NRCME Test Questions 2023/2024
NRCME Test Questions 2023/2024
What minimum PaO2 level is necessary if the driver has an ABG due to a chronic
respiratory disorder? a.70mmHg
b.55mmHg
c.60mmHg
d.65mmHg
Correct answer is "D". To be qualified, the driver should meet a minimum arterial blood
A driver
gas (PaO2) firstthan
greater perceives
65. a whispered voice at 5 feet in his right ear and 4 feet in
his left ear. All other aspects of his physical examination are unremarkable. The
examiner
ailed" the whispered voice
test.
should:
a.Permanently disqualify the driver because he "f
b.Certify the
d.Require
driver for
an 2audiometric
years. test to determine the extent of hearing loss in his
c.Certify the driver for 1 year. left ear.
Correct answer is "B". The driver is qualified to drive without restriction as long as he is
able to perceive a whispered voice at 5 feet in 1 ear.
,A driver reports for an examination 6 weeks after suffering a mild heart attack and presents a
note from his cardiologist stating that he is able to return to work immediately without
restriction. Included within the note, the cardiologist provides recent testing information
showing that the driver had an ETT that showed he was able to reach 12 METS during the
test. His echocardiogram showed an ejection fraction of 65%. The examination of the driver is
unremarkable. The examiner should: a. Temporarily disqualify the driver.
b. Qualify the driver for 1 year.
c. Qualify the driver for 2 years.
d. Consult with the cardiologist to determine if the
driver suffers from angina.Correct answer is "A". The
driver has not completed the required 2 but all other
requirements for medical clearance and required testing -monthwaiting period,
have been met. The driver would be certified for 1 year at
the completion of the waiting period. The date of the
certification would be from the date of the original
examination.
A driver provides an audiometric test documenting the following:
1. 500 Hz: 2. 1000 HZ: 3. 2000 HZ: 4. 4000 Hz: t ear 50 Right ear;
35 Right ear; 40 Left ear 40 Right ear; 45 Left ear 40 Right ear; 45 Lef 50
Left ear 5.
The medical examiner should:
a. Disqualify the driver because he does not meet
minimum hearing requirementsto drive.
b. Certify the driver for 2years.
c. Certify the driver for 1 year.
d. Require the driver to obtain a hearing exemption.
Correct answer is "B". The examiner would average the results from 500 Hz, 1000 Hz
,and 2000 Hz. This average is 38.33 in the Right and 43.33 in the Left ear. A driver must
have an average hearing loss of less than or equal to 40 in the better ear. This does not
have to be met in both ears.
During the examination of a commercial driver, the examiner notices that the driver's
peripheral vision is 70 degrees to the left and 80 degrees to the right. The examiner
should:
a. Qualify the driver for 2 years.
b. Require the driver to obtain a vision exemption because of the limitation in the
driver'sleft peripheral field.
c. Disqualify the driver.
d. Have the driver consult with an Ophthalmologist to determine if the driver's
peripheral vision meets minimum standards.
Correct answer is "A". A driver must exhibit a minimum peripheral vision of 70 degrees
bilaterally.
During examination, the medical examiner notices that the driver is distant, lacks eye
contact and shows absolutely no emotional response during the exam. The examiner's
best response should be:
a. Provide the driver with a "CAGE" questionnaire to determine if he suffers from
alcoholism. b.
c. Certify the driver with a 1-time, 3-month certificate to determine if there is any
effect on the driver's ability to drive a CMV.
d. Require a skill performance evaluation to ascertain if the driver has any
limitations with driving.
Correct answer is "B". The driver exhibits what may be considered a "flat affect" which is
seen in schizophrenia and in severe depression. The driver should be evaluated by a
mental health expert to make a diagnosis prior to certification.
A driver admits to the use of marijuana for the treatment of his glaucoma, which is legal
in the State in which he lives. He provides medical documentation for the glaucoma
indicating he is able to drive a truck. He began using the marijuana about three months
ago. His current medical card has no limitations listed and is for 2 years. His
certification examination is within normal limits. The medical examiner should: a.
Disqualify the driver.
b. Perform a urine drug collection and provide the release from the testing provider. c.
Certify the driver for 1 year.
d. Certify the driver for 2 years.
Correct answer is "A". Use of marijuana is prohibited by Federal law while driving a
CMV and trumps State law in this matter.
A driver has a blood pressure of 136/92 mm Hg. This is:
a. Within normal limits and would not affect the driver's certification.
b. Stage 1 Hypertension.
c. Stage 2 Hypertension.
d. Stage 3 Hypertension.
