NRCME DOT CERTIFICATION EXAM SCRIPT
2026 FULL QUESTIONS AND CORRECT
ANSWERS TESTED CONTENT VERIFIED
GRADED A+
⩥ What behaviors should a ME look for in a patient with a
psychological disorder? Answer: Any suspicious, evasive, threatening,
or hostile behaviors
Signs of being easily distracted
Signs of flat affect or lack of emotional response
Displays of unusual or bizarre ideas, auditory or visual hallucinations,
dishonesty, or a tendency to omit important information
⩥ Can a driver who is taking Amitriptyline be certified? Answer:
Drivers taking Amitriptyline should not be certified, however the ME
should evaluate the patient and in consultation with appropriate mental
health professional may determine if a driver is stable and has no side
effects that would interfere with driving. Driver should document
rationale and medical evidence that supports the certification decision.
⩥ A driver presents with history of depression taking an SSRI, but
appears depressed. Answer: The ME should have the patient referred to
the appropriate medical health professional who would treat and monitor
the driver. Before certification, the driver would have to complete a
symptom-free waiting period and have an effective, well-tolerated
,treatment plan, with no side effects that impair the ability of the driver to
operate a CMV safely.
⩥ Give examples of reported CMV driver symptoms and findings
related to mental health that may lead a ME to decide not to certify a
driver. Answer: Emotional or adjustment problems - have been linked a
changes in memory, reasoning, attention, and judgment (ex: severe
bereavement)
Functional disorders - may cause drowsiness, dizziness, confusion,
weakness, and paralysis, which may lead to poor coordination ,
inattention, loss of functional control, and increased risk of crashes
while driving.
Physical fatigue, headache, impaired coordination, recurring physical
ailment, chronic "nagging pain" (ex: severe cluster headaches) to a
degree that CMV driving is inadvisable.
Disorders of periodic incapacitation may warrant disqualification (ex:
schizophrenia, bipolar mood disorder)
⩥ Pt example:
Mr. Smith 43 y/o male
Pt takes Paxil 40 mg once daily
Mr. Smith provided a letter fro his psychiatrist that is dated four months
ago, history of suicide attempt 6 months before this report (10 months
prior to this current examination), suicide attempt followed the drowning
death of his two year old son in a swimming pool accident, psychiatrist
clearance to return to work and normal activities.
, Mr. Smith admits to seeking professional help because of his feelings of
excessive guilt over the accident, he denies current SI or HI or
hallucinations. He denies any adverse side effects. from the Paxil. He
admits to drinking several cups of coffee per day, drinking 1-2 beers on
weekends only, denies and drug use.
Pt's family history includes a father with depression and died of AMI at
83 years old. His mother has history of depression and remains
functional on medication.
Vision and hearing unremarkable.
BP 132 Answer: PE comments:
Although he related being stressed, his affect is normal, his appearance
is appropriate, and personal hygiene is good.
Disqualify until the patient meets the required waiting period after a
suicide attempt, then re-examine driver. Driver should be symptom free
for one year after a suicide attempt, a severe depression, or manic
episode.
⩥ Pt example:
Mr. Taylor 22 y/o male
No medications
Pt denies any medical history, admits to smoking two ppd and drinks 10
"Jolt" colas per day. He presents with poor eye contact and flat affect.
Vision and hearing unremarkable.
BP 120/68 P: 96, regular
UA normal Answer: PE comments:
2026 FULL QUESTIONS AND CORRECT
ANSWERS TESTED CONTENT VERIFIED
GRADED A+
⩥ What behaviors should a ME look for in a patient with a
psychological disorder? Answer: Any suspicious, evasive, threatening,
or hostile behaviors
Signs of being easily distracted
Signs of flat affect or lack of emotional response
Displays of unusual or bizarre ideas, auditory or visual hallucinations,
dishonesty, or a tendency to omit important information
⩥ Can a driver who is taking Amitriptyline be certified? Answer:
Drivers taking Amitriptyline should not be certified, however the ME
should evaluate the patient and in consultation with appropriate mental
health professional may determine if a driver is stable and has no side
effects that would interfere with driving. Driver should document
rationale and medical evidence that supports the certification decision.
⩥ A driver presents with history of depression taking an SSRI, but
appears depressed. Answer: The ME should have the patient referred to
the appropriate medical health professional who would treat and monitor
the driver. Before certification, the driver would have to complete a
symptom-free waiting period and have an effective, well-tolerated
,treatment plan, with no side effects that impair the ability of the driver to
operate a CMV safely.
⩥ Give examples of reported CMV driver symptoms and findings
related to mental health that may lead a ME to decide not to certify a
driver. Answer: Emotional or adjustment problems - have been linked a
changes in memory, reasoning, attention, and judgment (ex: severe
bereavement)
Functional disorders - may cause drowsiness, dizziness, confusion,
weakness, and paralysis, which may lead to poor coordination ,
inattention, loss of functional control, and increased risk of crashes
while driving.
Physical fatigue, headache, impaired coordination, recurring physical
ailment, chronic "nagging pain" (ex: severe cluster headaches) to a
degree that CMV driving is inadvisable.
Disorders of periodic incapacitation may warrant disqualification (ex:
schizophrenia, bipolar mood disorder)
⩥ Pt example:
Mr. Smith 43 y/o male
Pt takes Paxil 40 mg once daily
Mr. Smith provided a letter fro his psychiatrist that is dated four months
ago, history of suicide attempt 6 months before this report (10 months
prior to this current examination), suicide attempt followed the drowning
death of his two year old son in a swimming pool accident, psychiatrist
clearance to return to work and normal activities.
, Mr. Smith admits to seeking professional help because of his feelings of
excessive guilt over the accident, he denies current SI or HI or
hallucinations. He denies any adverse side effects. from the Paxil. He
admits to drinking several cups of coffee per day, drinking 1-2 beers on
weekends only, denies and drug use.
Pt's family history includes a father with depression and died of AMI at
83 years old. His mother has history of depression and remains
functional on medication.
Vision and hearing unremarkable.
BP 132 Answer: PE comments:
Although he related being stressed, his affect is normal, his appearance
is appropriate, and personal hygiene is good.
Disqualify until the patient meets the required waiting period after a
suicide attempt, then re-examine driver. Driver should be symptom free
for one year after a suicide attempt, a severe depression, or manic
episode.
⩥ Pt example:
Mr. Taylor 22 y/o male
No medications
Pt denies any medical history, admits to smoking two ppd and drinks 10
"Jolt" colas per day. He presents with poor eye contact and flat affect.
Vision and hearing unremarkable.
BP 120/68 P: 96, regular
UA normal Answer: PE comments:
