NRCME Test Questions with Verified Answers Latest Update 2024, Exams of Nursing

Download NRCME Test Questions with Verified Answers Latest Update 2024 and more Exams Nursing in PDF only on Docsity!

NRCME Test Questions And Answers 2024.

What minimum PaO2 level is necessary if the driver has an ABG due to

arespiratory chronic

disorder?a.70mmH

gb.55mmH

g c.60mmH

gd.65mmHg - Answer Correct answer is "D". To be qualified, the driver

shouldminimum meet arterial a 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

examinershould

:a.Permanently disqualify the driver because he "failed" the whispered

voiceb.Certify test. the driver for 2

years.c.Certify the driver for 1

year.d.Require an audiometric test to determine the extent of hearing loss in

hisAnswer left ear. Correct - answer is "B". The driver is qualified to drive without

restrictionlong as he asis 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

returnimmediately to work without restriction. Included within the note, the

cardiologist provides

recent testing information showing that the driver had an ETT that

showedable to reach he was 12 METS during the test. His echocardiogram showed

anfraction ejection 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

fromAnswer angina. Correct - answer is "A". The driver has not completed the

required 2- monthwaiting period, but all other requirements for medical clearance

and required

testing have been met. The driver would be certified for 1 year at the

completion o

f

the waiting period. The date of the certification would be from the date of

theexaminatio original

n.

A driver provides an audiometric test documenting the

following:1. 500 Hz: 2. 1000 HZ: 3. 2000 HZ: 4.

400035 Right Hz: ear; 40 Left ear 40 Right ear; 45 Left ear 40 Right ear; 45 Left

earear; 50 50 Right Left

ear 5

.The medical examiner

should:a. Disqualify the driver because he does not meet minimum hearing

requirementstodriv

e.b. Certify the driver for

2years. c. Certify the driver for 1

year.d. Require the driver to obtain a hearing exemption. - Answer Correct

answerThe examiner is "B". would average the results from 500 Hz, 1000 Hz and

2000 Hz. This

average is 38.33 in the Right and 43.33 in the Left ear. A driver

mustaverage have hearing an loss of less than or equal to 40 in the better ear. This

doesto be notmet have in both

ears.

During the examination of a commercial driver, the examiner notices that

the driver's

peripheral vision is 70 degrees to the left and 80 degrees to the right.

Theshould examiner

:a. Qualify the driver for 2

years.b. Require the driver to obtain a vision exemption because of the

limitationdriver' in the

sleft peripheral

field.c. Disqualify the

driver.d. Have the driver consult with an Ophthalmologist to determine if

theperipheral driver's vision meets minimum standards. - Answer Correct answer is

"A".must A exhibit driver a minimum peripheral vision of 70 degrees bilaterally.

During examination, the medical examiner notices that the driver is

distant,contact lacksand shows eye absolutely no emotional response during the

exam.examiner's The best response

shoulda. Provide be: the driver with a "CAGE" questionnaire to determine if he

suffersalcoholis from

m.b

.c. Certify the driver with a 1-time, 3-month certificate to determine if

thereeffect ison any the driver's ability to drive a

CMV.

d. Require a skill performance evaluation to ascertain if the driver has any

limitationswith driving. - Answer Correct answer is "B". The driver exhibits

whatconsidered may be a "flat affect" which is seen in schizophrenia and in severe

depression.The driver should be evaluated by a mental health expert to make a

diagnosisto certification. prior

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

documentationglaucoma indicating for the he is able to drive a truck. He began using the

marijuanathree months about ago. His current medical card has no limitations listed

and is for 2 years. His certification examination is within normal limits. The

medicalshould examiner

:a. Disqualify the

driver.b. Perform a urine drug collection and provide the release from the

testingc. Certify provider. the driver for 1

year.d. Certify the driver for 2 years. - Answer Correct answer is "A". Use of

marijuanaprohibited isby Federal law while driving a CMV and trumps State law in

this matter.

Aa. driverWithin has normal a blood limits pressure and would of 136/92 not affect mm theHg. driver'sThis is:

certification. b. Stage 1

Hypertension.c. Stage 2

Hypertension.d. Stage 3 Hypertension. - Answer Correct answer is "B". This is

StageHypertension, 1 which is defined as 140-

d. May certify for a maximum of 2 years. - Answer 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. - Answer Correct answer is "A". This is Stage 3

hypertension.The driver is disqualified until his blood pressure is less than 140/90 mm

Hgtime at he which will have a maximum certification of 6 months.

