NRCME DOT Medical Examiner Test Bank 2026 | 300 Questions & Answers
Q1: What federal regulation governs the physical qualification standards
for commercial motor vehicle (CMV) drivers?
Answer: 49 CFR Part 391, Subpart E – Physical Qualifications and
Examinations. This regulation establishes the minimum physical requirements for
CMV drivers operating in interstate commerce.
Q2: What is the minimum vision requirement for CMV drivers in each eye?
Answer: Drivers must have distant visual acuity of at least 20/40 (Snellen) in
each eye, with or without corrective lenses. Additionally, drivers must have a field
of vision of at least 70° in the horizontal meridian in each eye.
Q3: What is the maximum duration of a Medical Examiner's Certificate
(MEC)?
Answer: The maximum duration of a Medical Examiner's Certificate is 24
months (2 years). However, the ME may issue a certificate for a shorter period if
a medical condition warrants more frequent monitoring.
Q4: What is the National Registry of Certified Medical Examiners (NRCME)?
Answer: The NRCME is a program established by FMCSA requiring all medical
examiners who perform physical examinations for CMV drivers to be listed on the
National Registry. MEs must complete accredited training and pass a certification
test to be listed.
Q5: Which drivers are subject to FMCSA physical qualification
requirements?
Answer: Drivers operating CMVs in interstate commerce weighing over 10,001
lbs GVWR, vehicles designed to transport 9 or more passengers including the
driver for compensation, vehicles transporting 16 or more passengers not for
compensation, or vehicles transporting hazardous materials requiring placards.
Q6: What is the FMCSA Form MCSA-5875?
Answer: MCSA-5875 is the Federal Motor Carrier Safety Administration Medical
Examination Report form, used by certified medical examiners to document
findings during the CMV driver physical examination. It replaced the previous
649-F form.
Federal Motor Carrier Safety Administration (FMCSA) | Page 1 of 52
, NRCME DOT Medical Examiner Test Bank 2026 | 300 Questions & Answers
Q7: What is the purpose of the Medical Examiner's Certificate (Form MCSA-
5876)?
Answer: Form MCSA-5876 is the Medical Examiner's Certificate issued to a
driver who passes the physical examination. The driver must carry this certificate
while operating a CMV in interstate commerce. It serves as proof of medical
qualification.
Q8: Under what circumstances can a medical examiner issue a certificate
for less than 24 months?
Answer: A ME may issue a certificate for less than 24 months when a driver has
a medical condition that requires monitoring more frequently, such as
hypertension, diabetes managed with insulin (with exemption), or sleep apnea.
The ME should specify the monitoring interval.
Q9: What is the role of the Federal Diabetes Exemption Program?
Answer: The Federal Diabetes Exemption Program allows drivers who use
insulin to treat diabetes to apply for an exemption from the standard prohibition
on insulin use. Exemptions are granted by FMCSA and allow insulin-treated
drivers to operate CMVs in interstate commerce under specific conditions.
Q10: What blood pressure classification allows a 1-year medical
certificate?
Answer: Stage 1 hypertension (systolic 140–159 mmHg or diastolic 90–99
mmHg) qualifies for a 1-year certificate. This allows the examiner to recheck the
driver's BP annually and ensure it is being treated and controlled.
Q11: What is the minimum hearing standard for CMV drivers?
Answer: A driver must perceive a forced whispered voice in the better ear at not
less than 5 feet, with or without the use of a hearing aid. Alternatively, the driver
must not have average hearing loss in the better ear greater than 40 dB (hearing
level in ISO 1964), with or without a hearing aid when the audiometric device is
calibrated to American National Standard.
Q12: What is the minimum age requirement for interstate CMV drivers?
Answer: Drivers must be at least 21 years of age to operate CMVs in interstate
commerce. However, drivers between 18–20 years old may operate CMVs in
intrastate commerce, subject to individual state regulations.
Q13: What happens if a driver's medical condition changes between
examinations?
Answer: If a driver develops a disqualifying condition between examinations, the
driver is required to cease operating a CMV and the motor carrier must be
notified. The driver should seek re-evaluation by a certified ME before returning
to CMV operation.
Federal Motor Carrier Safety Administration (FMCSA) | Page 2 of 52
, NRCME DOT Medical Examiner Test Bank 2026 | 300 Questions & Answers
Q14: Who regulates the physical qualification standards for intrastate CMV
drivers?
