NRCME Test Questions with Correct & Verified Solutions 2023\2024., Exams of Nursing

Download NRCME Test Questions with Correct & Verified Solutions 2023\2024. and more Exams Nursing in PDF only on Docsity! NRCME Test Questions with Correct & Verified Solutions 2023\2024. 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. 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. NRCME Test Questions with Correct & Verified Solutions 2023\2024. 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. 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 NRCME Test Questions with Correct & Verified Solutions 2023\2024. is "A". A driver must exhibit a minimum peripheral vision of 70 degrees bilaterally. 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 NRCME Test Questions with Correct & Verified Solutions 2023\2024. and in severe depression. The driver should be evaluated by a mental health expert to make a diagnosis prior to certification. 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. NRCME Test Questions with Correct & Verified Solutions 2023\2024. 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. 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. NRCME Test Questions with Correct & Verified Solutions 2023\2024. 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. 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. NRCME Test Questions with Correct & Verified Solutions 2023\2024. d. May certify for a maximum of 2 years. - c. May certify for a maximum of 12 months. A driver has a blood pressure of 168/112 mm Hg confirmed during the examination. The driver should be: a. Disqualified. b. Certified for 6 months. c. Certified for 1 year. d. Certified for 2 years. - Correct Answer is "A". This is Stage 3 hypertension. The driver is disqualified until his blood pressure is less than 140/90 mm Hg at which time he will have a maximum certification of 6 months. For how long would a driver be certified if he is taking Micardis HCT for hypertension, and has a confirmed blood pressure of 148/96 mm Hg at the time of the examination? NRCME Test Questions with Correct & Verified Solutions 2023\2024. a. 3 months b. 6 months c. 1 year d. 2 years - Correct Answer is "A". Because the driver has a history of hypertension (he is taking medication), and he had Stage 1 hypertension during his exam, he would be provided a 1- time, 3-month certificate in order to lower his blood pressure to an acceptable level during that time. During the examination, a driver is found to have a positive "Babinski" reflex. The examiner should: a. Certify the driver for 1 year. b. Certify the driver for 2 years. c. Council the driver to obtain an SPE. d. Disqualify the driver until s/he has a neurological consultation. - Correct Answer is "D". A positive Babinski reflex is indicative of NRCME Test Questions with Correct & Verified Solutions 2023\2024. established that the driver is 10 years seizure-free while off anti- convulsants. A driver reports for a re-certification examination 8 weeks after having triple coronary artery bypass surgery. He presents a note from his treating provider stating that he is able to return to driving without restriction. Additionally, the note mentions that the driver's results of his ETT were normal, and his echo showed a left ventricular ejection fraction of 75%. The examiner should? a. Temporarily disqualify the driver until he has completed the required waiting period. b. Permanently disqualify the driver because his ejection fraction is too low. c. Certify the driver for 1 year only. d. Certify the driver for 2 years because he has medical clearance. - Correct Answer "A". Following CABG, there is a 3-month waiting period. Since the driver is only at 8 weeks post-op, he would have to wait 4 NRCME Test Questions with Correct & Verified Solutions 2023\2024. more weeks until he can certify. Once he completes his waiting period, he would be certified for 1 year from the date of the original examination. What is the maximum number of hours a CMV driver can drive in 7 consecutive days? a. 50. b. 60. c. 70. d. 80. - Correct Answer "B". 60-70 Hour Limit: A driver may not drive after 60/70 hours of duty in 7/8 consecutive days. Many versions of the NRCME exam will have one question about the 60/70 rule. A blood pressure of 166/92 mm Hg would be? a. Considered normal NRCME Test Questions with Correct & Verified Solutions 2023\2024. b. Stage 1 hypertension. c. Stage 2 hypertension. d. Stage 3 hypertension. - Correct Answer is "C". The driver has Stage 2 hypertension (160 - 179/100 - 109). The driver is taking "Sinemet" for the treatment of Parkinson's disease. The medical examiner should: a. Disqualify the driver. b. Obtain medical clearance from a neurologist. c. Counsel the driver to obtain a neurologist waiver. d. Certify the driver for 1 year. - Correct Answer is "A". A driver who is diagnosed with Parkinson's is permanently disqualified. The driver uses hearing aids during the whisper test. He is able to hear at 5 feet on the right and 4 feet on the left. NRCME Test Questions with Correct & Verified Solutions 2023\2024. b. 6 months c. 12 months d. 24 months - Correct Answer is "B". The driver may