For how long would a driver be certified if he is taking Micardis

HCThypertension, for and has a confirmed blood pressure of 148/96 mm Hg at

thethe time of

examination?a. 3

monthsb. 6

months c. 1

yeard. 2 years - Answer Correct answer is "A". Because the driver has a

historyhypertension of (he is taking medication), and he had Stage 1 hypertension

duringexam, hehis would be provided a 1- time, 3-month certificate in order to

lowerpressure his toblood an acceptable level during that time.

During the examination, a driver is found to have a positive "Babinski"

reflex.examiner The

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. -

Answer Correct answer is "D". A positive Babinski reflex is indicative of abnormalities in

thecontrol motor pathways leading from the cerebral cortex and is widely used as a

diagnosticaide in disorders of the central nervous system. The examiner

shouldclearance obtain from a neurologist prior to reconsidering the driver for

certification.

All of the following are required components of all DOT medical

examinations

EXCEPT?

a.

Visionb.

Hearingc. Blood

Pressured. Ophthalmoscopic examination - Answer Correct answer is "D".

Thererequired are components four of every examination: vision, hearing, blood

pressureurinalysis. and Ophthalmoscopic examination is not required but may be done

ifnecessary. deemed

A driver reports in his history that he was treated for epilepsy 14

years ago but

stopped taking anti-epileptic medication on his own since his move to

youryears area ago. 11 He has not seen a neurologist nor a health care provider in

overand reports 10 years no seizures during this period. The examiner

should:a. Request medical clearance, and if obtained the driver may be certified

for 1 year. b. Request medical clearance, and if obtained the driver may be certified

for 2 years.

c. Refer the driver to the epilepsy/seizure exemption

program.

d. Disqualify the driver. - Answer D.

DisqualifyComment: Even though the driver reports exceeding the 10-year

waitingwas not period,under medicalit supervision and the driver discontinued

medicationtreatment outside use and of medical oversight. Since the driver cannot a

documentedmedical history this driver does not meet the non- discretionary

epilepsyuntil it is standardestablished that the driver is 10 years seizure-free

whileconvulsant off anti-

s.

A driver reports for a re-certification examination 8 weeks after having

tripleartery coronary bypass surgery. He presents a note from his treating provider

statingable to thatreturn he to is driving without restriction. Additionally, the note

mentionsdriver's results that the of his ETT were normal, and his echo showed a left

ventricularejection 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

isc. tooCertify low. the driver for 1 year

only.d. Certify the driver for 2 years because he has medical clearance. -

Answeranswer "A".Correct 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 more weeks until he

canOnce certify. he completes his waiting period, he would be certified for 1 year

fromof the the original date examination.

What is the maximum number of hours a CMV driver can drive in 7

consecutive

days

?a.

50.b.

c.

d. 80. - Answer Correct answer "B". 60- 70 Hour Limit: A driver may not

drive60/70 after hours of duty in 7/8 consecutive days. Many versions of the NRCME

examhave onewill question about the 60/70 rule.

A blood pressure of 166/92 mm Hg

woulda. Considered be?

normalb. Stage 1

hypertension.c. Stage 2

hypertension. d. Stage 3 hypertension. - Answer Correct answer is "C". The driver

hashypertension Stage 2 (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. - Answer Correct answer is "A". A

driverdiagnosed who withis 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.

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

providesfrom his neurologista note stating that he suffered no seizures and that he is

ableto driving. to return He does not list any medications in his history. The

examinera. Disqualify should: the

driver.b. Require the driver to take a "Folstein's mini mental

statec. Certify exam." the driver for one

year.d. Certify the driver for two years. - Answer Correct answer is "C".

Thesuffered driver no seizures from the TBI, has completed the required waiting

periodyears), (2and 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

dailyreports and he he feels fine now and is moving on with his life. He provides a

releasehis doctor from that he may return to work without restrictions. The

medicalshould examiner

:a. Disqualify the

driver.b. Require a CAGE

questionnaire.c. Certify the driver for 1

year.d. Certify the driver for 2 years. - Answer Correct answer is "A".

