DOT practice test-with 100% verified solutions-2024- 2025.docx, Exams of Advanced Education

Download DOT practice test-with 100% verified solutions-2024- 2025.docx and more Exams Advanced Education in PDF only on Docsity! DOT practice test-with 100% verified solutions-2024- 2025 Fatigue is a major concern. What do current FMCSA regulations allow from drivers? 60 hours on the road over a 7 day period, or 70 hours over 8 days (also 14 hours on the road at a stretch if given 8 hours off to rest between) driver presents with a heart attack 1 month previous. He is following up with his MD again in 1 week. He is unsure of his prescriptions, but is asymptomatic. Should he be certified today? No. There is a minimum waiting period of 2 months and specific criteria that must be met thereafter before certification Driver has been trying to stop smoking for 10 years without success. 1 month ago, she began taking Chantix. She reports no blackout, suicidal thoughts, or change in mood. The rest of the exam is normal. Can she be qualified? No. Chantix is diqualifying Which of the following diagnoses is NOT always disqualifying? (narcolepsy, type 1 diabetes, meniere's disease, current alcoholism, bipolar disorder) bipolar disorder when asked about seizures, a driver reports several febrile seizures as a young child. Is this disqualifying? No. What does the acronym FMCSA stand for? Federal motor carrier safety administration What is NOT a mission of the FMCSA? -develop and enforce data-driven regulations that balance motor carrier (truck and bus companies) safety with industry efficiency -target educational messages to carriers, commercial drivers, and the public -partner with stakeholders including federal, state, and local enforcement agencies, the motor carrier industry, safety groups, and organized labor on efforts to reduce bus and truck- related crashes -oversee the prosecution of criminally negligent cases of motor carrier safety breaches oversee the prosecution of criminally negligent cases of motor carrier safety breaches who is NOT eligible to be a medical examiner? (APNs, DC, MD, PharmD, DO, PA, PT) pharmacists and PTs cannot be medical examiners as they do not have the training, scope of practice, or licensure that allows them to diagnose what is the role of the medical examiner? -assess the driver for medical fitness to safely perform all driver duties -ensure the driver is properly following up on any potentially dangerous conditions -treat the driver for health conditions -council the driver on health conditions and consequences -diagnose new health concerns of the driver -assess the driver for medical fitness to safely perform all driver duties -ensure the driver is properly following up on any potentially dangerous conditions -council the driver on health conditions and consequences what is ensured as a part of the NRCME's medical oversight mission? -individuals performing medical examinations are qualified to do so and are educated about occupational issues for drivers -a tracking mechanism that ensures that every prior application by an individual for medical certification is recorded and reviewed -medical certification regulations are updated periodically -a review process that prevents or identifies and corrects the inappropriate issuance of medical certification -all of the above all of the above according to the DOT, the AVERAGE driver falls into all of these categories, EXCEPT: (male, between 25 and 39 years of age, sedentary, overweight, smoker, poor eating habits, less healthy than the average person, more than 2 medical conditions, cardiovascular disease prevalent) between 25 and 39 years of age- the average driver is more than 40 years of age what of these abilities is NOT required of a driver to safely perform his/her duties? -perceptual skills to monitor sometimes complex driving situations -judgment skills to make quick decisions when necessary -manipulative/manual skills to control his vehicle -social sills to act kindly to interpersonal activities on the road social sills to act kindly to interpersonal activities on the road- mental and physical abilities are required (social skills are not unless their absence indicates mental illness) fatigue is a major concern. what do current FMCSA regulations allow from drivers? 60 hours on the road over a 7 day period, or 70 hours over 8 days a driver presents with a BP of 118/72. pulse is 66. he previously was on HTN medication, but stopped taking it 6 months ago. in the last year, he lost 55 pounds, stopped smoking, and began exercising regularly. can he be given a 2 year card? yes. he is stable and off his Rx. this is at the discretion of the medical examiner driver has no previous diagnosis of HTN. today his BP is 146/88. all else is clear. what certificate time should be given? 