only be certified for a maximum of 6 months for the rest of his/her driving career. A driver is taking Wellbutrin to help him stop smoking. He has provided a note from his PCP stating that he has no side effects and confirms that he is taking the medication for smoking cessation.The examiner would? a. Certify the driver for 2 years. b. Certify the driver for 1 year. c. Disqualify the driver because the medication is not allowed. d. Council the driver to only take the medication at night. - Correct Answer is "A". The driver is not being treated for a psychiatric condition such as anxiety or depression, and he has clearance. He would be able to be certified for 2 years. NRCME Test Questions with Correct & Verified Solutions 2023\2024. During the history, the driver admits to taking Benadryl for seasonal allergies. The examiner should? a. Counsel the driver to not take the medication for 12 hours prior to driving. b. Obtain medical clearance from the driver's PCP that he/she can drive. c. Disqualify the driver until he/she is no longer taking Benadryl. d. Provide a 1-time, 3-month certificate to determine the medication's effect on the driver. - Correct Answer is "A". Counsel the driver concerning use of over-the-counter anti- histamines, and anti-tussives (both cause drowsiness and should not be taken while driving) and about the 12- hour rule. A driver has a history of a moderate Traumatic Brain Injury that occurred 3 years ago as a result of a car accident. He reports he has fully recovered and provides a note from his neurologist stating that he suffered no seizures and that he is able to return to driving. He does not list any medications in his history. The examiner should: NRCME Test Questions with Correct & Verified Solutions 2023\2024. a. Disqualify the driver. b. Require the driver to take a "Folstein's mini mental state exam." c. Certify the driver for one year. d. Certify the driver for two years. - Correct Answer is "C". The driver suffered no seizures from the TBI, has completed the required waiting period (2 years), and has medical clearance. If the rest of the examination is unremarkable, the driver could be certified for 1 year. A driver reports a suicide attempt 10 months earlier, following the break-up of his marriage. He noted seeing a psychiatrist and he takes Citalopram daily and he reports he feels fine now and is moving on with his life. He provides a release from his doctor that he may return to work without restrictions. The medical examiner should: a. Disqualify the driver. b. Require a CAGE questionnaire. c. Certify the driver for 1 year. NRCME Test Questions with Correct & Verified Solutions 2023\2024. A driver should not be certified when an ABG reveals a PaO2 of less than 65 at altitudes below: a. 2,000 feet b. 3,000 feet c. 5,000 feet d. 7,000 feet - Correct Answer "C" The threshold changes to 60 mm Hg at altitudes above 5,000 feet. A driver presents for certification after a myocardial infarction. What is theminimum waiting period status post myocardial infarction? 2 months 6 months 1 year NRCME Test Questions with Correct & Verified Solutions 2023\2024. 2 years - Correct Answer is "A". There is a 2-month waiting period from the date of the MI. A driver presents for certification 6 weeks after suffering a myocardial infarction. She presents a note from her cardiologist, clearing her to drive a CMV without restrictions. Her post MI echocardiogram shows an EF of 50%. Her EKG shows no ischemia. Her ETT exceeds FMCSA standards. The medical examiner should: Certify the driver for 3 months. Certify the driver for 1 year. Certify the driver for 2 years Disqualify the driver. - Correct Answer is "D". The driver should be disqualified because she has not met the minimum wait time of 2 months (8 weeks) after suffering a myocardial infarction. The driver can return for certification in two more weeks. NRCME Test Questions with Correct & Verified Solutions 2023\2024. A driver presents for certification. He checks "yes" for "Anxiety, depression, nervousness, and other mental health problems" for the Driver Health History portion of the Medical Examiner Report Form. He clarifies he has depression which is controlled with medications and electroconvulsive therapy (ECT). Following ECT, the driver should be symptoms free for how long before being certified? a. 3 months b. 6 months c. 12 months d. 24 months - Correct Answer is "B". Following ECT, the waiting period is 6 months. Maintenance or ongoing ECT for depression is not certifiable. According to FMCSA regulations, which of the following must the medical examiner evaluate when examining a driver's eyes? a. Pupil reactivity NRCME Test Questions with Correct & Verified Solutions 2023\2024. certification, not treatment of the infected finger. There will be questions like this on the exam. 