NRCME Test Bank Questions with Verified Solutions (Latest Update 2024/25), Exams of Nursing

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(Latest Update 2024/25)

Which of the following is a requirement for drivers with a diabetes exemption? A) Possess a rapidly absorbable form of glucose while driving B) Self—monitor blood glucose one hour before driving and at least once every 2 hours while driving C) Plan to submit blood glucose monitoring logs every 6 months D) Maintain a Hemoglobin A1C value less than 7 - correct answers ✅A. Drivers with diabetes should self monitor blood glucose before driving and every 4 hours while driving. Blood glucose monitoring logs should be submitted annually. There is no specific requirement for HgA1C level. Drivers with insulin dependent diabetes: A) May be certified for a maximum of 6 months B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certification C) Cannot be certified if they have a history of myocardial infarction D) May be eligible for a diabetes exemption - correct answers ✅D) Drivers with insulin dependent diabetes cannot be certified but may be eligible for a diabetes exemption Which of the following is true? A) A driver with diabetes who uses insulin does not meet the minimum requirements of 49 CFR Part 391.

(Latest Update 2024/25)

B) The most important concert related to medication use for treating diabetes is hyperglycemia C) Peripheral neuropathy is not a disqualifying condition D) Diabetes is not a coronary heart disease (CHD) equivalent condition - correct answers ✅A) The greatest risk for medication use for drivers with diabetes in hypoglycemia, not hyperglycemia. Peripheral neuropathy is disqualifying condition. Diabetes is a CHD equivalent condition. What is the recommended certification interval for a driver with diabetes mellituse who does not use insulin? A) Three months B) Six months C) One year D) Two years - correct answers ✅C) Drivers with non-insulin dependent diabetes should be certified for a maximum of one year A diabetes exemption may be issued by: A) An endocrinologist B) The Medical Examiner C) The driver's personal physician

(Latest Update 2024/25)

Drivers with a history of _____________ severe hypoglycemic reactions in the past year or _____________ severe hypoglycemic reactions in the past five years should not be certifed. A) one, three B) one, two C) two, three D) two, five - correct answers ✅B) A driver should not be certified if the driver has had one hypoglycemic reaction in the past year or two in the past five years. Which of the following is not a criteria that the FMCSA uses to define a severe hypoglycemic reaction? A) Seizure B) Dizziness C) Need of assistance from another person D) Period of impaired cognitive function that occurred without warning - correct answers ✅B) FMCSA defines severe hypoglycemia as reactions that result in seizure, loss of consciousness, need of assistance from another person, and a period of impaired congitive function that occurred without warning Which diabetes mellitus risk poses the greatest threat to public safety A) Hyperglycemia

(Latest Update 2024/25)

B) Peripheral neuropathy C) Hypoglycemia D) Metabolic encephalopathy - correct answers ✅C) Although hyperglycemia, peripheral neuropathy, and metabolic encephalopathy all pose significant risks for safe driving, hypoglycemia poses the greatest risk. The risk is particularly pronounced in drivers who use insulin. FMCSA defines a hypoglycemia episode as one that results in seizure, loss of consciousness, need of assistance from another person, or a period of impaired cognitive function that occurs without warning. A driver with a diabetes exemption should check glucose levels when? A) One hour before driving and at least once every four hours while driving B) One hour before driving and at least every eight hours while driving C) Once after four hours of driving D) Once a day after driving period has ended - correct answers ✅A) Driver's with diabetes exemption should check glucose values one hour before driving and once every four hours while driving Which of the following is true for diagnosis of a hernia? A) The driver should be referred to a surgeon to determine whether repair of a hernia is necessary B) The waiting period following hernia surgery is two weeks

(Latest Update 2024/25)

