MRO PRACTICE EXAM ACTUAL EXAM PAPER
2026 QUESTIONS WITH SOLUTIONS GRADED
A+
◉ 3. 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.
◉ 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
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.
◉ 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.
,◉ 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.
◉ 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
D.Assess safety risks from medications. Answer: B
A, C and D are all part of the considerations of an MRO in assessing
workplace safety. However, the DOT has made it explicitly clear that
while an MRO may express safety concerns to the donor and discuss
them with prescribing health care professional, the MRO is
, admonished NOT to determine whether the medication was
appropriately prescribed.
The one exception for federal employees is mentioned the SAMHSA
MRO Guidance Manual, which does allow MROs to "use reasonable
medical judgement to make the decision that the provided
prescription was generated in response to the donor's current
medical condition
◉ 8. At what age does use of illicit drugs peak in the U.S.?
A.12-17
B.18-24
C.25-3
D.33-50
E.51 and older. Answer: B
The National Survey on Drug Use and Health has consistently shown
in all its surveys from 2000-2018 that illicit drug use peaks at ages
18-24.
◉ 9. The greatest increase in U.S. drug overdose deaths is due to
which of the following categories of drugs?
A.Cocaine
B.Heroin
C.Methamphetamine
2026 QUESTIONS WITH SOLUTIONS GRADED
A+
◉ 3. 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.
◉ 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
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.
◉ 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.
,◉ 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.
◉ 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
D.Assess safety risks from medications. Answer: B
A, C and D are all part of the considerations of an MRO in assessing
workplace safety. However, the DOT has made it explicitly clear that
while an MRO may express safety concerns to the donor and discuss
them with prescribing health care professional, the MRO is
, admonished NOT to determine whether the medication was
appropriately prescribed.
The one exception for federal employees is mentioned the SAMHSA
MRO Guidance Manual, which does allow MROs to "use reasonable
medical judgement to make the decision that the provided
prescription was generated in response to the donor's current
medical condition
◉ 8. At what age does use of illicit drugs peak in the U.S.?
A.12-17
B.18-24
C.25-3
D.33-50
E.51 and older. Answer: B
The National Survey on Drug Use and Health has consistently shown
in all its surveys from 2000-2018 that illicit drug use peaks at ages
18-24.
◉ 9. The greatest increase in U.S. drug overdose deaths is due to
which of the following categories of drugs?
A.Cocaine
B.Heroin
C.Methamphetamine