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 monitoringintervals? Receritification/Excercise Tolerance Test a. Every year/ Every year b. Every 2 years/ Every year c. Every year / Every 2 years d. Every 2 years / Every 2 years - Correct Answer "C". According to FMCSA medical guidelines, when an MI is part of the medical history, there is a significant increased risk of another MI to occur within six months to 1 year; therefore, a maximum of one-year certification is the NRCME Test Questions with Correct & Verified Solutions 2023\2024. guideline. MI guidelines also recommend exercise tolerance testing at least every two years to demonstrate continued ability to safely operate a CMV A 25-year-old driver denies a history of any medical problems. She is a nonsmoker 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 Answer "C". 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, NRCME Test Questions with Correct & Verified Solutions 2023\2024. 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 one year? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4 - Correct Answer "A". 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 mm Hg. Lastly, Stage 4 hypertension doesn't exist. Which of the following is true of psychological disorders in drivers? NRCME Test Questions with Correct & Verified Solutions 2023\2024. b. Does his or her family have a history of cardiovascular disease? c. Does the driver have a cardiovascular disease that increases the risk of sudden death or incapacitation? d. What is the likelihood that he or she will contract a cardiovascular disease? - Correct Answer "C". When looking at the cardiovascular health of a driver, the fundamental question is whether the driver has a cardiovascular disease that increases the risk of sudden death or incapacitation, creating a danger to the safety and health of the driver, as well as the public sharing the road. While history and family history of such diseases are important, they are not the fundamental questions necessary about which to ask. If a medical examiner uses the number 1 during the physical examination, the medical examiner is indicating which of the following parts of the body system? a. Ears b. General Appearance NRCME Test Questions with Correct & Verified Solutions 2023\2024. c. Abdomen d. Heart - Correct Answer "B". 1 refers to General Appearance, 4 refers to Ears, 6 refers to Heart, and 8 refers to Abdomen When conducting a vision examination, a driver must have at least what distant visual acuity in each eye with or without correction? a. 20/10 b. 20/20 c. 20/40 d. 20/60 - Correct Answer "C". The driver must have at least 20/40 distant visual acuity in each eye with or without correction. 20/20 and 20/10 are higher standards than necessary. Which of the following is NOT true regarding the physical examination? a. The individual parts of the body system are categorized numerically NRCME Test Questions with Correct & Verified Solutions 2023\2024. b. For each body system, mark "Yes" on the Report Form if abnormalities are detected, or "No" if the body system is normal c. There is a maximum height requirement d. The medical examiner must document all abnormal findings on the Report Form, even if they are not disqualifying - Correct Answer "C". There is not in fact a maximum (or minimum) height (or weight) requirement for drivers. For each body system, mark "Yes" on the Report Form if abnormalities are detected or "No" if the body system is normal. The medical examiner must document all abnormal findings on the Report Form, even if they are not disqualifying. Lastly, the individual parts of the body system are categorized numerically. Which of the following colors is not necessary to be able to distinguish and recognize in traffic signals and devices? a. Blue NRCME Test Questions with Correct & Verified Solutions 2023\2024. b. Refer for diagnostic imaging and probable emergency care. c. Refer to a gastroenterologist. d. Give the driver a 1-year recertification. - Correct Answer "B". Possible Abdominal Aortic Aneurysm which is a medical emergency. A driver has a limitation of 35 degrees of cervical rotation to the right and left but can view both side mirrors. What is the next best step?: a. Disqualify the driver. b. Certify the driver for 1 year. c. Certify the driver for 2 years. d. Disqualify the driver pending a functional evaluation. - Correct Answer "C". The FMCSA has not adopted a standard cervical range of motion guideline for drivers. However, drivers must be able to view both mirrors. If the driver can rotate the spine as needed to see both mirrors s/he can be certified for up to 2 years. NRCME Test Questions with Correct & Verified Solutions 2023\2024. A driver presents with a history of an isolated TIA 6 months previously. He presents with a return to work letter from his primary care physician and his neurologist. The driver is taking Hydrochlorothiazide and Simvastatin. All other aspects of the exam and history were normal. What should the examiner do next? a. Certify the driver for 1 year. b. Temporarily disqualify the driver. c. Certify the driver for 3 months. d. Certify the driver for 2 years. - Correct Answer "B". There is a waiting period of one year following a TIA. If there is any presence of seizure, the driver must wait 5 years before being certified. Which of the following is a criterion for certification after a myocardial infarction? a. EKG showing no signs of ischemia. b. Echocardiogram showing an EF >= 40%. NRCME Test Questions with Correct & Verified Solutions 2023\2024. c. ETT showing 85% of maximum predicted HR. d. All of the above. - Correct Answer is "D". All the listed choices are criteria for certification post myocardial infarction after meeting the 2- month wait time. Certification is granted for one 1 year. A driver presents for initial certification. His blood pressure is 180/102 mm Treated with amlodipine 5 mg daily. Which of the following best represents the medical examiner's BP staging and certification decision? a. Stage II hypertension b.c. Stage III hypertension d. Stage II hypertension Certify: 3-month card Certify: 6-month card Certify: 1 year - Correct Answer is "B". 