NRCME Training DOT Question Bank Answered A+ 2025

1. An unrestricted Commercial Motor Vehicle Driver Medical Certificate must be renewed: A. Annually B. Every Two Years C. Every Four Years D. Whenever the State Issued Driver's License is renewed - B 2. A driver presents with history of an isolated TIA 6 months ago. He has a return-towork letter from his primary care provider (PCP) and neurologist. He is taking and tolerating well hydrochlorothiazide and simvastatin. All other aspects of the exam and history were normal. What should the medical examiner do next? A. Certify driver for 1 year B. Disqualify driver for now C. Certify driver for 3 months D. Certify driver for 2 years - B 3. FMCSA regulates interstate commercial operation including the: A. Driver B. Vehicle C. Motor Carrier D. All of above - D 4. During the CMV exam a driver perceived a whispered voice at 5 feet in his left year and 4 feet in his right year. Exam was otherwise normal. What do you do as the medical examiner? A. Required audiometric test to determine the extent of hearing loss in left ear B. Certify driver for 2 years C. Certify driver for 1 year D. Disqualify driver - B 5. Which of the following is an assessment of L4 nerve root pathology? A. Plantar flexion B. Patellar reflex C. Hip extension D. Babinski reflex - B 6. A driver presents for medical exam and reports being a smoker and having frequent shortness of breath. What do you do next? A. Order an ECG B. Refer to a pulmonologist NRCME Training DOT Question Bank Answered A+ 2025 C. Order a spirometer test D. Provide 1 year certification - C 7. According to regulation, which of the following must be evaluated as part of the eye exam? A. Pupil reaction B. Iris symmetry C. Conjunctiva injection D. Tonometry pressure - A 8. Continued certification of NRCE Medical Examiners requires all EXCEPT which of the following? A. Periodic training at least every five years B. Completion of recertification test every five years C. Completion of certification test every 10 years D. Electronic transmission to FMCSA CMV Medical Examination Results at least monthly - B 9. A driver presents for recertification. The only condition he lists is GERD, for which he takes OTC omeprazole. He says that when he is driving and eating fast foods, he is more likely to have heartburn than when off‐duty. You should: A. Request recent UGI results B. Correlate history with abdominal exam C. Certify for one year with restricted diet D. Discuss alternative employment - B 10. Which of the following findings is disqualifying? A. Oxygen saturation 90% B. LVEF 40% C. FEV 68% predicted D. All of the above - A 11. The driver presents for recertification and submits an ultrasound report indicating an abdominal aortic aneurysm from two months ago, shortly before he had surgical correction. He has surgical clearance and says he is doing well, has no symptoms. You should: A. Certify for 1 year B. Certify for 2 years C. Inform the driver of the 3 month waiting period before he can be certified D. Inform the driver of the 6 month waiting period before he can be certified - C 12. The driver takes diphenhydramine twice a day to treat nasal congestion. What must you document in order to certify? A. Take the lowest dose effective on days when driving B. Cannot drive within 12 hours of taking diphenhydramine C. Cannot drive within 6 hours of taking diphenhydramine D. Diphenhydramine is disqualifying - B 13. The driver has a history of carpal tunnel repair of her right hand 2 months ago. Her grip strengths are symmetrical and strong. What is necessary in order to qualify this driver? A. Must first complete a 3‐month post‐op waiting period B. Document her findings for 1‐year certification C. Document her findings for 2‐year certification D. Request that an SPE be obtained before certification - C 14. Which of the following abdominal complaints is most likely to be incapacitating? A. IBS B. GERD C. Urinary tract infection D. Nephrolithiasis - D 15. The waiting period for benign positional vertigo is: A. 1 month B. 2 months C. 3 months D. 6 months - B 16. The driver's BP is 148/96. You verify her history, which indicates she has no prior history of hypertension. If otherwise qualified, you may certify her for: A. 3 months B. 6 months C. 1 year D. 2 years - C 17. The driver's current BP is 135/76. Your records indicate at history of Stage III hypertension 4 years ago. The maximum certification for this driver is: A. 3 months B. 6 months C. 1 year D. 2 years - B 18. The driver presents for examination with a recent history (five weeks ago) of pneumothorax. He has no prior history of pneumothorax. In order to be considered medically qualified, his forced vital capacity (FVC) should be greater than: A. 40% B. 55% C. 65% D. 90% - C 19. The recommended waiting period (WP) and certification period (CP) for a driver following surgical correction for intermittent claudication are: A. WP 1 month, CP 6 months B. WP 3 months, CP 1 year C. WP 3 months, CP 2 years D. WP 6 months, CP 2 years - B 20. Which of the following are disqualifying? A. Pacemaker B. Implanted defibrillator C. Both a and b D. Neither - B 21. Five years post‐CABG, the driver must provide a copy of in order to qualify for recertification A. Ultrasound B. EKG C. Lipid profile D. ETT - D 22. The driver has a 5‐year history of asthma, described as "well‐controlled". He carries rescue inhaler