DOT Actual 2025 Exam Study Guide: Verified Questions & Answers (A+), Exams of Occupational therapy

Download DOT Actual 2025 Exam Study Guide: Verified Questions & Answers (A+) and more Exams Occupational therapy in PDF only on Docsity! DOT Actual 2025 Latest Update Study Guide Exam With Verified Questions and Answers Graded A+ A CMV driver must perceive a forced whispered voice in the better eat at not less than with or w/o a hearing aid ✔✔5 Feet This test is performed only when the Forced Whisper Test is failed in both ears ✔✔Audiogram If tested by the use of an audiometric device, they must not have an AVERAGE hearing loss in the better ear greater than at 500Hz, 1000Hz, and 2000Hz ✔✔40 decibels ear and two eyes certifies! ✔✔One A driver with a hearing aid usually must go to an or a hearing aid center for audiometry testing ✔✔Audiologist How long can a driver who meets the hearing requirements in one ear be certified? ✔✔2 Years Inflammation of the inner ear that causes a sudden onset of vertigo. This requires a 2 month waiting period. ✔✔Acute and Peripheral Vesitbulopathy This occurs when a small piece of bone-like calcium breaks free and floats inside the Eustachian tube sending confusing messages to your brain about your body's position. This requires a 2- month waiting period. ✔✔Benign Positional Vertigo T/F It is OK to certify someone with Uncontrolled Vertigo, Meniere's Disease, Labrythine Fistula, or Non-Functioning Labryinthes ✔✔False An inner ear disorder that affects balance and hearing. ✔✔Meniere's Disease An abnormal opening in the bony capsule of the inner ear resulting in the leakage of the peri lymph from the semicircular canals of the middle ear. ✔✔Labrythine Fistula Loss of vestibular function in both Labryinths leading to characteristic dysfunction in vision and balance. These symptoms reflect how crucial our Labryinth sense is for generating proper reflexes so that we can see clearly when we are moving and not lose our balance when we are standing or walking. ✔✔Non-Functioning Labryinths Another name for the Labryinth ✔✔Inner Ear 1 or 2 readings greater than or equal to 140/90 on the same day ✔✔Elevated Blood Pressure Two readings greater than or equal to 140/90 on consecutive exams on two different days ✔✔Hypertension Who should remeasure abnormal BP and or pulse rate or rhythm, especially if they are significant factors in determining certification? ✔✔The examiner When measuring a driver's BP they should sit in the chair for at least 5 min, back is supported, legs are uncrossed, and feet are touching the ground. Support the drivers arm at the elbow so the midpoint of the BP cuff is... ✔✔Even with the Sternum or right atrium of the driver Stage 1 HTN ✔✔140-159/90-99 How long can you certify someone who comes in for certification for the first time and has Stage 1 HTN? ✔✔1 year take immediate action to remove employees from safety sensitive duties, and to make required When a driver returns to duty after violating drug and ETOH standards, how many f/u drug and ETOH tests would they need in the first year of returning to driving? ✔✔6 drug tests within the first year Employee must raise shirt and lower underpants to mid-thigh to show no device is being worn during what kind of urine testing? ✔✔Directly Observed Testing Heavy drinking average for men and women? ✔✔>2 drinks/day for men >1 drink/day for women A pattern of ETOH consumption that brings the Blood Alcohol Concentration (BAC) level to 0.08% or more in a 2-hour period - Men 5 or more drinks and Women 4 or more drinks ✔✔Binge Drinking A pattern of drinking that results in harm to one's health, interpersonal relationships, or ability to work. Long term use can turn into dependence. ✔✔Alcohol Abuse A chronic disease that includes a strong craving for ETOH despite repeated physical, psychological, or intepersonal problems; An inability to limit drinking ✔✔Alcohol Dependence Evaluates employees who have violated DOT drug and ETOH regulations and makes recommendations concerning education, treatment, F/U testing, and aftercare ✔✔SAP (Substance Abuse Professional) Licensed MD responsible for receiving and reviewing labs generated by a drug testing program, contacts the user when there is a positive result for an interview to determine if there is an alternate explanation for drug findings in the urine specimen ✔✔MRO (Medical Review Officer) Individual who receives communications and test results from service agents, authorized to decisions in the