The driver is temporarily disqualified because he has not completed the mandatory

waitingfor suicide period attempt of 1 year. Once he has completed this, he may be

certifiedyear due for to the 1 continued treatment of depression (taking an SSRI). The

certificationis from the date of the original examination.

The driver lists Synthroid for the treatment of hypothyroidism. He has

been taking it

for about 6 months and feels fine now. His examination is essentially

normal.examiner's The best course of action

isa. to?Request medical clearance for the medication prior to

certification.b. Certify the driver for 1

year. c. Certify the driver for 2

years.d. Counsel the driver that he needs to apply for an endocrine

exemption.Correct answer - Answer is "C". The driver's hypothyroidism is well managed

andasymptomatic. he is The driver may be certified for

2 years.

A 48-year-old male driver presents for a certification examination. He

reportshistory ain back his injury that had occurred 4 years earlier. He states that he

waswork out following of back surgery for over a year, but since has returned to

drivinglast certification and his was good for 2 years. He lists as his only medication

Oxycodone,which he takes only as needed. He reports seeing his "pain doctor"

every few months for evaluation. He also reports he has had a steroid injection

(seriesabout a of year 3) ago, which "helped a lot." The examiner

should:a. Request medical

clearance.b. Certify the driver for 1

year.c. Certify the driver for 2

years.

d. Disqualify the driver. - Answer Correct answer is "A". The driver suffers

a chronic

pain condition which may inhibit his ability to perform all

essentialassociated functions with driving a CMV. He is also taking a narcotic medication.

Bothwill need of these clearance from a treating provider prior to making a

decisioncertification. regarding

A driver should not be certified when an ABG reveals a PaO2 of less

thanaltitudes 65 at

below:a. 2,

feetb. 3,

feetc. 5,

feetd. 7,000 feet - Answer Correct answer "C" The threshold changes to 60

mmaltitudes Hg at 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 2 years - Answer Correct answer is "A". There is a 2-month waiting

perioddate of from the MI.the

A driver presents for certification 6 weeks after suffering a myocardial

infarction.presents a Shenote from her cardiologist, clearing her to drive a

CMV without restrictions. Her post MI echocardiogram shows an EF of 50%. Her EKG

showsischemia. no 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. - Answer Correct answer is "D". The driver

shoulddisqualified be because she has not met the minimum wait time of 2

monthsafter suffering (8 weeks) a myocardial infarction. The driver can return for

certificationmore weeks. in two

A driver presents for certification. He checks "yes" for "Anxiety,

depression,

nervousness, and other mental health problems" for the Driver Health

Historyof the Medical portion Examiner Report Form. He clarifies he has depression

whichcontrolled is with medications and electroconvulsive therapy (ECT).

Followingdriver should ECT, be the symptoms free for how long before being

certified?a. 3

monthsb. 6

monthsc. 12

monthsd. 24 months - Answer Correct answer is "B". Following ECT, the waiting

periodmonths. is Maintenance 6 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

reactivityb. Iris

symmetry c. Conjunctival

injection

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. -

AnswerAnswer Correct"C". This is the correct response because the driver has a non-

diagnosedrespiratory or thoracic illness that might interfere with the ability to

safelyCMV. The operate driver a should not be certified until the etiology is confirmed

and treatmen

t

has been shown to be effective, safe, and stable. Also, according to

FMCSAguidelines, medical a SpO2 of less than 92 percent warrants obtaining an arterial

bloodanalysis. gas

Which of the following stages of hypertension calls for a medical

certificateexpires in onethat

year?a. Stage

1 b. Stage

2 c. Stage

3 d. Stage 4 - Answer Correct Answer "A". Medical certificates for drivers

withhypertension Stage 1 expire after a year. Stage 2 hypertension results in a one-

time,month three- medical certificate. Stage 3 corresponds to a medical certificate,

goodmonths for from 6 date of examination if the reading is less than or equal to

140/90Hg. Lastly, mm Stage 4 hypertension doesn't exist.

