NRCME EXAM ACTUAL QUESTIONS
AND ANSWERS
vision requirements - ANSWER-20/40 each eye and 20/40 both eyes
peripheral vision - ANSWER-70 degrees
Federal exemption for monocular vision: can certify for how long? - ANSWER-1 year
hearing requirements - ANSWER-whisper at not less than 5 feet better ear, or average hearing
loss no greater than 40 dB at 500Hz, 1000Hz, 2000 Hz.
name 4 otic conditions that are automatic DQs - ANSWER-Meniere's, uncontrolled vertigo,
labyrinthine fistula, nonfunctioning labyrinth
Max cert period for Syncope - ANSWER-1 year (needs neurologist clearance)
Post MI drivers can be certified for 1 year with all 5 of these criteria: (almost the same criteria
for post CABG) (first 4 also apply for CHF drivers) - ANSWER-1. Asymptomatic
2. Tolerating meds
3. Satisfactory ETT with workload capacity of 6 METs (has to have this biennially)
4. LVEF >=40%
5. No ST depression on ECG - for post CABG this one is replaced by completely healed sternal
incision
Stable angina: max cert period - ANSWER-1 year
minimum waiting period post CABG - ANSWER-3 months
Min waiting period for post heart transplant - ANSWER-1 year
Max cert period for post heart transplant - ANSWER-6 months
Min waiting period post PCI (percutaneous coronary intervention) - ANSWER-1 week
Min waiting period for pacemaker implantation for sinus node dysfunction - ANSWER-1 month
Min waiting period for pacemaker implantation for neurocardiogenic syncope or hypersensitive
carotid sinus with syncope - ANSWER-3 months
Min waiting period post AAA repair - ANSWER-3 months
Max cert period for being on anticoagulation for a CV condition - ANSWER-1 year
, 3 criteria for certification if patient on anticoagulation for a CV condition - ANSWER-1. Stable
on meds for 1 month
2. Provide copy of INR at exam
3. Have INR checked and monitored at least monthly
True or false: driver on anticoagulation for CVA can be certified for max 1 year - ANSWER-
False. Should not be certified due to high risk of bleeding
5 reasons to DQ a driver with AAA - ANSWER-1. Symptomatic
2. AAA >5cm
3. AAA 4-5 cm and does not have clearance from a cardiologist
4. AAA increased in size 0.5cm in 6 months
5. Surgical repair was recommended but not done
Max size of a thoracic aneurysm that can be certified - ANSWER-3.5 cm
Min waiting period for PE - ANSWER-3 months
True or false: having an ICD is automatic DQ - ANSWER-true
True or false: dx of severe aortic stenosis is automatic DQ - ANSWER-true
Max certification post aortic valve repair - ANSWER-1 year
Do not certify for moderate aortic stenosis if they have 1 of these 5 things - ANSWER-angina,
CHF, A fib, LVEF <50%, thromboembolic disease
How often to repeat echo for aortic stenosis? (answer for both mild and moderate AS) -
ANSWER-Mild: 5 years
moderate: 1-2 years
Max certification for severe aortic regurgitation - ANSWER-6 months and must be
asymptomatic, normal LV function, LVEDD <=60mm, LVESD <=50mm
Max cert period for balloon mitral valvotomy - ANSWER-1 year
Min waiting period for balloon mitral valvotomy - ANSWER-4 weeks
BP above which you must treat and do one time 3 month certificate - ANSWER-160/100. For
140/90 and above up to this level, it says 3 month certificate but does not say must treat.
BP above which you cannot certify until lowered below 140/90 - ANSWER-180/110 - and then
this patient can only be certified for 6 months
Max cert period for diabetic patients - ANSWER-Technically 2 years, but 1 year is
RECOMMENDED. What the hell.
AND ANSWERS
vision requirements - ANSWER-20/40 each eye and 20/40 both eyes
peripheral vision - ANSWER-70 degrees
Federal exemption for monocular vision: can certify for how long? - ANSWER-1 year
hearing requirements - ANSWER-whisper at not less than 5 feet better ear, or average hearing
loss no greater than 40 dB at 500Hz, 1000Hz, 2000 Hz.
name 4 otic conditions that are automatic DQs - ANSWER-Meniere's, uncontrolled vertigo,
labyrinthine fistula, nonfunctioning labyrinth
Max cert period for Syncope - ANSWER-1 year (needs neurologist clearance)
Post MI drivers can be certified for 1 year with all 5 of these criteria: (almost the same criteria
for post CABG) (first 4 also apply for CHF drivers) - ANSWER-1. Asymptomatic
2. Tolerating meds
3. Satisfactory ETT with workload capacity of 6 METs (has to have this biennially)
4. LVEF >=40%
5. No ST depression on ECG - for post CABG this one is replaced by completely healed sternal
incision
Stable angina: max cert period - ANSWER-1 year
minimum waiting period post CABG - ANSWER-3 months
Min waiting period for post heart transplant - ANSWER-1 year
Max cert period for post heart transplant - ANSWER-6 months
Min waiting period post PCI (percutaneous coronary intervention) - ANSWER-1 week
Min waiting period for pacemaker implantation for sinus node dysfunction - ANSWER-1 month
Min waiting period for pacemaker implantation for neurocardiogenic syncope or hypersensitive
carotid sinus with syncope - ANSWER-3 months
Min waiting period post AAA repair - ANSWER-3 months
Max cert period for being on anticoagulation for a CV condition - ANSWER-1 year
, 3 criteria for certification if patient on anticoagulation for a CV condition - ANSWER-1. Stable
on meds for 1 month
2. Provide copy of INR at exam
3. Have INR checked and monitored at least monthly
True or false: driver on anticoagulation for CVA can be certified for max 1 year - ANSWER-
False. Should not be certified due to high risk of bleeding
5 reasons to DQ a driver with AAA - ANSWER-1. Symptomatic
2. AAA >5cm
3. AAA 4-5 cm and does not have clearance from a cardiologist
4. AAA increased in size 0.5cm in 6 months
5. Surgical repair was recommended but not done
Max size of a thoracic aneurysm that can be certified - ANSWER-3.5 cm
Min waiting period for PE - ANSWER-3 months
True or false: having an ICD is automatic DQ - ANSWER-true
True or false: dx of severe aortic stenosis is automatic DQ - ANSWER-true
Max certification post aortic valve repair - ANSWER-1 year
Do not certify for moderate aortic stenosis if they have 1 of these 5 things - ANSWER-angina,
CHF, A fib, LVEF <50%, thromboembolic disease
How often to repeat echo for aortic stenosis? (answer for both mild and moderate AS) -
ANSWER-Mild: 5 years
moderate: 1-2 years
Max certification for severe aortic regurgitation - ANSWER-6 months and must be
asymptomatic, normal LV function, LVEDD <=60mm, LVESD <=50mm
Max cert period for balloon mitral valvotomy - ANSWER-1 year
Min waiting period for balloon mitral valvotomy - ANSWER-4 weeks
BP above which you must treat and do one time 3 month certificate - ANSWER-160/100. For
140/90 and above up to this level, it says 3 month certificate but does not say must treat.
BP above which you cannot certify until lowered below 140/90 - ANSWER-180/110 - and then
this patient can only be certified for 6 months
Max cert period for diabetic patients - ANSWER-Technically 2 years, but 1 year is
RECOMMENDED. What the hell.