A) Cancer requiring chemotherapy treatment B) Umbilical hernia not surgically repaired C) Renal failure on peritoneal dialysis D) Hemochromatosis - correct answers ✅C) Dialysis of any type is disqualifying If a significant abnormal finding for urinalysis specific gravity, protein, or blood is found, the medical examiner should: A) Disqualify the driver B) Request that a renal specialist determine if the driver is medically qualified C) Use clinical expertise to determine a certification decision and to determine if additional evaluation is required or recommended D) Obtain blood chemistries for renal function - correct answers ✅C) The medical examiner must determine whether additional evaluation is needed and whether the certification decision should be postponed or limited A driver with a history of kidney disease with or without transplant: A) Is medically disqualified B) Must be assessed regarding the severity, stability, medications used, and medication side effects/adverse reactions C) Should not be assessed for functional ability to operate a CMV safely

(Latest Update 2024/25)

D) Should have the medical certificaton determination made by a renal specialist - correct answers ✅B) ASsessment for kidney disease must be ade on a case-by-case basis. Dialysis of any kind is disqualifying. The medical examiner may choose to test the driver for functional ability to operate a CMV safely. The medical certification decision must be made by the medical examiner. Which of the following is not a disqualifying condition? A) Peritoneal dialysis B) Hemodialysis C) Hernia D) Peripheral neuropathy - correct answers ✅Any type of dialysis is a disqualifying condition. Peripheral neuropathy is usually disqualifying. Although a hernia may be disqualifying, often a driver can be certified if the symptoms and/or examination findings are mild or if the hernia has been surgically repaired and the condition has stabilized (there is no specified waiting period following hernia treatment, including surgery). Urinalysis is required for the driver physical examination and the results must include A) Specific gravity, creatinine, bilirubin, and glucose B) Creatinine, bilirubin, blood, and protein

(Latest Update 2024/25)

D) The underlying cause has been identified and recurrence risk is low following treatment - correct answers ✅D) Drivers with bleeding ulcers should not be certified until the underlying cause has been identified and the recurrence risk is low A driver with a successful kidney transplant can be certified A) True B) False - correct answers ✅A) Kidney transplants are not disqualifying Which of the following is true? A) Medical marijuana use if disqualifying B) The medical examiner should drug test the driver for marijuana if the driver gives a history of recent marijuana's C) A driver with a history of only occasional marijuana may not have to complete a substance abuse professional assessment D) Marijuana is a Schedule II drug - correct answers ✅A) If a driver gives a history of recent marijuana use, the driver should be referred for substance abuse professional evaluation regardless of drug test result. Drivers with a history of marijuana use, or a drug test positive for marijuana, must undergo substance abuse professional assessment and complete any recommended rehabilitation prior to returning to driving. Marijuana is a Schedule I drug.

(Latest Update 2024/25)

Which of the following is a requirement for a driver with a history of alcoholism to be certified? A) No residual disqualifying physical impairment B) Successful treatment with naltrexone C) Currently in counseling and/or treatment D) No more than one current alcohol-related disorder - correct answers ✅A) Treatment with naltrexone is not required for driver certification for a driver with a history of alcoholism. A driver with a history of alcoholism must have completed counseling and/or treatment and must not have a current alcohol-related disorder in order to be certified. Which of the following is a disqualifying condition? A) A past clinical diagnosis of alcoholism B) A breath alcohol result of 0.019% C) An alcohol-related stable physical condition, regardless of the time element D) Use of methadone - correct answers ✅D) A current diagnosis of alcoholism is disqualifying. A breath alcohol result of 0.02% or higher renders the driver unqualified to drive. An alcohol-related unstable physical condition is disqualifying.

(Latest Update 2024/25)

C) 2 and 4 only D) 4 only E) all of the above - correct answers ✅According to the FMCSA, all of these are defined as mental health professionals The maximal certification internal for a driver with a history of drug abuse or alcoholism is A) Six months B) One year C) Two years D) Do not certify - correct answers ✅C) Drivers with a history of drug abuse or alcoholism may be certified forup to two years. Drivers may be subject to drug and/or alcohol testing more frequently, but such testing is performed under 49 CFR Part 40 drug and alcohol testing regulations, not under 49 CFR Part 391. driver qualification standards Which of the following is true? A) One of the requirements for the CMV drier physical examination is testing for controlled substances

(Latest Update 2024/25)

