NRCME Test Bank Questions with Correct Detailed Answers UPDATED 2025

Which of the following is a requirement for drivers with a diabetes exemption? A) Possess a rapidly absorbable form of glucose while driving B) Self—monitor blood glucose one hour before driving and at least once every 2 hours while driving C) Plan to submit blood glucose monitoring logs every 6 months D) Maintain a Hemoglobin A1C value less than 7 -Correct Answer A. Drivers with diabetes should self monitor blood glucose before driving and every 4 hours while driving. Blood glucose monitoring logs should be submitted annually. There is no specific requirement for HgA1C level. Drivers with insulin dependent diabetes: A) May be certified for a maximum of 6 months B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certification C) Cannot be certified if they have a history of myocardial infarction D) May be eligible for a diabetes exemption -Correct Answer D) Drivers with insulin dependent diabetes cannot be certified but may be eligible for a diabetes exemption Which of the following is true? A) A driver with diabetes who uses insulin does not meet the minimum requirements of 49 CFR Part 391.41 B) The most important concert related to medication use for treating diabetes is hyperglycemia C) Peripheral neuropathy is not a disqualifying condition D) Diabetes is not a coronary heart disease (CHD) equivalent condition -Correct Answer A) The greatest risk for medication use for drivers with diabetes in hypoglycemia, not hyperglycemia. Peripheral neuropathy is disqualifying condition. Diabetes is a CHD equivalent condition. What is the recommended certification interval for a driver with diabetes mellituse who does not use insulin? A) Three months B) Six months C) One year D) Two years -Correct Answer C) Drivers with non-insulin dependent diabetes should be certified for a maximum of one year A diabetes exemption may be issued by: A) An endocrinologist B) The Medical Examiner C) The driver's personal physician D) The FMCSA -Correct Answer D) Only the FMCSA can grant exemptions A driver with diabetes mellliktus who uses insulin is determined to be otherwise medically qualified. The medical examiner must indicate that a diabetes exemption is required on the : A) Medical Examination Report status section and Medical Examiners Certificate B) Letter to the FMCSA C) Employer authorization form D) Endocrinology consultation form -Correct Answer A) Exemption requirements must be noted on the Medical Examination Report status section and the Medical Examiners Certificate If glucose is detected on urinalysis in a driver with no history of diabetes, an appropriate next step is: A) Endocrinology consultation B) One year clearance and recommendation to see personal physician C) Fingerstick or blood glucose determination D) Temporary disqualification -Correct Answer C) The medical examiner should first determine blood glucose and then make an appropriate certification determination and referral Drivers with a history of _____________ severe hypoglycemic reactions in the past year or _____________ severe hypoglycemic reactions in the past five years should not be certifed. A) one, three B) one, two C) two, three D) two, five -Correct Answer B) A driver should not be certified if the driver has had one hypoglycemic reaction in the past year or two in the past five years. Which of the following is not a criteria that the FMCSA uses to define a severe hypoglycemic reaction? A) Seizure B) Dizziness C) Need of assistance from another person D) Period of impaired cognitive function that occurred without warning -Correct Answer B) FMCSA defines severe hypoglycemia as reactions that result in seizure, loss of consciousness, need of assistance from another person, and a period of impaired congitive function that occurred without warning Which diabetes mellitus risk poses the greatest threat to public safety A) Hyperglycemia B) Peripheral neuropathy C) Hypoglycemia D) Metabolic encephalopathy -Correct Answer C) Although hyperglycemia, peripheral neuropathy, and metabolic encephalopathy all pose significant risks for safe driving, hypoglycemia poses the greatest risk. The risk is particularly pronounced in drivers who use insulin. FMCSA defines a hypoglycemia episode as one that results in seizure, loss of consciousness, need of assistance from another person, or a period of impaired cognitive function that occurs without warning. A driver with a diabetes exemption should check glucose levels when? A) One hour before driving and at least once every four hours while driving B) One hour before driving and at least every eight hours while driving C) Once after four hours of driving D) Once a day after driving period has ended -Correct Answer A) Driver's with diabetes exemption should check glucose values one hour before driving and once every four hours while driving Which of the following is true for diagnosis of a hernia? A) The driver should be referred to a surgeon to determine whether repair of a hernia is necessary B) The waiting period following hernia surgery is two weeks C) Inguinal hernias have been associated with an increased risk for CMV accidents D) The maximum certification interval for a driver with a hernia is two years -Correct Answer D) The medical examiner can use his/her judgment as to whether a driver should be referred to a surgeon or other specialist. There is no specified waiting period following hernia surgery - the driver should not be certified until the medical examiner determines that treatment is safe and effective, and that the condition is stable. No evidence has linked hernias of any type to increased CMV accident risk. Which of the following is true of nephropathy? A) Nephropathy is a disqualifying condition B) The maximum certification interval for nephropathy is two years C) A driver with 3+ proteinuria should not be certified D) A renal specialist should make the certification determination for a driver with nephropathy -Correct Answer B) Nephropathy is considered on a case-by-case basis. The medical examiner determines what evaluation or monitoring is necessary for a driver with 3+ proteinuria and may disqualify the driver. The certification is always made by the medical examiner and cannot be deferred to a specialist. Drivers with which of the following conditions should be disqualified? A) Cancer requiring chemotherapy treatment B) Umbilical hernia not surgically repaired C) Renal failure on peritoneal dialysis D) Hemochromatosis -Correct Answer C) Dialysis of any type is disqualifying If a significant abnormal finding for urinalysis specific gravity, protein, or blood is found, the medical examiner should: A) Disqualify the driver B) Request that a renal specialist determine if the driver is medically qualified C) Use clinical expertise to determine a certification decision and to determine if additional evaluation is required or recommended D) Obtain blood chemistries for renal function -Correct Answer C) The medical examiner must determine whether additional evaluation is needed and whether the certification decision should be postponed or limited