1 year driver has been on HTN Rx for 3 years. he is inconsistent about taking his Rx. today BP is read at 146/96. what should be done? give 1 time certificate for 3 months. refer him back to his treating physician for immediate consultation on treatment options. discuss the consequences and council on diet, exercise, prognosis, etc. which of the following should be considered for a sleep study (but given a certificate of up to 2 months to get the study done)? -driver admits loud snoring and score of 13 on ESS -BMI of 38 and neck circumference of 18 inches -BMI of 40 and new diagnosis of HTN -driver falls asleep during the exam -previous diagnosis and CPAP, but non-compliant -all of the above -A and C -driver admits loud snoring and score of 13 on ESS -BMI of 38 and neck circumference of 18 inches -BMI of 40 and new diagnosis of HTN D and E should be DISQUALIFIED and referred for evaluation. the others should be further evaluated driver has been blind in 1 eye since a childhood accident. he previously got his certificate from his family doctor and always was certified for 2 years. what is the proper time period for certification? monocular vision is disqualifying. driver may apply for an exemption (it is common that drivers have been improperly certified in the past) driver presents with a heart attack 1 month previous. he is following up with his MD again in 1 week. he is unsure of his prescriptions, but is asymptomatic. should he be certified today? no. there is a minimum waiting period of 2 months and specific criteria that must be met thereafter before certification. driver had heart surgery 6 months ago. he reports recovering well and is asymptomatic. documentation from his MD shows he is indeed recovering well and tolerating his medication. surgery included installation of an implantable cardioverter defibrillator (ICD). can he be qualified today? no. an ICD is disqualifying driver claims to be on no illegal drugs, but he looks haggard and has fresh needle sticks on his forearm. can you order lab testing for drugs? yes. this is outside of standard DOT drug testing, but a non-DOT drug test can be ordered. refusal to test is a failure. driver hears a forced whisper at 8 feet out of his right ear with no aid. he is deaf in his left ear. is this adequate? yes. hearing out of one ear at >5 feet is adequate driver is missing the distal half of his left 4th and 5th fingers. dynamometer shows grip strength to be a comparable to the right at 77 lbs. is this disqualifying? it is up to your clinical judgment on the nature of his specific injury. this case is likely fine as grip strength is WNL. driver tells you that he is red/green colorblind. he is unable to pick out the numbers in an Ishihara color blindness test. however, he is able to identify red, green, and amber stoplights. does he meet vision standards? yes. red, green, and amber are the only colors of concern. he may be fully qualified. which of the following is NOT a non-discretionary disqualifier? (epilepsy, insulin dependent diabetes, use of medical marijuana, hypertension) hypertension driver has no glasses. her visual acuity is 20/20 with her left eye alone, 20/50 in her right eye, and 20/30 with both eyes together. what is the proper course of action? temporarily disqualify. refer for vision correction. retest afterward. driver is evasive when asked about alcohol use, but upon further pressing admits to drinking every day of the week, but not on the job. he has never been diagnosed as an alcoholic. what is a proper course of action? -check for signs of alcoholism in exam. inquire further using alcohol abuse questionnaire. -refer to a substance abuse professional or chemical dependency center for evaluation. temporarily disqualify- possibly longer depending on outcomes -disqualify -qualify. drinking is not affecting his job/safety -check for signs of alcoholism in exam. inquire further using alcohol abuse questionnaire. -refer to a substance abuse professional or chemical dependency center for evaluation. temporarily disqualify- possibly longer depending on outcomes driver has been trying to stop smoking for 10 years without success. 1 month ago, she began taking Chantix. she reports no blackout, suicidal thoughts, or change in mood. the rest of the exam is normal. can she be qualified? no. chantix is disqualifying a morbidly obese driver comes for a DOT physical. he weighs 385 pounds and stands 5'10" (70 inches) tall. his BMI is 55.2. what BMI is considered "overweight"? "obese"? 25-29.9 is overweight. 