Correct answer is "B". This is Stage 1 Hypertension, which is defined as 140-159/90 -
99.
, A driver is taking Celexa for the treatment of what he calls a "mild depression." He
reports he has not considered or attempted suicide. The examiner should?
a.Temporarily disqualify the driver until he obtains written clearance for the depression
and the medication from the treating provi b. Certify the driver for a period of 1 year.
c. Certify the driver for a period of 2 years.
d. Disqualify the driver until he is no longer requiring medication for the treatment of
depression.
Correct answer is "A". Medical clearance is required for all mental health disorders.
Celexa is an SSRI or 2nd Generation anti-depressant and is acceptable.
A driver reports that he had a hunting accident wherein he suffered a left orbital fracture.
He presents a note at the time of the examination from an ophthalmologist stating "may
drive". His exam is unremarkable except for a limitation in peripheral vision in his left
eye, which was inconclusive. His distance vision was 20/20 right and 20/40 left. The
medical examiner should?
a. Council the driver on the need for a vision exemption.
b. Disqualify the driver pending vision exam to determine if it meets peripheral vision
requirements.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years.
Correct answer is "B". The driver must have a peripheral vision of 70 degrees bilaterally
to certify to drive a CMV.
What minimum PaO2 level on an ABG performed for a chronic respiratory disorder is
necessary to certify a commercial driver? a. 55 mm Hg.
b. 60 mm Hg.
c. 65 mm Hg.
d. 70 mm Hg.
Correct answer is "C". Blood oxygen saturation must be a minimum of 65 mm Hg for the
driver to certify.
A driver is taking Topamax for the treatment of migraine headaches. He reports good
management of his headaches and they never seem to interfere with his driving ability
with the medication. The medical examiner should?
a. Obtain medical clearance for the condition and the medication.
b. Disqualify the driver because he is taking an anti-seizure medication.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years.
Correct answer is "A". Topamax is a medication that is used for seizure control. The
examiner should confirm with the prescribing provider that the driver does not take it to
control seizures, and he is capable of driving a CMV. 00:0201:18
A 26 year-old driver presents for a first-time certification. He has a long-standing history
of ADHD and is taking methylphenidate. You have verified his diagnosis and obtained
clearance from his treating psychiatrist. As the certified examiner, you:
NRCME Test Questions 2023/2024
What minimum PaO2 level is necessary if the driver has an ABG due to a chronic
respiratory disorder? a.70mmHg
b.55mmHg
c.60mmHg
d.65mmHg
Correct answer is "D". To be qualified, the driver should meet a minimum arterial blood
A driver
gas (PaO2) firstthan
greater perceives
65. a whispered voice at 5 feet in his right ear and 4 feet in
his left ear. All other aspects of his physical examination are unremarkable. The
examiner
ailed" the whispered voice
test.
should:
a.Permanently disqualify the driver because he "f
b.Certify the
d.Require
driver for
an 2audiometric
years. test to determine the extent of hearing loss in his
c.Certify the driver for 1 year. left ear.
Correct answer is "B". The driver is qualified to drive without restriction as long as he is
able to perceive a whispered voice at 5 feet in 1 ear.
,A driver reports for an examination 6 weeks after suffering a mild heart attack and presents a
note from his cardiologist stating that he is able to return to work immediately without
restriction. Included within the note, the cardiologist provides recent testing information
showing that the driver had an ETT that showed he was able to reach 12 METS during the
test. His echocardiogram showed an ejection fraction of 65%. The examination of the driver is
unremarkable. The examiner should: a. Temporarily disqualify the driver.
b. Qualify the driver for 1 year.
c. Qualify the driver for 2 years.
d. Consult with the cardiologist to determine if the
driver suffers from angina.Correct answer is "A". The
driver has not completed the required 2 but all other
requirements for medical clearance and required testing -monthwaiting period,
have been met. The driver would be certified for 1 year at
the completion of the waiting period. The date of the
certification would be from the date of the original
examination.
A driver provides an audiometric test documenting the following:
1. 500 Hz: 2. 1000 HZ: 3. 2000 HZ: 4. 4000 Hz: t ear 50 Right ear;
35 Right ear; 40 Left ear 40 Right ear; 45 Left ear 40 Right ear; 45 Lef 50
Left ear 5.
The medical examiner should:
a. Disqualify the driver because he does not meet
minimum hearing requirementsto drive.
b. Certify the driver for 2years.
c. Certify the driver for 1 year.
d. Require the driver to obtain a hearing exemption.
