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FMCSA DOT Physical Medical Examiner Test 2025 – Verified Questions and Correct Solutions | NRCME Certification Study Guide

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This document provides the 2025 FMCSA DOT Physical Medical Examiner Test with verified questions and accurate solutions, ideal for professionals preparing for NRCME (National Registry of Certified Medical Examiners) certification. It covers all critical exam domains including driver medical qualification standards, cardiovascular and respiratory evaluations, neurological and vision assessments, medication use, and FMCSA regulatory updates. Fully aligned with the Federal Motor Carrier Safety Administration (FMCSA) guidelines, this comprehensive study resource ensures exam readiness and clinical competency for DOT medical examiners.

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Uploaded on
November 3, 2025
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Written in
2025/2026
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FMCSA DOT Physical Medical Examiner Test
2025– Verified Questions and Correct Solutions
| NRCME Certification Study Guide
Interstate commerce definition? - Answer Any material transported from 1 state to another state,
even if the individual driver never leaves 1 state, that:
a) weighs >10,001 lbs (if >26,001 lbs, they also need a drug test)
b) 9-15 passengers for compensation
c) 16+ passengers regardless of compensation
d) that requires placarding for hazardous materials

Does interstate commerce refer to the cargo or to the driver?
- Answer It refers to the cargo, tools,
vehicle, NOT to the driver.

When is a 12 month (or shorter) certification required?
- Answer a) intracity zone exempt drivers
b) waiver program drivers
c) insulin
d) any driver whose job duties have been impaired by mental/physical injury

Does the driver need a new exam after sustaining an injury?
- Answer That is up to the employer.

Can an examiner write schedule/MSK restrictions?
- Answer No.

Document every abnormality?
- Answer Yes, and then just write in comments, "not likely to
interfere."

Whisper test okay for hearing?
- Answer Yes

Need to fill out both state and federal?
- Answer No, one or the other

Is determination pending okay on both state and federal?
- Answer No, only permissible on federal

When to fill out state form?
- Answer If truly intrastate. Need to know the state variances for the
state in which the driver operates.

How short a period can you put on the card?
- Answer As short as you want. Eg. 30 days, 45 days, 3
months, etc.

2 reasons for not medically qualified?
- Answer 1) Disease/condition that temporarily or
permanently DQs them OR 2) Haven't fulfilled appropriate waiting period, eg. 1 year

What do you document if driver stops exam?
- Answer "Incomplete exam"

,FMCSA DOT Physical Medical Examiner Test
2025– Verified Questions and Correct Solutions
| NRCME Certification Study Guide

If you do determination pending, what do you put as the expiration-date?
Answer The date they
come back with whatever documentation you needed.

Is the medical certification limited to their current employer?
- Answer No. They are allowed to
switch employers that might require more strenuous tasks/different schedule, etc.

What is "acceptable risk?"
- Answer 1% annual risk of sudden incapacitation. If the driver is at
increased risk compared to the general population, than they shouldn't be operating a CMV.

When to certify for less than 2 years?
- Answer If their condition requires more frequent
monitoring by specialist/PCP, etc.

What do you put in the "medical record" box?
- Answer Can be blank, employee ID, etc. Up to you.

Okay to examine drivers from Canada and Mexico?
- Answer Yes

Driver ID requirements?- Answer You must see some sort of government issued ID to make sure
they're not having a friend/family member take the medical exam for them.

If they leave blank, check yes, or not sure under "medical certificate issued for less than 2 years,"
then what?- Answer Ask why and address. Review old exams done in your clinic!!!

If driver wrote "not sure" to any answer...
- Answer Ask about and address. Never cross out what
driver wrote but you can put additional comments below.

Does determination pending require a new exam?
- Answer No. A short medical certificate does,
but a DP does not.

What to do if current med certificate expires tomorrow, but you need their HgbA1C,- Answer
etc?
1) You can issue a short term certificate AND do determination pending but will need to repeat
exam
2) DQ and do determination pending if you do not think driver is safe to be on the road in the
meantime before you get the info

How long do you have to submit driver determination online after doing exam?
- Answer Close of
next calendar business day.

, FMCSA DOT Physical Medical Examiner Test
2025– Verified Questions and Correct Solutions
| NRCME Certification Study Guide
Whose responsibility is it to address driver's age and language?
- Answer Employer

What do you do after you make your determination?
- Answer Required to discuss with the driver
and what they need to do. Must be clear that you are making your decision based on best
practice/guidelines and NOT on regulation.

What if a driver from another country has a variance/waiver?
- Answer They are not qualified in
the US.

What are the 13 physical qualifications for drivers?
- Answer 1 + 2. No loss/impairment of
foot/leg/hand/arm.
3. No IDDM (new waiver)
4. No dx of heart dz
that might cause syncope, SOB, collapse, or CHF
5. No respiratory dysfunction likely to interfere
6. No HTN likely to interfere
7. No hx or dx of MSK dz likely to interfere
8. No hx of epilepsy or dz causing LOC
9. No mental/psych dz likely to interfere
10. Distance vision of 20/40 in each eye and together, 70 degrees horizontal field, and ability to
recognize red/green/yellow
11. Whisper at 5 feet in BETTER ear or no average HL in better ear>40 DBs at 500,1000,and 2000
hz
12. No schedule 1, amphetamine, narcotic, habit forming drugs except when prescribed by
someone who says it will not affect ability to operate CMV
13. No dx of alcoholism

Can a medical examiner grant a waiver?
- Answer No. They have to go through the online FMCSA
processes.

Don't certify until etiology is _______, and _____ is shown to be _____, ______, and -_____.
Answer Confirmed, treatment, safe, effective, stable.

What if multiple waiting periods for multiple comorbidities?
- Answer Wait until longest one is
done.

When to get additional tests/consults?
- Answer Case by case basis to adequately address fitness for
duty. No required to accept the consult/testing.
R276,39
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