testing and evaluation process-- Must be an employee of the company ✔✔DER (Designated Employee Representative) When in remission, is not disabling unless transient or permanent neurological changes have occurred ✔✔Alcoholism REVIEW MEDICATIONS AND IF THEY ARE SAFE FOR CMV DRIVERS ✔✔ A1C: 5% Fasting Glucose: 99 or below Oral GTT: 139 or Below ✔✔Normal Labs A1C: 5.7-6.4% Fasting Glucose: 100-125 Oral GTT: 140-199 ✔✔Prediabetes A1C: 6.5% or greater Fasting Glucose: 126 or above Oral GTT: 200 or above ✔✔Diabetes Lack of insulin production, must receive insulin, severely compromised counter-regulatory mechanisms ✔✔Type 1 DM Adult Onset or Non-Insulin Taking, patient can produce insulin, treatment is diet and oral medication which preserves blood glucose mechanisms for years ✔✔Type 2 DM Certification of a CMV driver with diabetes is based on what? ✔✔If the driver takes insulin Accelerated atherosclerosis of coronary, cerebral, and peripheral vessels, higher risk for cardiovascular disease, can cause TIA or stroke, leading cause of death among diabetics ✔✔Macrovascular Disease Neuropathy, Nephropathy, Retinopathy, Macular Degeneration ✔✔Microvascular Disease Disturbance in sensation and touch, loss of position sense, loss of vibratory sense, autonomic neuropathy ✔✔Neuropathy Fatigue, lethargy, sluggishness, transient cognitive disruption; Sudden onset unlikely; May begin around 280-300% but is more likely with a sustained plasma glucose of greater than 400% ✔✔Symptoms of Acute Hyperglycemia The FMCSA Medical Examiner Handbook states that a Hgb A1C of (275%) indicates poor glucose control ✔✔>10% Rapid heart rate, sweating, weakness, and hunger ✔✔Mild Hypoglycemia Seizure, loss of consciousness, need of assistance from another person, period of impaired cognitive function without warning ✔✔Severe Hypoglycemia When performing a UA... A MA detects glycosuria. What should be the test that she performs? ✔✔Blood Glucose Diabetics with excessive proteinuria may be indicative of what? ✔✔Glomerular Damage How often should diabetics be recertified because of the progressive nature of DM and the potential for complications? ✔✔Annualy This usually affects older adults and causes a loss of vision in the center of the visual field due to damage of the retina. It can make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow other ADL ✔✔Macular Degeneration Required vision tests ✔✔Distant Visual Acuity Peripheral Vision along the horizontal meridian in each eye Color vision If a driver has an inconclusive vision test, the next step should be to refer them to...? ✔✔An eye specialist Causes a progressive decrease in peripheral vision ✔✔Glaucoma Diminished visual acuity, contrast, and color resolution; also causes increased glare ✔✔Cataracts Leading cause of untreatable blindness in the US, Affects the central vision ✔✔Macular Degeneration DM is the most common cause; Can affect central vision, contrast sensitivity, and color discrimination. ✔✔Retinopathy 1 ear, certifies! Max certification is one year. ✔✔2 eyes Can someone be certified if they have contact lenses that correct distant acuity in one eye and near acuity in another eye? ✔✔No Vision in one eye; In low illumination or glare it can cause deficiencies in contrast, recognition, and depth perception compared to binocular vision ✔✔Monocular Vision because of larger stroke area and an increased incidence of blood at the stroke site; Treatment: Allows drivers with monocular vision to operate a CMV - Should be recertified annually ✔✔Vision Exemption Focal neurological dysfunction, lasts > than a few seconds but less than 30-40 min ✔✔Transient Ischemic Attack Waiting period after TIA ✔✔1 year Max certification for someone with TIA ✔✔1 year Most common cause of stroke ages 45-65, caused by large artery atherosclerosis, often preceded by TIA; Treatment: Medical: Antiplatelet agents Surgical: Carotid Endardectomy ✔✔Thrombotic Stroke The heart is usually the source of the embolus, prognosis often worse than thrombotic stroke Medical- Coumadin, Requires INR monitoring, Increased Bleeding Risks ✔✔Embolism Stroke Waiting period after a stroke ✔✔1 year if the driver is not at risk for seizures Bleeding into the substance of the brain, Caused by ruptured arteriovenous malformation, there are also other causes as well ✔✔Intracerebral Hemorrhage Bleeding primarily in the space around the brain; often from a ruptured aneurysm ✔✔Subarachnoid Hemorrhage Waiting period for cerebellum or brain stem stroke ✔✔1 