NRCME (DOT) Medical Examiner
Certification Exam 2026-2027: Questions
& Answers with Comple, Exams of
Nursing
minimum waiting period following electroconvulsive therapy? - ANSWER//- 6 months
SYMPTOM FREE What is the maximum certification period for adult ADHD? -
ANSWER//- 1 year What is the minimum waiting period... - following a nonpsychotic
major depression unaccompanied by suicidal behavior - following a severe depressive
episode, a suicide attempt, or a manic episode - ANSWER//- 6 months symptom free - 1
year symptom free What is the maximum certification period for mood disorders (MDD +
Bipolar)? - ANSWER//- 1 year What is the maximum certification period for personality
disorders? - ANSWER//- 1 year What are the minimum waiting periods for psychotic
disorders (e.g. schizophrenia)... -if a brief reactive psychosis or schizophreniform
disorder -if any other psychotic disorder - ANSWER//- 6 months symptom free - 1 year
symptom free What is the maximum certification period for a psychotic disorder (e.g.
schizophreniform)? - ANSWER//1 year ****but if the dx is chronic schizophrenia, DO
NOT CERTIFY Psychiatric questions hint - ANSWER//All psychiatric medications and
diagnoses had a maximum certification period of 1 year UNLESS they were classified
as a MODERATE psychiatric disorder. Then it was 6 months T/F: Examiners should use
whatever tools or additional assessments they feel are necessary to determine whether
a driver has a current clinical diagnosis of alcoholism, such as the CAGE questionnaire.
- ANSWER//T Can an examiner order an alcohol test for a driver? - ANSWER//Yes,
alcohol testing is not required as a part of the medical certification process, but can be
ordered if the examiner feels it will help them make certification decision. These test
results WILL NOT be reported to the FMCSA, but are used by the provider. When are
DOT drug/alcohol testing performed? *will likely get a question on this - ANSWER//-pre-
employment, post-accident, reasonable suspicion, random, return-to-duty and follow-up
testing. ***The take home point is that drug and alcohol testing are NOT performed as
part of a DOT physical. A provider can ordered a test for his clinical judgement but the
test is not reported to the FMCSA. In the above circumstances, the results are reported
to the FMCSA. T/F: Ongoing voluntary attendance at self-help groups (for example, 12-
step programs) for maintenance of recovery from substance abuse is disqualifying -
ANSWER//F T/F: If marijuana is legal in the driver's state, he can be certified if using
marijuana for medical purposes. - ANSWER//F: Marijuana is a schedule 1 drug. Federal
law prohibits schedule 1 drugs or substances from being prescribed for any purpose. It
does not matter what the laws of his state entail. T/F: Disclosure of prior illegal drug use
, does not preclude an individual from being medically certified. - ANSWER//T: The
FMCSRs do not include a mandatory waiting time prior to medical certification after
known or disclosed illegal drug use. What is Form MCSA-5850? When do you submit
this. - ANSWER//-An electronic form used by certified medical examiners (MEs) to
report the results of Commercial Motor Vehicle (CMV) driver physical exams to the
National Registry of Certified Medical Examiners - Must be submitted by midnight of the
next calendar day from the physical * If you did not do any exams during a calendar
month, this also must be reported. You get a test question that gives you the option to
refer a driver to a specialist or get additional testing, what answer do you go with? -
ANSWER//- The best answer will always be to get additional testing. Only consider
referring to a specialist if getting additional testing is not listed among the answers.
Handling "what should the examiner do next" questions: A driver fails a hearing test that
was performed by an assistant. What does the examiner do next? A) Ask the driver
about a history of hearing problems B) Perform an otoscopic examination C) Referral to
audiology - ANSWER//The answer is A; taking the history While all answers are
acceptable. You would inquire about the history NEXT. *Hint* For all of these "next"
questions, think of the natural order of an examination. History --> Physical -->
Additional testing --> referrals You get a question where the answer options are... -
order more tests - make a certification decision - ask for more information/obtain the
driver's medical records What is usually the right answer? - ANSWER//- ask for more
information/obtain the driver's medical records Always go with this unless there is an
obvious clear cut answer. The most common waiting periods asked on the exam are MI,
CABG, PCI, and TIA. What are the waiting periods for each of these conditions? -
There are 13 standards used to determine medical fitness for duty. What 3 are "non-
discretionary"? - ANSWER//vision, hearing, and epilepsy A commercial motor vehicle
means any self-propelled or towed motor vehicle used on a highway in interstate
commerce to transport passengers or property when the vehicle meets what 4 criteria? -
ANSWER//1. Combined weight of ≥ 10,001lbs 2. Transport >8 passengers including
driver for compensation 3. Transport >15 passengers including driver regardless of
compensation 4. Transport hazardous materials in quantities that require hazardous
placards Acceptable Risk: Does the driver pose a risk to public safety? If you answer
yes to this question, what should you do? - ANSWER//Do not certify as fit for duty You
get a question on the NRCME giving you a clinical scenario and they ask the treatment
you recommend. What do you answer? - ANSWER//None! You are an examining
provider during the DOT physical, not a treating provider. F/u with PCM or subspecialty
Can you use BP readings from anywhere (e.g. patient's primary care from last week)
and include it on the physical? What do you do if it is high? - ANSWER//-No, only what
was obtained during the exam -confirm with an additional reading later in the
examination Does the provider have to obtain all vitals and tests himself or can they use
other qualified personnel? - ANSWER//-You may use qualified personnel for these (e.g.