Which of the following is true of psychological disorders in

drivers?a. Drivers with a mood disorder may, during a manic episode, exhibit

grandiosity, impulsiveness, irritability, and

aggressivenessb. Drivers with a mood disorder will exhibit quicker reaction

timesdepressive during a

episodec. Drivers with an active psychotic disorder will exhibit completely

predictablebehavior, accompanied with poor

judgment d. Drivers with personality disorders may exhibit flexibility and

adaptivewith a decreased behaviors crash rate - Answer Correct Answer "A". Drivers with

anpsychotic active disorder will exhibit unpredictable behavior, accompanied

withjudgment. poor Drivers with a mood disorder will exhibit slower reaction

timesdepressive during episode a and grandiosity, impulsiveness, irritability, and

aggressiveness during a manic episode. Lastly, drivers with personality disorders

mayinflexibility exhibit and maladaptive behaviors, along with an increased rash

rate.

A medical examiner observes that a driver has a blood pressure of

160/100 mm Hg

and the driver had no prior knowledge of high blood pressure. Which of

theis the following appropriate subsequent action for the medical

examiner?a. Qualify the driver for 1

year.b. Obtain a second blood pressure reading later during the

examinationc. Qualify the driver for a 1 time 3-month

certificate.d. Put the driver in Determination Pending to allow time for a hypertension

evaluation by the PCP. - Answer Correct Answer "B". If the initial blood pressure

readingdriver is of equal a to or above 140/90 mm Hg, a second reading should be

takenduring later the

exam.

When deciding if a commercial driver should be medically certified,

what is the

fundamental question a medical examiner should examine regarding

cardiovascularhealth

?a. Has the driver ever had a cardiovascular

disease?b. Does his or her family have a history of cardiovascular

disease?c. Does the driver have a cardiovascular disease that increases the risk

ofdeath sudden or

incapacitation?d. What is the likelihood that he or she will contract a cardiovascular

disease?Answer Correct - Answer "C". When looking at the cardiovascular health

ofthe a fundamentaldriver, question is whether the driver has a cardiovascular

diseaseincreases that the risk of sudden death or incapacitation, creating a danger to

theand safetyhealth of the driver, as well as the public sharing the road. While

historyfamily historyand of such diseases are important, they are not the

fundamentalnecessary about questions 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

bodya. system?

Earsb. General

Appearancec.

Abdomend. Heart - Answer Correct Answer "B". 1 refers to General Appearance,

4 Ears, refers 6 refers to to Heart, and 8 refers to Abdomen

When conducting a vision examination, a driver must have at least

whatvisual distant acuity in each eye with or without

correction?a.

20/10b.

c.

d. 20/60 - Answer 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/

arestandards higher than necessary.

Which of the following is NOT true regarding the physical

examination?a. The individual parts of the body system are categorized

numerically b. For each body system, mark "Yes" on the Report Form if

abnormalitiesdetected, or "No" are if the body system is

normalc. There is a maximum height

requirementd. The medical examiner must document all abnormal findings on the

Reporteve Form,

nif they are not disqualifying - Answer Correct Answer "C". There is

notmaximum in fact (ora minimum) height (or weight) requirement for drivers. For

eachsystem, body mark "Yes" on the Report Form if abnormalities are detected or

"No"body ifsystem the is normal. The medical examiner must document all

abnormalon the Report findings Form, even if they are not disqualifying. Lastly, the

individualthe body system parts of are categorized numerically.

Which of the following colors is not necessary to be able to distinguish and

recognizein traffic signals and

devices?a.

Blue b.

Green

d. Certify the driver for 2 years. - Answer Correct answer "B". There is

aperiod waiting of one year following a TIA. If there is any presence of seizure,

themust driver 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%.c. ETT showing 85% of maximum

predictedd. All of the HR. above. - Answer Correct answer is "D". All the listed choices

arefor certificationcriteria post myocardial infarction after meeting the 2-

monthCertification wait time. is granted for one 1

year.

A driver presents for initial certification. His blood pressure is 180/

mmwith Treatedamlodipine 5 mg daily. Which of the following best represents

the medica

l

examiner's BP staging and certification

decision?a. Stage II hypertension b.c. Stage III hypertension d. Stage II

hypertensionCertify: 3-month

cardCertify: 6-month card Certify: 1 year - Answer Correct answer is "B".

