NRCME DOT ACTUAL EXAM WITH Q&A
NEWLY MODIFIED GRADED A+ LATEST
UPDATE 2025/2026
After a reading of Stage 3 hypertension, how often can a driver be certified? -- ANSWER--
Only 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? -- ANSWER--2nd gen -
Nonsedating
A driver must wait ___ hours after taking a sedating med before driving -- ANSWER--12+
hours
Urine drug testing includes: -- ANSWER--MJ
Tobacco
Amphetamines
Cocaine
Opiates
Page 1 of 38
,Which type of stroke only requires a 1 year waiting period? -- ANSWER--Cerebellar 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? -- ANSWER--There is not one
Vision requirements -- ANSWER--20/40 in each eye and both eyes (or better)
Field >70 degrees
Can see amber, red, green colors
Exam: Fundoscopic, PERRLA, ocular movements
Hearing requirements -- ANSWER--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.
- Can use hearing aids - mark on paperwork
- Only 1 ear required ("the better ear")
FMCSA -- ANSWER--Federal Motor Carrier Safety Administration
,Medical Examiner -- ANSWER--Licensed, certified, registered provider who can perform
PEs in accordance with laws and regulations ; registered through NRS ; has unique identifier
passes MEC test
FMCSA Mission Statement -- ANSWER--To reduce crashes, injuries, fatalities involving
large trucks/buses
NRCME -- ANSWER--National Registry of Certified Medical Examiners
Commerical Motor Vehicle -- ANSWER--Weight >1000 lb ; or transports >8 people for
compensation ; or >15 people without compensation ; transports hazardous materials
requiring placarding
Interstate commerce
vs.
Intrastate commerce -- ANSWER--Interstate: multiple states or international
Intrastate: within 1 state
Who regulates treatment/management and aftercare of substance abuse for drivers? --
ANSWER--SAP (Substance Abuse Professional)
Page 3 of 38
, Who determines the origin of abnormal drug test results, determining whether the driver has
violated drug use regulations? -- ANSWER--Medical Review Officer
Title 49 CFR 391.41 -- ANSWER--Medical Examiner Report Form
- Paperwork completed during DOT physical
- Physical exam requirements for driver
- Determines if Certificate is granted
Title 49 CFR 391.43 -- ANSWER--Describes responsibilities of Medical Examiner,
instructions for exam, and requirements for medical certification
- Supporting information to explain 391.41
When was DOT established? -- ANSWER--1966
Became separate entity on Jan 1, 2000
Motor Carrier Safety Improvement Act of 1999 -- ANSWER--Established DOT as separate
federal entity
Omnibus Transportation Employee Testing Act of 1991 -- ANSWER--Required drug testing
for drivers
NEWLY MODIFIED GRADED A+ LATEST
UPDATE 2025/2026
After a reading of Stage 3 hypertension, how often can a driver be certified? -- ANSWER--
Only 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? -- ANSWER--2nd gen -
Nonsedating
A driver must wait ___ hours after taking a sedating med before driving -- ANSWER--12+
hours
Urine drug testing includes: -- ANSWER--MJ
Tobacco
Amphetamines
Cocaine
Opiates
Page 1 of 38
,Which type of stroke only requires a 1 year waiting period? -- ANSWER--Cerebellar 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? -- ANSWER--There is not one
Vision requirements -- ANSWER--20/40 in each eye and both eyes (or better)
Field >70 degrees
Can see amber, red, green colors
Exam: Fundoscopic, PERRLA, ocular movements
Hearing requirements -- ANSWER--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.
- Can use hearing aids - mark on paperwork
- Only 1 ear required ("the better ear")
FMCSA -- ANSWER--Federal Motor Carrier Safety Administration
,Medical Examiner -- ANSWER--Licensed, certified, registered provider who can perform
PEs in accordance with laws and regulations ; registered through NRS ; has unique identifier
passes MEC test
FMCSA Mission Statement -- ANSWER--To reduce crashes, injuries, fatalities involving
large trucks/buses
NRCME -- ANSWER--National Registry of Certified Medical Examiners
Commerical Motor Vehicle -- ANSWER--Weight >1000 lb ; or transports >8 people for
compensation ; or >15 people without compensation ; transports hazardous materials
requiring placarding
Interstate commerce
vs.
Intrastate commerce -- ANSWER--Interstate: multiple states or international
Intrastate: within 1 state
Who regulates treatment/management and aftercare of substance abuse for drivers? --
ANSWER--SAP (Substance Abuse Professional)
Page 3 of 38
, Who determines the origin of abnormal drug test results, determining whether the driver has
violated drug use regulations? -- ANSWER--Medical Review Officer
Title 49 CFR 391.41 -- ANSWER--Medical Examiner Report Form
- Paperwork completed during DOT physical
- Physical exam requirements for driver
- Determines if Certificate is granted
Title 49 CFR 391.43 -- ANSWER--Describes responsibilities of Medical Examiner,
instructions for exam, and requirements for medical certification
- Supporting information to explain 391.41
When was DOT established? -- ANSWER--1966
Became separate entity on Jan 1, 2000
Motor Carrier Safety Improvement Act of 1999 -- ANSWER--Established DOT as separate
federal entity
Omnibus Transportation Employee Testing Act of 1991 -- ANSWER--Required drug testing
for drivers
