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NRCME 2025 ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION, EXAMS OF NURSING
A driver has a blood pressure of 168/112 mm Hg confirmed during the examination. The driver
should be:
a. Disqualified.
b. Certified for 6 months.
c. Certified for 1 year.
d. Certified for 2 years. Correct answer is "A". This is Stage 3 hypertension. The driver is
disqualified until his blood pressure is less than 140/90 mm Hg at which time he will have a
maximum certification of 6 months.
For how long would a driver be certified if he is taking Micardis HCT for hypertension, and has a
confirmed blood pressure of 148/96 mm Hg at the time of the examination?
a. 3 months
b. 6 months
c. 1 year
d. 2 years Correct answer is "A". Because the driver has a history of hypertension (he is
taking medication), and he had Stage 1 hypertension during his exam, he would be provided a
1- time, 3-month certificate in order to lower his blood pressure to an acceptable level during
that time.
During the examination, a driver is found to have a positive "Babinski" reflex. The examiner
should:
a. Certify the driver for 1 year.
b. Certify the driver for 2 years.
c. Council the driver to obtain an SPE.
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d. Disqualify the driver until s/he has a neurological consultation. Correct answer is "D". A
positive Babinski reflex is indicative of abnormalities in the motor control pathways leading from
the cerebral cortex and is widely used as a diagnostic aide in disorders of the central nervous
system. The examiner should obtain clearance from a neurologist prior to reconsidering the
driver for certification.
All of the following are required components of all DOT medical examinations EXCEPT?
a. Vision
b. Hearing
c. Blood Pressure
d. Ophthalmoscopic examination Correct answer is "D". There are four required components
of every examination: vision, hearing, blood pressure and urinalysis. Ophthalmoscopic
examination is not required but may be done if deemed necessary.
A driver reports in his history that he was treated for epilepsy 14 years ago but stopped taking
anti-epileptic medication on his own since his move to your area 11 years ago. He has not seen
a neurologist nor a health care provider in over 10 years and reports no seizures during this
period. The examiner should:
a. Request medical clearance, and if obtained the driver may be certified for 1 year.
b. Request medical clearance, and if obtained the driver may be certified for 2 years.
c. Refer the driver to the epilepsy/seizure exemption program.
d. Disqualify the driver. D. Disqualify
Comment: Even though the driver reports exceeding the 10-year waiting period, it was not
under medical supervision and the driver discontinued medication use and treatment outside of
medical oversight. Since the driver cannot a documented medical history this driver does not
meet the non- discretionary epilepsy standard until it is established that the driver is 10 years
seizure-free while off anti-convulsants.
A driver reports for a re-certification examination 8 weeks after having triple coronary artery
bypass surgery. He presents a note from his treating provider stating that he is able to return to
driving without restriction. Additionally, the note mentions that the driver's results of his ETT
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were normal, and his echo showed a left ventricular ejection fraction of 75%. The examiner
should?
a. Temporarily disqualify the driver until he has completed the required waiting period.
b. Permanently disqualify the driver because his ejection fraction is too low.
c. Certify the driver for 1 year only.
d. Certify the driver for 2 years because he has medical clearance. Correct answer "A".
Following CABG, there is a 3-month waiting period. Since the driver is only at 8 weeks post-op,
he would have to wait 4 more weeks until he can certify. Once he completes his waiting period,
he would be certified for 1 year from the date of the original examination.
What is the maximum number of hours a CMV driver can drive in 7 consecutive days?
a. 50.
b. 60.
c. 70.
d. 80. Correct answer "B". 60-70 Hour Limit: A driver may not drive after 60/70 hours of duty in
7/8 consecutive days. Many versions of the NRCME exam will have one question about the
60/70 rule.
A blood pressure of 166/92 mm Hg would be?
a. Considered normal
b. Stage 1 hypertension.
c. Stage 2 hypertension.
d. Stage 3 hypertension. Correct answer is "C". The driver has Stage 2 hypertension (160 -
179/100 - 109).
The driver is taking "Sinemet" for the treatment of Parkinson's disease. The medical examiner
should:
a. Disqualify the driver.
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b. Obtain medical clearance from a neurologist.
c. Counsel the driver to obtain a neurologist waiver.
d. Certify the driver for 1 year. Correct answer is "A". A driver who is diagnosed with
Parkinson's is permanently disqualified.
The driver uses hearing aids during the whisper test. He is able to hear at 5 feet on the right and
4 feet on the left.
a. Send the driver for an audiometric test.
b. Disqualify the driver.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years. Correct answer is "D". The driver is able to use hearing aids
during the whisper test (and this should be marked on the form). A driver must only qualify in 1
ear to certify and there is no limitation of certification time.
The minimum acceptable spirometry values required to certify a driver are:
a. FEV1 70%, FVC 65%, FEV1/FVC ratio 65%
b. FEV1 65%, FVC 60%, FEV1/FVC ratio 65%
c. FEV1 65%, FVC 65%, FEV1/FVC ratio 65%
d. FEV1 60%, FVC 60%, FEV1/FVC ratio 60% Correct answer is "B". The minimum acceptable
values are 65%, 60%, and 65% (FEV1, FVC, FEV1/FVC ratio).
A driver presenting to your office marks down that he is taking "nitroglycerin" for angina and he
has been doing so for a few years. Upon questioning he indicates that he has needed more
nitroglycerin recently because his episodes have become more frequent. Your best course of
action is to:
a. Council the driver to increase his dose of medication.
b. Certify the driver for 1 year.
c. Provide a 1-time, 3-month certificate to monitor his condition.
