The driver presents with a SPE Certificate. The Medical Examiner's next step should be: - AN-
SWER Proceed with the examination.
A 21-year-old driver presents with a history of ADHD for 10 years, taking stable dosing of Ad-
derall. He describes no side effects. Which of the following is true?
a. A significant percentage of individuals with adult ADHD show a moderate to marked de-
gree of improvement on central nervous system stimulant medication.
b. ADHD is a disqualifying condition.
c. Adderall is a Schedule 1 drug.
d. Medical Examiners should test for serum drug levels of Adderall. - ANSWER A signifi-
cant percentage of individuals with adult ADHD show a moderate to marked degree of im-
provement on central nervous system stimulant medication
Which of the following is the most important examination finding that requires additional
evaluation?
a. Acrochordon.
b. Hyperopia.
c. Palpable calf cords.
d. Verruca vulgaris. - ANSWER Palpable calf cords
The driver reports taking Digoxin. What findings would raise the most significant concerns
regarding certification?
a. Arrhythmias.
b. Anorexia.
c. Nausea and vomiting.
d. Diarrhea. - ANSWER Arrhythmias.
1
,The driver is taking theophylline. Which of the following is not true?
a. Serum levels may be checked.
b. The primary indication for theophylline is in the treatment of neurological conditions.
c. Cardiac toxicity is a significant risk of theophylline use.
d. Theophylline can be administered orally or intravenously (IV - ANSWER The primary
indication for theophylline is in the treatment of neurological conditions.
The driver is taking Celexa and melatonin. The Medical Examiner should:
a. Advise the driver to only take these medications more than 12 hours before driving.
b. Advise the driver to stop melatonin as it can cause drowsiness.
c. Recommend an alternative to Celexa.
d. Advise the driver to discuss benzodiazepines as an alternative treatment. with the driver's
prescribing provider - ANSWER Advise the driver to only take these medications more
than 12 hours before driving.
The driver tells the Medical Examiner he has recently been prescribed contact lenses. He
notes that after 3-4 hours of use the contacts cause irritation and he has to take them out.
The driver passes the vision test only with contacts and does not have eyeglasses. The Medi-
cal Examiner should:
a. Advise the driver to carry a spare pair of contact lenses.
b. Certify the driver wearing corrective lenses.
c. Refer the driver for evaluation under the Alternative Vision Qualification standard.
d. Certify the driver without qualifications - ANSWER Certify the driver wearing corrective
lenses.
The driver does not indicate any medical conditions on health history. During the exam the
Medical Examiner notes the presence of a hearing aid in one ear. The driver says that he
2
,doesn't need the hearing aid to drive and doesn't think it should be required. The next step
for the Medical Examiner is:
a. Test the driver's hearing without the hearing aid.
b. Examine the driver's ears.
c. Refer the driver for hearing assessment by a specialist with specialized audiometric testing
capabilities for testing drivers while wearing a hearing aid. d. Certify the driver with the qual-
ification "wearing hearing aid - ANSWER Test the driver's hearing without the hearing aid.
A driver has an indication for obtaining a cardiac stress test. If the driver is not taking a beta
blocker, what is the percentage of maximum heart rate that the driver should meet to indi-
cate a satisfactory stress test:
a. 60%.
b. 75%.
c. 85%.
d. 100%. - ANSWER 85%
The driver is missing the 4th finger of his right hand. The Medical Examiner should:
a. Refer for orthopedic evaluation.
b. Indicate the driver will need a SPE Certificate.
c. Test the driver's grasp and prehension.
d. Disqualify the driver - ANSWER Test the driver's grasp and prehension.
The driver describes a history of dizzy spells. Which examination finding is not indicated?
a. Test the driver for nystagmus.
b. Romberg testing.
c. Orthostatic blood pressure measurements.
3
, d. Liver and spleen palpation - ANSWER Liver and spleen palpation
Guidance (not regulatory) recommendations are that drivers with dizziness or vertigo should
not be qualified until the driver has achieved a 2-month symptom free interval regardless of
examination findings.
Vision testing may be performed by:
a. The Medical Examiner, an optometrist, or ophthalmologist.
b. Only an ophthalmologist.
c. Only the Medical Examiner.
d. Only an optometrist - ANSWER The Medical Examiner, an optometrist, or ophthalmol-
ogist
The driver has 1,000 ng/ml of glucose on urinalysis. What is the next appropriate step for
the Medical Examiner?
a. Disqualify the driver.
b. Refer the driver for evaluation by a kidney specialist.
c. Refer the driver for evaluation under the Insulin-Treated Diabetes Alternative Qualification
Standard.
d. Recommend the driver check blood glucose 4x per day. - ANSWER Recommend the
driver check blood glucose 4x per day.
The driver presents after having had a PCI procedure 3 days prior. The driver indicates no
symptoms and has a letter from his cardiologist indicating he is cleared to drive. The Medical
Examiner should:
a. Have the driver return for evaluation at least 3 weeks after the date of the PCI.