for the times when he becomes short of breath, but says this is rare. He provides pulmonary functions performed last week and his FEV1 is 62% of predicted and his Pa02 is 62 mm. You should: A. Qualify for 1 year B. Qualify for 2 years C. Disqualify and recommend that he return to his personal provider D. Disqualify and recommend that he pursue a chronic respiratory exemption - C 23. What is the Primary mission of FMCSA? A. To improve the quality of the highways. B. To promote the safety of the roadways. C. To regulate the performance of medical exams. D. To ensure state regulations coincide with federal regulations - B 24 . During a driver's history, she describes her role and responsibilities as limited to the driving component and excluding strenuous activities. You should: A. Limit the examination to those qualifications associated with driving B. Contact her employer for verification of this history prior to proceeding with the physical examination C. Disqualify Ms. Jeffries for her limited understanding of the driver role D. Conduct the full and standard physical examination - D 25. During the examination, a driver reveals, "I had a touch of sugar" two years ago, but stopped taking the prescribed medication when it ran out, the name of which was forgotten. Driver did not indicate "yes" on the medical history for diabetes. The examination and urinalysis are unremarkable. What is the appropriate action you would take to complete this examination? A. Perform a capillary blood test to determine the current blood glucose level B. Ask the driver to amend the medical history; list driver as temporarily unqualified until medical records are reviewed C. The normal examination and lack of glycosuria enables the driver to be issued a twoyear unrestricted medical certificate D. Correct the medical history in your narrative and discuss the signs, symptoms and health impact of diabetes and the need for regular follow‐up in certifying the driver - D 26. Which of the following tests is not recommended as medical guidance for initial pulmonary function testing? A. Forced expiratory volume in 1 second (FEV1) B. Peak flow spirometry, best effort C. Forced vital capacity (FVC) D. FEV1/FVC ratio - B 27. A 60 year old driver reveals a 6 month history of progressive worsening of dizziness and ringing in the ears. It is worse when he bends over. He denies hearing loss, no trauma or recent infections, and takes no chronic medications, but was told by another driver to try meclizine. He did try and it seemed to help. Which of the following routine screening tests may help you best decide on the severity of the symptoms during this CDL medical examination? A. Audiogram B. Weber and Rinne Test C. Romberg Test D. Tilt Table Test - C 28. Current Federal Motor Carrier Safety Regulations identify a person who can be a medical examiner by which two following criteria: A. Professional licensure and scope of practice that includes performing physical examinations B. Current Board Certification and Listed on the FMCSA Registry C. Completion of a Medical Examiner training program and an unrestricted professional licensure D. At least 5 years of experience in performing physical examinations and passing a Certification Examination - A 29. The driver has a 20 pack year of smoking and recent diagnosis of COPD. His breath sounds are slightly distant with a prolonged expiratory phase. His FEV1 is 63% of predicted. You should obtain: A. CXR B. Peak flow measure C. ABGs D. No tests are warranted - C 30. 32 yr. old new driver applicant is a military veteran with history of a Mild Traumatic Brain Injury in war zone 5 years ago while on Active Duty. He had no loss of consciousness -was only "dazed" by close blast - not hospitalized. CT was negative at combat emergency clinic. He was awarded a 10% VA disability later for this injury. Never had a seizure, never prescribed anti‐seizure medications. He is otherwise healthy. The ME's physical examination is negative for neurological impairment or deficit. According to medical guidelines, what is the appropriate ME decision? A. Document above and clear driver issuing a 2 year unrestricted certificate B. Certify driver for 3 months to allow time to obtain his medical records C. Temporarily disqualify until driver provides copy of neurological evaluations or test results. D. Do not certify - The past history of TBI and VA disability is automatically disqualifying - A 31. The newly hired driver's Employer requests a copy of the "Long Form" for their personnel file. Which statement below is accurate regarding the release of the CMV driver Medical Form? A. FMCSRs prohibits the ME from giving a copy of the CMV Medical Examination Report directly to the employer B. Employers who pay for the exam as part of the employee's conditions of employment are entitled to a copy of the CMV Medical Examination Report without a signed release by the driver C. The CMV Medical Examination Report is treated the same as any other confidential medical information and must have a signed release by the driver. D. The Driver is never permitted to have a copy of the CMV Medical Examination Report due to the increase in fraudulent documents being circulated. - C 32. Which of these statements about drinking alcohol is true. A. Alcohol first affects judgment and self‐control, which are essential for safe driving. B. Statistics show that drivers