180/102 is consistent with stage III hypertension (SBP of 180 is stage III, and DBP of 102 is stage II; the greater stage is obtained). Stage III hypertension is disqualified, according to FMCSA guidelines. In order to be recertified after disqualification for stage III hypertension, a driver must present evidence of good blood pressure control, i.e. <140/90. If upon NRCME Test Questions with Correct & Verified Solutions 2023\2024. The driver presents for re-certification. He admits a cerebellar stroke 2 years ago that has resolved without any residual deficits. He presents clearance from his neurologist, and he is on no anti-seizure or stroke medication. He is otherwise medically fit. What is the certification decision? a. Disqualify, as he has not met the waiting period. b. Certify for 1 year. c. Certify for 2 years. d. Obtain head CT to rule residual deficits. - Correct Answer is "B". The waiting period for cerebellar or brain stem strokes is 1 year. The driver has met the waiting period, obtained clearance from his neurologist and is on no medications for stroke. He can be certified for 1 year. A driver presents for examination following a spontaneous pneumothorax one month earlier. The records provided by the driver indicate that the pneumothorax reduced the driver's forced vital NRCME Test Questions with Correct & Verified Solutions 2023\2024. capacity (FVC) to 58% of the predicted forced vital capacity. As the medical examiner, you should: a. Certify the driver for one year. b. Certify the driver for two years. c. Do not certify the driver. d. Disqualify the driver for 6 months and re-evaluate at 6-month recheck. - Correct Answer "C". Do not certify. According to recommendations, this driver should not be certified until the medical examiner has verified that the recovery is complete, with X- rays, and the driver has an adequate FVC. Who can perform the vision portion of the interstate CMV driver physical examination other than the medical examiner? a. Medical assistant. b. Ophthalmologist. c. Optometrist. NRCME Test Questions with Correct & Verified Solutions 2023\2024. d. Any of the above. - Correct Answer "D". A Medical Examiner, Medical assistant, or Ophthalmologist/Optometrist may perform the vision testing. A driver has an abdominal aortic aneurysm. The medical examiner obtains a copy of a recent abdominal sonogram indicating that the aneurysm is 5.3 cm in diameter. According to current recommendations, can the medical examiner certify this driver? a. No. b. Only if there is written clearance by a vascular surgeon. c. Yes, but the patient must undergo serial ultrasounds every 3 months. d. Yes, but the patient must undergo serial ultrasounds every 6 months. - Correct Answer "A". An aneurysm must be less than 5 cm for certification. NRCME Test Questions with Correct & Verified Solutions 2023\2024. c. Contact lenses may not be worn to meet distant visual acuity requirements. d. The driver must meet either the distant visual acuity requirement for each eye OR the binocular visual acuity requirement. - Correct Answer "A". The Snellen chart or the Titmus Vision Tester measures static central vision acuity. The requirement for central distant visual acuity is at least 20/40 in each eye and distant binocular visual acuity of at least 20/40. Test results must be recorded in Snellen-comparable values. Eyeglasses or contact lenses may be worn to meet distant visual acuity requirements. When corrective lenses are worn to meet vision qualification requirements, corrective lenses must be worn while driving. Which is accurate regarding the hearing test required of commercial motor vehicle drivers? a. The forced whisper test must be administered first. b. Hearing aids cannot be used to pass the test. NRCME Test Questions with Correct & Verified Solutions 2023\2024. c. If the driver perceives a forced whisper in one ear at 6ft, he has met the hearing requirement. d. If the driver attempts to meet the requirement using a hearing aid, only the audiometric test is administered. - Correct Answer "C". The required tests screen for hearing loss in the range of normal conversational tones. Two tests are used to screen hearing: a forced whisper test AND/OR an audiometric test. Either test may be administered first. Administration of the second test may be omitted when the test results of the initial test meet the hearing requirement for that test. Hearing requirements are (1) First perceive a forced whispered voice, in one ear, at not less than five feet OR (2) Have an average hearing