Certification Exam 2026-2027: Questions
& Answers with Comple, Exams of
Nursing
minimum waiting period following electroconvulsive therapy? - ANSWER//- 6 months
SYMPTOM FREE What is the maximum certification period for adult ADHD? -
ANSWER//- 1 year What is the minimum waiting period... - following a nonpsychotic
major depression unaccompanied by suicidal behavior - following a severe depressive
episode, a suicide attempt, or a manic episode - ANSWER//- 6 months symptom free - 1
year symptom free What is the maximum certification period for mood disorders (MDD +
Bipolar)? - ANSWER//- 1 year What is the maximum certification period for personality
disorders? - ANSWER//- 1 year What are the minimum waiting periods for psychotic
disorders (e.g. schizophrenia)... -if a brief reactive psychosis or schizophreniform
disorder -if any other psychotic disorder - ANSWER//- 6 months symptom free - 1 year
symptom free What is the maximum certification period for a psychotic disorder (e.g.
schizophreniform)? - ANSWER//1 year ****but if the dx is chronic schizophrenia, DO
NOT CERTIFY Psychiatric questions hint - ANSWER//All psychiatric medications and
diagnoses had a maximum certification period of 1 year UNLESS they were classified
as a MODERATE psychiatric disorder. Then it was 6 months T/F: Examiners should use
whatever tools or additional assessments they feel are necessary to determine whether
a driver has a current clinical diagnosis of alcoholism, such as the CAGE questionnaire.
- ANSWER//T Can an examiner order an alcohol test for a driver? - ANSWER//Yes,
alcohol testing is not required as a part of the medical certification process, but can be
ordered if the examiner feels it will help them make certification decision. These test
results WILL NOT be reported to the FMCSA, but are used by the provider. When are
DOT drug/alcohol testing performed? *will likely get a question on this - ANSWER//-pre-
employment, post-accident, reasonable suspicion, random, return-to-duty and follow-up
testing. ***The take home point is that drug and alcohol testing are NOT performed as
part of a DOT physical. A provider can ordered a test for his clinical judgement but the
test is not reported to the FMCSA. In the above circumstances, the results are reported
to the FMCSA. T/F: Ongoing voluntary attendance at self-help groups (for example, 12-
step programs) for maintenance of recovery from substance abuse is disqualifying -
ANSWER//F T/F: If marijuana is legal in the driver's state, he can be certified if using
marijuana for medical purposes. - ANSWER//F: Marijuana is a schedule 1 drug. Federal
law prohibits schedule 1 drugs or substances from being prescribed for any purpose. It
does not matter what the laws of his state entail. T/F: Disclosure of prior illegal drug use
, does not preclude an individual from being medically certified. - ANSWER//T: The
FMCSRs do not include a mandatory waiting time prior to medical certification after
known or disclosed illegal drug use. What is Form MCSA-5850? When do you submit
this. - ANSWER//-An electronic form used by certified medical examiners (MEs) to
report the results of Commercial Motor Vehicle (CMV) driver physical exams to the
National Registry of Certified Medical Examiners - Must be submitted by midnight of the
next calendar day from the physical * If you did not do any exams during a calendar
month, this also must be reported. You get a test question that gives you the option to
refer a driver to a specialist or get additional testing, what answer do you go with? -
ANSWER//- The best answer will always be to get additional testing. Only consider
referring to a specialist if getting additional testing is not listed among the answers.
Handling "what should the examiner do next" questions: A driver fails a hearing test that
was performed by an assistant. What does the examiner do next? A) Ask the driver
about a history of hearing problems B) Perform an otoscopic examination C) Referral to
audiology - ANSWER//The answer is A; taking the history While all answers are
acceptable. You would inquire about the history NEXT. *Hint* For all of these "next"
questions, think of the natural order of an examination. History --> Physical -->
Additional testing --> referrals You get a question where the answer options are... -
order more tests - make a certification decision - ask for more information/obtain the
driver's medical records What is usually the right answer? - ANSWER//- ask for more
information/obtain the driver's medical records Always go with this unless there is an
obvious clear cut answer. The most common waiting periods asked on the exam are MI,
CABG, PCI, and TIA. What are the waiting periods for each of these conditions? -
There are 13 standards used to determine medical fitness for duty. What 3 are "non-
discretionary"? - ANSWER//vision, hearing, and epilepsy A commercial motor vehicle
means any self-propelled or towed motor vehicle used on a highway in interstate
commerce to transport passengers or property when the vehicle meets what 4 criteria? -
ANSWER//1. Combined weight of ≥ 10,001lbs 2. Transport >8 passengers including
driver for compensation 3. Transport >15 passengers including driver regardless of
compensation 4. Transport hazardous materials in quantities that require hazardous
placards Acceptable Risk: Does the driver pose a risk to public safety? If you answer
yes to this question, what should you do? - ANSWER//Do not certify as fit for duty You
get a question on the NRCME giving you a clinical scenario and they ask the treatment
you recommend. What do you answer? - ANSWER//None! You are an examining
provider during the DOT physical, not a treating provider. F/u with PCM or subspecialty
Can you use BP readings from anywhere (e.g. patient's primary care from last week)
and include it on the physical? What do you do if it is high? - ANSWER//-No, only what
was obtained during the exam -confirm with an additional reading later in the
examination Does the provider have to obtain all vitals and tests himself or can they use
other qualified personnel? - ANSWER//-You may use qualified personnel for these (e.g.