B) A driver taking multiple medications reports daily, regular or moderate use of alcohol. The Medical Examiner should evaluate the possibility of medication interactions with alcohol that may cause impairment C) Even in remission, alcoholism is disabling for the CMV driver D) Use of Schedule I drugs is not disqualifying - correct answers ✅B) Testing for controlled substances if not required for the CMV driver examination. Alcoholism in remission is not a disqualifying condition. Use of Schedule I drugs is disqualifying. Ongoing attendance at self-help groups A) Fulfills the requirement to complete a rehabilitation program B) Is not disqualifying when used for maintenance of recovery C) Eliminates the need for follow-up testing D) Is mandated by the FMCSA - correct answers ✅B) Attendance at self-help groups is to disqualifying but does not fulfill the requirement for participation ina rehabilitation program. Follow-up testing must be performed according to FMCSA guidelines, regardless of participation in a self-help group. The Substance Abuse Professional (SAP) determines the need for attendance at self-help groups as a condition of return to work as a CMV driver.

(Latest Update 2024/25)

The Medical Examiner should be familiar with DOT drug and alcohol testing requirements as outlined in: A) 49 CFR Part 40 B) 40 CFR Part 38 C) 49 CFR Part 66 D) 49 CFR Part 12 - correct answers ✅A) DOT drug and alcohol testing regulations are described in 49 CFR Part 40 If the Substance Abuse Professional determines that current alcoholism exists, the driver is not qualified to drive a commercial motor vehicle in interstate commerce A) True B) False - correct answers ✅A) Drivers with a current diagnosis of alcoholis are disqualified The impairment benchmark for FMCSA for alcohol is A) 0. B) 0. C) 0.

(Latest Update 2024/25)

D) 0.08 - correct answers ✅C) FMCSA recommendations use the degree of imipairment produced by a 0.04 percent food alcohol concentration as a benchmark for impairment A driver with monocular vision who has been granted a federal vision exemption or who is qualified by operation of 49 CFR 391.64 must have an annual physical examination. A) True B) False - correct answers ✅A) Even though a vision exemption is provided for two years, the driver must undergo annual examinatin Who of the following is not qualified to perform the vision testing portion of the interstate CMV driver physical examination? A) An optometrist B) The medical examiner C) A licensed vision testing technician D) An ophthalmologist - correct answers ✅C) Vision testing must be performed by the medical examiner, an optometrist, or ophthalmology Which of the following is true with regard to horizontal field of vision testing include:

(Latest Update 2024/25)

For a driver to be certified without a waiver for color recognition, they must

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A) Correctly identify the true colors of signs and traffic lights B) Sufficiently recognize traffic signals and devices showing the standard red, amber and green traffic signal colors C) Be able to identify the different signs and traffic lights through shape and positional analysis D) Pass an Ishahara color vision test - correct answers ✅B) Drivers must be able to recognize red, yellow, and green traffic signal colors A driver with monocular vision who has been grandfathered must provide proof of grandfathered status at what time? A) Within three oaths of certification B) When the certification is issued C) Before the certification process is complete D) Never - correct answers ✅C) Drivers with monocular vision who have grandfathered status must provide proof of such status before the medical examiner may issue certification The maximum duration of a federally-granted waiver or exemption is

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(Latest Update 2024/25)

A) Three months B) Six months C) One year D) Two years - correct answers ✅D) Waiver durations may vary, although they cannot exceed two years The medical examiner's role in the exemption process is _______________ A) Issuing the exemption B) Advising the FMCSA on the severity of the driver's impairment C) Providing the driver contact information for the Federal Vision Exemption Program D) Performing vision testing - correct answers ✅C) The medical examiner's role in securing a vision exemption is to help the driver get in contact with the Federal Vision Exemption Program Under what conditions may a driver diagnosed with lazy eye be certified? A) Under any conditions — lazy eye is not considered a visual impairment for CMV operators B) Only if the driver has a visual acuity of 20/70 or better, or a federal exemption C) Only if the driver has a visual acuity of 20/40 or better, or a federal exemption