NRCME TESTBAK LATEST VERSION EXAM WITH ACTUAL
QUESTION AND CORRECT DETAILED ANSWERS WITH
RATIONALES.
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 - 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 - 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 - 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 - 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 - A) Kidney transplants are not disqualifying
Which of the following is true?
A) Medical marijuana use if disqualifying
B) The medical examiner should drug test the driver for marijuana if the driver gives a
history of recent marijuana's
C) A driver with a history of only occasional marijuana may not have to complete a
substance abuse professional assessment
D) Marijuana is a Schedule II drug - A) If a driver gives a history of recent marijuana
use, the driver should be referred for substance abuse professional evaluation
regardless of drug test result. Drivers with a history of marijuana use, or a drug test
,positive for marijuana, must undergo substance abuse professional assessment and
complete any recommended rehabilitation prior to returning to driving. Marijuana is a
Schedule I drug.
Which of the following is a requirement for a driver with a history of alcoholism to be
certified?
A) No residual disqualifying physical impairment
B) Successful treatment with naltrexone
C) Currently in counseling and/or treatment
D) No more than one current alcohol-related disorder - A) Treatment with naltrexone is
not required for driver certification for a driver with a history of alcoholism. A driver with
a history of alcoholism must have completed counseling and/or treatment and must not
have a current alcohol-related disorder in order to be certified.
Which of the following is a disqualifying condition?
A) A past clinical diagnosis of alcoholism
B) A breath alcohol result of 0.019%
C) An alcohol-related stable physical condition, regardless of the time element
D) Use of methadone - D) A current diagnosis of alcoholism is disqualifying. A breath
alcohol result of 0.02% or higher renders the driver unqualified to drive. An alcohol-
related unstable physical condition is disqualifying.
Ongoing voluntary attendance at self-help groups (e.g. 12 step programs) for
maintenance of recovery from alcoholism:
A) Is required for all drivers recovering from alcoholism
B) Is disqualifying
C) Is allowed but not required for drivers recovering from alcoholism
D) Fulfills the requirement for rehabilitation following a violation of alcohol rules. - C) 12-
step or similar programs do not fulfill rehabiliation requirements for drivers with a
violation of alcohol (or drug) regulations. Participation in such programs is allowed, but
not required, and is not disqualifying.
Which of the following is a mental health professional that the medial examiner may
refer to or consult with?
1) Breath alcohol technician (BAT)
2) Designated employer representative (DER)
3) Medical review officer (MRO)
4) Substance abuse professional (SAP)
A) 1, 2, and 3
B) 1 and 3 only
C) 2 and 4 only
D) 4 only
E) all of the above - According to the FMCSA, all of these are defined as mental health
professionals
,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 - 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 - 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 - 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 - 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 - 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
D) 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, 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 - 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 - 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 - 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 - 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,
QUESTION AND CORRECT DETAILED ANSWERS WITH
RATIONALES.
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 - 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 - 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 - 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 - 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 - A) Kidney transplants are not disqualifying
Which of the following is true?
A) Medical marijuana use if disqualifying
B) The medical examiner should drug test the driver for marijuana if the driver gives a
history of recent marijuana's
C) A driver with a history of only occasional marijuana may not have to complete a
substance abuse professional assessment
D) Marijuana is a Schedule II drug - A) If a driver gives a history of recent marijuana
use, the driver should be referred for substance abuse professional evaluation
regardless of drug test result. Drivers with a history of marijuana use, or a drug test
,positive for marijuana, must undergo substance abuse professional assessment and
complete any recommended rehabilitation prior to returning to driving. Marijuana is a
Schedule I drug.
Which of the following is a requirement for a driver with a history of alcoholism to be
certified?
A) No residual disqualifying physical impairment
B) Successful treatment with naltrexone
C) Currently in counseling and/or treatment
D) No more than one current alcohol-related disorder - A) Treatment with naltrexone is
not required for driver certification for a driver with a history of alcoholism. A driver with
a history of alcoholism must have completed counseling and/or treatment and must not
have a current alcohol-related disorder in order to be certified.
Which of the following is a disqualifying condition?
A) A past clinical diagnosis of alcoholism
B) A breath alcohol result of 0.019%
C) An alcohol-related stable physical condition, regardless of the time element
D) Use of methadone - D) A current diagnosis of alcoholism is disqualifying. A breath
alcohol result of 0.02% or higher renders the driver unqualified to drive. An alcohol-
related unstable physical condition is disqualifying.
Ongoing voluntary attendance at self-help groups (e.g. 12 step programs) for
maintenance of recovery from alcoholism:
A) Is required for all drivers recovering from alcoholism
B) Is disqualifying
C) Is allowed but not required for drivers recovering from alcoholism
D) Fulfills the requirement for rehabilitation following a violation of alcohol rules. - C) 12-
step or similar programs do not fulfill rehabiliation requirements for drivers with a
violation of alcohol (or drug) regulations. Participation in such programs is allowed, but
not required, and is not disqualifying.
Which of the following is a mental health professional that the medial examiner may
refer to or consult with?
1) Breath alcohol technician (BAT)
2) Designated employer representative (DER)
3) Medical review officer (MRO)
4) Substance abuse professional (SAP)
A) 1, 2, and 3
B) 1 and 3 only
C) 2 and 4 only
D) 4 only
E) all of the above - According to the FMCSA, all of these are defined as mental health
professionals
,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 - 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 - 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 - 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 - 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 - 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
D) 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, 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 - 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 - 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 - 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 - 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,
