NRCME DOT UPDATED ACTUAL TEST
QUESTIONS AND VERIFIED ANSWERS
BUNDLE
●● Who and what does the FMCSA regulate?
Answer: Interstate commercial operation, including the driver, vehicle,
motor carrier, and the transport of hazardous materials.
●● Examples of CMV driver stress factors
Answer: Interruption of normal sleep, exercising, eating pattern, and
access to social support networks resulting in fatigue, obesity, and
or/alienation of affection. Environment that may have excessive
vibration, noise, and extremes in temperature and or/adverse road or
traffic conditions that can interfere with driver ability to recognize a
driving hazard, cause temporary or permanent physical damage to
sensory perception or affect driver behavior. Increased potential for
injury and fatalities should there be a crash when driver is responsible
for passenger safety or hazardous cargo.
●● What are the differences between the medical standards and medical
guidelines?
Answer: Regulations are law and are mandatory. The ME must use
standards to determine interstate CMV driver medical fitness for duty.
Medical guidelines are not regulatory and the ME may choose not to
follow the medical guidance.
,●● In which regulations are the driver physical qualification standards
and Medical Examiners cited?
Answer: Driver physical qualification standards are found in 49 CFR
391.41. ME responsibilities are found in 49 CFR 391.43
●● What objective tests and measurements are required as part of the
driver physical examination?
Answer: Height & weight
Vision
Hearing
BP & pulse
Urinalysis (spec gravity, protein, blood, glucose)
●● What are the possible outcomes of the driver physical examination?
Answer: Certification
Disqualification
Determination pending
●● What date is used to determine medical examiners certificate
expiration?
Answer: The date of the exam is used as the basis for certificate
expiration, except when determination pending is chosen.
,When determination pending is chosen, if the driver returns with the
necessary information prior to the expiration of the driver's current
certificate and the driver is qualified based on that information provided,
the date used for the basis of the certification timeframe is the date the
driver returned with the necessary information.
●● What is the ME certificate expiration date for the following drivers?
A - Exam 4/16/2011, meets standards in 49 CFR 391.41, qualifies for 2
year certificate.
B - Exam 4/16/2011, meets standards, but periodic monitoring required
due to HTN, qualifies for 1 year certificate.
C - Exam 4/16/2011, determination pending due to not having results of
post-CABG stress test, pt returns and provides that info on 4/25/2011,
driver is qualified for 1 year.
D - Exam 4/16/2011, disqualified due to benign position vertigo on
3/15/2011, returned to ME for certification examination on 5/20/11. He
has been asymptomatic since 3/11/2011. Qualified for two years.
Answer: A: 4/16/2013
B: 4/16/2012
C: 4/25/2012
D: 5/20/2013
●● Patient example:
Karen, recertification exam
42 y/o female
, No health history, no medications.
Vision acuity: right 20/20, left 20/30. Both 20/20. Horizontal field of
vision Rt 80 degrees, Lt 80 degrees. Not corrected vision.
No monocular vision.
No hearing aids, Whisper test 5' bilaterally. N/A audiometric testing
UA: spec grav 1.020, protein 1+, blood 4+, glucose neg.
Hgb 12.4
BP 134/88, P 80, regular.
PE: on 4th day of menses with heavy bleeding. Advised to consult PCP
or GYN for eval of excessive bleeding that could lead to anemia, leading
to fatigue that would affect her driving.
Answer: Two year certification - no disqualifying health history or PE
abnormalities.
Ask about medication use, including OTC medications.
ME obtained hemoglobin testing based on PE findings. (not required)
The ME should correctly note the body system in which there was an
abnormal finding. The note reflects inquiry as to the affect on driving
ability and is also supported by Hgb test results. ME also documented
medical follow up advice.
●● Who can perform the vision portion of the interstate CMV driver
physical examination?
Answer: The certified ME, optometrist, or an opthalmologist. If the
specialist provider performs the exam, they should complete and sign the
provider's information on the report form and provide the results.
