NRCME (DOT) Medical Examiner Certification
Exam 2026 –Actual Questions with Detailed
Answers & Rationales | Complete DOT/FMCSA
Exam Prep Guide | INSTANT PDF
DOWNLOAD
The NRCME (DOT) Exam is a complete study tool designed for candidates preparing for the
Federal Motor Carrier Safety Administration (FMCSA) Medical Examiner Certification
Exam.
This resource covers all critical medical conditions and functional standards assessed in NRCME
certification, including:
Cardiovascular health (hypertension, MI, angina, post-CABG recovery)
Neurological conditions (stroke, seizures, epilepsy)
Pulmonary and sleep disorders (COPD, obstructive sleep apnea)
Endocrine disorders (diabetes, insulin management, hypoglycemia)
Musculoskeletal conditions (knee replacements, mobility issues)
Psychiatric conditions (bipolar disorder, depression, anxiety)
Vision and hearing standards
Medication use and its effect on driver safety
Each question is multiple-choice with a detailed rationale, emphasizing FMCSA guidelines,
functional ability, and real-world safety implications.
This practice exam is ideal for:
Aspiring DOT/NRCME-certified medical examiners
Medical professionals preparing for federal certification
Review and reinforcement of DOT/FMCSA medical standards
Format: questions | Multiple choice | Answer key included | Detailed rationales for each answer
Edition: 2026, Updated for Current NRCME Standards
,Question 1:
Which of the following is required by FMCSA for all commercial driver medical
exams?
A) ECG for drivers over 40
B) Annual vision testing
C) Height and weight measurement
D) Complete blood panel
Answer: C) Height and weight measurement
Rationale: DOT regulations require documenting basic physical characteristics
such as height and weight at each exam. ECGs or blood panels are only indicated
for specific medical conditions, and vision is tested but not necessarily annually
for every driver.
Question 2:
A driver has a blood pressure of 165/95 mmHg during a DOT exam. According to
FMCSA guidelines, the examiner should:
A) Certify the driver without restrictions
B) Deny certification until blood pressure is controlled
C) Certify for 1 year with lifestyle counseling
D) Certify only if on antihypertensive medication
Answer: B) Deny certification until blood pressure is controlled
Rationale: FMCSA considers a systolic ≥160 mmHg or diastolic ≥90 mmHg as
uncontrolled hypertension. Certification requires that blood pressure be
controlled within acceptable limits.
Question 3:
Which vision standard must a commercial driver meet according to FMCSA?
A) 20/30 in each eye, corrected
B) 20/40 in each eye, corrected or uncorrected
C) 20/50 in one eye
D) Only distance vision, not near vision
,Answer: B) 20/40 in each eye, corrected or uncorrected
Rationale: Drivers must have at least 20/40 vision in each eye, with or without
corrective lenses, to meet federal requirements.
Question 4:
A driver reports a history of sleep apnea treated with CPAP. For certification, the
examiner should:
A) Ignore treatment history if symptoms are absent
B) Require documentation of adherence and symptom control
C) Automatically deny certification
D) Certify for 2 years without restrictions
Answer: B) Require documentation of adherence and symptom control
Rationale: FMCSA requires drivers with obstructive sleep apnea to provide proof
of treatment adherence and symptom control before certification, as untreated
OSA is a safety risk.
Question 5:
Which of the following medications is disqualifying for DOT drivers?
A) Metformin
B) Amitriptyline (tricyclic antidepressant)
C) Lisinopril
D) Levothyroxine
Answer: B) Amitriptyline (tricyclic antidepressant)
Rationale: Certain CNS-acting medications that impair alertness or reaction time,
such as tricyclic antidepressants, are disqualifying unless cleared and
documented. Other common medications for chronic conditions are allowed if
stable.
Question 6:
A driver presents with a history of myocardial infarction (MI) 6 months ago.
According to FMCSA, the examiner should:
A) Certify for 2 years immediately
B) Require at least 3 months symptom-free and cardiac clearance
, C) Deny certification permanently
D) Certify only if the driver is on beta-blockers
Answer: B) Require at least 3 months symptom-free and cardiac clearance
Rationale: FMCSA requires that drivers with MI provide documentation of cardiac
stability and clearance before certification; the exact time can vary but typically at
least 3 months post-event with no symptoms.
Question 7:
Which of the following hearing standards must a driver meet?
A) Must be able to hear a forced whisper at 5 feet in one ear
B) Must have audiometric testing showing ≤40 dB loss at 1000 Hz
C) Only speech discrimination is required
D) No hearing requirement for interstate drivers
Answer: A) Must be able to hear a forced whisper at 5 feet in one ear
Rationale: FMCSA regulations require drivers to be able to perceive a forced
whisper at 5 feet in one ear, with or without hearing aids. Audiometry may
supplement but is not the primary standard.
Question 8:
A driver reports epilepsy treated with a seizure-free period of 12 months. FMCSA
guidelines state:
A) Automatic disqualification
B) Conditional certification possible after seizure-free period and medication
stability
C) Certification only for 1 month
D) No certification allowed until 5 years seizure-free
Answer: B) Conditional certification possible after seizure-free period and
medication stability
Rationale: Drivers with epilepsy may qualify for certification if seizure-free for at
least 12 months and compliant with treatment, with documentation and ongoing
monitoring.
