MRO: MEDICAL REVIEW OFFICER CERTIFICATION |100% VERIFIED
QUESTIONS AND CORRECT ANSWERS | 2026/2027 LATEST UPDATE
(PASS GUARANTEE)
1. Q: What is the primary role of the Medical Review Officer (MRO)?
ANSWER To review and verify drug test results, acting as a gatekeeper to
ensure accuracy and scientific validity before they are reported to the
employer.
2. Q: Who is qualified to be an MRO under DOT regulations? ANSWER A
licensed doctor of medicine (MD) or osteopathy (DO) with a valid license
to practice medicine in the US, who is also certified as an MRO.
3. Q: Is a nurse practitioner (NP) or Physician Assistant (PA) allowed to
perform MRO duties? ANSWER No.
4. Q: Can an MRO delegate the interview of a donor to a non-physician?
ANSWER Yes, but only to a qualified "MRO assistant" for gathering
information; the final verification decision must be made by the MRO.
5. Q: What is the "Chain of Custody"? ANSWER The process used to
maintain control and document the handling of a specimen from
collection to reporting to ensure its integrity.
6. Q: What does "Shy Bladder" mean? ANSWER When a donor is unable to
provide a sufficient volume of urine (45 mL) for a drug test.
7. Q: What is the "Split Specimen"? ANSWER The urine specimen divided
into two bottles: the Primary (Bottle A) for the initial screen and the Split
(Bottle B) used if the donor requests a retest.
8. Q: What is the statute of limitations for the MRO to correct the record of
a drug test result reported to an employer? ANSWER The MRO has 60
days to correct errors in the "medical review" information.
,9. Q: Can an MRO own a drug testing laboratory? ANSWER No, conflict of
interest rules generally prohibit an MRO from having a financial interest
in a laboratory they review results from (under SAMHSA).
10.Q: What is the "Blind Specimen"? ANSWER A specimen sent to a lab
disguised as a donor sample to monitor the lab's performance (Quality
Control).
11.Q: What is the "Custody and Control Form" (CCF)? ANSWER The federal
form (Step 1, 2, 3, 4, 5) used to document the collection process.
12.Q: What does "Verified Positive" mean? ANSWER A result where the lab
found a drug/metabolite above the cutoff, and the MRO has determined
there is no legitimate medical explanation.
13.Q: What does "Verified Negative" mean? ANSWER A result where the
lab found no drugs/metabolites, or found them below the cutoff, or
found them above but the MRO verified a valid medical prescription
(except for Marijuana in DOT testing).
14.Q: What is a "Refusal to Test"? ANSWER A specific conduct by the donor
(e.g., refusing to sign, adulterating, substituting) that is treated by the
DOT as a positive test.
15.Q: What is "Dilute Specimen"? ANSWER A specimen with creatinine and
specific gravity levels indicating physiological dilution, but not
necessarily adulteration.
16.Q: What is "Substituted Specimen"? ANSWER A specimen with
creatinine and specific gravity levels so low or high they are consistent
with a non-human substance (e.g., water or synthetic urine).
17.Q: What is "Adulterated Specimen"? ANSWER A specimen containing a
foreign substance or having an abnormal endogenous characteristic
indicating an attempt to cheat the test (e.g., high nitrite, high pH).
18.Q: What does "DOT" stand for in drug testing? ANSWER Department of
Transportation.
19.Q: What does "FHWA" stand for? ANSWER Federal Highway
Administration.
20.Q: What does "FAA" stand for? ANSWER Federal Aviation
Administration.
, 21.Q: What does "FRA" stand for? ANSWER Federal Railroad
Administration.
22.Q: What does "FMCSA" stand for? ANSWER Federal Motor Carrier
Safety Administration.
23.Q: What does "FTA" stand for? ANSWER Federal Transit Administration.
24.Q: What does "PHMSA" stand for? ANSWER Pipeline and Hazardous
Materials Safety Administration.
25.Q: What is the "Safety-Sensitive Function"? ANSWER A period of time
when a covered employee performs a duty sensitive to safety (e.g.,
driving a truck, flying a plane).
26.Q: Can an MRO change a lab result? ANSWER No, the MRO reviews the
lab's finding but cannot change the scientific data (e.g., the ng/mL
number); they only verify the interpretation of the data.
27.Q: What is the "Verification" process? ANSWER The MRO's review and
final determination of the drug test result (Negative, Positive, Cancelled,
etc.).
28.Q: What is "Point of Collection Testing" (POCT)? ANSWER Drug testing
performed at the collection site using a rapid screening device (not yet
standard for Federal DOT urine, but used in oral fluid).
29.Q: What does "HHS" stand for? ANSWER Department of Health and
Human Services.
30.Q: What is "MROCC"? ANSWER Medical Review Officer Certification
Council (a certifying body).
31.Q: What is "AAMRO"? ANSWER American Association of Medical Review
Officers (a certifying body).
32.Q: What is "SAMHSA"? ANSWER Substance Abuse and Mental Health
Services Administration.
33.Q: Are MROs required to report test results to the State? ANSWER
Generally no, results are sent to the employer/DER, except for situations
involving child endangerment or specific state laws (e.g., some states
require reporting of impaired healthcare workers).