180/102consistent is with stage III hypertension (SBP of 180 is stage III, and DBP

ofstage 102 II; is the greater stage is obtained). Stage III hypertension is

disqualified,according to FMCSA guidelines. In order to be recertified after

disqualificationstage III hypertension, for a driver must present evidence of good blood

pressurecontrol, i.e. <140/90. If upon returning, the BP is controlled (<140/90),

thea 6- driver month gets

card.

A driver reports that he was hospitalized recently for palpitations. He

statesdiagnosed he was with atrial fibrillation and was put on warfarin therapy.

Whichfollowing of theis the correct certification criteria for atrial

fibrillation?a. Waiting time: 1 month INR monthly

Cert: 1yr b. Waiting time: 1 week INR: monthly

Cert: 2yrs

c. Waiting time: none INR: annually Cert:

6mond. Waiting time: 1 year INR: weekly Cert:1yr - Answer Correct answer

iswaiting "A". The period for atrial fibrillation is 1 month with at least monthly INR.

Iftolerating stable and medications without side effects, certification is

granted for 1 year

A driver presents for certification. She reports that she was hospitalized

recentlychest pain. for She states she was diagnosed with a myocardial

infarction,subsequently and underwent left coronary artery balloon angioplasty. She

wasXarelto. put onWhich of the following best represents certification decision for

thisa. waiting driver? time: 2mon INR:none

Cert:b. waiting 2yr time: 1wk INR: none

Cert:c. waiting 1yr time: 2mon INR: none

Cert:d: waiting 1yr time: 1 yr INR: monthly Cert: 2 yrs - Answer Correct answer is

"C".the angioplastySince was the result of a myocardial infarction, the

waiting time is 2 months. Without an MI, the waiting time post angioplasty is 1

week.monitoring No INR is required for the newer anticoagulants (Xarelto, Eliquis,

Pradaxa,A patient etc.).on warfarin requires at least monthly INRs. The maximum

certificationmyocardial infarction for a is 1

year.

The driver presents for re-certification. He admits a cerebellar stroke 2

years ago

that has resolved without any residual deficits. He presents

clearanceneurologist, from and his he is on no anti-seizure or stroke medication. He is

otherwisemedically 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. - Answer Correct answer is

"B".waiting The period for cerebellar or brain stem strokes is 1 year. The driver

haswaiting met period, the obtained clearance from his neurologist and is on no

medicationsstroke. He can for be certified for 1 year.

A driver presents for examination following a spontaneous pneumothorax

oneearlier. month The records provided by the driver indicate that the

pneumothoraxthe driver's forced reduced vital 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 - Answer "C". Do not certify. According to recommendations, this

drivernot be shouldcertified until the medical examiner has verified that the recovery

iswith complete, 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. d. Any of the above. - Answer Correct answer "D". A Medical

Examiner,assistant, orMedical Ophthalmologist/Optometrist may perform the vision testing.

A driver has an abdominal aortic aneurysm. The medical examiner

obtainsa recent a abdominal copy of sonogram indicating that the aneurysm is 5.3 cm

in diameter. According to current recommendations, can the medical examiner certify

thisa. driver?

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 - Answer "A". An aneurysm must be less than 5 cm for certification.

According to regulations, which of the following can grant drivers an SPE

certificate?a. Medical

examiners.b. Orthopedic

surgeons. c. Physical Medicine & Rehab

physicians.d. The FMCSA. - Answer Correct answer "D". Only the FMCSA can grant

ancertificate SPE at one of the FMCSA centers

As a certified medical examiner, for how long must you retain a copy of

the Medical Examination Report Form for each driver?

c. A hearing aid center.

d. Any of the above is acceptable. - Answer Correct answer "D". A

hearingbe used aidduring may forced whisper testing. When a driver who wears a

hearingunable to aid pass is a forced whisper test, referral to an audiologist,

otolaryngologist,hearing aid center or is required.

Which of the following frequencies is NOT included as part of the

audiometrichearing test for commercial motor vehicle

drivers?a. 500 hertz

(Hz).b. 1,

Hz.c. 2,

Hz.d. 4,000Hz. - Answer Correct answer "D". The hearing

requirementaudiometric testfor an is based on hearing loss only at the 500 Hz, 1,000 Hz,

andfrequencies 2,000 Hz that are typical of normal conversation.

