NRCME DOT Examiner Test Practice
Questions & Answers, latest Version.
Updated
According to FMCSA regulations, which of the following must the medical examiner evaluate when
examining a driver's eyes?
A. Pupil rea
...
NRCME DOT Examiner Test Practice
Questions & Answers, latest Version.
Updated
According to FMCSA regulations, which of the following must the medical examiner evaluate when
examining a driver's eyes?
A. Pupil reactivity
B. Iris symmetry
C. Conjunctival injection
D. Corneal thickness - ✔✔Correct Response:
A. Pupil reactivity
Incorrect Responses:
B. Iris symmetry
This is incorrect because determining iris symmetry is not required by FMCSA.
C. Conjunctival injection
This is incorrect because most causes of conjunctival injection would not be disqualifying. Causes that
are suspicious for a disqualifying condition need additional evaluation. While this abnormal finding
should be explained, with determination of possible effects on safe driving before making a certification
decision, it is not a condition that is specified in FMCSA regulations.
D. Corneal thickness
This is incorrect because it is not measured in an office examination except by an eye specialist.
According to FMCSA regulations, medical qualification for two years can be given to a driver who has... ?
A. An SPE certificate for a left below the knee amputation (BKA).
B. Hypertension.
C. A recent diagnosis of Lewy body dementia.
D. Documented medical marijuana use for pain control. - ✔✔Correct Response:
A. An SPE certificate for a left below the knee amputation.This is the correct response because in order
to obtain the SPE certificate, the driver had to demonstrate the ability to perform all tasks for the
commercial driver job description.
Incorrect Responses:
B. Hypertension.
This is not the correct response because drivers with hypertension are only given a medical certificate
that is good for one year.
C. A recent diagnosis of Lewy body dementia.
This is not the correct response because this is a progressive, degenerative condition with no known
treatment. The effects of Lewy body dementia impact the ability to operate a CMV safely.
D. Documented medical marijuana use for pain control.
This is not the correct response because marijuana remains a drug listed in Schedule I of the Controlled
Substances Act. It remains unacceptable for any safety-sensitive employee subject to drug testing under
the drug testing regulations of DOT to use marijuana. Also, FMCSA medical guidelines state that "driving
impairment due to marijuana use is well substantiated."
During his visit to the medical examiner, a driver complains of severe pain in his finger for the last two
weeks after it was punctured. The examination reveals an infected, swollen finger. After the medical
examiner inquiries, the driver states that the pain is made worse when he grips the steering wheel.
Which of the following should the medical examiner do next?
A. Obtain a hand X-ray.
B. Assess capillary refill in the hand.
C. Obtain a culture and sensitivity.
D. Assess the driver's grip strength. - ✔✔Correct Response:
D. Assess the driver's grip strength.This is the correct response because the condition does not present a
safety risk unless it interferes with the ability of the driver to hold and control the steering wheel.
Incorrect Responses:
A. Obtain a hand X-ray.
This is not the correct response because this is a diagnostic test that a healthcare provider or specialist
would perform or order. Your role as a medical examiner is to determine if the condition interferes with
the ability of the driver to safely operate a CMV.
B. Assess capillary refill in the hand.
This is not the correct response because given the information in the question it is not the primary
consideration for determining if the driver can safely operate a CMV.
C. Obtain a culture and sensitivity.
This is not the correct response because this is an action that a treating healthcare provider or specialist
would do in the course workup and treatment- Your role as a medical examiner is to determine if the
condition interferes with the ability of the driver to safely operate a CMV.
A new driver who had a myocardial infarction six months ago is certified after completing an acceptable
exercise tolerance test and is cleared by a cardiologist. According to FMCSA guidelines, which of the
following is recommended regarding recertification and exercise tolerance test monitoring intervals?
Recertification / Exercise tolerance
A. Every year / Every year
B. Every two years / Every year
C. Every year / Every two years
D. Every two years / Every two years - ✔✔Correct Response:
C. Every year / Every two years
This is the correct response because according to FMCSA medical guidelines, when a myocardial
infarction is part of the medical history, there is a significant increased risk for another myocardial
infarction to occur within six months to a year; therefore, a maximum of one-year certification is the
guideline. Myocardial infarction guidelines also recommend exercise tolerance testing at least every two
years to demonstrate continued ability to safely operate a CMV.
Incorrect Responses:
A. Every year / Every year
This is not the correct response because the FMCSA medical guidance is to obtain an exercise tolerance
test every two years. In this question, there is nothing to indicate that more frequent testing is
necessary.
B. Every two years / Every year
This is not the correct response because it reverses the guidelines. Even if you do not recall the
recommendation, logically, one would eliminate this option because having the driver obtain a test
every year and then waiting for up to a year to review the test results is not reasonable when
unacceptable test results indicate the driver may not be able to safely operate a CMV.
D. Every two years / Every two years
This is not the correct response because the guideline is to recertify every year. Even if you do not recall
the actual guideline, one would logically eliminate this option because this is the maximum
recertification period for a driver who meets all qualification requirements. It is appropriate that a driver
at increased risk for an incapacitating cardiac event should be monitored more frequently.