QUESTIONS AND CORRECT ANSWERS | 2026/2027 LATEST UPDATE
(PASS GUARANTEE)
1. Q: What is the primary role of the Medical Review Officer (MRO)?
ANSWER To review and verify drug test results, acting as a gatekeeper to
ensure accuracy and scientific validity before they are reported to the
employer.
2. Q: Who is qualified to be an MRO under DOT regulations? ANSWER A
licensed doctor of medicine (MD) or osteopathy (DO) with a valid license
to practice medicine in the US, who is also certified as an MRO.
3. Q: Is a nurse practitioner (NP) or Physician Assistant (PA) allowed to
perform MRO duties? ANSWER No.
4. Q: Can an MRO delegate the interview of a donor to a non-physician?
ANSWER Yes, but only to a qualified "MRO assistant" for gathering
information; the final verification decision must be made by the MRO.
5. Q: What is the "Chain of Custody"? ANSWER The process used to
maintain control and document the handling of a specimen from
collection to reporting to ensure its integrity.
6. Q: What does "Shy Bladder" mean? ANSWER When a donor is unable to
provide a sufficient volume of urine (45 mL) for a drug test.
7. Q: What is the "Split Specimen"? ANSWER The urine specimen divided
into two bottles: the Primary (Bottle A) for the initial screen and the Split
(Bottle B) used if the donor requests a retest.
8. Q: What is the statute of limitations for the MRO to correct the record of
a drug test result reported to an employer? ANSWER The MRO has 60
days to correct errors in the "medical review" information.
,9. Q: Can an MRO own a drug testing laboratory? ANSWER No, conflict of
interest rules generally prohibit an MRO from having a financial interest
in a laboratory they review results from (under SAMHSA).
10.Q: What is the "Blind Specimen"? ANSWER A specimen sent to a lab
disguised as a donor sample to monitor the lab's performance (Quality
Control).
11.Q: What is the "Custody and Control Form" (CCF)? ANSWER The federal
form (Step 1, 2, 3, 4, 5) used to document the collection process.
12.Q: What does "Verified Positive" mean? ANSWER A result where the lab
found a drug/metabolite above the cutoff, and the MRO has determined
there is no legitimate medical explanation.
13.Q: What does "Verified Negative" mean? ANSWER A result where the
lab found no drugs/metabolites, or found them below the cutoff, or
found them above but the MRO verified a valid medical prescription
(except for Marijuana in DOT testing).
14.Q: What is a "Refusal to Test"? ANSWER A specific conduct by the donor
(e.g., refusing to sign, adulterating, substituting) that is treated by the
DOT as a positive test.
15.Q: What is "Dilute Specimen"? ANSWER A specimen with creatinine and
specific gravity levels indicating physiological dilution, but not
necessarily adulteration.
16.Q: What is "Substituted Specimen"? ANSWER A specimen with
creatinine and specific gravity levels so low or high they are consistent
with a non-human substance (e.g., water or synthetic urine).
17.Q: What is "Adulterated Specimen"? ANSWER A specimen containing a
foreign substance or having an abnormal endogenous characteristic
indicating an attempt to cheat the test (e.g., high nitrite, high pH).
18.Q: What does "DOT" stand for in drug testing? ANSWER Department of
Transportation.
19.Q: What does "FHWA" stand for? ANSWER Federal Highway
Administration.
20.Q: What does "FAA" stand for? ANSWER Federal Aviation
Administration.
, 21.Q: What does "FRA" stand for? ANSWER Federal Railroad
Administration.
22.Q: What does "FMCSA" stand for? ANSWER Federal Motor Carrier
Safety Administration.
23.Q: What does "FTA" stand for? ANSWER Federal Transit Administration.
24.Q: What does "PHMSA" stand for? ANSWER Pipeline and Hazardous
Materials Safety Administration.
25.Q: What is the "Safety-Sensitive Function"? ANSWER A period of time
when a covered employee performs a duty sensitive to safety (e.g.,
driving a truck, flying a plane).
26.Q: Can an MRO change a lab result? ANSWER No, the MRO reviews the
lab's finding but cannot change the scientific data (e.g., the ng/mL
number); they only verify the interpretation of the data.
27.Q: What is the "Verification" process? ANSWER The MRO's review and
final determination of the drug test result (Negative, Positive, Cancelled,
etc.).
28.Q: What is "Point of Collection Testing" (POCT)? ANSWER Drug testing
performed at the collection site using a rapid screening device (not yet
standard for Federal DOT urine, but used in oral fluid).
29.Q: What does "HHS" stand for? ANSWER Department of Health and
Human Services.
30.Q: What is "MROCC"? ANSWER Medical Review Officer Certification
Council (a certifying body).
31.Q: What is "AAMRO"? ANSWER American Association of Medical Review
Officers (a certifying body).
32.Q: What is "SAMHSA"? ANSWER Substance Abuse and Mental Health
Services Administration.
33.Q: Are MROs required to report test results to the State? ANSWER
Generally no, results are sent to the employer/DER, except for situations
involving child endangerment or specific state laws (e.g., some states
require reporting of impaired healthcare workers).