loss, in one ear, less than or equal to 40 decibels (dB). When a driver who wears a hearing aid is unable to pass a forced whisper test, referral to which of the following is required? a. An audiologist. b. An otolaryngologist. NRCME Test Questions with Correct & Verified Solutions 2023\2024. c. A hearing aid center. d. Any of the above is acceptable. - Correct Answer "D". A hearing aid may be used during forced whisper testing. When a driver who wears a hearing aid is unable to pass a forced whisper test, referral to an audiologist, otolaryngologist, or hearing aid center is required. Which of the following frequencies is NOT included as part of the audiometric hearing test for commercial motor vehicle drivers? a. 500 hertz (Hz). b. 1,000 Hz. c. 2,000 Hz. d. 4,000Hz. - Correct Answer "D". The hearing requirement for an audiometric test is based on hearing loss only at the 500 Hz, 1,000 Hz, and 2,000 Hz frequencies that are typical of normal conversation. NRCME Test Questions with Correct & Verified Solutions 2023\2024. b. 35%. c. 40%. d. 45%. - Correct Answer is "C". For an initial certification following an MI, an in-hospital post-MI echocardiogram showing an LVEF greater than or equal to 40% is sufficient. What is the minimum waiting period following Coronary Artery Bypass Graftingsurgery? a. One month. b. Two months c. Three months d. Dependent on the type of CABG performed and the number of vessels involved. - Correct Answer "C". A significant risk associated with CABG surgery is the high long-term reocclusion rate of the bypass graft. The Waiting Period is a Minimum of 3 months regardless of type of CABG surgery performed. NRCME Test Questions with Correct & Verified Solutions 2023\2024. Following an uncomplicated, elective percutaneous coronary intervention procedure to treat stable angina, the post-procedure waiting period is: a. 1 week. b. 3 weeks. c. 1 month. d. 2 months. - Correct Answer "A". Following an uncomplicated, elective percutaneous coronary intervention procedure to treat stable angina, the post-procedure waiting period is 1 week. The waiting period allows for a small threat caused by acute complications at the vascular access site. Drivers undergoing PCI in the setting of an acute myocardial infarction or unstable angina should be restricted from driving duties for the longer waiting period recommended for these conditions. Which cardiac condition is disqualifying? NRCME Test Questions with Correct & Verified Solutions 2023\2024. a. Hypertrophic cardiomyopathy. b. Mitral valve prolapse. c. Ebstein anomaly. d. Aortic valve repair for aortic stenosis 4 months prior to exam. - Correct Answer "A": A driver with a diagnosis of Hypertrophic Cardiomyopathy may not be certified to drive. Similarly, a driver with a diagnosis of Restrictive Cardiomyopathy may not be certified to drive. A driver who exhibits difficulty breathing and has a history of COPD should undergo additional pulmonary testing. A forced expiratory volume in the first second of expiration (FEV1) less than what level of predicted should prompt arterial blood gas measurements? a. 50%. b. 55%. c. 65%. NRCME Test Questions with Correct & Verified Solutions 2023\2024. d. May elect to perform a finger stick to obtain a random blood glucose. - Correct Answer "D". Glycosuria may indicate poor blood glucose control. When urinalysis shows glycosuria, you may elect to perform a finger stick test to obtain a random blood glucose. You are required to perform a urinalysis (dip stick) as a part of every driver certification and recertification medical examination. An abnormal result for which of the following mandates temporarydisqualification? a. Protein. b. Blood. c. Glucose. d. NONE of the above. - Correct Answer "D". Proteinuria, hematuria, or glycosuria may be an indication for further testing to rule out any underlying medical problem. You should advise the driver of any abnormal findings and when indicated, encourage the driver to seek primary care provider evaluation, particularly if an abnormal urinalysis NRCME Test Questions with Correct & Verified Solutions 2023\2024. could indicate the presence of a medical condition that if left untreated could result in a serious illness that might affect driving. Each of the following mandates disqualification in a driver with a history of alcoholism EXCEPT: a. He voluntarily attends a 12-step program to maintain his recovery. b. He has not successfully completed counseling and/or treatment. c. He has a current diagnosis of alcoholism. d. ALL of the above are disqualifying. - Correct Answer "A". Ongoing voluntary attendance at self-help groups (e.g., 12-step programs) for maintenance of recovery is not disqualifying. A female driver presents for re-certification who is in her fourth day of menses with heavy bleeding. Her US shows a Specific gravity of 1.020; Protein is +1; Blood is +4; Glucose is negative. All other aspects of her medical examination are within normal. The examiner should: NRCME Test Questions with Correct & Verified Solutions 2023\2024. a. Obtain medical clearance prior to certification. b. Disqualify the driver. c. Certify the driver for 1 year. d. Certify the driver for 2 