QUESTIONS AND VERIFIED ANSWERS
BUNDLE
●● Who and what does the FMCSA regulate?
Answer: Interstate commercial operation, including the driver, vehicle,
motor carrier, and the transport of hazardous materials.
●● Examples of CMV driver stress factors
Answer: Interruption of normal sleep, exercising, eating pattern, and
access to social support networks resulting in fatigue, obesity, and
or/alienation of affection. Environment that may have excessive
vibration, noise, and extremes in temperature and or/adverse road or
traffic conditions that can interfere with driver ability to recognize a
driving hazard, cause temporary or permanent physical damage to
sensory perception or affect driver behavior. Increased potential for
injury and fatalities should there be a crash when driver is responsible
for passenger safety or hazardous cargo.
●● What are the differences between the medical standards and medical
guidelines?
Answer: Regulations are law and are mandatory. The ME must use
standards to determine interstate CMV driver medical fitness for duty.
Medical guidelines are not regulatory and the ME may choose not to
follow the medical guidance.
,●● In which regulations are the driver physical qualification standards
and Medical Examiners cited?
Answer: Driver physical qualification standards are found in 49 CFR
391.41. ME responsibilities are found in 49 CFR 391.43
●● What objective tests and measurements are required as part of the
driver physical examination?
Answer: Height & weight
Vision
Hearing
BP & pulse
Urinalysis (spec gravity, protein, blood, glucose)
●● What are the possible outcomes of the driver physical examination?
Answer: Certification
Disqualification
Determination pending
●● What date is used to determine medical examiners certificate
expiration?
Answer: The date of the exam is used as the basis for certificate
expiration, except when determination pending is chosen.
,When determination pending is chosen, if the driver returns with the
necessary information prior to the expiration of the driver's current
certificate and the driver is qualified based on that information provided,
the date used for the basis of the certification timeframe is the date the
driver returned with the necessary information.
●● What is the ME certificate expiration date for the following drivers?
A - Exam 4/16/2011, meets standards in 49 CFR 391.41, qualifies for 2
year certificate.
B - Exam 4/16/2011, meets standards, but periodic monitoring required
due to HTN, qualifies for 1 year certificate.
C - Exam 4/16/2011, determination pending due to not having results of
post-CABG stress test, pt returns and provides that info on 4/25/2011,
driver is qualified for 1 year.
D - Exam 4/16/2011, disqualified due to benign position vertigo on
3/15/2011, returned to ME for certification examination on 5/20/11. He
has been asymptomatic since 3/11/2011. Qualified for two years.
Answer: A: 4/16/2013
B: 4/16/2012
C: 4/25/2012
D: 5/20/2013
●● Patient example:
Karen, recertification exam
42 y/o female
, No health history, no medications.
Vision acuity: right 20/20, left 20/30. Both 20/20. Horizontal field of
vision Rt 80 degrees, Lt 80 degrees. Not corrected vision.
No monocular vision.
No hearing aids, Whisper test 5' bilaterally. N/A audiometric testing
UA: spec grav 1.020, protein 1+, blood 4+, glucose neg.
Hgb 12.4
BP 134/88, P 80, regular.
PE: on 4th day of menses with heavy bleeding. Advised to consult PCP
or GYN for eval of excessive bleeding that could lead to anemia, leading
to fatigue that would affect her driving.
Answer: Two year certification - no disqualifying health history or PE
abnormalities.
Ask about medication use, including OTC medications.
ME obtained hemoglobin testing based on PE findings. (not required)
The ME should correctly note the body system in which there was an
abnormal finding. The note reflects inquiry as to the affect on driving
ability and is also supported by Hgb test results. ME also documented
medical follow up advice.
●● Who can perform the vision portion of the interstate CMV driver
physical examination?
Answer: The certified ME, optometrist, or an opthalmologist. If the
specialist provider performs the exam, they should complete and sign the
provider's information on the report form and provide the results.