Exam 2026 –Actual Questions with Detailed
Answers & Rationales | Complete DOT/FMCSA
Exam Prep Guide | INSTANT PDF
DOWNLOAD
The NRCME (DOT) Exam is a complete study tool designed for candidates preparing for the
Federal Motor Carrier Safety Administration (FMCSA) Medical Examiner Certification
Exam.
This resource covers all critical medical conditions and functional standards assessed in NRCME
certification, including:
Cardiovascular health (hypertension, MI, angina, post-CABG recovery)
Neurological conditions (stroke, seizures, epilepsy)
Pulmonary and sleep disorders (COPD, obstructive sleep apnea)
Endocrine disorders (diabetes, insulin management, hypoglycemia)
Musculoskeletal conditions (knee replacements, mobility issues)
Psychiatric conditions (bipolar disorder, depression, anxiety)
Vision and hearing standards
Medication use and its effect on driver safety
Each question is multiple-choice with a detailed rationale, emphasizing FMCSA guidelines,
functional ability, and real-world safety implications.
This practice exam is ideal for:
Aspiring DOT/NRCME-certified medical examiners
Medical professionals preparing for federal certification
Review and reinforcement of DOT/FMCSA medical standards
Format: questions | Multiple choice | Answer key included | Detailed rationales for each answer
Edition: 2026, Updated for Current NRCME Standards
,Question 1:
Which of the following is required by FMCSA for all commercial driver medical
exams?
A) ECG for drivers over 40
B) Annual vision testing
C) Height and weight measurement
D) Complete blood panel
Answer: C) Height and weight measurement
Rationale: DOT regulations require documenting basic physical characteristics
such as height and weight at each exam. ECGs or blood panels are only indicated
for specific medical conditions, and vision is tested but not necessarily annually
for every driver.
Question 2:
A driver has a blood pressure of 165/95 mmHg during a DOT exam. According to
FMCSA guidelines, the examiner should:
A) Certify the driver without restrictions
B) Deny certification until blood pressure is controlled
C) Certify for 1 year with lifestyle counseling
D) Certify only if on antihypertensive medication
Answer: B) Deny certification until blood pressure is controlled
Rationale: FMCSA considers a systolic ≥160 mmHg or diastolic ≥90 mmHg as
uncontrolled hypertension. Certification requires that blood pressure be
controlled within acceptable limits.
Question 3:
Which vision standard must a commercial driver meet according to FMCSA?
A) 20/30 in each eye, corrected
B) 20/40 in each eye, corrected or uncorrected
C) 20/50 in one eye
D) Only distance vision, not near vision
,Answer: B) 20/40 in each eye, corrected or uncorrected
Rationale: Drivers must have at least 20/40 vision in each eye, with or without
corrective lenses, to meet federal requirements.
Question 4:
A driver reports a history of sleep apnea treated with CPAP. For certification, the
examiner should:
A) Ignore treatment history if symptoms are absent
B) Require documentation of adherence and symptom control
C) Automatically deny certification
D) Certify for 2 years without restrictions
Answer: B) Require documentation of adherence and symptom control
Rationale: FMCSA requires drivers with obstructive sleep apnea to provide proof
of treatment adherence and symptom control before certification, as untreated
OSA is a safety risk.
Question 5:
Which of the following medications is disqualifying for DOT drivers?
A) Metformin
B) Amitriptyline (tricyclic antidepressant)
C) Lisinopril
D) Levothyroxine
Answer: B) Amitriptyline (tricyclic antidepressant)
Rationale: Certain CNS-acting medications that impair alertness or reaction time,
such as tricyclic antidepressants, are disqualifying unless cleared and
documented. Other common medications for chronic conditions are allowed if
stable.
Question 6:
A driver presents with a history of myocardial infarction (MI) 6 months ago.
According to FMCSA, the examiner should:
A) Certify for 2 years immediately
B) Require at least 3 months symptom-free and cardiac clearance
, C) Deny certification permanently
D) Certify only if the driver is on beta-blockers
Answer: B) Require at least 3 months symptom-free and cardiac clearance
Rationale: FMCSA requires that drivers with MI provide documentation of cardiac
stability and clearance before certification; the exact time can vary but typically at
least 3 months post-event with no symptoms.
Question 7:
Which of the following hearing standards must a driver meet?
A) Must be able to hear a forced whisper at 5 feet in one ear
B) Must have audiometric testing showing ≤40 dB loss at 1000 Hz
C) Only speech discrimination is required
D) No hearing requirement for interstate drivers
Answer: A) Must be able to hear a forced whisper at 5 feet in one ear
Rationale: FMCSA regulations require drivers to be able to perceive a forced
whisper at 5 feet in one ear, with or without hearing aids. Audiometry may
supplement but is not the primary standard.
Question 8:
A driver reports epilepsy treated with a seizure-free period of 12 months. FMCSA
guidelines state:
A) Automatic disqualification
B) Conditional certification possible after seizure-free period and medication
stability
C) Certification only for 1 month
D) No certification allowed until 5 years seizure-free
Answer: B) Conditional certification possible after seizure-free period and
medication stability
Rationale: Drivers with epilepsy may qualify for certification if seizure-free for at
least 12 months and compliant with treatment, with documentation and ongoing
monitoring.