years. - Correct Answer "D". The abnormality in the UA is the level of blood in the urine, which is likely a result of the driver's menstrual cycle. Without any other identified abnormality, the driver would be certified for 2 years. At initial certification, a driver is found to have a blood pressure of 165/105 mm Hg. You give him a certification for three months. Upon recheck, his blood pressure is 135/85. As medical examineryou: a. Give him a 6-month certification. b. Give him a one-year certification from date of initial exam. c. Give him a one-year certification from date of recheck. NRCME Test Questions with Correct & Verified Solutions 2023\2024. FMCSA guidance recommends drivers NOT be certified with the following conditions EXCEPT: a. Uncontrolled vertigo. b. Meniere's disease. c. Labyrinthine fistula. d. Otitis Media. - Correct Answer "D". Otitis media is not disqualifying. A driver with a history of congestive heart failure is asymptomatic at time of presentation for certification. What minimum left ventricular ejection fraction is required for certification? a. 40% b. 45% c. 50% d. 55% - Correct Answer "A". The minimum LVEF for certification is 40% in a patient with known Congestive Heart Failure. NRCME Test Questions with Correct & Verified Solutions 2023\2024. A driver presents for certification and notes that he is recently had a surgical repair of an aneurysm in his left leg. What is the minimum waiting period following surgical repair of an aneurysm? a. 1 month b. 3 months c. 6 months. d. 1 year. - Correct Answer "B". Aneurysms can develop in visceral and peripheral arteries and venous vessels. Rupture of any of these aneurysms can lead to gradual or sudden incapacitation and death. Much of the information on aortic aneurysms is applicable to aneurysms in other arteries. The waiting period is a minimum 3 months post-surgical repair of an aneurysm. Which of the following is true regarding the FMCSA Blood Pressure regulations for commercial motor vehicle drivers? NRCME Test Questions with Correct & Verified Solutions 2023\2024. a. Only BP readings taken during the driver physical or follow-up examinations may be used for certification decisions. b. A BP greater than 145/89 mm Hg should be confirmed with a second measurement taken later during the examination. c. Trained assistive personnel may take and record the BP. d. All of the above are correct. - Correct Answer "D". Trained assistive personnel may take and record the BP and pulse. When BP, pulse rate, or both are significant factors in your decision not to certify a driver, it is prudent for you to measure the readings yourself. However, the Medical Examiner must sign the Medical Examination Report form. By signing the Medical Examination Report form, you are taking responsibility for and attesting to the validity of all documented test results. As part of the evaluation of a driver presenting for initial certification, as the medical examiner, you must perform testing for: a. Alcohol. NRCME Test Questions with Correct & Verified Solutions 2023\2024. c. 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. d. Oversee the prosecution of criminally negligent cases of motor carrier safety breaches. - d. Oversee the prosecution of criminally negligent cases of motor carrier safety breaches. In which of the following cases should you mark an exam as "incomplete examination"? a. When you do not have enough information to make a decision. b. When you have scheduled a follow up appointment for the to return with additional lab tests. c. When one provider begins an exam that will be completed by another provider. NRCME Test Questions with Correct & Verified Solutions 2023\2024. d. When the driver leaves before you have completed the exam and made a decision. - d. When the driver leaves before you have completed the exam and made a decision. It is the responsibility of the Motor Carrier to make sure that commercial motor vehicle drivers meet each of the following requirements EXCEPT: a. Be at least 21 years old. b. Speak and read English well enough to understand highway/traffic signals and converse with law enforcement. c. Have a current Medical Examiner's Certificate on file. d. Provide their full Medical Examination Report Form to the motor carrier. - d. Provide their full Medical Examination Report Form to the motor carrier. NRCME Test Questions with Correct & Verified Solutions 2023\2024. What HgbA1C level is indicative of a diagnosis of diabetes? a. 4.8% b. 6.5% c. 7.9% d. 10% - b. 6.5% A driver presents for her first DOT medical exam. She is 48 years old and starting truck-driving school as a second career. She has no previous diagnosis of HTN, but her blood pressure today is 176/124 mm Hg. What time period is appropriate for certification? a. 1 year. b. 6 months. c. 1-time certification for 3 months. NRCME Test Questions with Correct & Verified Solutions 2023\2024. unsure of his prescriptions but is asymptomatic. Should he be certified today? a. Yes. Give him a 6-month certificate. b. Not until you check his medication. Then, yes. c. No. There is a minimum wait period of 2 months and specific criteria that must be met thereafter before certification. d. No. He