NRCME TEST QUESTIONS / 240+ COMPLETE QUESTION
AND CORRECT DE TAILED ANSWERS / 2025-2026
1. 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 is "D". To be qualified, the driver should meet a
minimum arterial blood gas (PaO2) greater than 65.
2. 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 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.
3. 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 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 waiting period. The date of the certification would be from the
date of the original examination.
4. A driver provides an audiometric test documenting the following:
1. 500 Hz: 2. 1000 HZ: 3. 2000 HZ: 4. 4000 Hz:
, NRCME TEST QUESTIONS / 240+ COMPLETE QUESTION
AND CORRECT DE TAILED ANSWERS / 2025-2026
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 require-
mentsto 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 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.
5. 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 is "A". A driver
must exhibit a minimum peripheral vision of 70 degrees bilaterally.
6. 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 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.
, NRCME TEST QUESTIONS / 240+ COMPLETE QUESTION
AND CORRECT DE TAILED ANSWERS / 2025-2026
7. 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 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 is "A". Use of marijuana is
prohibited by Federal law while driving a CMV and trumps State law in this matter.
8. 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 is "B". This is Stage 1 Hypertension,
which is defined as 140-159/90 - 99.
9. 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 is "A". Medical clearance is required
for all mental health disorders. Celexa is an SSRI or 2nd Generation anti-
depressant and is acceptable.
10. 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
, NRCME TEST QUESTIONS / 240+ COMPLETE QUESTION
AND CORRECT DE TAILED ANSWERS / 2025-2026
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 is "B". The driver must have a
peripheral vision of 70 degrees bilaterally to certify to drive a CMV.
11. 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 is "C". Blood oxygen saturation must be a minimum
of 65 mm Hg for the driver to certify.
12. 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 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.
13. 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.: c. May certify for a maximum of 12
months.
AND CORRECT DE TAILED ANSWERS / 2025-2026
1. 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 is "D". To be qualified, the driver should meet a
minimum arterial blood gas (PaO2) greater than 65.
2. 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 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.
3. 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 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 waiting period. The date of the certification would be from the
date of the original examination.
4. A driver provides an audiometric test documenting the following:
1. 500 Hz: 2. 1000 HZ: 3. 2000 HZ: 4. 4000 Hz:
, NRCME TEST QUESTIONS / 240+ COMPLETE QUESTION
AND CORRECT DE TAILED ANSWERS / 2025-2026
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 require-
mentsto 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 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.
5. 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 is "A". A driver
must exhibit a minimum peripheral vision of 70 degrees bilaterally.
6. 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 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.
, NRCME TEST QUESTIONS / 240+ COMPLETE QUESTION
AND CORRECT DE TAILED ANSWERS / 2025-2026
7. 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 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 is "A". Use of marijuana is
prohibited by Federal law while driving a CMV and trumps State law in this matter.
8. 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 is "B". This is Stage 1 Hypertension,
which is defined as 140-159/90 - 99.
9. 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 is "A". Medical clearance is required
for all mental health disorders. Celexa is an SSRI or 2nd Generation anti-
depressant and is acceptable.
10. 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
, NRCME TEST QUESTIONS / 240+ COMPLETE QUESTION
AND CORRECT DE TAILED ANSWERS / 2025-2026
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 is "B". The driver must have a
peripheral vision of 70 degrees bilaterally to certify to drive a CMV.
11. 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 is "C". Blood oxygen saturation must be a minimum
of 65 mm Hg for the driver to certify.
12. 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 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.
13. 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.: c. May certify for a maximum of 12
months.
