NRCME Exam with complete solution

NRCME Exam with complete solution What are regulations? - Laws that must be followed What are disqualifying medical conditions? - Epilepsy monocular vision hearing loss What are guidelines? - Recommendation to follow but can have raptor ale for variation FMCSA medical program responsibilities include: Oversee the Department of Transportation. Regulation of intrastate commercial motor vehicle operations. Conduct and oversee the agency's medical exemption and certificate programs. Provide commercial motor vehicle driver examinations. - Conduct and oversee the agency's medical exemption and certificate programs. Which of the following is true? The FMCSA does not consider feasibility or impact in the rule-making process. Only the Medical Review Board can provide advice and opinions on FMCSA rulemaking. FMCSA medical standards and guidelines are subject to public notice and comment rulemaking. The Code of Federal Regulations provide guidance that the medical examiner may or may not ner may or may not follow. - FMCSA medical standards and guidelines are subject to public notice and comment rulemaking. FMCSA content sources rules and regulations include 49 CFR Part 16 DOT Procedures for Drug and Alcohol Testing. 49 CFR 391.41 Physical Qualifications for Drivers. 49 CFR 391.82 Medical examination; certificate of physical qualification. 49 CFR Part 73: Medical Review Board procedures. - 49 CFR 391.41 Physical Qualifications for Drivers. Which of the following is true regarding why regulation is needed to protect public safety? There is little environmental risk from crashes involving hazardous materials. There is greater risk of injury and fatalities to individuals in smaller vehicles from crashes involving commercial motor vehicles. The economic cost of crashes involving commercial vehicles is relatively low. Commercial vehicles do not carry members of the public. - There is greater risk of injury and fatalities to individuals in smaller vehicles from crashes involving commercial motor vehicles. Which of the following is true? By May 21, 2015, medical providers that perform medical examinations for commercial motor vehicle drivers must have completed an approved training program and passed a national certification examination. The Medical Examiner may request that an appropriate specialist provider make the driver certification determination. The purpose of the commercial motor vehicle driver examination is for treatment of driver medical conditions. FMCSA guidance recommendations may or may not be followed by the Medical Examiner. - FMCSA guidance recommendations may or may not be followed by the Medical Examiner.` What is the role of the medical examiner? - to determine medical fitness for duty. What are the differences between the medical standards and the medical guidelines - Medical Standards - regulations that are non-discretionary - the medical examiner cannot use judgment to certify a driver who does not meet a regulatory standard Medical Guidelines are discretionary - Medical Examiners may decide to certify drivers who do not meet medical guidelines. Most recommendations related to certification of specific medical conditions are guidance What are some medical standards for certifications that need to be done? - Vision requirements, including distant visual acuity, horizontal vision, and color vision. Drivers who do not meet standards cannot be certified unless accompanied by a vision exemption/waiver. Diabetes requirements: drivers using insulin cannot be certified unless special procedures for evaluation and certification of such drivers are followed. Epilepsy: drivers with a diagnosis of epilepsy cannot be certified unless accompanied by an epilepsy waiver/exemption. Hearing: drivers who cannot meet whisper test or audiometric test requirements cannot be certified unless accompanied by a hearing waiver/exemption. What are Turn around or short relay drivers? - drivers return to their home base each evening what are Long relay drivers? - drivers drive 9 to 11 hours and then have at least a 10-hour off duty period) What are Straight through haul drivers? - cross country What are Team drivers? - drivers share the driving by alternating their 5-hour driving periods and 5-hour rest periods What are the instructions for completion of a DOT physical? - Driver arrives at medical examiner's office Driver may bring paperwork -Verify driver identification with photo ID Driver completes formsMCSA 5875 - Medical Examination Report Form driver history -Confirm driver signature and date -Recommend driver sign HIPAA compliant release form(s) Driver testing then completed by medical examiner and/or staff -Vision testing -Hearing - whisper test or audiometry -Dipstick urinalysis -Blood pressure - pulse -Height and weight Medical Examiner examination =Review driver historyAcknowledge driver "Yes" answers and clarify with questions and additional information -Ask if driver has ever received less than a 2-year certification at any prior DOT medical examination Physical examination - driver should be in medical gown or equivalent -Medical Examiner notes abnormal findings with comments Medical Examiner completes forms (MCSA 5875 and MCSA 5876) Provide copy of Driver Certificate to driver and, if requested, to employer Complete online completion of driver certification information no later than midnight (local time) of the calendar day following the date of the examination When does the online completion of driver certification information have to be done? - no later than midnight (local time) of the calendar day following the date of the examination An individual diagnosed with Stage 1 hypertension (BP is 140/90-159/99) may be certified for how long? - 1 year At recertification, an individual with a hx of HTN; BP is greater than 140/90 but less than 160/100, - 3 months An individual diagnosed with Stage 2 (BP is 160/100-179/109) should be treated and given certificate for how long? - 3 months An individual diagnosed with Stage 3 hypertension (BP equal to or greater than 180/110) should - not be certified until his or her BP is reduced to 140/90 or less, and may be recertified every 6 months What are the four required tests for DOT exam? - Vision Hearing Blood pressure/pulse Urinalysis What should you tell a driver with contact lenses and/or glasses? - that he or she should carry extra contacts/pairs of glasses while driving. What should you tell a driver who wears a hearing aide? - that he/she should possess a spare power source for the device while driving. What are some reasons to disqualify a driver? - Who is currently using methadone. Who has a current clinical diagnosis of alcoholism or who uses a controlled substance including a narcotic, an amphetamine, or another habit-forming drug without a prescription from the treating physician. Who has a diagnosis of a regulatory disqualifying condition such as epilepsy, monocular vision, or hearing loss. When evidence shows a condition exists that will likely interfere with the safe operation What are the only conditions that a driver is medically qualified "only when" - Wearing corrective lenses Wearing a hearing aid. Accompanied by a ______ waiver/exemption. (E.g. federal vision). Driving within an exempt intracity zone (49 CFR 391.62). Accompanied by a Skill Performance Evaluation (SPE) certificate. (SPE certificates are issued by the FMCSA for fixed extremity deficits if the driver demonstrates the ability to meet FMCSA safe driving requirements). Qualified by operation of 49 CFR 391.64 (grandfathering for a limited number of drivers who participated in diabetes and vision waiver study programs). When a Determination Pending status was previously chosen, and the driver returns with the required information that establishes that the driver meets certification requirements what is the certification date? - the date that the driver provided the required information is used as the date from which certification is determined. Can someone be certified if they are taking a schedule 1 drug? - no Should you certify someone of a controlled medication? - prescribing doctor can write that the driver is safe to be a commercial driver while taking the medication