year; No additional time if no increased seizure risk and not on any anti-seizure meds 1 year for stroke plus an additional 4 years if there is a seizure risk; Must be seizure free and off meds for 5 years but this waiting period may be shortened after consultation ✔✔Cortical or Subcortical Stroke waiting period Loss of position sense with peripheral neuropathies is disqualifying but loss of sensation... ✔✔Requires an individual assessment Hereditary or aquired conditions that affect nerves, including the axon, myelin, or the myelin outside the spinal cord; common complication of DM ✔✔Peripheral Neuropathies If a clinician chooses to certify a driver with an established medical history of epilepsy the driver must be... ✔✔Seizure free and off anticonvulsants for 10 years Two or more unprovoked seizures ✔✔Epilepsy Minimum 5 years seizure free and off anti-convulsants meds; Requires annual recertification and biennial medical examination ✔✔ Dural penetration, loss of consciousness for >24 hours, with or without a prior history of seizures the risk of unprovoked seizures does not decrease over time, driver should not be considered for certification. ✔✔Severe Head Injury No Dural penetration, loss of consciousness >30 min but <24 hours, 5 years waiting period off of anticonvulsants and seizure free if there were early seizures, 2 year waiting period if there was no early seizure, Max certification = 1 year ✔✔Moderate Head Injury No Dural penetration, loss of consciousness <30 minutes, waiting period 2 years if there was an early seizure, max 1 year certification, No seizure = No waiting period; Max certification = 2 years ✔✔Mild Head Injury Sleepiness when the individual is expected to be awake and alert; Daily or almost daily for nearly 3 months or greater ✔✔Excessive Daytime Sleepiness 3 Primary Sleep Disorders ✔✔OSA, Narcolepsy, Restless Leg Syndrome The most common sleep disorder that causes Excessive Daytime Sleepiness ✔✔OSA (Obstructive Sleep Apnea) This index and the blood oxygen saturation determines the severity of the Obstructive Sleep Apnea ✔✔Apnea Hypopnea Index (AHI) This score standardizes the assessment of the oropharynx ✔✔Mallampati Score A Mallampati Score of what standardizes the assessment of the oropharynx ✔✔A score of 3 or 4 A hallmark of OSA but a poor predictor because of the prevelance in the general population ✔✔Chronic Snoring A good predictor of OSA but not its severity; 6% of the population without OSA experience this during sleep ✔✔Witnessed apneas or breathing pauses during a sleep study Measurement of neck size in men or women that is a predictor of OSA ✔✔Men >17" and Women >16" In men with the a BMI >40 what is the greatest predictor of OSA severity? ✔✔Neck circumference A neck circumference of indicates high risk of OSA ✔✔20" Epworth Sleepiness Scale of 16 or higher ✔✔Disqualified A driver presents with suspected OSA. What can the provider give them while awaiting a sleep study? ✔✔Grant a limited-time certification (Typically around 30 days) > or = to 7 channels in a lab setting, gold standard, diagnoses all sleep disorders, this is required when the examiner suspects another sleep disorder in addition to sleep apnea ✔✔Full, Attended Polysomnography > or = to 7 channels ✔✔Full, Unattended Polysomnography Home sleep tests use what type of tests? Limited channel devices and usually uses oximetry as a parameter ✔✔Type 3 or 4 A test based on staying awake as an indicator of a sleep disorder or of treatment effectiveness ✔✔Maintenance of Wakefullness Test A test based on going to sleep as an indicator of a sleep disorder or of treatment effectiveness ✔✔Multiple Sleep Latency Tests Airflow ceases for 10 or more seconds ✔✔Apnea Airflow decreases for 10 or more seconds ✔✔Hypopnea Mild: 5+ Episodes/Hour Moderate: 15+ Episodes/Hour Severe: 30+ Episodes/Hour ✔✔Apnea/Hypopnea Index Polysomonogram shows what happens when ✔✔Airflow ceases while effort to breathe continues followed by arousal after airflow resumes An AHI > /hour needs treatment ✔✔20 A sleep study diagnostic for OSA that requires treatment is until treatment is documented ✔✔Disqualifying PAP compliance is ✔✔At least 4 hours/night for 70% of nights According to the FMCSA how long should you wait to certify after patient starts PAP? ✔✔1 month The use of cannot be considered an acceptable alternative in treating OSA ✔✔Dental Appliances If a driver is PAP compliant at one month, how long of a certification can they be issued? ✔✔3 month certification