NRCME (DOT) Exam 2023 Questions And Answers
FMCSA Mission Statement - correct answerTo reduce crashes, injuries, fatalities involving large trucks/buses
Medical Examiner - correct answerLicensed, certified, registered provider who can perform PEs in accordance with laws and
regulations ; registered through NRS ; has unique identifier ; passes MEC test
FMCSA - correct answerFederal Motor Carrier Safety Administration
NRCME - correct answerNational Registry of Certified Medical Examiners
Commerical Motor Vehicle - correct answerWeight >1000 lb ; or transports >8 people for compensation ; or >15 people without
compensation ; transports hazardous materials requiring placarding
Interstate commerce
vs.
Intrastate commerce - correct answerInterstate: multiple states or international
Intrastate: within 1 state
Who regulates treatment/management and aftercare of substance abuse for drivers? - correct answerSAP (Substance Abuse
Professional)
Who determines the origin of abnormal drug test results, determining whether the driver has violated drug use regulations? - correct
answerMedical Review Officer
Title 49 CFR 391.41 - correct answerMedical Examiner Report Form
- Paperwork completed during DOT physical
- Physical exam requirements for driver
- Determines if Certificate is granted
Title 49 CFR 391.43 - correct answerDescribes responsibilities of Medical Examiner, instructions for exam, and requirements for
medical certification
- Supporting information to explain 391.41
When was DOT established? - correct answer1966
Became separate entity on Jan 1, 2000
Motor Carrier Safety Improvement Act of 1999 - correct answerEstablished DOT as separate federal entity
Omnibus Transportation Employee Testing Act of 1991 - correct answerRequired drug testing for drivers
The driver must always keep a copy of ____________________ with them while driving - correct answerMedical Certificate
SPE if applicable
Does the driver need to sign a medical release before you release their Medical Certification? - correct answerNo. Certificate is
provided to employer.
(Release is required for a copy of medical report form)
How many standards are used to determine driver fitness for duty? - correct answer13
How many standards of "driver fitness for duty" are *discretionary*? - correct answer9
(according to my review course)
- Other sources say 10 and say that T2DM is discretionary
How many standards of "driver fitness for duty" are *NON- discretionary*? - correct answer4
- Vision
- Hearing
- Epilepsy
- T2DM
(Some sources say 3 and do not include T2DM)
Age requirement for drivers - correct answer21+
Language requirement for drivers - correct answerMust be able to read/speak English well enough to read signs, communicate
Height/weight requirement for drivers - correct answerThere is none
What is tested for in urine? - correct answerUSG
PRO
BLO
GLU
How long are you (the provider) required to keep a copy of a driver's Medical Certificate? - correct answer3 years
After a reading of Stage 3 hypertension, how often can a driver be certified? - correct answerOnly every 6 months max
- Disqualify until BP <140/90
- 3 month cert if <160/100 and they are initiating treatment for the first time
- May certify Q1 year post surgical correction of secondary HTN
Which generation of antihistamines should be used for drivers? - correct answer2nd gen
- Nonsedating
A driver must wait ___ hours after taking a sedating med before driving - correct answer12+ hours
Urine drug testing includes: - correct answerMJ
Tobacco
Amphetamines
, Cocaine
Opiates
Which type of stroke only requires a 1 year waiting period? - correct answerCerebellar or brainstem, which has low risk for seizures
- And NO hx of seizure
- + Neuro clearance and normal neuro exam
What is the A1C requirement for drivers with T2DM? - correct answerThere is not one
Vision requirements - correct answer20/40 in each eye and both eyes (or better)
Field >70 degrees
Can see amber, red, green colors
Exam: Fundoscopic, PERRLA, ocular movements
Hearing requirements - correct answerWhisper 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.
