NRCME Test Bank Questions And
Answers 2023
Which of the following is a requirement for drivers with a diabetes exemption?
A) Possess a rapidly absorbable form of glucose while driving
B) Self—monitor blood glucose one hour before driving and at least once every 2
hours while driving
C) Plan to submit blood glucose monitoring logs every 6 months
D) Maintain a Hemoglobin A1C value less than 7 - Answer A. Drivers with diabetes
should self monitor blood glucose before driving and every 4 hours while driving.
Blood glucose monitoring logs should be submitted annually. There is no specific
requirement for HgA1C level.
Drivers with insulin dependent diabetes:
A) May be certified for a maximum of 6 months
B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certification
C) Cannot be certified if they have a history of myocardial infarction
D) May be eligible for a diabetes exemption - Answer D) Drivers with insulin
dependent diabetes cannot be certified but may be eligible for a diabetes exemption
Which of the following is true?
A) A driver with diabetes who uses insulin does not meet the minimum requirements
of 49 CFR Part 391.41
B) The most important concert related to medication use for treating diabetes is
hyperglycemia
C) Peripheral neuropathy is not a disqualifying condition
D) Diabetes is not a coronary heart disease (CHD) equivalent condition - Answer A)
The greatest risk for medication use for drivers with diabetes in hypoglycemia, not
hyperglycemia. Peripheral neuropathy is disqualifying condition. Diabetes is a CHD
equivalent condition.
What is the recommended certification interval for a driver with diabetes mellituse
who does not use insulin?
A) Three months
B) Six months
C) One year
D) Two years - Answer C) Drivers with non-insulin dependent diabetes should be
certified for a maximum of one year
A diabetes exemption may be issued by:
A) An endocrinologist
B) The Medical Examiner
C) The driver's personal physician
D) The FMCSA - Answer D) Only the FMCSA can grant exemptions
A driver with diabetes mellliktus who uses insulin is determined to be otherwise
medically qualified. The medical examiner must indicate that a diabetes exemption is
required on the :
A) Medical Examination Report status section and Medical Examiners Certificate
B) Letter to the FMCSA
C) Employer authorization form
,NRCME Test Bank Questions And
Answers 2023
D) Endocrinology consultation form - Answer A) Exemption requirements must be
noted on the Medical Examination Report status section and the Medical Examiners
Certificate
If glucose is detected on urinalysis in a driver with no history of diabetes, an
appropriate next step is:
A) Endocrinology consultation
B) One year clearance and recommendation to see personal physician
C) Fingerstick or blood glucose determination
D) Temporary disqualification - Answer C) The medical examiner should first
determine blood glucose and then make an appropriate certification determination
and referral
Drivers with a history of _____________ severe hypoglycemic reactions in the past
year or _____________ severe hypoglycemic reactions in the past five years should
not be certifed.
A) one, three
B) one, two
C) two, three
D) two, five - Answer B) A driver should not be certified if the driver has had one
hypoglycemic reaction in the past year or two in the past five years.
Which of the following is not a criteria that the FMCSA uses to define a severe
hypoglycemic reaction?
A) Seizure
B) Dizziness
C) Need of assistance from another person
D) Period of impaired cognitive function that occurred without warning - Answer B)
FMCSA defines severe hypoglycemia as reactions that result in seizure, loss of
consciousness, need of assistance from another person, and a period of impaired
congitive function that occurred without warning
Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy - Answer 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
,NRCME Test Bank Questions And
Answers 2023
D) Once a day after driving period has ended - Answer 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 - Answer
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 - Answer 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 - Answer 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 - Answer 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
, NRCME Test Bank Questions And
Answers 2023
D) Should have the medical certificaton determination made by a renal specialist -
Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer A) Kidney transplants are not disqualifying
Which of the following is true?
Answers 2023
Which of the following is a requirement for drivers with a diabetes exemption?
A) Possess a rapidly absorbable form of glucose while driving
B) Self—monitor blood glucose one hour before driving and at least once every 2
hours while driving
C) Plan to submit blood glucose monitoring logs every 6 months
D) Maintain a Hemoglobin A1C value less than 7 - Answer A. Drivers with diabetes
should self monitor blood glucose before driving and every 4 hours while driving.
Blood glucose monitoring logs should be submitted annually. There is no specific
requirement for HgA1C level.
Drivers with insulin dependent diabetes:
A) May be certified for a maximum of 6 months
B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certification
C) Cannot be certified if they have a history of myocardial infarction
D) May be eligible for a diabetes exemption - Answer D) Drivers with insulin
dependent diabetes cannot be certified but may be eligible for a diabetes exemption
Which of the following is true?
A) A driver with diabetes who uses insulin does not meet the minimum requirements
of 49 CFR Part 391.41
B) The most important concert related to medication use for treating diabetes is
hyperglycemia
C) Peripheral neuropathy is not a disqualifying condition
D) Diabetes is not a coronary heart disease (CHD) equivalent condition - Answer A)
The greatest risk for medication use for drivers with diabetes in hypoglycemia, not
hyperglycemia. Peripheral neuropathy is disqualifying condition. Diabetes is a CHD
equivalent condition.
What is the recommended certification interval for a driver with diabetes mellituse
who does not use insulin?
A) Three months
B) Six months
C) One year
D) Two years - Answer C) Drivers with non-insulin dependent diabetes should be
certified for a maximum of one year
A diabetes exemption may be issued by:
A) An endocrinologist
B) The Medical Examiner
C) The driver's personal physician
D) The FMCSA - Answer D) Only the FMCSA can grant exemptions
A driver with diabetes mellliktus who uses insulin is determined to be otherwise
medically qualified. The medical examiner must indicate that a diabetes exemption is
required on the :
A) Medical Examination Report status section and Medical Examiners Certificate
B) Letter to the FMCSA
C) Employer authorization form
,NRCME Test Bank Questions And
Answers 2023
D) Endocrinology consultation form - Answer A) Exemption requirements must be
noted on the Medical Examination Report status section and the Medical Examiners
Certificate
If glucose is detected on urinalysis in a driver with no history of diabetes, an
appropriate next step is:
A) Endocrinology consultation
B) One year clearance and recommendation to see personal physician
C) Fingerstick or blood glucose determination
D) Temporary disqualification - Answer C) The medical examiner should first
determine blood glucose and then make an appropriate certification determination
and referral
Drivers with a history of _____________ severe hypoglycemic reactions in the past
year or _____________ severe hypoglycemic reactions in the past five years should
not be certifed.
A) one, three
B) one, two
C) two, three
D) two, five - Answer B) A driver should not be certified if the driver has had one
hypoglycemic reaction in the past year or two in the past five years.
Which of the following is not a criteria that the FMCSA uses to define a severe
hypoglycemic reaction?
A) Seizure
B) Dizziness
C) Need of assistance from another person
D) Period of impaired cognitive function that occurred without warning - Answer B)
FMCSA defines severe hypoglycemia as reactions that result in seizure, loss of
consciousness, need of assistance from another person, and a period of impaired
congitive function that occurred without warning
Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy - Answer 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
,NRCME Test Bank Questions And
Answers 2023
D) Once a day after driving period has ended - Answer 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 - Answer
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 - Answer 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 - Answer 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 - Answer 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
, NRCME Test Bank Questions And
Answers 2023
D) Should have the medical certificaton determination made by a renal specialist -
Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer 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 - Answer A) Kidney transplants are not disqualifying
Which of the following is true?
