepsycb14cbyearscbagocbbutcbstoppedcbtakingcbantiepilepticcbmedicationcboncbhiscbowncb1
1cbyearscbago.cbHascbnotcbseencbacbneurologistcbnorcbacbhealthcbcarecbprovidercbincbovercb1
0cbyearscbandcbreportscbnocbseizurescbduringcbthiscbperiod.cbThecbexaminercbshould:cb-
cb correctcbanswer✔ ✔
Disqualifycbdriver.cbEvencbthoughcbthecbdrivercbreportscbexceedingcbthecb10-
yearcbwaitingcbperiod,cbitcbwascbnotcbundercbmedicalcbsupervisioncbandcbthecbdrivercbdiscont
inuedcbmedicationcbusecbandcbtreatmentcboutsidecbofcbmedicalcboversight.
WaitingcbperiodcbfollowingcbMIcb-cbcorrectcbanswer✔ ✔ 2cbmonths
, WaitingcbperiodcbfollowingcbCABGcb-cbcorrectcbanswer✔ ✔ 3cbmonths
Thecbdrivercbusescbhearingcbaidscbduringcbthecbwhispercbtest.cbHecbiscbablecbtocbhearcbatcb5cb
feetcboncbthecbrightcbandcb4cbfeetcboncbthecbleft.cbCertificationcborcbno?cb-cbcorrectcbanswer✔
✔ Certifycbxcb2cbyrs.cb
Thecbdrivercbiscbablecbtocbusecbhearingcbaidscbduringcbthecbwhispercbtestcb(andcbthiscbshould
cb becbmarkedcboncbthecbform).cbAcbdrivercbmustcbonlycbqualifycbincb1cbearcbtocbcertify.
ModeratecbTBIcbthatcboccurredcb3cbyearscbago.cbneurologistcbconfirmedcbnocbseizurescband
cb clearedcbdriver.cbExaminercbshouldcb-cbcorrectcbanswer✔ ✔ certifycbxcb1cbyr
waitingcbperiodcbiscb2cbyears,cbmaxcbcertcbforcbmodcbTBIcbwithoutcbseizurecbiscb1cbyr.
Waitingcbperiodcbandcbmaxcbcertcbincbdrivercbwithcbdepressioncbwithcbsuicidecbattemptcb10cb
monthscbago.cbReportscbfeelingcbfinecbnowcbandcbcompliantcbwithcbmeds.cbExaminercbshoul
dcb-cbcorrectcbanswer✔ ✔ Disqualify.cb
Waitingcbperiodcbiscb1cbyr,cbmaxcbcertcb1cbyr
historycbacbbackcbinjurycbthatcbhadcboccurredcb4cbyearscbearlier.cbHecbstatescbthatcbhecbwasc
boutcbofcbworkcbfollowingcbbackcbsurgerycbforcbovercbacbyear,cbbutcbsincecbhascbreturnedcbtoc
bdrivingcbandcbhiscblastcbcertificationcbwascbgoodcbforcb2cbyears.cbHecblistscbascbhiscbonlycbm
edicationcbOxycodone,cbwhichcbhecbtakescbonlycbascbneeded.cbHecbreportscbseeingcbhiscb"p
aincbdoctor"cbeverycbfewcbmonthscbforcbevaluation.cbHecbalsocbreportscbhecbhascbhadcbacbste
roidcbinjectioncb(seriescbofcb3)cbaboutcbacbyearcbago,cbwhichcb"helpedcbacblot."cbThecbexamin
ercbshould:cb-cbcorrectcbanswer✔ ✔ Requestcbmedicalcbclearance.
cb cb cb
Drivercb6cbweekscbpost-
MI,cbhascbcardiocbclearedcbtocbreturncbtocbworkcbwithoutcbrestrictions.cbETTcb12cbMETs,cbec
hocbEFcb65%.cbExaminercbshould:cb-
correctcbanswer✔ ✔ temporarilycbdisqualifycbdrivercbuntilcbdrivercbmeetscbwaitingcbperi
cb
odcbofcb2cbmonths
drivercbiscbdistant,cblackscbeyecbcontactcbandcbshowscbabsolutelycbnocbemotionalcbresponse
duringcbthecbexam.cbThecbexaminer'scbbestcbresponsecbshouldcbbe:cb-cbcorrectcbanswer✔
cb
✔
disqualifycbandcbrefercbtocbSAPcbpriorcbtocbconsiderationcb(flatcbaffectcbseencbincbseverecbd
epressioncbandcbschizophrenia)
Acbdrivercbhascbacbbloodcbpressurecbofcb136/92cbmmcbHg.cbThiscbiscbwhatcbstagecbofcbHTN?c
- correctcbanswer✔ ✔ StagecbI.cbBPcb140-159/*90-99*
b cb
AcbdrivercbiscbtakingcbCelexacbforcbthecbtreatmentcbofcbwhatcbhecbcallscbacb"mildcbdepression
."cbHecbreportscbhecbhascbnotcbconsideredcborcbattemptedcbsuicide.cbThecbexaminercbshould
?cb-cbcorrectcbanswer✔ ✔
Temporarilycbdisqualifycbthecbdrivercbuntilcbhecbobtainscbwrittencbclearancecbforcbthecbdepr
essioncbandcbthecbmedicationcbfromcbthecbtreatingcbprovider.cb
Medicalcbclearancecbiscbrequiredcbforcballcbmentalcbhealthcbdisorders
Acbdrivercbreportscbthatcbhecbhadcbacbhuntingcbaccidentcbwhereincbhecbsufferedcbacbleftcborbit
alcbfracture.cbHecbpresentscbacbnotecbatcbthecbtimecbofcbthecbexaminationcbfromcbancbophthal
mologistcbstatingcb"maycbdrive".cbHiscbexamcbiscbunremarkablecbexceptcbforcbacblimitationcbi
ncbperipheralcbvisioncbincbhiscbleftcbeye,cbwhichcbwascbinconclusive.cbHiscbdistancecbvisioncb
,wascb20/20cbrightcbandcb20/40cbleft.cbThecbmedicalcbexaminercbshould?cb-cbcorrectcbanswer
✔ ✔
Disqualifycbthecbdrivercbpendingcbvisioncbexamcbtocbdeterminecbifcbmeetscbperipheralcbvisi
oncbrequirements
AcbdrivercbiscbtakingcbTopamaxcbforcbthecbtreatmentcbofcbmigrainecbheadaches.cbHecbreport
scbgoodcbmanagementcbofcbhiscbheadachescbandcbtheycbnevercbseemcbtocbinterferecbwithcbh
iscbdrivingcbabilitycbwithcbthecbmedication.cbThecbmedicalcbexaminercbshouldcb-
cb correctcbanswer✔ ✔
Obtaincbmedicalcbclearancecbforcbthecbconditioncbandcbthecbmedication
Topamaxcbiscbacbmedicationcbthatcbiscbusedcbforcbseizurecbcontrol.cbThecbexaminercbshouldc
bconfirmcbwithcbthecbprescribingcbprovidercbthatcbthecbdrivercbdoescbnotcbtakecbitcbtocbcontrolc
bseizures.
