NRCME EVALUATION EXAM ACTUAL QUESTIONS AND
ANSWERS RATED A+
✔✔Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy - ✔✔C) Although hyperglycemia, peripheral neuropathy,
and metabolic encephalopathy all pose significant risks for safe driving, hypoglycemia
poses the greatest risk. The risk is particularly pronounced in drivers who use insulin.
FMCSA defines a hypoglycemia episode as one that results in seizure, loss of
consciousness, need of assistance from another person, or a period of impaired
cognitive function that occurs without warning.
✔✔A driver with a diabetes exemption should check glucose levels when?
A) One hour before driving and at least once every four hours while driving
B) One hour before driving and at least every eight hours while driving
C) Once after four hours of driving
D) Once a day after driving period has ended - ✔✔A) Driver's with diabetes exemption
should check glucose values one hour before driving and once every four hours while
driving
✔✔Which of the following is true for diagnosis of a hernia?
A) The driver should be referred to a surgeon to determine whether repair of a hernia is
necessary
B) The waiting period following hernia surgery is two weeks
C) Inguinal hernias have been associated with an increased risk for CMV accidents
D) The maximum certification interval for a driver with a hernia is two years - ✔✔D) The
medical examiner can use his/her judgment as to whether a driver should be referred to
a surgeon or other specialist. There is no specified waiting period following hernia
surgery - the driver should not be certified until the medical examiner determines that
treatment is safe and effective, and that the condition is stable. No evidence has linked
hernias of any type to increased CMV accident risk.
✔✔Which of the following is true of nephropathy?
A) Nephropathy is a disqualifying condition
B) The maximum certification interval for nephropathy is two years
C) A driver with 3+ proteinuria should not be certified
D) A renal specialist should make the certification determination for a driver with
nephropathy - ✔✔B) Nephropathy is considered on a case-by-case basis. The medical
examiner determines what evaluation or monitoring is necessary for a driver with 3+
proteinuria and may disqualify the driver. The certification is always made by the
medical examiner and cannot be deferred to a specialist.
✔✔Drivers with which of the following conditions should be disqualified?
,A) Cancer requiring chemotherapy treatment
B) Umbilical hernia not surgically repaired
C) Renal failure on peritoneal dialysis
D) Hemochromatosis - ✔✔C) Dialysis of any type is disqualifying
✔✔If a significant abnormal finding for urinalysis specific gravity, protein, or blood is
found, the medical examiner should:
A) Disqualify the driver
B) Request that a renal specialist determine if the driver is medically qualified
C) Use clinical expertise to determine a certification decision and to determine if
additional evaluation is required or recommended
D) Obtain blood chemistries for renal function - ✔✔C) The medical examiner must
determine whether additional evaluation is needed and whether the certification
decision should be postponed or limited
✔✔A driver with a history of kidney disease with or without transplant:
A) Is medically disqualified
B) Must be assessed regarding the severity, stability, medications used, and medication
side effects/adverse reactions
C) Should not be assessed for functional ability to operate a CMV safely
D) Should have the medical certificaton determination made by a renal specialist -
✔✔B) ASsessment for kidney disease must be ade on a case-by-case basis. Dialysis of
any kind is disqualifying. The medical examiner may choose to test the driver for
functional ability to operate a CMV safely. The medical certification decision must be
made by the medical examiner.
✔✔Which of the following is not a disqualifying condition?
A) Peritoneal dialysis
B) Hemodialysis
C) Hernia
D) Peripheral neuropathy - ✔✔Any type of dialysis is a disqualifying condition.
Peripheral neuropathy is usually disqualifying. Although a hernia may be disqualifying,
often a driver can be certified if the symptoms and/or examination findings are mild or if
the hernia has been surgically repaired and the condition has stabilized (there is no
specified waiting period following hernia treatment, including surgery).