A 46-year-old male driver presents for recertification. He has a history of chronic gastro esophageal
reflux disease (GERD). He takes esomeprazole (Nexium) and over-the-counter cimetidine (Tagamet). He
states that he feels fine, but has trouble finding foods that do not trigger his GERD when he is on the
road. Which of the following should the medical examiner do first?
A. Disqualify the driver until he has a nutritional consultation.
B. Certify the driver and advise him to carry non-triggering foods in a cooler.
C. Contact the driver's physician and request an upper GI study.
D. Correlate the GI history findings with the abdominal examination. - ✔✔Correct Response:
D. Correlate the GI history findings with the abdominal examination.
This is the correct response because given the information in the question; a medical examiner would
need to examine the driver before having sufficient information about the health of the driver to
consider any of the other options.
Incorrect Responses:
A. Disqualify the driver until he has a nutritional consultation.This is not the correct response because
until completion of the examination, there is insufficient information to make a certification decision. In
addition, there is no regulation or medical guideline that requires a nutritional consultation in order to
be certified.
B. Certify the driver and advise him to carry non-triggering foods in a cooler.
This is not the correct response because until completion of the examination, there is insufficient
information to make a certification decision.
C. Contact the driver's primary care provider and request an upper-GI study.
This is not the correct response because until completion of the examination, one does not have
sufficient information to make a referral decision.
A 25-year-old female driver denies a history of any medical problems. She is a non-smoker who
exercises regularly without symptoms. The medical examiner auscultates bilateral wheezes during the
examination. The driver's SpO2 is 90 percent in the medical examiner's office. The rest of the
examination is normal. The driver should be... ?
A. Temporarily disqualified pending results of a cardiac workup.
B. Qualified since she has no cardiac symptoms.
C. Temporarily disqualified until further evaluation.
D. Qualified because her O2 saturation exceeds the minimum. - ✔✔Correct Response:
C. Temporarily disqualified until further evaluation.
This is the correct response because the driver has a non-diagnosed respiratory or thoracic illness that
might interfere with the ability to safely operate a CMV. The driver should not be certified until the
etiology is confirmed and treatment has been shown to be effective, safe, and stable. Also, according to
FMCSA medical guidelines, a SpO2 of less than 92 percent warrants obtaining an arterial blood gas
analysis.
Which of the following stages of hypertension calls for a medical certificate that expires in a year?
A. Stage 1
B. Stage 3
C. Stage 2
D. Stage 4 - ✔✔A. Stage 1
Medical certificates for drivers with Stage 1 hypertension expire after a year. Stage 2 hypertension
results in a one-time, three-month medical certificate. Stage 3 corresponds to a medical certificate,
good for 6 months from date of examination if the reading is less than or equal to 140/90. Lastly, Stage 4
hypertension doesn't exist.
The FMCSA provides exemption programs for which of the following?
A. Vision and diabetes
B. Vision and hearing
C. Hearing
D. Pulmonary disease - ✔✔A. Vision and diabetes
FMCSA has two medical driver exemption programs: Federal Vision Exemption Program (established in
1998) and Diabetes Exemption Program (established in September of 2003). The medical examiner
determines whether the driver would be otherwise qualified if accompanied by the Federal vision or
diabetes exemption. As a result of the exemptions, the driver must have an annual medical examination
for maintenance and renewal of the exemption.
Which of the following colors is not necessary to be able to distinguish and recognize in traffic signals
and devices?
A. Blue
B. Amber
C. Red
D. Green - ✔✔A. Blue
Due to specifically the colors of a stoplight and most road signs, it is necessary for a driver to be able to
recognize the colors amber, red, and green. Blue is not a necessary color to recognize in traffic signals
and devices.
Which of the following is a medical examiner required to inquire about from a driver with diabetes
mellitus?
A. If the driver uses incretin mimetic
B. If the driver has glycosuria
C. If the driver carries rescue glucose while driving
D. If the driver routinely monitors his or her blood glucose level - ✔✔B. If the driver has glycosuria
While all of the questions are recommended to ask, the only question that is necessary is to see if the
driver has glycosuria (dip stick urinalysis). It is recommended, though, to ask about carrying rescue
glucose while driving, using incretin mimetic, and routinely monitoring his or her blood glucose level.
Which of the following is not a concern that predisposes commercial drivers to an increased risk of
cardiovascular disease?
A. Exposed to environmental stressors that are detrimental to the cardiovascular system
B. Driving stressors can lead to increased neurosympathetic and adrenocortical catecholamine and
cortisol release
C. Obesity and a sedentary lifestyle increase the risk of such a disease
D. Long hours and rotating work schedules - ✔✔D. Long hours and rotating work schedules
Obesity and a sedentary lifestyle increase the risk of cardiovascular diseases. Driving stressors can lead
to increased neurosympathetic and adrenocortical catecholamine and cortisol release. Also, exposed
environmental stressors that are detrimental to the cardiovascular system. However, the long hours and
rotating work schedules do not predispose a driver for increase
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