A commercial driver is taking Coumadin for a diagnosis of atrial

fibrillation. As the

medical examiner, you explain to the

drivera. He cannotthat: be certified to

drive.b. He can be certified to drive for 2 years as long as he provides

documentationhis INR is that

therapeutic.c. He must undergo monthly INR

monitoring.d. He can be certified to drive only if he switches to a newer

anticoagulantnot require INR that monitoring. does - Answer Correct answer "C". For a

patientCoumadin, taking the maximum certification period is 1 year. Recommend to

certify the driver if the driver is stabilized on medication for at least 1 month,

providesthe INR results a copy at of the examination, and has at least monthly INR

monitoring.

Which of the following scenarios regarding a driver with a known

abdominal aortic

aneurysm would warrant disqualification from commercial

driving? a. The AAA is 4.5 cm and it is asymptomatic; the driver has

notcardiovascular seen a specialist - he is only followed by

hisb. The PCP. AAA increased from 3.4 cm to 4.0 cm during the last 6-

monthc. The AAAperiod. has 5.1 cm in size, and has been stable for over

1 d. year.ALL of the above are disqualifying. - Answer Correct answer "D". Do not

certify the driver if the AAA Is greater than 4 cm but less than 5 cm and driver

doesmedical not clearance have for commercial driving from a cardiovascular

specialist;than or equal Is greater to 5 cm; has increased more than 0.5 cm during a 6-

monthregardless period, of size.

A driver presents for initial certification to drive 3 months following a

myocardial

infarction.An in-hospital post-MI echocardiogram showing at least

whatventricular left ejection fraction is sufficient for certification

toa. drive?

30%.b.

35%.c.

40%.d. 45%. - Answer Correct answer is "C". For an initial certification following

anin- hospitalMI, an post-MI echocardiogram showing an LVEF greater than or

equalis to 40%

sufficient.

What is the minimum waiting period following Coronary

Artery Bypass Graftingsurgery?

a. One

month.b. Two

monthsc. Three

monthsd. Dependent on the type of CABG performed and the number of vessels

involved.Answer Correct - answer "C". A significant risk associated with CABG

surgeryhigh long- is termthe reocclusion rate of the bypass graft. The Waiting Period is a

Minimum of 3 months regardless of type of CABG surgery performed.

Following an uncomplicated, elective percutaneous coronary intervention

procedure

to treat stable angina, the post-procedure waiting

perioda. 1 is:

week.b. 3

weeks.c. 1

month.d. 2 months. - Answer Correct answer "A". Following an

uncomplicated,percutaneous coronary elective intervention procedure to treat stable

angina,procedure the waiting post- period is 1 week. The waiting period allows for a

smallcaused threat by acute complications at the vascular access site. Drivers

undergoingin the setting PCI of an acute myocardial infarction or unstable angina

shouldrestricted be from driving duties for the longer waiting period

recommendedconditions. for these

Which cardiac condition is

disqualifying?a. Hypertrophic

cardiomyopathy.b. Mitral valve

prolapse.c. Ebstein

anomaly.d. Aortic valve repair for aortic stenosis 4 months prior to exam. -

AnswerAnswer Correct"A": A driver with a diagnosis of Hypertrophic Cardiomyopathy

may not be certified to drive. Similarly, a driver with a diagnosis of Restrictive

Cardiomyopathymay not be certified to drive.

A driver who exhibits difficulty breathing and has a history of COPD

shouldadditional undergo pulmonary testing. A forced expiratory volume in the first

second of expiration (FEV1) less than what level of predicted should prompt arterial

bloodmeasurement gas

s?a.

50%.b.

c.

65%.d. 70%. - Answer Correct answer is "C". Obvious difficulty breathing in

aposition resting is an indicator for additional pulmonary function tests. If the

forcedvolume expiratory in the first second of expiration (FEV1) is less than 65% of that

predicted,arterial blood gas measurements should be evaluated.