- Can use hearing aids - mark on paperwork
- Only 1 ear required ("the better ear")
Blood pressure requirement for 2-year certification - correct answer<140/90 with no HTN therapy
No previous diagnosis of HTN
Blood pressure requirement for 1-year certification - correct answerFirst finding of Stage 1 hypertension (140-159/90-99)
or
History of Hypertension or taking 1+ HTN med and BP is controlled at <140/90
BP requirement for 3-month certification - correct answer- Has not yet had antihypertensive therapy
- Previously had a 1-year certificate for uncontrolled Stage 1 BP
- OR: first finding of Stage 2 HTN
Required Echocardiography criteria - correct answer- LVEF >40%
- No Pulm HTN (Right heart pressure < 50 mmHg)
When is Echo required? - correct answer- Aortic Regurg
- Aortic stenosis (Q1 year moderate, Q5 years mild)
- Mitral stenosis (annual)
- MVP (annual)
One time:
Eval of CHF, CHD
Post CABG, MI
Which conditions require an annual Echo? - correct answer- Mitral stenosis
- MVP
- Moderate aortic stenosis
Exercise Tolerance Test (ETT) requirements - correct answer- Attain >85% max HR
- SBP >20 mmHg increase without sx
- Tolerate 6 METs
- No ST depression or ischemic changes
When is an ETT (stress test) required? - correct answer- Unstable angina (Biennial)
- CABG (annual starting 5 years after surgery)
- Congenital heart defect (x1)
- CHF (x1)
- PCI (6 months post-procedure, then biennial)
- MI (prior to re-certification)
- Severe mitral regurg (Q6 months)
Which conditions result in a max recertification period of 6 months? - correct answer- Heart transplant
- Stage 3 hypertension without surgical correction
- Severe Aortic regurg or Aortic stenosis without surgical correction
PFT requirements - correct answer- FVC >60%
- FEV1 >65%
- FEV1/FVC ratio > 65%
- Pulse ox > 92%
If above are not met, do an ABG and PaO2 must be >65
1 week waiting period: - correct answerPost PCI
4 week waiting period: - correct answerPost mitral balloon valvuloplasty
1 month waiting period: - correct answer- A-fib, stabilized
- Anticoagulation, stabilized (a-fib)
- SVT
- Post-pacemaker for AV block or SV arrythmia
2 month waiting period: - correct answer- Post MI
- BPPV or vertigo
3 month waiting period: - correct answer- Post surgery (CABG, CV, aneurysm repair, PVD, PAD, OSA, 2ry hypertension)
- PE
- Unstable angina
- Syncopal episode
- Post-pacemaker for carotid hypersensitivity or neurogenic syncope
6 month waiting period: - correct answerECT therapy
FMCSA Mission Statement - correct answerTo reduce crashes, injuries, fatalities involving large trucks/buses
Medical Examiner - correct answerLicensed, certified, registered provider who can perform PEs in accordance with laws and
regulations ; registered through NRS ; has unique identifier ; passes MEC test
FMCSA - correct answerFederal Motor Carrier Safety Administration
NRCME - correct answerNational Registry of Certified Medical Examiners
Commerical Motor Vehicle - correct answerWeight >1000 lb ; or transports >8 people for compensation ; or >15 people without
compensation ; transports hazardous materials requiring placarding
Interstate commerce
vs.
Intrastate commerce - correct answerInterstate: multiple states or international
Intrastate: within 1 state
Who regulates treatment/management and aftercare of substance abuse for drivers? - correct answerSAP (Substance Abuse
Professional)
Who determines the origin of abnormal drug test results, determining whether the driver has violated drug use regulations? - correct
answerMedical Review Officer
Title 49 CFR 391.41 - correct answerMedical Examiner Report Form
- Paperwork completed during DOT physical
- Physical exam requirements for driver
- Determines if Certificate is granted
Title 49 CFR 391.43 - correct answerDescribes responsibilities of Medical Examiner, instructions for exam, and requirements for
medical certification
- Supporting information to explain 391.41
When was DOT established? - correct answer1966
Became separate entity on Jan 1, 2000
Motor Carrier Safety Improvement Act of 1999 - correct answerEstablished DOT as separate federal entity
Omnibus Transportation Employee Testing Act of 1991 - correct answerRequired drug testing for drivers
The driver must always keep a copy of ____________________ with them while driving - correct answerMedical Certificate
SPE if applicable
Does the driver need to sign a medical release before you release their Medical Certification? - correct answerNo. Certificate is
provided to employer.