Correct answer is "B". The examiner would average the results from 500 Hz, 1000 Hz
,and 2000 Hz. This average is 38.33 in the Right and 43.33 in the Left ear. A driver must
have an average hearing loss of less than or equal to 40 in the better ear. This does not
have to be met in both ears.
During the examination of a commercial driver, the examiner notices that the driver's
peripheral vision is 70 degrees to the left and 80 degrees to the right. The examiner
should:
a. Qualify the driver for 2 years.
b. Require the driver to obtain a vision exemption because of the limitation in the
driver'sleft peripheral field.
c. Disqualify the driver.
d. Have the driver consult with an Ophthalmologist to determine if the driver's
peripheral vision meets minimum standards.
Correct answer is "A". A driver must exhibit a minimum peripheral vision of 70 degrees
bilaterally.
During examination, the medical examiner notices that the driver is distant, lacks eye
contact and shows absolutely no emotional response during the exam. The examiner's
best response should be:
a. Provide the driver with a "CAGE" questionnaire to determine if he suffers from
alcoholism. b.
c. Certify the driver with a 1-time, 3-month certificate to determine if there is any
effect on the driver's ability to drive a CMV.
d. Require a skill performance evaluation to ascertain if the driver has any
limitations with driving.
Correct answer is "B". The driver exhibits what may be considered a "flat affect" which is
seen in schizophrenia and in severe depression. The driver should be evaluated by a
mental health expert to make a diagnosis prior to certification.
A driver admits to the use of marijuana for the treatment of his glaucoma, which is legal
in the State in which he lives. He provides medical documentation for the glaucoma
indicating he is able to drive a truck. He began using the marijuana about three months
ago. His current medical card has no limitations listed and is for 2 years. His
certification examination is within normal limits. The medical examiner should: a.
Disqualify the driver.
b. Perform a urine drug collection and provide the release from the testing provider. c.
Certify the driver for 1 year.
d. Certify the driver for 2 years.
Correct answer is "A". Use of marijuana is prohibited by Federal law while driving a
CMV and trumps State law in this matter.
A driver has a blood pressure of 136/92 mm Hg. This is:
a. Within normal limits and would not affect the driver's certification.
b. Stage 1 Hypertension.
c. Stage 2 Hypertension.
d. Stage 3 Hypertension.
Correct answer is "B". This is Stage 1 Hypertension, which is defined as 140-159/90 -
99.
, A driver is taking Celexa for the treatment of what he calls a "mild depression." He
reports he has not considered or attempted suicide. The examiner should?
a.Temporarily disqualify the driver until he obtains written clearance for the depression
and the medication from the treating provi b. Certify the driver for a period of 1 year.
c. Certify the driver for a period of 2 years.
d. Disqualify the driver until he is no longer requiring medication for the treatment of
depression.
Correct answer is "A". Medical clearance is required for all mental health disorders.
Celexa is an SSRI or 2nd Generation anti-depressant and is acceptable.
A driver reports that he had a hunting accident wherein he suffered a left orbital fracture.
He presents a note at the time of the examination from an ophthalmologist stating "may
drive". His exam is unremarkable except for a limitation in peripheral vision in his left
eye, which was inconclusive. His distance vision was 20/20 right and 20/40 left. The
medical examiner should?
a. Council the driver on the need for a vision exemption.
b. Disqualify the driver pending vision exam to determine if it meets peripheral vision
requirements.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years.
Correct answer is "B". The driver must have a peripheral vision of 70 degrees bilaterally
to certify to drive a CMV.
What minimum PaO2 level on an ABG performed for a chronic respiratory disorder is
necessary to certify a commercial driver? a. 55 mm Hg.
b. 60 mm Hg.
c. 65 mm Hg.
d. 70 mm Hg.
Correct answer is "C". Blood oxygen saturation must be a minimum of 65 mm Hg for the
driver to certify.
A driver is taking Topamax for the treatment of migraine headaches. He reports good
management of his headaches and they never seem to interfere with his driving ability
with the medication. The medical examiner should?
a. Obtain medical clearance for the condition and the medication.
b. Disqualify the driver because he is taking an anti-seizure medication.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years.
Correct answer is "A". Topamax is a medication that is used for seizure control. The
examiner should confirm with the prescribing provider that the driver does not take it to
control seizures, and he is capable of driving a CMV. 00:0201:18
A 26 year-old driver presents for a first-time certification. He has a long-standing history
of ADHD and is taking methylphenidate. You have verified his diagnosis and obtained
clearance from his treating psychiatrist. As the certified examiner, you:
