MRO Practice Questions with correct answers 2026\2027
A+ Grade
2. Which of the following drug tests is not required for federal employees under the federal Drug-Free
Workplace Program?
A.Preplacement
B.Post-accident
C.Return to duty
D.Unreasonable suspicion
E.Random
- correct answer D
SAMHSA's Drug Free Workplace Program specifies "Reasonable Suspicion" as one of the types of drug
testing. This is found on the federal Custody and Control Form. The incorrect answer was unreasonable
suspicion.
3. Which of the following is the "weakest link" in drug testing, i.e., generally produces the most frequent
errors?
A.Specimen collection
B.Laboratory testing
C.MRO review
- correct answer A
Among drug testing personnel, there are far more specimen collectors than laboratory staff or MROs.
Collectors receive the least amount of training, are paid the lowest wages, and have the highest job
turnover.
Quality reviews show that a substantially larger number of errors occur in collection and properly
completing the Custody and Control Form.
4. MROs must pass a nationally recognized certifying examination for which of the following activities?
,A.All MRO work
B.All federally regulated MRO work
C.All DHHS and DOT MRO work
D.All states with provisions allowing medical marijuana
- correct answer C
A. All MRO work - Incorrect: includes non-federally regulated drug testing, in which only a handful of
states require MRO certification
B. All federally-regulated MRO work - Incorrect: includes DOD, NRC and other agencies, which do not
require MRO certification
C. All DHHS and DOT MRO work - Correct Answer: Both SAMHSA and DOT clearly specify this
requirement for MROs.
D. All states with provisions allowing medical marijuana - Incorrect: state Marijuana laws make no
reference to MROs, and only allow medical authorization or recommendation permitting marijuana use.
Health care professions do not "prescribe" marijuana.
5. Which of the following roles is primary for the MRO?
A.Lab checker
B.SAP advisor
C.Gatekeeper
D.Mediator
E.Substance Abuse Identifier
- correct answer c
Although each of these monikers identify occasional, peripheral roles of the MRO, the DOT has clearly
earmarked the role of the MRO as a gatekeeper.
6. After completing review of drug test results, interviewing the donor and documenting findings, an
MRO must do which of the following?
A.Confirm laboratory results
B.Reconfirm laboratory results
C.Verify drug test results
,D.Report findings to laboratory and employer
- correct answer C
The determination of an MRO is called a "verification" decision. Laboratories confirm lab results though
performing a second test using a different analytical method and performing internal quality control
measures. A laboratory to which a split specimen is send reconfirms or fails to reconfirm the original
laboratory's findings. MROs report findings to employers, but do not routinely report to laboratories.
7. The MRO safety duties include all but which of the following activities?
A.Consider essential job functions
B.Review appropriateness of medications donor is taking
C.Verify prescriptions with PCP/pharmacy
D.Assess safety risks from medications
- correct answer B
A, C and D are all part of the considerations of an MRO in assessing workplace safety. However, the DOT
has made it explicitly clear that while an MRO may express safety concerns to the donor and discuss
them with prescribing health care professional, the MRO is admonished NOT to determine whether the
medication was appropriately prescribed.
The one exception for federal employees is mentioned the SAMHSA MRO Guidance Manual, which does
allow MROs to "use reasonable medical judgement to make the decision that the provided prescription
was generated in response to the donor's current medical condition
8. At what age does use of illicit drugs peak in the U.S.?
A.12-17
B.18-24
C.25-3
D.33-50
E.51 and older
- correct answer B
The National Survey on Drug Use and Health has consistently shown in all its surveys from 2000-2018
that illicit drug use peaks at ages 18-24.
, 9. The greatest increase in U.S. drug overdose deaths is due to which of the following categories of
drugs?
A.Cocaine
B.Heroin
C.Methamphetamine
D.Natural and semi-synthetic opioids
E.Synthetic opioids other than methadone (e.g., fentanyl)
- correct answer E
The Centers for Disease Control and Prevention (CDC) National Center for Health Statistics has tracked
drug overdose deaths from 1999-2017. Overdose deaths from many different drug classes have risen,
including heroin, natural and semisynthetic opioids, cocaine, and methamphetamine. But none have
risen so dramatically as synthetic opioids other than methadone
9a. What are the most frequent sources of pain relievers that are misused in the U.S.?
A.Drug dealers
B.Health care providers
C.Friends or relatives
- correct answer A. Drug dealers or other stranger - 6.5%
B. Prescriptions or stone from a health care provider - 37.6%
C. Given by, bought from or took from friend or relative - 51.3%
10. Which type of drug tests are non-DOT employers most likely to require?
A.Post-accident
B.Reasonable Suspicion
C.Return to Duty
D.Pre-placement
E.Random
- correct answer D
SAMHSA has tracked workplace drug testing and confirmed over many years that the most frequent
type of drug testing required by employers is pre-employment/pre-placement. The least frequent is
random testing.
