DOT EXAM: Questions & Answers: Updated A+ Score Solution

Upon examination of a 46 y/o male smoker, you detect an irregularly irregular heart rhythm. The rate is 140 bpm. This is unknown to the driver and he denies any symptoms of lightheadedness, shortness of breath, dizziness, palpitations, nor any cardiac history. You would: (Ans- Disqualify and refer to his PMD or cardiologist for further evaluation. Concerning the medical certificate, which is false? (Ans- Provide the original to the driver being examined. Retain a copy for at least 3 years. You may not provide a copy to the current or prospective employer, they must get it from the driver. The driver must carry the original certificate during operation of a CMV. How soon may a driver be certified after coronary artery bypass grafting (CABG) surgery? (Ans- 3 months with clearance by cardiologist, resting echocardiogram with an LVEF >40% after CABG, and asymptomatic status with no angina. FMCSA defines a severe hypoglycemic reaction as one that results in: (Ans- Need of assistance from another person, loss of consciousness, any period of impaired cognitive function that occurs without warning, or seizure Medical fitness for duty includes the ability to perform strenuous labor and to have good judgment, impulse control, and _____________________. (Ans- Problem solving skills All of the following may perform and certify vision test results except: (Ans- A chiropractor Ophthalmologist Optometrist or Registered Nurse The grace period for the expiration of a Medical Examiner's Certification is (Ans- There is no grace period, the certification expires at midnight on the date listed A 28 year old female presents for her CDL physical exam. She indicates she has been enrolled in a Methadone program for three months secondary to a previous substance abuse issue in the recent past. She presents a letter from the administrator of the program documenting her compliance with the program and absence of any history of prior violations of their agreement. According to medical guidance, can a driver be certified while taking methadone. (Ans- No, since Methadone is a habit-forming narcotic that can produce drug dependence. Methadone is not an allowable drug for CMV operators. Arriving for a recertification exam, a 48 y/o male non-smoker is 5'4", 275lbs. His supervisor calls you ahead of time stating he recently went off the side of the road crashing into a guard rail. There were no injuries and the truck sustained only minor damage. When the medical assistant goes to bring him back, he is found asleep, snoring in the waiting room and she needs to wake him by gently shaking him by the shoulder. She reports this to you. When you arrive in the exam room the patient appears to be nodding off while sitting on the exam table. Upon further questioning, he admits that his wife frequently elbows him because of his snoring and that he gasps and snorts in his sleep. When asked, he denies nodding off while driving. His exam is notable for obesity, Mallampati 4 oropharynx, HTN controlled with 2 medications, otherwise normal. Appropriate next steps: (Ans- Disqualify and refer to PMD for sleep study. You examine a 37 male driver with missing fingers on his left hand, you must evaluate and do all of the following, (Ans- Document the effect that the deficit has on the ability of the driver to safely operate a CMV Provide a copy of the Medical Examination Report form and medical examiner's certificate for an SPE initial or renewal application Ensure that the driver with an existing SPE certificate is complying with medical requirements You examine a 37 male driver with missing fingers on his left hand, you must evaluate and obtained Obtain approval from the primary care doctor (Ans- no When you perform a urinalysis (dip stick) test, you are to test for what? (Ans- Specific gravity, protein (proteinuria), blood (hematuria) and glucose (glycosuria) Commercial drivers have a greater propensity to develop hypertension than their peers in other professions. (Ans- true The percentage of drivers with hypertension increases with years of driving, from 29% in drivers with fewer than 10 years driving experience to 39% in drivers with over 20 years of experience. (Ans- true Effective hypertension management reduces overall cardiac morbidity and mortality. (Ans- true