A driver has a fixed deficit that is less than the whole hand. Which of the

following is

true regarding certification of this

driver?a. The driver requires a Skill Performance Evaluation (SPE)

certificate.b. As a medical examiner, you determine if the severity of a fixed deficit

thatthan isthe less whole hand is medically disqualifying unless the driver

has an SPE certificat

e.

b. Disqualify the

driver.

c. Certify the driver for 1

year.d. Certify the driver for 2 years. - Answer Correct answer "D". The

abnormalityUA is the level in ofthe blood in the urine, which is likely a result of the driver's

menstrualcycle. Without any other identified abnormality, the driver would be

certifiedyears for 2

At initial certification, a driver is found to have a blood pressure of

165/105You give mmhim aHg. certification for three months. Upon recheck, his blood

pressure135/85. As is medical

examineryou:a. Give him a 6-month

certification.b. Give him a one-year certification from date of

initialc. Give exam. him a one-year certification from date of

recheck.d. Repeat the 3-month certification. - Answer Correct answer is "B". This

driverstage 2 has hypertension on initial exam. He qualifies for certification

haspressure his blood at recheck is below 140/90.

A diagnosis of which of the following mandates disqualification from

commercialmotor vehicle

driving?a.

Schizophrenia.b. Hypertrophic

cardiomyopathy.c. Parkinson's

disease.d. All of the above. - Answer Correct answer "D". Each condition listed

entailtoo great risks for commercial motor vehicle driving.

Which of the following accurately describes the FMCSA's requirement

regarding grip

strength for certifying commercial

drivers?a. The FMCSA requires Dynamometer testing to measure grip

strength.b. The FMCSA requires Sphygmomanometer used as a screening test

for grip by having

theapplicant repeatedly squeeze the inflated cuff while noting the

maximum deflection

on

thegauge

.c. The FMCSA accepts either Dynamometer testing or

Sphygmomanometer testingf

orcertificatio

n.d. The Federal Motor Carrier Safety Administration does not require any

specificfor assessing test grip power. - Answer Correct answer "D". The Federal

MotorSafety Carrier Administration does not require any specific test for assessing

gripThe driverpower. must have sufficient grasp and prehension to control an

oversizewheel, shift steering gears using a manual transmission, and maneuver a vehicle

inareas. crowded

FMCSA guidance recommends drivers NOT be certified with the following

conditionsEXCEPT:

a. Uncontrolled

vertigo.b. Meniere's

disease.c. Labyrinthine

fistula.d. Otitis Media. - Answer 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

ejectionrequired fractionfor is

certification?a.

40%b.

45%c.

d. 55% - Answer Correct answer "A". The minimum LVEF for certification is

40%patient in awith known Congestive Heart Failure.

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

followingrepair of ansurgical

aneurysm?a. 1

monthb. 3

monthsc. 6

months.d. 1 year. - Answer Correct answer "B". Aneurysms can develop in

visceralperipheral and arteries and venous vessels. Rupture of any of these

aneurysmsto gradual or can sudden lead incapacitation and death. Much of the

informationaneurysms ison applicable aortic to aneurysms in other arteries. The waiting

periodminimum is a 3 months post-surgical repair of an aneurysm.

Which of the following is true regarding the FMCSA Blood Pressure

regulationscommercial formotor vehicle

drivers?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

ameasurement second taken later during the

examination.c. Trained assistive personnel may take and record

thed. All BP. of the above are correct. - Answer Correct answer "D". Trained

assistive personnel may take and record the BP and pulse. When BP, pulse rate, or

bothsignificant are factors in your decision not to certify a driver, it is

prudentmeasure for the you readings to yourself. However, the Medical Examiner

mustMedical sign Examination the Report form. By signing the Medical Examination

Reportyou are form, taking responsibility for and attesting to the validity of all

documentedresults. test

As part of the evaluation of a driver presenting for initial certification, as

the medical

examiner, you must perform

testinga. for:

Alcohol.b.

Marijuana.c.

Opiates.d. NONE of the above. - Answer Correct answer "D". Testing for

controlledsubstances is not a part of the physical qualifications for the driver

examinationprocess. Testing for controlled substances falls under a different

regulation. However, if you suspect a need for drug/alcohol testing, contact the

FederalCarrier SafetyMotor Administration, or the motor carrier directly, for

information on

controlled substances and alcohol testing under Part 382 of the

FederalCarrier SafetyMotor

Regulations.