A+ Grade
2. Which of the following drug tests is not required for federal employees under the federal Drug-Free
Workplace Program?
A.Preplacement
B.Post-accident
C.Return to duty
D.Unreasonable suspicion
E.Random
- correct answer D
SAMHSA's Drug Free Workplace Program specifies "Reasonable Suspicion" as one of the types of drug
testing. This is found on the federal Custody and Control Form. The incorrect answer was unreasonable
suspicion.
3. Which of the following is the "weakest link" in drug testing, i.e., generally produces the most frequent
errors?
A.Specimen collection
B.Laboratory testing
C.MRO review
- correct answer A
Among drug testing personnel, there are far more specimen collectors than laboratory staff or MROs.
Collectors receive the least amount of training, are paid the lowest wages, and have the highest job
turnover.
Quality reviews show that a substantially larger number of errors occur in collection and properly
completing the Custody and Control Form.
4. MROs must pass a nationally recognized certifying examination for which of the following activities?
,A.All MRO work
B.All federally regulated MRO work
C.All DHHS and DOT MRO work
D.All states with provisions allowing medical marijuana
- correct answer C
A. All MRO work - Incorrect: includes non-federally regulated drug testing, in which only a handful of
states require MRO certification
B. All federally-regulated MRO work - Incorrect: includes DOD, NRC and other agencies, which do not
require MRO certification
C. All DHHS and DOT MRO work - Correct Answer: Both SAMHSA and DOT clearly specify this
requirement for MROs.
D. All states with provisions allowing medical marijuana - Incorrect: state Marijuana laws make no
reference to MROs, and only allow medical authorization or recommendation permitting marijuana use.
Health care professions do not "prescribe" marijuana.
5. Which of the following roles is primary for the MRO?
A.Lab checker
B.SAP advisor
C.Gatekeeper
D.Mediator
E.Substance Abuse Identifier
- correct answer c
Although each of these monikers identify occasional, peripheral roles of the MRO, the DOT has clearly
earmarked the role of the MRO as a gatekeeper.
6. After completing review of drug test results, interviewing the donor and documenting findings, an
MRO must do which of the following?
A.Confirm laboratory results
B.Reconfirm laboratory results
C.Verify drug test results
,D.Report findings to laboratory and employer
- correct answer C
The determination of an MRO is called a "verification" decision. Laboratories confirm lab results though
performing a second test using a different analytical method and performing internal quality control
measures. A laboratory to which a split specimen is send reconfirms or fails to reconfirm the original
laboratory's findings. MROs report findings to employers, but do not routinely report to laboratories.
7. The MRO safety duties include all but which of the following activities?
A.Consider essential job functions
B.Review appropriateness of medications donor is taking
C.Verify prescriptions with PCP/pharmacy
D.Assess safety risks from medications
- correct answer B
A, C and D are all part of the considerations of an MRO in assessing workplace safety. However, the DOT
has made it explicitly clear that while an MRO may express safety concerns to the donor and discuss
them with prescribing health care professional, the MRO is admonished NOT to determine whether the
medication was appropriately prescribed.
The one exception for federal employees is mentioned the SAMHSA MRO Guidance Manual, which does
allow MROs to "use reasonable medical judgement to make the decision that the provided prescription
was generated in response to the donor's current medical condition
8. At what age does use of illicit drugs peak in the U.S.?
A.12-17
B.18-24
C.25-3
D.33-50
E.51 and older
- correct answer B
The National Survey on Drug Use and Health has consistently shown in all its surveys from 2000-2018
that illicit drug use peaks at ages 18-24.
, 9. The greatest increase in U.S. drug overdose deaths is due to which of the following categories of
drugs?
A.Cocaine
B.Heroin
C.Methamphetamine
D.Natural and semi-synthetic opioids
E.Synthetic opioids other than methadone (e.g., fentanyl)
- correct answer E
The Centers for Disease Control and Prevention (CDC) National Center for Health Statistics has tracked
drug overdose deaths from 1999-2017. Overdose deaths from many different drug classes have risen,
including heroin, natural and semisynthetic opioids, cocaine, and methamphetamine. But none have
risen so dramatically as synthetic opioids other than methadone
9a. What are the most frequent sources of pain relievers that are misused in the U.S.?
A.Drug dealers
B.Health care providers
C.Friends or relatives
- correct answer A. Drug dealers or other stranger - 6.5%
B. Prescriptions or stone from a health care provider - 37.6%
C. Given by, bought from or took from friend or relative - 51.3%
10. Which type of drug tests are non-DOT employers most likely to require?
A.Post-accident
B.Reasonable Suspicion
C.Return to Duty
D.Pre-placement
E.Random
- correct answer D
SAMHSA has tracked workplace drug testing and confirmed over many years that the most frequent
type of drug testing required by employers is pre-employment/pre-placement. The least frequent is
random testing.
