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NRCME Test Questions Exam with complete solutions latest version

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NRCME Test Questions Exam with complete solutions latest version

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BRAINSCAPE1




NRCME Test Questions Exam with
complete solutions latest version




What minimum PaO2 level is necessary if the driver has an ABG due to a chronic
respiratory disorder?
a.70mmHg
b.55mmHg
c.60mmHg
d.65mmHg - CORRECT ANSWER-Correct answer is "D". To be qualified, the driver
should meet a minimum arterial blood gas (PaO2) greater than 65.

A driver first perceives a whispered voice at 5 feet in his right ear and 4 feet in his left
ear. All other aspects of his physical examination are unremarkable. The examiner
should:
a.Permanently disqualify the driver because he "failed" the whispered voice test.
b.Certify the driver for 2 years.
c.Certify the driver for 1 year.
d.Require an audiometric test to determine the extent of hearing loss in his left ear. -
CORRECT ANSWER-Correct answer is "B". The driver is qualified to drive without
restriction as long as he is able to perceive a whispered voice at 5 feet in 1 ear.

A driver reports for an examination 6 weeks after suffering a mild heart attack and
presents a note from his cardiologist stating that he is able to return to work immediately
without restriction. Included within the note, the cardiologist provides recent testing
information showing that the driver had an ETT that showed he was able to reach 12
METS during the test. His echocardiogram showed an ejection fraction of 65%. The
examination of the driver is unremarkable. The examiner should:
a. Temporarily disqualify the driver.
b. Qualify the driver for 1 year.
c. Qualify the driver for 2 years.
d. Consult with the cardiologist to determine if the driver suffers from angina. -
CORRECT ANSWER-Correct answer is "A". The driver has not completed the required
2-monthwaiting period, but all other requirements for medical clearance and required
testing have been met. The driver would be certified for 1 year at the completion of the
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waiting period. The date of the certification would be from the date of the original
examination.

A driver provides an audiometric test documenting the following:
1. 500 Hz: 2. 1000 HZ: 3. 2000 HZ: 4. 4000 Hz:
35 Right ear; 40 Left ear 40 Right ear; 45 Left ear 40 Right ear; 45 Left ear 50 Right ear;
50 Left ear
5.
The medical examiner should:
a. Disqualify the driver because he does not meet minimum hearing requirementsto
drive.
b. Certify the driver for 2years.
c. Certify the driver for 1 year.
d. Require the driver to obtain a hearing exemption. - CORRECT ANSWER-Correct
answer is "B". The examiner would average the results from 500 Hz, 1000 Hz and 2000
Hz. This average is 38.33 in the Right and 43.33 in the Left ear. A driver must have an
average hearing loss of less than or equal to 40 in the better ear. This does not have to
be met in both ears.

During the examination of a commercial driver, the examiner notices that the driver's
peripheral vision is 70 degrees to the left and 80 degrees to the right. The examiner
should:
a. Qualify the driver for 2 years.
b. Require the driver to obtain a vision exemption because of the limitation in the driver's
left peripheral field.
c. Disqualify the driver.
d. Have the driver consult with an Ophthalmologist to determine if the driver's peripheral
vision meets minimum standards. - CORRECT ANSWER-Correct answer is "A". A
driver must exhibit a minimum peripheral vision of 70 degrees bilaterally.

During examination, the medical examiner notices that the driver is distant, lacks eye
contact and shows absolutely no emotional response during the exam. The examiner's
best response should be:
a. Provide the driver with a "CAGE" questionnaire to determine if he suffers from
alcoholism.
b.
c. Certify the driver with a 1-time, 3-month certificate to determine if there is any effect
on the driver's ability to drive a CMV.
d. Require a skill performance evaluation to ascertain if the driver has any limitations
with driving. - CORRECT ANSWER-Correct answer is "B". The driver exhibits what may
be considered a "flat affect" which is seen in schizophrenia and in severe depression.
The driver should be evaluated by a mental health expert to make a diagnosis prior to
certification.

A driver admits to the use of marijuana for the treatment of his glaucoma, which is legal
in the State in which he lives. He provides medical documentation for the glaucoma
indicating he is able to drive a truck. He began using the marijuana about three months
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ago. His current medical card has no limitations listed and is for 2 years. His certification
examination is within normal limits. The medical examiner should:
a. Disqualify the driver.
b. Perform a urine drug collection and provide the release from the testing provider.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years. - CORRECT ANSWER-Correct answer is "A". Use of
marijuana is prohibited by Federal law while driving a CMV and trumps State law in this
matter.

A driver has a blood pressure of 136/92 mm Hg. This is:
a. Within normal limits and would not affect the driver's certification.
b. Stage 1 Hypertension.
c. Stage 2 Hypertension.
d. Stage 3 Hypertension. - CORRECT ANSWER-Correct answer is "B". This is Stage 1
Hypertension, which is defined as 140-159/90 - 99.

A driver is taking Celexa for the treatment of what he calls a "mild depression." He
reports he has not considered or attempted suicide. The examiner should?
a.Temporarily disqualify the driver until he obtains written clearance for the depression
and the medication from the treating provi
b. Certify the driver for a period of 1 year.
c. Certify the driver for a period of 2 years.
d. Disqualify the driver until he is no longer requiring medication for the treatment of
depression. - CORRECT ANSWER-Correct answer is "A". Medical clearance is required
for all mental health disorders. Celexa is an SSRI or 2nd Generation anti-depressant
and is acceptable.

A driver reports that he had a hunting accident wherein he suffered a left orbital fracture.
He presents a note at the time of the examination from an ophthalmologist stating "may
drive". His exam is unremarkable except for a limitation in peripheral vision in his left
eye, which was inconclusive. His distance vision was 20/20 right and 20/40 left. The
medical examiner should?
a. Council the driver on the need for a vision exemption.
b. Disqualify the driver pending vision exam to determine if it meets peripheral vision
requirements.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years. - CORRECT ANSWER-Correct answer is "B". The
driver must have a peripheral vision of 70 degrees bilaterally to certify to drive a CMV.

What minimum PaO2 level on an ABG performed for a chronic respiratory disorder is
necessary to certify a commercial driver?
a. 55 mm Hg.
b. 60 mm Hg.
c. 65 mm Hg.
d. 70 mm Hg. - CORRECT ANSWER-Correct answer is "C". Blood oxygen saturation
must be a minimum of 65 mm Hg for the driver to certify.

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A driver is taking Topamax for the treatment of migraine headaches. He reports good
management of his headaches and they never seem to interfere with his driving ability
with the medication. The medical examiner should?
a. Obtain medical clearance for the condition and the medication.
b. Disqualify the driver because he is taking an anti-seizure medication.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years. - CORRECT ANSWER-Correct answer is "A". Topamax
is a medication that is used for seizure control. The examiner should confirm with the
prescribing provider that the driver does not take it to control seizures, and he is
capable of driving a CMV.

A 26 year-old driver presents for a first-time certification. He has a long-standing history
of ADHD and is taking methylphenidate. You have verified his diagnosis and obtained
clearance from his treating psychiatrist. As the certified examiner, you:
a. Should disqualify the driver, explaining that use of such stimulants is cause for
disqualification.
b. May certify for a maximum of 6 months.
c. May certify for a maximum of 12 months.
d. May certify for a maximum of 2 years. - CORRECT ANSWER-c. May certify for a
maximum of 12 months.

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-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-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.
d. Disqualify the driver until s/he has a neurological consultation. - CORRECT
ANSWER-Correct answer is "D". A positive Babinski reflex is indicative of abnormalities
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