Answer: Intrastate CMV drivers are regulated by individual state agencies, not
FMCSA. States may adopt FMCSA standards or establish their own, and many
states mirror the federal standards. Some states have adopted exemption
programs similar to federal ones.
Q15: What is a Skills Performance Evaluation (SPE) Certificate?
Answer: An SPE Certificate is issued by FMCSA to drivers who have a limb
impairment (loss or impairment of a limb) and have demonstrated the ability to
safely operate a CMV using adaptive equipment or techniques. It allows
physically impaired drivers to operate CMVs.
Q16: What disqualifies a driver from receiving a Medical Examiner's
Certificate?
Answer: Disqualifying conditions include: loss of foot, leg, hand, or arm (without
SPE); limb impairment interfering with safe driving; established diagnosis of
epilepsy; currently using insulin (without exemption); current clinical diagnosis of
alcoholism; any other condition that interferes with safe driving.
Q17: How long must the completed Medical Examination Report be
retained by the medical examiner?
Answer: The medical examiner must retain a copy of the completed Medical
Examination Report (MCSA-5875) for a minimum of 3 years from the date of
examination. Records must be available for inspection by authorized FMCSA
personnel.
Q18: What is the FMCSA's definition of a Commercial Motor Vehicle (CMV)?
Answer: A CMV is any self-propelled or towed vehicle used on highways in
interstate commerce to transport passengers or property when the vehicle has a
GVWR of 10,001 lbs or more; is designed to transport 9 or more passengers for
compensation; is designed for 16+ passengers not for compensation; or
transports hazardous materials requiring placards.
Q19: What recertification requirements must NRCME-listed medical
examiners fulfill?
Answer: NRCME-listed MEs must complete recertification every 10 years. This
includes completing an accredited training program and passing the NRCME
certification test again. MEs must also maintain their underlying medical license
in good standing throughout the certification period.
Q20: What is the medical examiner's responsibility when a driver discloses
use of a Schedule II controlled substance?
Federal Motor Carrier Safety Administration (FMCSA) | Page 3 of 52
, NRCME DOT Medical Examiner Test Bank 2026 | 300 Questions & Answers
Answer: The ME must determine if the medication is a disqualifying condition.
Use of Schedule II narcotics or habit-forming drugs is generally disqualifying
unless the ME determines the medication does not adversely affect the driver's
ability to safely operate a CMV. Additional specialist evaluation may be
warranted.
Q21: What is the waiting period after a myocardial infarction before a CMV
driver may return to duty?
Answer: FMCSA guidelines recommend a minimum waiting period, typically at
least 2 years following a myocardial infarction, with full recovery confirmed by
cardiac stress testing. The driver must demonstrate adequate cardiac reserve
and absence of disqualifying conditions such as angina or EF < 40%.
Q22: When must a Diabetes Exemption holder be re-evaluated?
Answer: Insulin-treated diabetes mellitus (ITDM) exemption holders must be
evaluated annually by their treating endocrinologist or diabetes specialist and
submit a Medical Evaluation Report to FMCSA. They must also pass the regular
DOT physical examination.
Q23: What is the significance of the FMCSA Medical Advisory Criteria?
Answer: The FMCSA Medical Advisory Criteria provide guidance to medical
examiners on how to interpret and apply the physical qualification standards
found in 49 CFR Part 391.41. They are advisory only and not legally binding but
represent best practices for certification decisions.
Q24: Can a driver with a single kidney be medically certified to drive a
CMV?
Answer: Yes, a driver with a single functioning kidney may be medically certified
if kidney function is adequate (eGFR ≥ 60 mL/min/1.73 m²) and there are no
disqualifying symptoms such as hypertension, anemia, or electrolyte
abnormalities that would affect safe driving. Frequent monitoring may be
required.
Q25: What is the FMCSA's guidance on obstructive sleep apnea (OSA) for
CMV drivers?
Answer: FMCSA has not issued a formal rule on OSA but has advisory criteria
recommending that drivers with moderate-to-severe OSA (AHI ≥ 15) be
disqualified until successfully treated. Treatment adequacy is typically shown by
CPAP compliance data demonstrating AHI < 5 with ≥ 4 hours of use per night on
≥ 70% of nights.
Q26: What is the disqualifying blood pressure threshold for CMV drivers?
Answer: Stage 3 hypertension (systolic ≥ 180 mmHg or diastolic ≥ 110 mmHg) is
disqualifying at time of examination. The driver should be treated and the BP
Federal Motor Carrier Safety Administration (FMCSA) | Page 4 of 52
Q1: What federal regulation governs the physical qualification standards
for commercial motor vehicle (CMV) drivers?