30+ is obese a morbidly obese driver comes for a DOT physical. he weighs 385 pounds and stands 5'10" (70 inches) tall. his BMI is 55.2. what is the maximum allowable BMI to qualify? there is no standard BMI is a simple calculation for determining a person's thinness or thickness. it can be useful in discussing weight with patients. the DOT uses it as a screening tool for sleep apnea. in which case is the measurement most likely to be INaccurate. -driver is generally sedentary. BMI is 29 -driver is also a body-builder. BMI is 36 driver is also a body-builder. BMI is 36. (although BMI is written as a measurement to be clinically used in the FMCSA guidelines, but can be inaccurate- especially in athletes. it should not be the sole reason for a sleep study for OSA. driver has a long history of major depression. his only current Rx is Paxil, and he reports no side effects. 3 months ago, he attempted to commit suicide by hanging, but was unsuccessful. physicially, all is within standards. can be be qualified? -no. paxil is disqualifying -not until consultation with his mental health professional. -yes. this is not disqualifying -yes. the waiting period following a suicide attempt is 2 months minimum -no. the waiting period following a suicide attempt is 1 year minimum -not until consultation with his mental health professional -no. the waiting period following a suicide attempt is 1 year minimum a 35 year old man was in an MVA 7 years ago with trauma to his brain. in the first week therafter, he had a single seizure. for 1 year, he took anticonvulsive medication. he has been off all prescriptions and seizure free for 6 years. can he be certified? yes. he has been seizure and Rx free for over 5 years. there was a seizure, but not epilepsy after a diagnosis of meniere's disease, what is the recommendation for certification of a driver? meniere's disease is progressive and considered completely disabling. disqualify. which of these is intrastate (as opposed to interstate) commerce? -a landscaper drives his pickup and trailer for jobs with 5 counties in central MN. All his sod and supplies are bought locally -a UPS driver delivers packages from far and wide within a single city -a semi driver drives a long haul route from FL to TX -a commercial driver makes a run from New Orleans, LA to Monroe, LA, but passes through MS on the route a landscaper drives his pickup and trailer for jobs with 5 counties in central MN. All his sod and supplies are bought locally which of the following diagnoses is NOT always disqualifying? narcolepsy, type 1 diabetes, meniere's disease, current alcoholism, bipolar disorder bipolar disorder proteinuria can be caused by any of the following except: kidney disease or damage, dehydration, fever, emotional stress, gastritis, diabetes mellitus, HTN gastritis in case of high proteinuria, what is a reasonable first step for follow-up? -second dipstick 1 week later. if still present, urine protein-to-creatinine ratio -second dipstick in 1 week. if still present, referral for further evaluation -kidney blood panel -second dipstick 1 week later. if still present, urine protein-to-creatinine ratio -second dipstick in 1 week. if still present, referral for further evaluation an obese driver's urinalysis shows 500 mg/dL of glucose. he claims he is not diabetic, but it is simply because of the 20 oz. bottle of pop he drank in the hour before the test. what should be done? order follow-up test: fasting blood glucose or A1c -kidneys will not secrete glucose into the urine if there is healthy blood-sugar control. alimentary glycosuria is possible, but should not cause glucose to appear in the urine unless >100 g of sugar is consumed at once, and even then it should not be this much. he is likely diabetic. given the serious nature of diabetes, follow up testing is necessary a driver's blood pressure is found to be 164/90 during his DOT exam in January. he is given a 3-month certificate. he returns in March, having lost 10 pounds and started a HTN Rx. blood pressure is found to be 136/84. a full exam is not performed. what length certification should be written and from what date? 1 year from January -although he now qualifies for a 1 year card, it can only be issued from the date of the full exam who can grant a waiver or exemption? the FMCSA i've already passed by FAA pilot physical. do i still need a DOT medical exam to drive a CMV? yes, the exams are different and separate which of the following questions is UNimportant when considering any disease regarding certification, time limitation, or disqualifications? -is there likelihood of sudden incapacitation? -is the disease stable? -will the driver be financially stable if not certified? -what is the likelihood of progression? -does the nature of the disease affect safety? -will the driver be able to seek adequate care on the road? will the driver be financially stable if not certified? in what time period must you give the medical examiner's certificate to the driver after the exam? there is no standard -the medical examiner can give the card to the driver immediately or at a later time of his/her choosing. follow-up labs, tests, and communication with treating doctors can reasonably cause delays which is NOT a major risk of cor pulmonale? dizziness, drowsiness, hypotension, syncope, shortness of breath drowsiness you refer a driver for a sleep study. it is determined there that he should have a CPAP machine. how long must he wait, at minimum, to check for tolerance of the treatment before you may certify him? 1 month if a driver has had a cortical stroke, what is the minimum waiting period before he/she may possibly be certified to drive? 