who have been drinking have a much greater chance of being in a motor vehicle crash. C. A commercial motor vehicle driver can lose his / her CDL for driving while under the influence of alcohol. D. All of the above are true - D 33. What level of risk is acceptable when qualifying CDL drivers? A. 0% B. 1% C. 10% D. 11% - B 34. Which of the following is TRUE concerning discretionary qualification standards? A. It is the examiner's discretion whether to assess these standards B. It is the CDL employer's discretion whether to accept the medical examiner's determination C. It is up to the examiner's discretion and clinical judgment regarding the driver's qualifications in these areas D. All of the above are true - C 35. The driver marks history of high blood pressure, shortness of breath, lung disease, emphysema and chronic bronchitis. His medications include tiotropium bromide, salmeterol/fluticasone propionate inhaler, and albuterol inhaler. As he walks into the exam room, he is short of breath, but says he recently cut down to ½ PPD cigarettes after smoking two PPD for 45 years and is improved. During his last PCP visit a year ago, he was diagnosed with borderline hypertension and COPD with cor pulmonale. He is tolerating his medications well and takes them as prescribed, using his albuterol no more than twice a day, depending on his level of activity. His PCP record shows mild right ventricular hypertrophy, mild pulmonary hypertension. He had a CXR 6 months ago which confirmed COPD. His blood pressure today is 138/88, with regular pulse at 88. He is slightly flushed. Chest exam reveals grade II/VI murmur and S4. During the musculoskeletal exam, he becomes short of breath. The exam is otherwise normal. Which of the following actions should the ME NOT take? A. Order a CXR and repeat PFTs B. Disqualify driver C. Refer driver to specialist for further evaluation and treatment D. Inform the driver of factors contributing to the certification decision - A 36. According to 49 CFR391.41(b)(8) regarding neurological conditions, which is considered unequivocal grounds for medical disqualification for the interstate CMV driver medical certification: A. Migraine Headache B. Active Seizure Disorder C. Cervical Spinal Stenosis D. Transient Ischemic Attack - B 37. The purpose of the commercial driver physical exam includes which of the following? A. Determine "medical fitness for duty" B. Detect the presence of any physical, mental, or organic conditions of such character and extent as to affect the ability of the driver to operate a CMV safely C. Both of the above D. Neither of the above - C 38. Driver(s) of which of the following vehicles DO NOT require a CDL certificate? A. Vehicle weighs over 26,000 lb B. Vehicle weighs less than 26,000 lb and designed to transport up to 12 passengers (including driver) without compensation C. Vehicle weighs less than 26,000 and transports hazardous material D. Drivers of all of the above must be certified - B 39. The driver presents for recertification following a recent diagnosis with pulmonary TB. She recently completed a 4‐month course of streptomycin. You should assess: A. Rapid alternative movement B. Rhomberg C. EKG D. LVEF - C 40. A driver who has a history of or more episode(s) of spontaneous pneumothorax requires before qualifying. A. 1, CXR B. 1, surgical correction C. 2, CXR D. 2, surgical correction - D 41. A driver who is otherwise qualified when accompanied by an SPE can be certified for: A. 3 months B. 6 months C. 1 year D. 2 years - D 42. Which of the following conditions is NOT disqualifying? A. Diagnosed epilepsy treated with anticonvulsant B. Narcolepsy C. Untreated sleep apnea D. Benign positional vertigo treated for 6 months - D 43. The minimum waiting period for anticoagulation is: A. 1 week B. 1 month C. 2 months D. 3 months - B 44. prescribed with a sulfonylurea is associated with increased risk of hypoglycemia. A. Metformin B. Alpha‐glucosidase inhibitors C. Thiazolidinediones D. Incretin mimetics - D 45. A driver is taking levodopa/carbidopa (Sinemet). Levodopa/carbidopa may cause the driver to be disqualified because it is usually used for the treatment of: A. Autonomic neuropathy B. Peripheral neuropathy C. Parkinson's syndrome D. Huntington disorder - C 46. Which of the following conditions would require the driver to complete qualifying procedures to include an SPE? A. Missing fourth and fifth fingers of right hand, has strong hand grasp B. Nerve impingement syndrome, left leg weakness C. Post crush injury to left arm 10 years ago, with atrophy and weakness in ulnar distribution D. Carpal tunnel syndrome with weak hand grasp - C 47. What is the recommended certification period for a driver with diabetes mellitus who does not use insulin? A. Three months for initial four certifications B. Three months initially followed by one‐year certification C. One year certification D. Two year certification - C 48. The driver provides documentation of recent diagnosis of Stage 4 chronic kidney disease. Which of the following findings would be disqualifying? A. History of diabetes B. Abnormal ECG C. Ejection fraction 45% D. BP 146/92 - B 49. The driver presents for recertification. He discloses a head injury sustained 4 months ago in a bike accident. His biking companion said that he "passed out" for about 15 minutes, but did not have any seizure activity. Which of the following