✔✔Urinalysis is required for the driver physical examination and the results must
include
A) Specific gravity, creatinine, bilirubin, and glucose
B) Creatinine, bilirubin, blood, and protein
C) Specific gravity, protein, blood, and glucose
D) Specific gravity, bilirubin, blood, and protein - ✔✔C) Specific gravity, protein, blood,
and glucose should be checked at every driver examination
✔✔Disqualifying conditions include:
,A) Chronic constipation
B) Obesity
C) Cystitis
D) Dialysis - ✔✔D) Dialysis of any type of disqualifying
✔✔A driver who has Hepatitis C who is stable and whose condition does not represent
a safety risk may be certified
A) True
B) False - ✔✔A) Hepatitis C is not disqualifying
✔✔A driver with a history of acute bleeding ulcer may be certified if:
A) Pain has subsided
B) Driver tolerates food without nausea and vomiting
C) Bleeding has subsided
D) The underlying cause has been identified and recurrence risk is low following
treatment - ✔✔D) Drivers with bleeding ulcers should not be certified until the
underlying cause has been identified and the recurrence risk is low
✔✔A driver with a successful kidney transplant can be certified
A) True
B) False - ✔✔A) Kidney transplants are not disqualifying
✔✔Which of the following is true?
A) Medical marijuana use if disqualifying
B) The medical examiner should drug test the driver for marijuana if the driver gives a
history of recent marijuana's
C) A driver with a history of only occasional marijuana may not have to complete a
substance abuse professional assessment
D) Marijuana is a Schedule II drug - ✔✔A) If a driver gives a history of recent marijuana
use, the driver should be referred for substance abuse professional evaluation
regardless of drug test result. Drivers with a history of marijuana use, or a drug test
positive for marijuana, must undergo substance abuse professional assessment and
complete any recommended rehabilitation prior to returning to driving. Marijuana is a
Schedule I drug.
✔✔Which of the following is a requirement for a driver with a history of alcoholism to be
certified?
A) No residual disqualifying physical impairment
B) Successful treatment with naltrexone
C) Currently in counseling and/or treatment
D) No more than one current alcohol-related disorder - ✔✔A) Treatment with naltrexone
is not required for driver certification for a driver with a history of alcoholism. A driver
with a history of alcoholism must have completed counseling and/or treatment and must
not have a current alcohol-related disorder in order to be certified.
, ✔✔Which of the following is a disqualifying condition?
A) A past clinical diagnosis of alcoholism
B) A breath alcohol result of 0.019%
C) An alcohol-related stable physical condition, regardless of the time element
D) Use of methadone - ✔✔D) A current diagnosis of alcoholism is disqualifying. A
breath alcohol result of 0.02% or higher renders the driver unqualified to drive. An
alcohol-related unstable physical condition is disqualifying.
✔✔Ongoing voluntary attendance at self-help groups (e.g. 12 step programs) for
maintenance of recovery from alcoholism:
A) Is required for all drivers recovering from alcoholism
B) Is disqualifying
C) Is allowed but not required for drivers recovering from alcoholism
D) Fulfills the requirement for rehabilitation following a violation of alcohol rules. - ✔✔C)
12-step or similar programs do not fulfill rehabiliation requirements for drivers with a
violation of alcohol (or drug) regulations. Participation in such programs is allowed, but
not required, and is not disqualifying.
✔✔Which of the following is a mental health professional that the medial examiner may
refer to or consult with?
1) Breath alcohol technician (BAT)
2) Designated employer representative (DER)
3) Medical review officer (MRO)
4) Substance abuse professional (SAP)
A) 1, 2, and 3
B) 1 and 3 only
C) 2 and 4 only
D) 4 only
E) all of the above - ✔✔According to the FMCSA, all of these are defined as mental
health professionals
✔✔The maximal certification internal for a driver with a history of drug abuse or
alcoholism is
A) Six months
B) One year
C) Two years
D) Do not certify - ✔✔C) Drivers with a history of drug abuse or alcoholism may be
certified forup to two years. Drivers may be subject to drug and/or alcohol testing more
frequently, but such testing is performed under 49 CFR Part 40 drug and alcohol testing
regulations, not under 49 CFR Part 391.41 driver qualification standards
✔✔Which of the following is true?