Answer: 49 CFR Part 391, Subpart E – Physical Qualifications and
Examinations. This regulation establishes the minimum physical requirements for
CMV drivers operating in interstate commerce.
Q2: What is the minimum vision requirement for CMV drivers in each eye?
Answer: Drivers must have distant visual acuity of at least 20/40 (Snellen) in
each eye, with or without corrective lenses. Additionally, drivers must have a field
of vision of at least 70° in the horizontal meridian in each eye.
Q3: What is the maximum duration of a Medical Examiner's Certificate
(MEC)?
Answer: The maximum duration of a Medical Examiner's Certificate is 24
months (2 years). However, the ME may issue a certificate for a shorter period if
a medical condition warrants more frequent monitoring.
Q4: What is the National Registry of Certified Medical Examiners (NRCME)?
Answer: The NRCME is a program established by FMCSA requiring all medical
examiners who perform physical examinations for CMV drivers to be listed on the
National Registry. MEs must complete accredited training and pass a certification
test to be listed.
Q5: Which drivers are subject to FMCSA physical qualification
requirements?
Answer: Drivers operating CMVs in interstate commerce weighing over 10,001
lbs GVWR, vehicles designed to transport 9 or more passengers including the
driver for compensation, vehicles transporting 16 or more passengers not for
compensation, or vehicles transporting hazardous materials requiring placards.
Q6: What is the FMCSA Form MCSA-5875?
Answer: MCSA-5875 is the Federal Motor Carrier Safety Administration Medical
Examination Report form, used by certified medical examiners to document
findings during the CMV driver physical examination. It replaced the previous
649-F form.
Federal Motor Carrier Safety Administration (FMCSA) | Page 1 of 52
, NRCME DOT Medical Examiner Test Bank 2026 | 300 Questions & Answers
Q7: What is the purpose of the Medical Examiner's Certificate (Form MCSA-
5876)?
Answer: Form MCSA-5876 is the Medical Examiner's Certificate issued to a
driver who passes the physical examination. The driver must carry this certificate
while operating a CMV in interstate commerce. It serves as proof of medical
qualification.
Q8: Under what circumstances can a medical examiner issue a certificate
for less than 24 months?
Answer: A ME may issue a certificate for less than 24 months when a driver has
a medical condition that requires monitoring more frequently, such as
hypertension, diabetes managed with insulin (with exemption), or sleep apnea.
The ME should specify the monitoring interval.
Q9: What is the role of the Federal Diabetes Exemption Program?
Answer: The Federal Diabetes Exemption Program allows drivers who use
insulin to treat diabetes to apply for an exemption from the standard prohibition
on insulin use. Exemptions are granted by FMCSA and allow insulin-treated
drivers to operate CMVs in interstate commerce under specific conditions.
Q10: What blood pressure classification allows a 1-year medical
certificate?
Answer: Stage 1 hypertension (systolic 140–159 mmHg or diastolic 90–99
mmHg) qualifies for a 1-year certificate. This allows the examiner to recheck the
driver's BP annually and ensure it is being treated and controlled.
Q11: What is the minimum hearing standard for CMV drivers?
Answer: A driver must perceive a forced whispered voice in the better ear at not
less than 5 feet, with or without the use of a hearing aid. Alternatively, the driver
must not have average hearing loss in the better ear greater than 40 dB (hearing
level in ISO 1964), with or without a hearing aid when the audiometric device is
calibrated to American National Standard.
Q12: What is the minimum age requirement for interstate CMV drivers?
Answer: Drivers must be at least 21 years of age to operate CMVs in interstate
commerce. However, drivers between 18–20 years old may operate CMVs in
intrastate commerce, subject to individual state regulations.
Q13: What happens if a driver's medical condition changes between
examinations?
Answer: If a driver develops a disqualifying condition between examinations, the
driver is required to cease operating a CMV and the motor carrier must be
notified. The driver should seek re-evaluation by a certified ME before returning
to CMV operation.
Federal Motor Carrier Safety Administration (FMCSA) | Page 2 of 52
, NRCME DOT Medical Examiner Test Bank 2026 | 300 Questions & Answers
Q14: Who regulates the physical qualification standards for intrastate CMV
drivers?