PositivecbBabinski"reflexcbindicatescbwhat?cbWhatcbiscbexaminer'scbnextcbstep?cb-
cb correctcbanswer✔ ✔
indicativecbofcbabnormalitiescbincbthecbmotorcbcontrolcbpathwayscbleadingcbfromcbthecbcer
ebralcbcortex;cbobtaincbclearancecbfromcbacbneurologistcbpriorcbtocbreconsideringcbthecbdrive
rcbforcbcertification
Epilepsycb14cbyearscbagocbbutcbstoppedcbtakingcbantiepilepticcbmedicationcboncbhiscbowncb1
1cbyearscbago.cbHascbnotcbseencbacbneurologistcbnorcbacbhealthcbcarecbprovidercbincbovercb1
0cbyearscbandcbreportscbnocbseizurescbduringcbthiscbperiod.cbThecbexaminercbshould:cb-
cb correctcbanswer✔ ✔
Disqualifycbdriver.cbEvencbthoughcbthecbdrivercbreportscbexceedingcbthecb10-
yearcbwaitingcbperiod,cbitcbwascbnotcbundercbmedicalcbsupervisioncbandcbthecbdrivercbdiscont
inuedcbmedicationcbusecbandcbtreatmentcboutsidecbofcbmedicalcboversight.
WaitingcbperiodcbfollowingcbMIcb-cbcorrectcbanswer✔ ✔ 2cbmonths
, WaitingcbperiodcbfollowingcbCABGcb-cbcorrectcbanswer✔ ✔ 3cbmonths
Thecbdrivercbusescbhearingcbaidscbduringcbthecbwhispercbtest.cbHecbiscbablecbtocbhearcbatcb5cb
feetcboncbthecbrightcbandcb4cbfeetcboncbthecbleft.cbCertificationcborcbno?cb-cbcorrectcbanswer✔
✔ Certifycbxcb2cbyrs.cb
Thecbdrivercbiscbablecbtocbusecbhearingcbaidscbduringcbthecbwhispercbtestcb(andcbthiscbshould
cb becbmarkedcboncbthecbform).cbAcbdrivercbmustcbonlycbqualifycbincb1cbearcbtocbcertify.
ModeratecbTBIcbthatcboccurredcb3cbyearscbago.cbneurologistcbconfirmedcbnocbseizurescband
cb clearedcbdriver.cbExaminercbshouldcb-cbcorrectcbanswer✔ ✔ certifycbxcb1cbyr
waitingcbperiodcbiscb2cbyears,cbmaxcbcertcbforcbmodcbTBIcbwithoutcbseizurecbiscb1cbyr.
Waitingcbperiodcbandcbmaxcbcertcbincbdrivercbwithcbdepressioncbwithcbsuicidecbattemptcb10cb
monthscbago.cbReportscbfeelingcbfinecbnowcbandcbcompliantcbwithcbmeds.cbExaminercbshoul
dcb-cbcorrectcbanswer✔ ✔ Disqualify.cb
Waitingcbperiodcbiscb1cbyr,cbmaxcbcertcb1cbyr
historycbacbbackcbinjurycbthatcbhadcboccurredcb4cbyearscbearlier.cbHecbstatescbthatcbhecbwasc
boutcbofcbworkcbfollowingcbbackcbsurgerycbforcbovercbacbyear,cbbutcbsincecbhascbreturnedcbtoc
bdrivingcbandcbhiscblastcbcertificationcbwascbgoodcbforcb2cbyears.cbHecblistscbascbhiscbonlycbm
edicationcbOxycodone,cbwhichcbhecbtakescbonlycbascbneeded.cbHecbreportscbseeingcbhiscb"p
aincbdoctor"cbeverycbfewcbmonthscbforcbevaluation.cbHecbalsocbreportscbhecbhascbhadcbacbste
roidcbinjectioncb(seriescbofcb3)cbaboutcbacbyearcbago,cbwhichcb"helpedcbacblot."cbThecbexamin
ercbshould:cb-cbcorrectcbanswer✔ ✔ Requestcbmedicalcbclearance.
