Page 1 of 129
MRO Medical Review Officer ACTUAL EXAM 2026-2027
COMPLETE 400 QUESTIONS AND VERIFIED SOLUTIONS
LATEST UPDATE THIS YEAR
MRO Medical Review Officer
QUESTION: 1. Which of the following is the "weakest link" in drug testing, i.e., generally
produces the most frequent errors?
A.Specimen collection
B.Laboratory testing
C.MRO review - ANSWER-A
Among drug testing personnel, there are far more specimen collectors than laboratory staff or
MROs. Collectors receive the least amount of training, are paid the lowest wages, and have the
highest job turnover.
Quality reviews show that a substantially larger number of errors occur in collection and
properly completing the Custody and Control Form.
2. Which of the following drug tests is not required for federal employees under the federal
Drug-Free Workplace Program?
A.Preplacement
,Page 2 of 129
B.Post-accident
C.Return to duty
D.Unreasonable suspicion
E.Random - ANSWER-D
SAMHSA's Drug Free Workplace Program specifies "Reasonable Suspicion" as one of the types
of drug testing. This is found on the federal Custody and Control Form. The incorrect answer
was unreasonable suspicion.
QUESTION: 4. MROs must pass a nationally recognized certifying examination for which of the
following activities?
A.All MRO work
B.All federally regulated MRO work
C.All DHHS and DOT MRO work
D.All states with provisions allowing medical marijuana - ANSWER-C
A. All MRO work - Incorrect: includes non-federally regulated drug testing, in which only a
handful of states require MRO certification
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B. All federally-regulated MRO work - Incorrect: includes DOD, NRC and other agencies, which
do not require MRO certification
C. All DHHS and DOT MRO work - Correct Answer: Both SAMHSA and DOT clearly specify this
requirement for MROs.
D. All states with provisions allowing medical marijuana - Incorrect: state Marijuana laws make
no reference to MROs, and only allow medical authorization or recommendation permitting
marijuana use. Health care professions do not "prescribe" marijuana.
QUESTION: 5. Which of the following roles is primary for the MRO?
A.Lab checker
B.SAP advisor
C.Gatekeeper
D.Mediator
E.Substance Abuse Identifier - ANSWER-c
Although each of these monikers identify occasional, peripheral roles of the MRO, the DOT has
clearly earmarked the role of the MRO as a gatekeeper.
, Page 4 of 129
QUESTION: 6. After completing review of drug test results, interviewing the donor and
documenting findings, an MRO must do which of the following?
A.Confirm laboratory results
B.Reconfirm laboratory results
C.Verify drug test results
D.Report findings to laboratory and employer - ANSWER-C
The determination of an MRO is called a "verification" decision. Laboratories confirm lab results
though performing a second test using a different analytical method and performing internal
quality control measures. A laboratory to which a split specimen is send reconfirms or fails to
reconfirm the original laboratory's findings. MROs report findings to employers, but do not
routinely report to laboratories.
QUESTION: 7. The MRO safety duties include all but which of the following activities?
A.Consider essential job functions
B.Review appropriateness of medications donor is taking
C.Verify prescriptions with PCP/pharmacy
MRO Medical Review Officer ACTUAL EXAM 2026-2027
COMPLETE 400 QUESTIONS AND VERIFIED SOLUTIONS
LATEST UPDATE THIS YEAR
MRO Medical Review Officer
QUESTION: 1. Which of the following is the "weakest link" in drug testing, i.e., generally
produces the most frequent errors?
A.Specimen collection
B.Laboratory testing
C.MRO review - ANSWER-A
Among drug testing personnel, there are far more specimen collectors than laboratory staff or
MROs. Collectors receive the least amount of training, are paid the lowest wages, and have the
highest job turnover.
Quality reviews show that a substantially larger number of errors occur in collection and
properly completing the Custody and Control Form.
2. Which of the following drug tests is not required for federal employees under the federal
Drug-Free Workplace Program?
A.Preplacement
,Page 2 of 129
B.Post-accident
C.Return to duty
D.Unreasonable suspicion
E.Random - ANSWER-D
SAMHSA's Drug Free Workplace Program specifies "Reasonable Suspicion" as one of the types
of drug testing. This is found on the federal Custody and Control Form. The incorrect answer
was unreasonable suspicion.
QUESTION: 4. MROs must pass a nationally recognized certifying examination for which of the
following activities?
A.All MRO work
B.All federally regulated MRO work
C.All DHHS and DOT MRO work
D.All states with provisions allowing medical marijuana - ANSWER-C
A. All MRO work - Incorrect: includes non-federally regulated drug testing, in which only a
handful of states require MRO certification
,Page 3 of 129
B. All federally-regulated MRO work - Incorrect: includes DOD, NRC and other agencies, which
do not require MRO certification
C. All DHHS and DOT MRO work - Correct Answer: Both SAMHSA and DOT clearly specify this
requirement for MROs.
D. All states with provisions allowing medical marijuana - Incorrect: state Marijuana laws make
no reference to MROs, and only allow medical authorization or recommendation permitting
marijuana use. Health care professions do not "prescribe" marijuana.
QUESTION: 5. Which of the following roles is primary for the MRO?
A.Lab checker
B.SAP advisor
C.Gatekeeper
D.Mediator
E.Substance Abuse Identifier - ANSWER-c
Although each of these monikers identify occasional, peripheral roles of the MRO, the DOT has
clearly earmarked the role of the MRO as a gatekeeper.
, Page 4 of 129
QUESTION: 6. After completing review of drug test results, interviewing the donor and
documenting findings, an MRO must do which of the following?
A.Confirm laboratory results
B.Reconfirm laboratory results
C.Verify drug test results
D.Report findings to laboratory and employer - ANSWER-C
The determination of an MRO is called a "verification" decision. Laboratories confirm lab results
though performing a second test using a different analytical method and performing internal
quality control measures. A laboratory to which a split specimen is send reconfirms or fails to
reconfirm the original laboratory's findings. MROs report findings to employers, but do not
routinely report to laboratories.
QUESTION: 7. The MRO safety duties include all but which of the following activities?
A.Consider essential job functions
B.Review appropriateness of medications donor is taking
C.Verify prescriptions with PCP/pharmacy