must wait 6 months at the minimum before being evaluated further. - c. No. There is a minimum wait period of 2 months and specific criteria that must be met thereafter before certification. A driver had heart surgery 6 months ago. He reports recovering well and is asymptomatic. Documentation from his physician shows he is indeed recovering well and tolerating his medication. Surgery included installation of an implantable cardioverter defibrillator. Can he be qualified today? a. Yes, he is stable. NRCME Test Questions with Correct & Verified Solutions 2023\2024. b. No. More information is needed on his exercise tolerance. c. No. An lCD is disqualifying. d. No. He has not yet met an adequate waiting period. - c. No. An lCD is disqualifying. A driver denies using illegal drugs, but he looks haggard and has fresh needle sticks on his forearm. Can you order lab testing for drugs? a. No. Drug testing is beyond the scope of the DOT medical exam. b. Only if you call the employer and have them do a reasonable suspicion DOT drug test. c. Yes, this is outside of standard DOT drug testing, but a non-DOT drug test can be ordered. Refusal to test is a failure. - c. Yes, this is outside of standard DOT drug testing, but a non-DOT drug test can be ordered. Refusal to test is a failure. What is the maximum allowable BMI to qualify driver? NRCME Test Questions with Correct & Verified Solutions 2023\2024. a. 40. b. 50. c. 55. d. There is no standard. - d. There is no standard. The FMCSA provides no definitive guidance regarding criteria that mandate screening for obstructive sleep apnea nor any OSA risk factor thresholds that mandate disqualification. A driver has a long history of major depression. His only current medication is Paxil, and he reports no side effects. Three months ago, he attempted to commit suicide by hanging but was unsuccessful. Physically, all is within standards. Can he be qualified? a. No. Paxil is disqualifying. b. Yes. This scenario is not disqualifying. c. No. The waiting period following a suicide attempt is 2 months minimum. NRCME Test Questions with Correct & Verified Solutions 2023\2024. d. Schedule V. - b. Schedule I. Marijuana is what listed as which of the following? a. Schedule 1 drug. b. Schedule 2 drug. c. Schedule V drug d. It used to be considered a Schedule 1 drug. It is no longer a listed drug. - a. Schedule 1 drug. A driver is 35 years of age. He has a diagnosis of Ankylosing Spondylitis since he was 19. He has fusion throughout his spine, excluding the upper cervical spine. Neck rotation is limited to 15 degrees bilaterally. His neck is permanently flexed 25 degrees forward and he can only extend it 10 degrees. Agility is greatly diminished and he cannot climb well. He now presents for recertification, but notes he primarily does an NRCME Test Questions with Correct & Verified Solutions 2023\2024. administrative desk job. Based on this, what is the proper course ofaction? a. Disqualify. b. Certify for 1 year. c. Order a Skill Performance Evaluation. d. Certify for 6 months. - a. Disqualify. Transient Ischemic Attacks are a major concern. They can be one of the earliest signs of cerebrovascular disease. Symptoms usually only last 10- 20 minutes. All of the following are symptoms that may present in the history as a result of a TIA, EXCEPT: a. Sudden temporary tingling, numbness, or weakness. b. Confusion. c. Sudden visual changes. d. Sciatica. - d. Sciatica. NRCME Test Questions with Correct & Verified Solutions 2023\2024. A driver with a history of a TIA should be removed from the road for what minimum waiting period? a. 2 months. b. 6 months. c. 1 year. d. 2 years. - c. 1 year. Epilepsy is a major concern due to risk of seizure or loss of consciousness. How many unprovoked seizures are required for a diagnosis of epilepsy? a. One. b. Two. c. There is no single definition; diagnosis is made on a case-by-case basis. - b. Two. NRCME Test Questions with Correct & Verified Solutions 2023\2024. Which of the following diagnoses is NOT always disqualifying? a. Narcolepsy. b. Bipolar Disorder. c. Meniere's disease. d. Current Alcoholism. - b. Bipolar Disorder. An obese driver's urinalysis shows 500mg/dL of glucose. He claims he is not diabetic, but it is simply because of the 20-ounce bottle of soda he drank in the hour before the test. What should be done? a. Obtain a finger stick glucose. b. Certify for 1 year and recheck at that time. c. Use determination pending and have the patient return for a repeat glucose dipstick within 45 days. d. Disqualify. - a. Obtain a finger stick glucose. NRCME Test Questions with Correct & Verified Solutions 2023\2024. A driver's blood pressure is found to be 164/90 mm Hg during his DOT exam in January. He is given a 3-month certificate. He returns in March, having lost 10 pounds and starting an anti-hypertensive medication. His blood pressure is now found to be 136/84 mm Hg. How should you proceed? a. Certify for 9 months from today's date. b. Certify for 1 year from today's date. c. Blood pressure remains too high. Disqualify. d. Amend your exam for 3 months ago and certify for 1 year from today's date. - a. Certify for 9 months from today's