5 years- as potential for seizure is a concern diabetes mellitus is a major concern. which of the following is a long-term outcome of uncontrolled blood sugar? cardiovascular disease, retinopathy, neuropathy, alzheimer's disease, nephropathy, death, all of the above all of the above both schizoid and bipolar disorders can be disqualifying. which of the following conditions is NOT a major reason to disqualify? -substantially compromised judgment -swings in energy levels and mood -attention difficulties -suicidal behavior or ideation -personality disorder that is repeatedly manifested by overt inappropriate acts swings in energy levels and mood what are the FMCSA guidelines for certification of a driver on Coumadin? use clinical judgment- not on the coumadin, but on the underlying disease if a driver is only taking OTC medications, what are the possible ramifications? OTC medications can affect the decision to certify, time limit, or disqualify as determined by the clinical judgment of the medical examiner insulin use is a major concern. which of these is NOT a possible outcome of a hypoglycemic reaction? seizure, loss of consciousness, shooting extremity pain, palpitations and tachycardia, period of impaired cognitive function that occurs without warning shooting extremity pain exercise tolerance tests (cardiac stress tests) are needed to assess the driver after a cardiovascular incident or to assess for cardiac abnormalities. if ordered this test, there are specific measures that need to be met/ordered. which of these is NOT one of them? in a shy-bladder situation where a driver is unable to provide a urine sample, which 2 courses of action are INappropriate? -allow the driver to return the next day to provide a sample -give the driver water and time to relax until he/she is ready -disqualify the driver -send the driver home with a collection cup and have him/her return with a sample -disqualify the driver -send the driver home with a collection cup and have him/her return with a sample a shy bladder is a relatively common occurrence. it is generally no reason for disqualification. drivers cannot bring in a sample varicose veins have the potential for complications including chronic venous insufficiency, leg ulcerations, and recurrent deep vein thrombosis. what is the maximum certification period for a driver with varicose veins? 2 years gross vehicle weight is one measure of whether a driver needs a DOT medical exam. another is the number of passengers the vehicle is DESIGNED to transport. what is the minimum number of passengers (including driver)? 9 for compensation, 16 not for compensation a driver reports that he had arthroscopic surgery to repair a torn meniscus in his right knee 15 years previous. should this be recorded on the form? yes -all conditions and past surgeries should be noted- even if not a reason for denial a bipolar driver has been stable for 5 years without any manic or major depressive episodes. paperwork from his mental health provider confirms this. he is treated with lithium. what is the best certification period? 1 year -lithium therapy is not shown to interfere with safe driving. for stable bipolar disorder, 1 year is appropriate once a driver has a diagnosis of type 2 diabetes mellitus, regular monitoring by his treating physician is needed, what other follow-up is needed to qualify for DOT certification? annual evaluation by optometrist or ophthalmologist there are a number of conditions for which the medical examiner should automatically disqualify the driver, but an appeal can be made to a neurologist familiar with the demands of CMV driving. which is NOT one of these? narcolepsy, benign tumor of the CNS, multiple sclerosis, parkinson's disease narcolepsy -narcolepsy is always disqualifying. the others may be stable or mild enough to allow the driver to safely stay on the road the medical examiner should know where to look up relevant regulations. what code of federal regulations describes the qualifications of drivers, the responsibilities of medical examiners, and the DOT medical examination process? 42 CFR 221, 45 CFR 224, 39 CFR 158.8, 49 CFR 391 49 CFR 391