Answer: Intrastate CMV drivers are regulated by individual state agencies, not
FMCSA. States may adopt FMCSA standards or establish their own, and many
states mirror the federal standards. Some states have adopted exemption
programs similar to federal ones.
Q15: What is a Skills Performance Evaluation (SPE) Certificate?
Answer: An SPE Certificate is issued by FMCSA to drivers who have a limb
impairment (loss or impairment of a limb) and have demonstrated the ability to
safely operate a CMV using adaptive equipment or techniques. It allows
physically impaired drivers to operate CMVs.
Q16: What disqualifies a driver from receiving a Medical Examiner's
Certificate?
Answer: Disqualifying conditions include: loss of foot, leg, hand, or arm (without
SPE); limb impairment interfering with safe driving; established diagnosis of
epilepsy; currently using insulin (without exemption); current clinical diagnosis of
alcoholism; any other condition that interferes with safe driving.
Q17: How long must the completed Medical Examination Report be
retained by the medical examiner?
Answer: The medical examiner must retain a copy of the completed Medical
Examination Report (MCSA-5875) for a minimum of 3 years from the date of
examination. Records must be available for inspection by authorized FMCSA
personnel.
Q18: What is the FMCSA's definition of a Commercial Motor Vehicle (CMV)?
Answer: A CMV is any self-propelled or towed vehicle used on highways in
interstate commerce to transport passengers or property when the vehicle has a
GVWR of 10,001 lbs or more; is designed to transport 9 or more passengers for
compensation; is designed for 16+ passengers not for compensation; or
transports hazardous materials requiring placards.
Q19: What recertification requirements must NRCME-listed medical
examiners fulfill?
Answer: NRCME-listed MEs must complete recertification every 10 years. This
includes completing an accredited training program and passing the NRCME
certification test again. MEs must also maintain their underlying medical license
in good standing throughout the certification period.
Q20: What is the medical examiner's responsibility when a driver discloses
use of a Schedule II controlled substance?
Federal Motor Carrier Safety Administration (FMCSA) | Page 3 of 52
, NRCME DOT Medical Examiner Test Bank 2026 | 300 Questions & Answers
Answer: The ME must determine if the medication is a disqualifying condition.
Use of Schedule II narcotics or habit-forming drugs is generally disqualifying
unless the ME determines the medication does not adversely affect the driver's
ability to safely operate a CMV. Additional specialist evaluation may be
warranted.
Q21: What is the waiting period after a myocardial infarction before a CMV
driver may return to duty?
Answer: FMCSA guidelines recommend a minimum waiting period, typically at
least 2 years following a myocardial infarction, with full recovery confirmed by
cardiac stress testing. The driver must demonstrate adequate cardiac reserve
and absence of disqualifying conditions such as angina or EF < 40%.
Q22: When must a Diabetes Exemption holder be re-evaluated?
Answer: Insulin-treated diabetes mellitus (ITDM) exemption holders must be
evaluated annually by their treating endocrinologist or diabetes specialist and
submit a Medical Evaluation Report to FMCSA. They must also pass the regular
DOT physical examination.
Q23: What is the significance of the FMCSA Medical Advisory Criteria?
Answer: The FMCSA Medical Advisory Criteria provide guidance to medical
examiners on how to interpret and apply the physical qualification standards
found in 49 CFR Part 391.41. They are advisory only and not legally binding but
represent best practices for certification decisions.
Q24: Can a driver with a single kidney be medically certified to drive a
CMV?
Answer: Yes, a driver with a single functioning kidney may be medically certified
if kidney function is adequate (eGFR ≥ 60 mL/min/1.73 m²) and there are no
disqualifying symptoms such as hypertension, anemia, or electrolyte
abnormalities that would affect safe driving. Frequent monitoring may be
required.
Q25: What is the FMCSA's guidance on obstructive sleep apnea (OSA) for
CMV drivers?
Answer: FMCSA has not issued a formal rule on OSA but has advisory criteria
recommending that drivers with moderate-to-severe OSA (AHI ≥ 15) be
disqualified until successfully treated. Treatment adequacy is typically shown by
CPAP compliance data demonstrating AHI < 5 with ≥ 4 hours of use per night on
≥ 70% of nights.
Q26: What is the disqualifying blood pressure threshold for CMV drivers?
Answer: Stage 3 hypertension (systolic ≥ 180 mmHg or diastolic ≥ 110 mmHg) is
disqualifying at time of examination. The driver should be treated and the BP
Federal Motor Carrier Safety Administration (FMCSA) | Page 4 of 52