NRCME 2025 ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION, EXAMS OF NURSING
A driver has a blood pressure of 168/112 mm Hg confirmed during the examination. The driver
should be:
a. Disqualified.
b. Certified for 6 months.
c. Certified for 1 year.
d. Certified for 2 years. Correct answer is "A". This is Stage 3 hypertension. The driver is
disqualified until his blood pressure is less than 140/90 mm Hg at which time he will have a
maximum certification of 6 months.
For how long would a driver be certified if he is taking Micardis HCT for hypertension, and has a
confirmed blood pressure of 148/96 mm Hg at the time of the examination?
a. 3 months
b. 6 months
c. 1 year
d. 2 years Correct answer is "A". Because the driver has a history of hypertension (he is
taking medication), and he had Stage 1 hypertension during his exam, he would be provided a
1- time, 3-month certificate in order to lower his blood pressure to an acceptable level during
that time.
During the examination, a driver is found to have a positive "Babinski" reflex. The examiner
should:
a. Certify the driver for 1 year.
b. Certify the driver for 2 years.
c. Council the driver to obtain an SPE.
,2|Page
d. Disqualify the driver until s/he has a neurological consultation. Correct answer is "D". A
positive Babinski reflex is indicative of abnormalities in the motor control pathways leading from
the cerebral cortex and is widely used as a diagnostic aide in disorders of the central nervous
system. The examiner should obtain clearance from a neurologist prior to reconsidering the
driver for certification.
All of the following are required components of all DOT medical examinations EXCEPT?
a. Vision
b. Hearing
c. Blood Pressure
d. Ophthalmoscopic examination Correct answer is "D". There are four required components
of every examination: vision, hearing, blood pressure and urinalysis. Ophthalmoscopic
examination is not required but may be done if deemed necessary.
A driver reports in his history that he was treated for epilepsy 14 years ago but stopped taking
anti-epileptic medication on his own since his move to your area 11 years ago. He has not seen
a neurologist nor a health care provider in over 10 years and reports no seizures during this
period. The examiner should:
a. Request medical clearance, and if obtained the driver may be certified for 1 year.
b. Request medical clearance, and if obtained the driver may be certified for 2 years.
c. Refer the driver to the epilepsy/seizure exemption program.
d. Disqualify the driver. D. Disqualify
Comment: Even though the driver reports exceeding the 10-year waiting period, it was not
under medical supervision and the driver discontinued medication use and treatment outside of
medical oversight. Since the driver cannot a documented medical history this driver does not
meet the non- discretionary epilepsy standard until it is established that the driver is 10 years
seizure-free while off anti-convulsants.
A driver reports for a re-certification examination 8 weeks after having triple coronary artery
bypass surgery. He presents a note from his treating provider stating that he is able to return to
driving without restriction. Additionally, the note mentions that the driver's results of his ETT
,3|Page
were normal, and his echo showed a left ventricular ejection fraction of 75%. The examiner
should?
a. Temporarily disqualify the driver until he has completed the required waiting period.
b. Permanently disqualify the driver because his ejection fraction is too low.
c. Certify the driver for 1 year only.
d. Certify the driver for 2 years because he has medical clearance. Correct answer "A".
Following CABG, there is a 3-month waiting period. Since the driver is only at 8 weeks post-op,
he would have to wait 4 more weeks until he can certify. Once he completes his waiting period,
he would be certified for 1 year from the date of the original examination.
What is the maximum number of hours a CMV driver can drive in 7 consecutive days?
a. 50.
b. 60.
c. 70.
d. 80. Correct answer "B". 60-70 Hour Limit: A driver may not drive after 60/70 hours of duty in
7/8 consecutive days. Many versions of the NRCME exam will have one question about the
60/70 rule.
A blood pressure of 166/92 mm Hg would be?
a. Considered normal
b. Stage 1 hypertension.
c. Stage 2 hypertension.
d. Stage 3 hypertension. Correct answer is "C". The driver has Stage 2 hypertension (160 -
179/100 - 109).
The driver is taking "Sinemet" for the treatment of Parkinson's disease. The medical examiner
should:
a. Disqualify the driver.
, 4|Page
b. Obtain medical clearance from a neurologist.
c. Counsel the driver to obtain a neurologist waiver.
d. Certify the driver for 1 year. Correct answer is "A". A driver who is diagnosed with
Parkinson's is permanently disqualified.
The driver uses hearing aids during the whisper test. He is able to hear at 5 feet on the right and
4 feet on the left.
a. Send the driver for an audiometric test.
b. Disqualify the driver.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years. Correct answer is "D". The driver is able to use hearing aids
during the whisper test (and this should be marked on the form). A driver must only qualify in 1
ear to certify and there is no limitation of certification time.
The minimum acceptable spirometry values required to certify a driver are:
a. FEV1 70%, FVC 65%, FEV1/FVC ratio 65%
b. FEV1 65%, FVC 60%, FEV1/FVC ratio 65%
c. FEV1 65%, FVC 65%, FEV1/FVC ratio 65%
d. FEV1 60%, FVC 60%, FEV1/FVC ratio 60% Correct answer is "B". The minimum acceptable
values are 65%, 60%, and 65% (FEV1, FVC, FEV1/FVC ratio).
A driver presenting to your office marks down that he is taking "nitroglycerin" for angina and he
has been doing so for a few years. Upon questioning he indicates that he has needed more
nitroglycerin recently because his episodes have become more frequent. Your best course of
action is to:
a. Council the driver to increase his dose of medication.
b. Certify the driver for 1 year.
c. Provide a 1-time, 3-month certificate to monitor his condition.