(Release is required for a copy of medical report form)
How many standards are used to determine driver fitness for duty? - correct answer13
How many standards of "driver fitness for duty" are *discretionary*? - correct answer9
(according to my review course)
- Other sources say 10 and say that T2DM is discretionary
How many standards of "driver fitness for duty" are *NON- discretionary*? - correct answer4
- Vision
- Hearing
- Epilepsy
- T2DM
(Some sources say 3 and do not include T2DM)
Age requirement for drivers - correct answer21+
Language requirement for drivers - correct answerMust be able to read/speak English well enough to read signs, communicate
Height/weight requirement for drivers - correct answerThere is none
What is tested for in urine? - correct answerUSG
PRO
BLO
GLU
How long are you (the provider) required to keep a copy of a driver's Medical Certificate? - correct answer3 years
After a reading of Stage 3 hypertension, how often can a driver be certified? - correct answerOnly every 6 months max
- Disqualify until BP <140/90
- 3 month cert if <160/100 and they are initiating treatment for the first time
- May certify Q1 year post surgical correction of secondary HTN
Which generation of antihistamines should be used for drivers? - correct answer2nd gen
- Nonsedating
A driver must wait ___ hours after taking a sedating med before driving - correct answer12+ hours
Urine drug testing includes: - correct answerMJ
Tobacco
Amphetamines
, Cocaine
Opiates
Which type of stroke only requires a 1 year waiting period? - correct answerCerebellar or brainstem, which has low risk for seizures
- And NO hx of seizure
- + Neuro clearance and normal neuro exam
What is the A1C requirement for drivers with T2DM? - correct answerThere is not one
Vision requirements - correct answer20/40 in each eye and both eyes (or better)
Field >70 degrees
Can see amber, red, green colors
Exam: Fundoscopic, PERRLA, ocular movements
Hearing requirements - correct answerWhisper 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.
- Can use hearing aids - mark on paperwork
- Only 1 ear required ("the better ear")
Blood pressure requirement for 2-year certification - correct answer<140/90 with no HTN therapy
No previous diagnosis of HTN
Blood pressure requirement for 1-year certification - correct answerFirst finding of Stage 1 hypertension (140-159/90-99)
or
History of Hypertension or taking 1+ HTN med and BP is controlled at <140/90
BP requirement for 3-month certification - correct answer- Has not yet had antihypertensive therapy
- Previously had a 1-year certificate for uncontrolled Stage 1 BP
- OR: first finding of Stage 2 HTN
Required Echocardiography criteria - correct answer- LVEF >40%
- No Pulm HTN (Right heart pressure < 50 mmHg)
When is Echo required? - correct answer- Aortic Regurg
- Aortic stenosis (Q1 year moderate, Q5 years mild)
- Mitral stenosis (annual)
- MVP (annual)
One time:
Eval of CHF, CHD
Post CABG, MI
Which conditions require an annual Echo? - correct answer- Mitral stenosis
- MVP
- Moderate aortic stenosis
Exercise Tolerance Test (ETT) requirements - correct answer- Attain >85% max HR
- SBP >20 mmHg increase without sx
- Tolerate 6 METs
- No ST depression or ischemic changes
When is an ETT (stress test) required? - correct answer- Unstable angina (Biennial)
- CABG (annual starting 5 years after surgery)
- Congenital heart defect (x1)
- CHF (x1)
- PCI (6 months post-procedure, then biennial)
- MI (prior to re-certification)
- Severe mitral regurg (Q6 months)
Which conditions result in a max recertification period of 6 months? - correct answer- Heart transplant
- Stage 3 hypertension without surgical correction
- Severe Aortic regurg or Aortic stenosis without surgical correction
PFT requirements - correct answer- FVC >60%
- FEV1 >65%
- FEV1/FVC ratio > 65%
- Pulse ox > 92%
If above are not met, do an ABG and PaO2 must be >65
1 week waiting period: - correct answerPost PCI
4 week waiting period: - correct answerPost mitral balloon valvuloplasty
1 month waiting period: - correct answer- A-fib, stabilized
- Anticoagulation, stabilized (a-fib)
- SVT
- Post-pacemaker for AV block or SV arrythmia
2 month waiting period: - correct answer- Post MI
- BPPV or vertigo
3 month waiting period: - correct answer- Post surgery (CABG, CV, aneurysm repair, PVD, PAD, OSA, 2ry hypertension)
- PE
- Unstable angina
- Syncopal episode
- Post-pacemaker for carotid hypersensitivity or neurogenic syncope
6 month waiting period: - correct answerECT therapy