date. Who can grant a waiver or exemption? a. The Medical Examiner. b. The FMCSA. c. A Board-Certified Specialist in the field of the relevant disease. NRCME Test Questions with Correct & Verified Solutions 2023\2024. d. Any of the above. - b. The FMCSA. If a driver has had a cortical stroke, what is the minimum waiting period before he/she may possibly be certified to drive? a. 5 years, as potential for seizure is a concern. b. 1 year If there is no seizure. c. 6 months. d. 6 months once off anticoagulants. - a. 5 years, as potential for seizure is a concern. Both Schizophreniform and Bipolar Disorders can be disqualifying. Which of the following conditions is NOT a reason in and of itself to disqualify? a. Substantially compromised judgment. b. Swings in energy levels and mood. NRCME Test Questions with Correct & Verified Solutions 2023\2024. c. Have a rise in systolic blood pressure greater than or equal to 20 mm Hg without angina. d. Have no increase in diastolic pressure. - d. Have no increase in diastolic pressure. Which of the following are not required for the urinalysis portion of the DOT medical exam? a. Specific Gravity. b. Blood. c. Ketones. d. Protein. - c. Ketones. If a dipstick urinalysis shows findings that are abnormal but do not immediately threaten the driver or the public, such as mild proteinuria, which is the most reasonable course of action? NRCME Test Questions with Correct & Verified Solutions 2023\2024. a. Disqualify until further testing is done. b. Encourage the driver to seek further care from his primary care provider and document the findings for him/her to take to the PCP. c. Make a note in the medical examination report form, but take no other action until the next DOT exam. - b. Encourage the driver to seek further care from his primary care provider and document the findings for him/her to take to the PCP. What is the advised minimum waiting period following coronary artery bypass surgery? a. 1 month. b. 2 months. c. 3 months. d. This is disqualifying. - Correct Answer is "C". NRCME Test Questions with Correct & Verified Solutions 2023\2024. Severe traumatic brain injuries are disqualifying. How is a "severe TBI" defined? a. Injury penetrates the dura and/or causes loss of consciousness > 24 hours. b. Injury causes loss of consciousness longer than 6 hours. c. Physically or chemically induced brain injury causing motor or sensory loss. d. Injury to the head resulting in permanent neurologic deficit. - Correct Answer is "A". A vehicle that is used to transport a minimum of which of the following number of persons (including the driver) would be defined as a commercial motor vehicle for interstate commerce? 4 for compensation, 10 not for compensation. 6 for compensation, 8 not for compensation. NRCME Test Questions with Correct & Verified Solutions 2023\2024. The Role of the Medical Examiner specifically includes: a. Assessing the Driver for medical fitness to safely perform all driver duties. b. Refilling medications required by the driver for safe driving. c. Addressing new health concerns of the driver. d. ALL of the above. - Correct Answer is "A". The Medical Examiner can diagnose and treat if within his/her scope of practice, but it is a separate role. These roles can be referred. It is generally accepted that a HgbA1C above what level indicates poor control of diabetes? a. 7%. b. 10%. c. 12% d. 13% - Correct Answer is "B". NRCME Test Questions with Correct & Verified Solutions 2023\2024. Central vision loss is a finding suggestive of: a. Macular degeneration. b. Cataracts. c. Glaucoma. d. All of the above. - Correct Answer is "A". Central vision loss results from degeneration of the fovea - the central pit of the retina, where visual acuity is sharpest. The most common cause is age-related macular degeneration, which is also the leading cause of blindness in older adults. On examination, the medical examiner palpates an enlarged liver on a driver and find signs suggestive of early hepatic failure. The medical examiner should: a. Order an abdominal ultrasound as a first step. b. Order an abdominal CT scan as a first step. NRCME Test Questions with Correct & Verified Solutions 2023\2024. c. Order a set of Liver Function Tests as a first step. d. Refer the driver to his Primary Care Provider. - Correct Answer is "D". The medical examiner's responsibility is to determine a driver's fitness to operate a commercial vehicle. It is not to diagnose or prescribe medication. This is an important concept in the context of the NRCME exam as it will likely be asked several different ways. Questions are often asked about a disease which may be complex or unfamiliar to the examinee, causing confusion regarding diagnostic steps. In fact, the Answer is simply to refer the patient to the PCP or specialist and not initiate a diagnostic work-up. A 20-year-old person approaches you and asks you to perform a medical examination for him as he is planning to apply for an interstate CMV driver job advertised by a local transportation company. According to the FMCSA standards, a person under 21 is not eligible to work as an interstate CMV driver; however, you can still perform the examination because: