NRCME Study Sheet Exam Questions and Correct Answers (Complete
Solution) Graded A+
vision requirements ✔✔ Distant vision 20/40 each eye and 20/40 both eyes, Peripheral
vision at least 70 degrees, Ability to recognize and distinguish betwen the colors of
traffic signals and devices.
If the driver presents a valid vision exemption, how long can he be certified? ✔✔ 1 year
The driver with a vision exemption must present what 2 things before receiving the
medical examiner's certificate. ✔✔ Valid vision exemption and copy of the specialist eye
examination report.
When applying for a vision exemption, the driver should include a copy of the Medical
Examination Report form and the medical examiner's certification with what marked?
✔✔ The "accompanied by" exemption checkbox and write "vision" to identify the type of
exemption.
If the driver is qualified by operation of 49 CFR 391.64 due to participation in the vision
study program, what must the driver present to qualify for certification? ✔✔ Letter
identifying the driver as a participant and copy of the specialist eye examination.
How long can a driver who is qualified by operation of 49 CFR 391.64 be certified. ✔✔ 1
year
hearing requirements ✔✔ Whisper at not less than 5 feet in 1 ear, or average hearing
loss no greater than 40 dB at 500Hz, 1000Hz, 2000 Hz in 1 ear.
What is the waiting period for vertigo caused by benign positional vertigo or
acute/chronic peripheral vestibulopathy? ✔✔ 3 months
Name 4 otic conditions that are automatic disqualification ✔✔ Meniere's, uncontrolled
vertigo, labyrinthine fistula, nonfunctioning labyrinth
Apnea-hypopnea index of [blank] or more episodes per hour is diagnostic of OSA ✔✔
30
3 requirements for a passing ETT ✔✔ 1. increased SBP of at least 20 without angina
2. workload capacity >6 METs
3. no significant ST depression
Examiners must retain records for how many years? ✔✔ 3
Regulation that describes the physical qualifications of drivers. ✔✔ 49 CFR 391.41
,Regulation that describes the responsibilities of the medical examiner. ✔✔ 49 CFR
391.43
Regulation that describes the process for conflict resolution when there is a
disagreement between the primary care provider for the driver and the medical
examiner for the motor carrier concerning driving qualifications. ✔✔ 49 CFR 391.47
Regulation that describes the Skill Performance Evaluation (SPE) Certification Program.
✔✔ 49 CFR 391.49
Regulation that describes limited exemptions for intra-city zone drivers. ✔✔ 49 CFR
391.62
Regulation that describes grandfathering for certain drivers who participated in vision
and diabetes waiver study programs. ✔✔ 49 CFR 391.64
Regulation that includes regulations for medical review officers and substance abuse
professionals, including drug and alcohol testing procedures. ✔✔ 49 CFR 40
Define Stage I Hypertension ✔✔ BP greater than or equal to 140/90
What is the maximum certification period for stage I hypertension if this is the 1st
examination at which the driver has BP equivalent to stage I hypertension and has no
history of hypertension? ✔✔ 1 year
What is the maximum certification period for untreated known or inadequately controlled
stage I hypertension? ✔✔ 3 months
What is the maximum certification period for blood pressure >140/90 and the following:
follow-up 3 months certificate or history of stage III hypertension ✔✔ None, driver is
disqualified
Define Stage II hypertension. ✔✔ BP is ≥ 160 to <180 SYSTOLIC, and is ≥100 to < 110
Diastolic
What is the maximum certification period for Stage II hypertension with blood pressure
>140/90? ✔✔ 3 months
What is the maximum certification period for Stage II hypertension with blood pressure
</140/90? ✔✔ 1 year
Define Stage III hypertension. ✔✔ BP >180 Systolic and > 110 Diastolic
, What is the maximum certification period for Stage III hypertension with blood pressure
>140/90? ✔✔ 1 time certificate for 3 months in accordance with stage 1 or 2 HTN
guidelines, as determined by a case by case basis.
What is the maximum certification period for a driver with a history of Stage III
hypertension but t exam his BP is at or less 140/90 and treatment is well tolerated? ✔✔
6 months
What is the maximum certification period for Stage III hypertension with blood pressure
>180/110? ✔✔ None, driver is disqualified.
What is the waiting period and maximum certification period for surgical correction of
secondary hypertension? ✔✔ 3 months and 1 year post surgical correction
What is the waiting period and maximum certification period for driver on anticoagulants
for cardiovascular cause? ✔✔ 1 month stabilized and 1 year with monthly INRs
What is the waiting period and maximum certification period for driver on anticoagulants
for neurlogical condition? ✔✔ None, driver is disqualified.
5 reasons to disqualify a driver with AAA ✔✔ 1. Symptomatic
2. AAA >5cm
3. AAA 4-5 cm and does not have clearance from a cardiologist
4. AAA increased in size 0.5cm in 6 months
5. Surgical repair was recommended but not done
Maximum certification period for driver with AAA that is asymptomatic or <4cm, >4cm
and <5cm but has clearance from cardiologist ✔✔ 1 year
Maximum certification period for Acute DVT ✔✔ 1 year
Maximum certification period for Chronic DVT ✔✔ 2 years
Waiting period and maximum certification period for intermittent claudication if driver
has no resting pain. ✔✔ 3 months for post-surgical repair and 1 year
Waiting period and maximum certification for aneurysms of visceral, peripheral arteries
or venous vessels ✔✔ 3 months post-surgical repair and 1 year with clearance from
cardiologist
Waiting period and maximum certification for peripheral vascular disease ✔✔ 3 months
post-surgical repair and 1 year without resting pain
Solution) Graded A+
vision requirements ✔✔ Distant vision 20/40 each eye and 20/40 both eyes, Peripheral
vision at least 70 degrees, Ability to recognize and distinguish betwen the colors of
traffic signals and devices.
If the driver presents a valid vision exemption, how long can he be certified? ✔✔ 1 year
The driver with a vision exemption must present what 2 things before receiving the
medical examiner's certificate. ✔✔ Valid vision exemption and copy of the specialist eye
examination report.
When applying for a vision exemption, the driver should include a copy of the Medical
Examination Report form and the medical examiner's certification with what marked?
✔✔ The "accompanied by" exemption checkbox and write "vision" to identify the type of
exemption.
If the driver is qualified by operation of 49 CFR 391.64 due to participation in the vision
study program, what must the driver present to qualify for certification? ✔✔ Letter
identifying the driver as a participant and copy of the specialist eye examination.
How long can a driver who is qualified by operation of 49 CFR 391.64 be certified. ✔✔ 1
year
hearing requirements ✔✔ Whisper at not less than 5 feet in 1 ear, or average hearing
loss no greater than 40 dB at 500Hz, 1000Hz, 2000 Hz in 1 ear.
What is the waiting period for vertigo caused by benign positional vertigo or
acute/chronic peripheral vestibulopathy? ✔✔ 3 months
Name 4 otic conditions that are automatic disqualification ✔✔ Meniere's, uncontrolled
vertigo, labyrinthine fistula, nonfunctioning labyrinth
Apnea-hypopnea index of [blank] or more episodes per hour is diagnostic of OSA ✔✔
30
3 requirements for a passing ETT ✔✔ 1. increased SBP of at least 20 without angina
2. workload capacity >6 METs
3. no significant ST depression
Examiners must retain records for how many years? ✔✔ 3
Regulation that describes the physical qualifications of drivers. ✔✔ 49 CFR 391.41
,Regulation that describes the responsibilities of the medical examiner. ✔✔ 49 CFR
391.43
Regulation that describes the process for conflict resolution when there is a
disagreement between the primary care provider for the driver and the medical
examiner for the motor carrier concerning driving qualifications. ✔✔ 49 CFR 391.47
Regulation that describes the Skill Performance Evaluation (SPE) Certification Program.
✔✔ 49 CFR 391.49
Regulation that describes limited exemptions for intra-city zone drivers. ✔✔ 49 CFR
391.62
Regulation that describes grandfathering for certain drivers who participated in vision
and diabetes waiver study programs. ✔✔ 49 CFR 391.64
Regulation that includes regulations for medical review officers and substance abuse
professionals, including drug and alcohol testing procedures. ✔✔ 49 CFR 40
Define Stage I Hypertension ✔✔ BP greater than or equal to 140/90
What is the maximum certification period for stage I hypertension if this is the 1st
examination at which the driver has BP equivalent to stage I hypertension and has no
history of hypertension? ✔✔ 1 year
What is the maximum certification period for untreated known or inadequately controlled
stage I hypertension? ✔✔ 3 months
What is the maximum certification period for blood pressure >140/90 and the following:
follow-up 3 months certificate or history of stage III hypertension ✔✔ None, driver is
disqualified
Define Stage II hypertension. ✔✔ BP is ≥ 160 to <180 SYSTOLIC, and is ≥100 to < 110
Diastolic
What is the maximum certification period for Stage II hypertension with blood pressure
>140/90? ✔✔ 3 months
What is the maximum certification period for Stage II hypertension with blood pressure
</140/90? ✔✔ 1 year
Define Stage III hypertension. ✔✔ BP >180 Systolic and > 110 Diastolic
, What is the maximum certification period for Stage III hypertension with blood pressure
>140/90? ✔✔ 1 time certificate for 3 months in accordance with stage 1 or 2 HTN
guidelines, as determined by a case by case basis.
What is the maximum certification period for a driver with a history of Stage III
hypertension but t exam his BP is at or less 140/90 and treatment is well tolerated? ✔✔
6 months
What is the maximum certification period for Stage III hypertension with blood pressure
>180/110? ✔✔ None, driver is disqualified.
What is the waiting period and maximum certification period for surgical correction of
secondary hypertension? ✔✔ 3 months and 1 year post surgical correction
What is the waiting period and maximum certification period for driver on anticoagulants
for cardiovascular cause? ✔✔ 1 month stabilized and 1 year with monthly INRs
What is the waiting period and maximum certification period for driver on anticoagulants
for neurlogical condition? ✔✔ None, driver is disqualified.
5 reasons to disqualify a driver with AAA ✔✔ 1. Symptomatic
2. AAA >5cm
3. AAA 4-5 cm and does not have clearance from a cardiologist
4. AAA increased in size 0.5cm in 6 months
5. Surgical repair was recommended but not done
Maximum certification period for driver with AAA that is asymptomatic or <4cm, >4cm
and <5cm but has clearance from cardiologist ✔✔ 1 year
Maximum certification period for Acute DVT ✔✔ 1 year
Maximum certification period for Chronic DVT ✔✔ 2 years
Waiting period and maximum certification period for intermittent claudication if driver
has no resting pain. ✔✔ 3 months for post-surgical repair and 1 year
Waiting period and maximum certification for aneurysms of visceral, peripheral arteries
or venous vessels ✔✔ 3 months post-surgical repair and 1 year with clearance from
cardiologist
Waiting period and maximum certification for peripheral vascular disease ✔✔ 3 months
post-surgical repair and 1 year without resting pain