If a driver is PAP compliant at 3 months, how long of a certification can they be issued? ✔✔1 year certification A BMI of requires a sleep study according to the FMCSA ✔✔35 Usually requires 6 months or more to lose weight, may use CPAP until there is adequate weight loss to treat OSA, requires annual certification, reevaluate if there is a 5% weight gain or symptoms recur ✔✔Bariatric Surgery CNS stimulants improve performance on simple tasks but not on tasks requiring ✔✔Complex intellectual functions The FMCSA recommends that you someone on benzodiazepines ex. Ambien ✔✔Do not certify Electro convulsive therapy is used to treat major depression, schizophrenia, and related psychotic episodes. Causes confusion, disorientation, and a loss of short-term memory that usually resolve. The examiner should not certify a driver who has maintenance ECT but can certify a driver if... ✔✔Comprehensive eval from a medical professional and no disqualifying side effects The use of oxygen is disqualifying ✔✔Supplemental Inflammation of the nasal portion of the respiratory tract that causes sneezing, coughing, watery eyes, and rhinorrhea; Max certification is two years ✔✔Allergic Rhinitis Are avaliable without an RX and are sedating - You should abstain from antihistatimes for 12 hours prior to operating a CMV ✔✔1st generation antihistamines Chronic reduction of the maximal expiratory flow most often caused by a combination of chronic bronchitis and emphysema, need PFT to diagnose, smoking is the primary cause ✔✔COPD Obtain this test if there is any history of specific lung disease, any symptoms of SOB, chest tightness, or wheezing ✔✔Pulmonary Function Test FEV1 <65% of predicted; FEV1/FVC ratio <65% ✔✔Airway Obstruction FVC <60% of predicted, Obtain Oximetry ✔✔Restrictive Impairment If the oximetry is less that 92% then what is the next step that needs to be taken? ✔✔Obtain ABGs Do not certify if <65mm HG at altitudes below 5000 feet and <60 mm HG at altitudes above 5000 feet ✔✔PaO2 Do not certify if >45 mm HG at any altitude ✔✔PaCO2 The risk of recurrence of pulmonary TB is low after adequate therapy - Advanced TB may cause respiratory insufficiency - You should not certify a driver if they are not and ✔✔Compliant with antitubercular therapy and has no side effects interfering with safe driving TB treatment can cause what eye issues that can be disqualifying? ✔✔Color Blindness Max certification for someone with Cystic Fibrosis (They must have continuous antibiotic therapy and daily respiratory therapy to mobilize secretions) ✔✔1 year Can be traumatic or spontaneous, treated with a chest tube, complete recovery confirmed by CXR, max certification is two years ✔✔Pneumothorax Who should not certify someone with Pneumothorax whos has hypoxemia with rest, Chronic respiratory failure, cough with syncope, and... ✔✔Two or more spontaneous pneumothorax on one side if no procedure has been done to prevent recurrence Hypertrophy and/or dilation of the right ventricle secondary to disorders that affect lung structure or function - Secondary to left heart disease ✔✔Cor Pulmonale Major symptoms of Cor Pulmonale include dizziness, hypotension, and syncope. What medication does someone with Cor Pulmonale possibly take that can interfere with safe driving? ✔✔Vasodilators You may certify someone diagnosed with Cor Pulmonale if their is treated and has resolved. They should be recertified every 3-6 months. ✔✔Pulmonary HTN This driver should be disqualified because it means that they have chronic fixed pulmonary hypertension ✔✔Disqualified A pulmonary emboli is a clot. How long is the waiting period for this clot in which a DVT is a major source? ✔✔3 months If a user is on Coumadin they must be properly monitored, shift needs to focus on the underlying condition, and user must wait prior to certification ✔✔1 month waiting period There is a one month waiting period for Coumadin, driver needs to also bring a copy of INR results to the exam, and you must monitor the INR how often? ✔✔Monthly Most commonly used to detect CAD, less expensive, love sensitivity ✔✔Exercise Tolerance Test Major prognostic indicator in CAD, Ejection Fraction >40%, LVEF does not correlate with exercise capacity, LVEF does correlate with risk for sudden death ✔✔Left Ventricular Function The measurement of how much blood the left ventricle pumps out with each contraction ✔✔Ejection Fraction To be certified, a driver with heart disease should exercise to a workload capacity of ✔✔>6 METS