NRCME Test Actual Questions and
Correct Answers Graded A+
1. What minimum arterial oxygen level is recommended if a
commercial driver has an arterial blood gas analysis because of a
chronic respiratory disorder?
A. 70 mm Hg
B. 55 mm Hg
C. 60 mm Hg
D. 65 mm Hg
Answer D. 65 mm Hg
Rationale: A driver with a chronic respiratory disorder should
generally have a PaO₂ greater than 65 mm Hg to meet recommended
oxygenation requirements. A value at or below this level may require
additional evaluation and may not support certification.
2. A driver first perceives a whispered voice at 5 feet in his right ear
and at 4 feet in his left ear. All other aspects of the physical
examination are normal. What should the medical examiner do?
,A. Disqualify the driver because he failed the whispered-voice test
B. Certify the driver for 2 years
C. Certify the driver for 1 year
D. Require an audiometric test to determine the extent of hearing
loss in his left ear
Answer B. Certify the driver for 2 years
Rationale: The driver meets the hearing standard because he can
perceive a forced whispered voice at 5 feet in the better ear. Hearing
the voice at 4 feet in the other ear does not disqualify him when the
better ear meets the requirement.
3. A driver presents for examination 6 weeks after suffering a mild
myocardial infarction. He has a note from his cardiologist stating that
he may return to work immediately without restrictions. The note
includes recent testing showing that the driver achieved 12 METS on
an exercise tolerance test and had an echocardiographic ejection
fraction of 65%. The physical examination is normal. What should the
medical examiner do?
A. Disqualify the driver
B. Qualify the driver for 1 year
,C. Qualify the driver for 2 years
D. Consult with the cardiologist to determine whether the driver has
angina
Answer A. Disqualify the driver
Rationale: Following an acute myocardial infarction, the driver must
complete the recommended 2-month waiting period before
certification. Although the cardiac testing is favorable, the driver is
being examined too soon. He may be reconsidered after the waiting
period if all other requirements are satisfied, generally with a 1-year
certification.
4. A driver provides an audiometric test with the following results:
Frequency Right Ear Left Ear
500 Hz 35 dB 40 dB
1,000 Hz 40 dB 45 dB
2,000 Hz 40 dB 45 dB
4,000 Hz 50 dB 50 dB
What should the medical examiner do?
A. Disqualify the driver because he does not meet the minimum
,hearing requirements
B. Certify the driver for 2 years
C. Certify the driver for 1 year
D. Require the driver to obtain a hearing exemption
Answer B. Certify the driver for 2 years
Rationale: The average hearing loss is calculated using the 500-,
1,000-, and 2,000-Hz results. The right-ear average is 38.3 dB, and
the left-ear average is 43.3 dB. The better ear must have an average
hearing loss of 40 dB or less. Because the right ear meets the
requirement, the driver qualifies.
5. During the examination of a commercial driver, the medical
examiner determines that the driver’s peripheral vision is 70 degrees
to the left and 80 degrees to the right. What should the examiner do?
A. Qualify the driver for 2 years
B. Require the driver to obtain a vision exemption because of the
limitation in the left peripheral field
C. Disqualify the driver
D. Have the driver consult an ophthalmologist to determine whether
the peripheral vision meets minimum standards
Correct Answers Graded A+
1. What minimum arterial oxygen level is recommended if a
commercial driver has an arterial blood gas analysis because of a
chronic respiratory disorder?
A. 70 mm Hg
B. 55 mm Hg
C. 60 mm Hg
D. 65 mm Hg
Answer D. 65 mm Hg
Rationale: A driver with a chronic respiratory disorder should
generally have a PaO₂ greater than 65 mm Hg to meet recommended
oxygenation requirements. A value at or below this level may require
additional evaluation and may not support certification.
2. A driver first perceives a whispered voice at 5 feet in his right ear
and at 4 feet in his left ear. All other aspects of the physical
examination are normal. What should the medical examiner do?
,A. Disqualify the driver because he failed the whispered-voice test
B. Certify the driver for 2 years
C. Certify the driver for 1 year
D. Require an audiometric test to determine the extent of hearing
loss in his left ear
Answer B. Certify the driver for 2 years
Rationale: The driver meets the hearing standard because he can
perceive a forced whispered voice at 5 feet in the better ear. Hearing
the voice at 4 feet in the other ear does not disqualify him when the
better ear meets the requirement.
3. A driver presents for examination 6 weeks after suffering a mild
myocardial infarction. He has a note from his cardiologist stating that
he may return to work immediately without restrictions. The note
includes recent testing showing that the driver achieved 12 METS on
an exercise tolerance test and had an echocardiographic ejection
fraction of 65%. The physical examination is normal. What should the
medical examiner do?
A. Disqualify the driver
B. Qualify the driver for 1 year
,C. Qualify the driver for 2 years
D. Consult with the cardiologist to determine whether the driver has
angina
Answer A. Disqualify the driver
Rationale: Following an acute myocardial infarction, the driver must
complete the recommended 2-month waiting period before
certification. Although the cardiac testing is favorable, the driver is
being examined too soon. He may be reconsidered after the waiting
period if all other requirements are satisfied, generally with a 1-year
certification.
4. A driver provides an audiometric test with the following results:
Frequency Right Ear Left Ear
500 Hz 35 dB 40 dB
1,000 Hz 40 dB 45 dB
2,000 Hz 40 dB 45 dB
4,000 Hz 50 dB 50 dB
What should the medical examiner do?
A. Disqualify the driver because he does not meet the minimum
,hearing requirements
B. Certify the driver for 2 years
C. Certify the driver for 1 year
D. Require the driver to obtain a hearing exemption
Answer B. Certify the driver for 2 years
Rationale: The average hearing loss is calculated using the 500-,
1,000-, and 2,000-Hz results. The right-ear average is 38.3 dB, and
the left-ear average is 43.3 dB. The better ear must have an average
hearing loss of 40 dB or less. Because the right ear meets the
requirement, the driver qualifies.
5. During the examination of a commercial driver, the medical
examiner determines that the driver’s peripheral vision is 70 degrees
to the left and 80 degrees to the right. What should the examiner do?
A. Qualify the driver for 2 years
B. Require the driver to obtain a vision exemption because of the
limitation in the left peripheral field
C. Disqualify the driver
D. Have the driver consult an ophthalmologist to determine whether
the peripheral vision meets minimum standards