4
SWER Proceed with the examination.
A 21-year-old driver presents with a history of ADHD for 10 years, taking stable dosing of Ad-
derall. He describes no side effects. Which of the following is true?
a. A significant percentage of individuals with adult ADHD show a moderate to marked de-
gree of improvement on central nervous system stimulant medication.
b. ADHD is a disqualifying condition.
c. Adderall is a Schedule 1 drug.
d. Medical Examiners should test for serum drug levels of Adderall. - ANSWER A signifi-
cant percentage of individuals with adult ADHD show a moderate to marked degree of im-
provement on central nervous system stimulant medication
Which of the following is the most important examination finding that requires additional
evaluation?
a. Acrochordon.
b. Hyperopia.
c. Palpable calf cords.
d. Verruca vulgaris. - ANSWER Palpable calf cords
The driver reports taking Digoxin. What findings would raise the most significant concerns
regarding certification?
a. Arrhythmias.
b. Anorexia.
c. Nausea and vomiting.
d. Diarrhea. - ANSWER Arrhythmias.
1
,The driver is taking theophylline. Which of the following is not true?
a. Serum levels may be checked.
b. The primary indication for theophylline is in the treatment of neurological conditions.
c. Cardiac toxicity is a significant risk of theophylline use.
d. Theophylline can be administered orally or intravenously (IV - ANSWER The primary
indication for theophylline is in the treatment of neurological conditions.
The driver is taking Celexa and melatonin. The Medical Examiner should:
a. Advise the driver to only take these medications more than 12 hours before driving.
b. Advise the driver to stop melatonin as it can cause drowsiness.
c. Recommend an alternative to Celexa.
d. Advise the driver to discuss benzodiazepines as an alternative treatment. with the driver's
prescribing provider - ANSWER Advise the driver to only take these medications more
than 12 hours before driving.
The driver tells the Medical Examiner he has recently been prescribed contact lenses. He
notes that after 3-4 hours of use the contacts cause irritation and he has to take them out.
The driver passes the vision test only with contacts and does not have eyeglasses. The Medi-
cal Examiner should:
a. Advise the driver to carry a spare pair of contact lenses.
b. Certify the driver wearing corrective lenses.
c. Refer the driver for evaluation under the Alternative Vision Qualification standard.
d. Certify the driver without qualifications - ANSWER Certify the driver wearing corrective
lenses.
The driver does not indicate any medical conditions on health history. During the exam the
Medical Examiner notes the presence of a hearing aid in one ear. The driver says that he
2
,doesn't need the hearing aid to drive and doesn't think it should be required. The next step
for the Medical Examiner is:
a. Test the driver's hearing without the hearing aid.
b. Examine the driver's ears.
c. Refer the driver for hearing assessment by a specialist with specialized audiometric testing
capabilities for testing drivers while wearing a hearing aid. d. Certify the driver with the qual-
ification "wearing hearing aid - ANSWER Test the driver's hearing without the hearing aid.
A driver has an indication for obtaining a cardiac stress test. If the driver is not taking a beta
blocker, what is the percentage of maximum heart rate that the driver should meet to indi-
cate a satisfactory stress test:
a. 60%.
b. 75%.
c. 85%.
d. 100%. - ANSWER 85%
The driver is missing the 4th finger of his right hand. The Medical Examiner should:
a. Refer for orthopedic evaluation.
b. Indicate the driver will need a SPE Certificate.
c. Test the driver's grasp and prehension.
d. Disqualify the driver - ANSWER Test the driver's grasp and prehension.
The driver describes a history of dizzy spells. Which examination finding is not indicated?
a. Test the driver for nystagmus.
b. Romberg testing.
c. Orthostatic blood pressure measurements.
3
, d. Liver and spleen palpation - ANSWER Liver and spleen palpation
Guidance (not regulatory) recommendations are that drivers with dizziness or vertigo should
not be qualified until the driver has achieved a 2-month symptom free interval regardless of
examination findings.
Vision testing may be performed by:
a. The Medical Examiner, an optometrist, or ophthalmologist.
b. Only an ophthalmologist.
c. Only the Medical Examiner.
d. Only an optometrist - ANSWER The Medical Examiner, an optometrist, or ophthalmol-
ogist
The driver has 1,000 ng/ml of glucose on urinalysis. What is the next appropriate step for
the Medical Examiner?
a. Disqualify the driver.
b. Refer the driver for evaluation by a kidney specialist.
c. Refer the driver for evaluation under the Insulin-Treated Diabetes Alternative Qualification
Standard.
d. Recommend the driver check blood glucose 4x per day. - ANSWER Recommend the
driver check blood glucose 4x per day.
The driver presents after having had a PCI procedure 3 days prior. The driver indicates no
symptoms and has a letter from his cardiologist indicating he is cleared to drive. The Medical
Examiner should:
a. Have the driver return for evaluation at least 3 weeks after the date of the PCI.
4