waiting period (WP) and certification period (CP) are recommended? A. WP 0 year, CP 2 years B. WP 1 year CP 1 year C. WP 2 years, CP 1 year D. WP 5 years, CP 1 year - A 50. The new driver has a history of bacterial meningitis with early seizures. However, he has been seizure free and otherwise symptomatic since recovery six years ago. He has been off of anticonvulsants for approximately 5.5 years. With adequate documentation, you may certify this driver for up to: A. 6 months B. 1 year C. 2 years D. Is disqualified - C 51. Many neuromuscular conditions are disqualifying. For which of the following can a driver be certified? A. Myotonia B. Parkinson's C. Autonomic neuropathy D. Muscular dystrophy - C 52. The driver has held a commercial driving license for 40 year. He shows up 2 months early for recertification. When you point this out, he says he just thought he'd come in because he saw your sign. He volunteers that using his new GPS system is really confusing and he has ended up in the wrong town more than once lately, requiring added hours on the road. So he thought he might as well take advantage of the opportunity rather than miss the expiration date as he also has trouble staying on schedule. For many of the history questions, he provides flippant responses rather than specifics and is unable to recall three words five minutes later. You should: A. Order a brain scan B. Contact the motor carrier for recent drug test results C. Indicate "determination pending" and tell him he must return within 45 days with medical clearance in order to continue driving when his current certification expires D. Disqualify the driver - D 53. The driver had a CABG 3 months ago. His echo dated last week showed LVEF 50% and his cardiologist has submitted medical clearance. He should be: A. Disqualified due to not completing the necessary waiting period B. Disqualified due to the elevated LVEF C. Disqualified until he provides results of an ETT D. Qualified - D 54. The driver has been impatient awaiting his CMV exam, saying he will not tolerate "this disrespect" and threatening to sue if he is not seen immediately. He is agitated and pacing. He should be: A. Disqualified and encouraged to seek mental health B. Informed that your determination is pending submission of SPE C. Informed that your determination is pending submission of SAP D. Asked to provide his employer's contact so that you can discuss his presentation - A 55. Which diabetes risk poses the greatest threat to public safety? A. Hypoglycemia B. Hyperglycemia C. Macular degeneration D. Peripheral neuropathy - A 56. The driver with a history of depression presents taking SSRI. He has been on the same drug and dose for 6 months and is tolerating it well. He appears depressed with a flat affect and monotone voice. On questioning, admits that he has been very depressed lately. He has two weeks left on his current CMV driver certification. What certification decision should be made? A. Qualify with contract to see his PCP within two weeks. B. Adjust his SSRI and have him return for reevaluation in two weeks. C. Mark determination pending with a return date in two weeks D. Disqualify the driver - D 57. The driver has a history of ADHD and submits clearance from his provider indicating he has been on treatment for six months, during which he has tolerated treatment well with good results. What is his maximum certification period? A. 3 months for initial certification B. 6 months C. 1 year D. 2 years - C 58. The driver presents for recertification following a "major breakdown" and had a failed suicide attempt following his wife's death six months ago after she suffered a lengthy illness. He says that he was diagnosed with major depression, tried on a couple of antidepressants before he finally began to feel better but is now feeling well, has recovered, and realizes his wife would want him to continue life and find some happiness. He has taken on new activities on his free days and assures you that he no longer has any ideas of suicide. His mental health provider's clearance supports this history. What certification decision is recommended? A. Certify for 1 year B. Certify for 2 years C. Disqualify until he has been symptom free for at least a year D. Disqualify permanently due to the history of suicide attempt - C 59. Drivers on lithium should be advised to: A. Document drug level weekly B. Avoid night driving C. Seek alternative treatment in order to qualify for CMV operation D. None of the above are accurate - B 60. Which of the following are disqualifying? A. Benzodiazepines B. Methadone C. Disulfiram D. All of the above - D 61. A 28 year old otherwise healthy driver reports he had a sudden brief seizure two months ago, thought to be due to high fever during a recent serious lung infection. He is adamant he does not have epilepsy and takes no medications. The seizure was unwitnessed. According to medical guidance from FMSA, what should the examiner do? A. Request medical records for neurological diagnosis and related information, temporarily disqualify until clearance verified B. Do not certify as seizure history is always disqualifying C. Provide a conditional 30 day medical certification giving him time to bring in proof of medical clearance from his PCP D. Certify for one year as your examination shows no neurological deficits and he is not taking anti‐seizure medications - A