NRCME TEST BANK QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
Which of the following is a requirement for drivers with a diabetes exemption?
• Possess a rapidly absorbable form of glucose while driving
• Self—monitor blood glucose one hour before driving and at least once every 2
hours while driving
• Plan to submit blood glucose monitoring logs every 6 months
• Maintain a Hemoglobin A1C value less than 7
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:
• May be certified for a maximum of 6 months
• Must maintain a hemoglobin A1C level of less than 7 to qualify for certification
• Cannot be certified if they have a history of myocardial infarction
• May be eligible for a diabetes exemption
D) Drivers with insulin dependent diabetes cannot be certified but may be eligible fora
diabetes exemption
Which of the following is true?
• A driver with diabetes who uses insulin does not meet the minimum requirements
of 49 CFR Part 391.41
• The most important concert related to medication use for treating diabetes is
hyperglycemia
• Peripheral neuropathy is not a disqualifying condition
• Diabetes is not a coronary heart disease (CHD) equivalent condition
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 mellitusewho
does not use insulin?
• Three months
,• Six months
• One year
• Two years
C) Drivers with non-insulin dependent diabetes should be certified for a maximum of
one year
A diabetes exemption may be issued by:
• An endocrinologist
• The Medical Examiner
• The driver's personal physician
• The FMCSA
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 :
• Medical Examination Report status section and Medical Examiners Certificate
• Letter to the FMCSA
• Employer authorization form
• Endocrinology consultation form
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, anappropriate
next step is:
• Endocrinology consultation
• One year clearance and recommendation to see personal physician
• Fingerstick or blood glucose determination
• Temporary disqualification
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.
• one, three
• one, two
,• two, three
• two, five
B) A driver should not be certified if the driver has had one hypoglycemic reaction inthe
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?
• Seizure
• Dizziness
• Need of assistance from another person
• Period of impaired cognitive function that occurred without warning
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
• Hyperglycemia
• Peripheral neuropathy
• Hypoglycemia
• Metabolic encephalopathy
C) Although hyperglycemia, peripheral neuropathy, and metabolic encephalopathyall
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?
• One hour before driving and at least once every four hours while driving
• One hour before driving and at least every eight hours while driving
• Once after four hours of driving
• 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?
, • The driver should be referred to a surgeon to determine whether repair of a
hernia is necessary
• The waiting period following hernia surgery is two weeks
• Inguinal hernias have been associated with an increased risk for CMV accidents
• 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?
• Nephropathy is a disqualifying condition
• The maximum certification interval for nephropathy is two years
• A driver with 3+ proteinuria should not be certified
• 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?
• Cancer requiring chemotherapy treatment
• Umbilical hernia not surgically repaired
• Renal failure on peritoneal dialysis
• 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:
• Disqualify the driver
• Request that a renal specialist determine if the driver is medically qualified
• Use clinical expertise to determine a certification decision and to determine if
additional evaluation is required or recommended
• Obtain blood chemistries for renal function
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
Which of the following is a requirement for drivers with a diabetes exemption?
• Possess a rapidly absorbable form of glucose while driving
• Self—monitor blood glucose one hour before driving and at least once every 2
hours while driving
• Plan to submit blood glucose monitoring logs every 6 months
• Maintain a Hemoglobin A1C value less than 7
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:
• May be certified for a maximum of 6 months
• Must maintain a hemoglobin A1C level of less than 7 to qualify for certification
• Cannot be certified if they have a history of myocardial infarction
• May be eligible for a diabetes exemption
D) Drivers with insulin dependent diabetes cannot be certified but may be eligible fora
diabetes exemption
Which of the following is true?
• A driver with diabetes who uses insulin does not meet the minimum requirements
of 49 CFR Part 391.41
• The most important concert related to medication use for treating diabetes is
hyperglycemia
• Peripheral neuropathy is not a disqualifying condition
• Diabetes is not a coronary heart disease (CHD) equivalent condition
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 mellitusewho
does not use insulin?
• Three months
,• Six months
• One year
• Two years
C) Drivers with non-insulin dependent diabetes should be certified for a maximum of
one year
A diabetes exemption may be issued by:
• An endocrinologist
• The Medical Examiner
• The driver's personal physician
• The FMCSA
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 :
• Medical Examination Report status section and Medical Examiners Certificate
• Letter to the FMCSA
• Employer authorization form
• Endocrinology consultation form
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, anappropriate
next step is:
• Endocrinology consultation
• One year clearance and recommendation to see personal physician
• Fingerstick or blood glucose determination
• Temporary disqualification
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.
• one, three
• one, two
,• two, three
• two, five
B) A driver should not be certified if the driver has had one hypoglycemic reaction inthe
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?
• Seizure
• Dizziness
• Need of assistance from another person
• Period of impaired cognitive function that occurred without warning
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
• Hyperglycemia
• Peripheral neuropathy
• Hypoglycemia
• Metabolic encephalopathy
C) Although hyperglycemia, peripheral neuropathy, and metabolic encephalopathyall
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?
• One hour before driving and at least once every four hours while driving
• One hour before driving and at least every eight hours while driving
• Once after four hours of driving
• 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?
, • The driver should be referred to a surgeon to determine whether repair of a
hernia is necessary
• The waiting period following hernia surgery is two weeks
• Inguinal hernias have been associated with an increased risk for CMV accidents
• 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?
• Nephropathy is a disqualifying condition
• The maximum certification interval for nephropathy is two years
• A driver with 3+ proteinuria should not be certified
• 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?
• Cancer requiring chemotherapy treatment
• Umbilical hernia not surgically repaired
• Renal failure on peritoneal dialysis
• 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:
• Disqualify the driver
• Request that a renal specialist determine if the driver is medically qualified
• Use clinical expertise to determine a certification decision and to determine if
additional evaluation is required or recommended
• Obtain blood chemistries for renal function