A) One of the requirements for the CMV drier physical examination is testing for
controlled substances
ANSWERS RATED A+
✔✔Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy - ✔✔C) Although hyperglycemia, peripheral neuropathy,
and metabolic encephalopathy all pose significant risks for safe driving, hypoglycemia
poses the greatest risk. The risk is particularly pronounced in drivers who use insulin.
FMCSA defines a hypoglycemia episode as one that results in seizure, loss of
consciousness, need of assistance from another person, or a period of impaired
cognitive function that occurs without warning.
✔✔A driver with a diabetes exemption should check glucose levels when?
A) One hour before driving and at least once every four hours while driving
B) One hour before driving and at least every eight hours while driving
C) Once after four hours of driving
D) Once a day after driving period has ended - ✔✔A) Driver's with diabetes exemption
should check glucose values one hour before driving and once every four hours while
driving
✔✔Which of the following is true for diagnosis of a hernia?
A) The driver should be referred to a surgeon to determine whether repair of a hernia is
necessary
B) The waiting period following hernia surgery is two weeks
C) Inguinal hernias have been associated with an increased risk for CMV accidents
D) The maximum certification interval for a driver with a hernia is two years - ✔✔D) The
medical examiner can use his/her judgment as to whether a driver should be referred to
a surgeon or other specialist. There is no specified waiting period following hernia
surgery - the driver should not be certified until the medical examiner determines that
treatment is safe and effective, and that the condition is stable. No evidence has linked
hernias of any type to increased CMV accident risk.
✔✔Which of the following is true of nephropathy?
A) Nephropathy is a disqualifying condition
B) The maximum certification interval for nephropathy is two years
C) A driver with 3+ proteinuria should not be certified
D) A renal specialist should make the certification determination for a driver with
nephropathy - ✔✔B) Nephropathy is considered on a case-by-case basis. The medical
examiner determines what evaluation or monitoring is necessary for a driver with 3+
proteinuria and may disqualify the driver. The certification is always made by the
medical examiner and cannot be deferred to a specialist.
✔✔Drivers with which of the following conditions should be disqualified?
,A) Cancer requiring chemotherapy treatment
B) Umbilical hernia not surgically repaired
C) Renal failure on peritoneal dialysis
D) Hemochromatosis - ✔✔C) Dialysis of any type is disqualifying
✔✔If a significant abnormal finding for urinalysis specific gravity, protein, or blood is
found, the medical examiner should:
A) Disqualify the driver
B) Request that a renal specialist determine if the driver is medically qualified
C) Use clinical expertise to determine a certification decision and to determine if
additional evaluation is required or recommended
D) Obtain blood chemistries for renal function - ✔✔C) The medical examiner must
determine whether additional evaluation is needed and whether the certification
decision should be postponed or limited
✔✔A driver with a history of kidney disease with or without transplant:
A) Is medically disqualified
B) Must be assessed regarding the severity, stability, medications used, and medication
side effects/adverse reactions
C) Should not be assessed for functional ability to operate a CMV safely
D) Should have the medical certificaton determination made by a renal specialist -
✔✔B) ASsessment for kidney disease must be ade on a case-by-case basis. Dialysis of
any kind is disqualifying. The medical examiner may choose to test the driver for
functional ability to operate a CMV safely. The medical certification decision must be
made by the medical examiner.
✔✔Which of the following is not a disqualifying condition?
A) Peritoneal dialysis
B) Hemodialysis
C) Hernia
D) Peripheral neuropathy - ✔✔Any type of dialysis is a disqualifying condition.
Peripheral neuropathy is usually disqualifying. Although a hernia may be disqualifying,
often a driver can be certified if the symptoms and/or examination findings are mild or if
the hernia has been surgically repaired and the condition has stabilized (there is no
specified waiting period following hernia treatment, including surgery).
✔✔Urinalysis is required for the driver physical examination and the results must
include
A) Specific gravity, creatinine, bilirubin, and glucose
B) Creatinine, bilirubin, blood, and protein
C) Specific gravity, protein, blood, and glucose
D) Specific gravity, bilirubin, blood, and protein - ✔✔C) Specific gravity, protein, blood,
and glucose should be checked at every driver examination
✔✔Disqualifying conditions include:
,A) Chronic constipation
B) Obesity
C) Cystitis
D) Dialysis - ✔✔D) Dialysis of any type of disqualifying
✔✔A driver who has Hepatitis C who is stable and whose condition does not represent
a safety risk may be certified
A) True
B) False - ✔✔A) Hepatitis C is not disqualifying
✔✔A driver with a history of acute bleeding ulcer may be certified if:
A) Pain has subsided
B) Driver tolerates food without nausea and vomiting
C) Bleeding has subsided
D) The underlying cause has been identified and recurrence risk is low following
treatment - ✔✔D) Drivers with bleeding ulcers should not be certified until the
underlying cause has been identified and the recurrence risk is low
✔✔A driver with a successful kidney transplant can be certified
A) True
B) False - ✔✔A) Kidney transplants are not disqualifying
✔✔Which of the following is true?
A) Medical marijuana use if disqualifying
B) The medical examiner should drug test the driver for marijuana if the driver gives a
history of recent marijuana's
C) A driver with a history of only occasional marijuana may not have to complete a
substance abuse professional assessment
D) Marijuana is a Schedule II drug - ✔✔A) If a driver gives a history of recent marijuana
use, the driver should be referred for substance abuse professional evaluation
regardless of drug test result. Drivers with a history of marijuana use, or a drug test
positive for marijuana, must undergo substance abuse professional assessment and
complete any recommended rehabilitation prior to returning to driving. Marijuana is a
Schedule I drug.
✔✔Which of the following is a requirement for a driver with a history of alcoholism to be
certified?
A) No residual disqualifying physical impairment
B) Successful treatment with naltrexone
C) Currently in counseling and/or treatment
D) No more than one current alcohol-related disorder - ✔✔A) Treatment with naltrexone
is not required for driver certification for a driver with a history of alcoholism. A driver
with a history of alcoholism must have completed counseling and/or treatment and must
not have a current alcohol-related disorder in order to be certified.
, ✔✔Which of the following is a disqualifying condition?
A) A past clinical diagnosis of alcoholism
B) A breath alcohol result of 0.019%
C) An alcohol-related stable physical condition, regardless of the time element
D) Use of methadone - ✔✔D) A current diagnosis of alcoholism is disqualifying. A
breath alcohol result of 0.02% or higher renders the driver unqualified to drive. An
alcohol-related unstable physical condition is disqualifying.
✔✔Ongoing voluntary attendance at self-help groups (e.g. 12 step programs) for
maintenance of recovery from alcoholism:
A) Is required for all drivers recovering from alcoholism
B) Is disqualifying
C) Is allowed but not required for drivers recovering from alcoholism
D) Fulfills the requirement for rehabilitation following a violation of alcohol rules. - ✔✔C)
12-step or similar programs do not fulfill rehabiliation requirements for drivers with a
violation of alcohol (or drug) regulations. Participation in such programs is allowed, but
not required, and is not disqualifying.
✔✔Which of the following is a mental health professional that the medial examiner may
refer to or consult with?
1) Breath alcohol technician (BAT)
2) Designated employer representative (DER)
3) Medical review officer (MRO)
4) Substance abuse professional (SAP)
A) 1, 2, and 3
B) 1 and 3 only
C) 2 and 4 only
D) 4 only
E) all of the above - ✔✔According to the FMCSA, all of these are defined as mental
health professionals
✔✔The maximal certification internal for a driver with a history of drug abuse or
alcoholism is
A) Six months
B) One year
C) Two years
D) Do not certify - ✔✔C) Drivers with a history of drug abuse or alcoholism may be
certified forup to two years. Drivers may be subject to drug and/or alcohol testing more
frequently, but such testing is performed under 49 CFR Part 40 drug and alcohol testing
regulations, not under 49 CFR Part 391.41 driver qualification standards
✔✔Which of the following is true?
A) One of the requirements for the CMV drier physical examination is testing for
controlled substances
