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NRCME – DOT EXAM COMPREHENSIVE REVIEW
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NRCME – DOT EXAM COMPREHENSIVE REVIEW
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NRCME – DOT EXAM COMPREHENSIVE REVIEWCorrective lenses that are prohibited by the FMCSA, including: - answer- lenses that
correct distance vision in one eye and near vision in the other.
telescopic lenses
Medical guidelines for the driver with diabetes mellitus include: - answer- Annual
medical examination.
Annual ophthalmologist or optometrist eye evaluation.
Disqualification for a diagnosis of unstable proliferative retinopathy.
Monocular Vision - answer- Monocular vision is disqualifying.
However, the driver who has monocular vision that with the better eye meets all vision
qualification requirements may be considered for a Federal Vision Exemption if the
Medical Examiner finds the driver otherwise medically fit for duty.
Monocular vision is defined as vision that is at least 20/40 for distance in one eye with
or without correction and vision that is less than 20/40 for distance in one eye with or
without correction.
The driver must meet other vision requirements in each eye, including visual fields
(horizontal field of vision).
Federal Vision Exemption: the driver with monocular vision who is applying for or has a
federal exemption or is qualified by operation of 49 CFR 391.64 must have an annual
physical examination.
Drivers with vision loss who meet standards may be certified for up to two years.
A driver who wears contact lenses which correct farsightedness in one eye and
nearsightedness in the other, but has no other visual impairments can be certified under
what additional conditions?
Only if the driver wears prescription glasses which provide the same correction as the
contact lenses.
FMCSA guidance indicates that a driver should not be certified under these
circumstances.
Only by federal exemption.
The driver is always certifiable under these conditions. - answer- FMCSA guidance
indicates that a driver should not be certified under these circumstances.
Explanation: FMCSA guidance indicates that contact lenses that correct one eye for
distance and one eye for near vision are not acceptable.
Guidance recommends not to certify with ear problem diagnoses of: - answer- a)
Uncontrolled vertigo.
b) Ménière's disease.
,c) Nonfunctioning labyrinth.
d) Nonfunctioning fistula.
The medical examiner's role in the exemption process includes _________.
Issuing the exemption.
Issuing the prescription for the driver's contact lenses and/or glasses.
Providing the driver with contact information for the Federal Vision Exemption Program.
Assuring that the driver has peripheral vision of at least 110 degrees in each eye. -
answer- Providing the driver with contact information for the Federal Vision Exemption
Program.
Explanation: The medical examiner's role in the exemption process is limited to
performing the driver examination and providing the driver with contact information for
the FMCSA related to the exemption process.
An audiometric test produces the following results: Left ear: 500 Hz, 35dB Loss; 1,000
Hz, 35 dB loss; 2,000 Hz 45 dB loss. Right ear: 500 Hz, 40 dB loss; 1,000 Hz, 45 dB
loss; 2,000 40 dB loss. What is the certification?
Certify for one year.
Certify for two years.
Do not certify.
Certify only when accompanied by hearing aid. - answer- Certify for two years.
Explanation: Drivers with an average hearing loss of < 40 decibels averaged across
500, 1000, and 2000 Hz in the better ear may be certified for two years.
What eye conditions must the medical examiner ask the driver about?
Cataracts, color deficiencies, retinitis pigmentosa, aphakia, glaucoma.
Lazy eye, cataracts, aphakia, floaters, retinopathy.
Glaucoma, macular degeneration, retinitis pigmentosa, color deficiencies.
Retinopathy, cataracts, aphakia, glaucoma, macular degeneration. - answer-
Retinopathy, cataracts, aphakia, glaucoma, macular degeneration.
Explanation: These are the "ask about" vision conditions. The medical examiner may
ask the driver about any eye conditions, but should ask the driver about these specified
conditions.
Which of the following is true with respect to drivers with psychological disorders?
Drivers with chronic schizophrenia must be evaluated at least yearly by a qualified
specialist such as a psychiatrist or psychologist who understands the function and
demands of CMV driving.
,The waiting period for a brief reactive psychosis or schizophreniform disorder is three
months.
Alcohol and drug dependency and abuse are profound risk factors in the presence of
personality disorders.
The waiting period following electroconvulsive therapy for treatment of depression is
one year. - answer- Correct Answer: Alcohol and drug dependency and abuse are
profound risk factors in the presence of personality disorders.
Explanation: Drivers with chronic schizophrenia should be disqualified. The waiting
period for a brief reactive psychosis or schizophreniform disorder is six months as is the
waiting period for electroconvulsive therapy treatment.
After a heart transplant, the minimum waiting period is _________ and the maximum
certification period is _________.
Six months, six months.
Six months, one year.
One year, six months.
One year, one year. - answer- One year, six months.
Explanation: Following heart transplant, the waiting period is one year and the
maximum certification interval is six months.
Which of the following is a requirement for drivers with insulin-treated diabetes mellitus
(ITDM) evaluated according to 49 CFR Part 391.46?
Possess a rapidly absorbable form of glucose while driving.
Maintain a hemoglobin A1c value less than 7.
Submit blood glucose monitoring records with each certification examination.
Check blood glucose 1 hour prior to driving and at least every 2 hours while driving. -
answer- Correct Answer: Submit blood glucose monitoring logs for each annual
certification.
Explanation: Drivers with ITDM (insulin-treated diabetes mellitus) must submit at least 3
months of blood glucose monitoring records as part of the annual examination process
described in 49 CFR Part 391.46. Although the other practices may represent best
practice guidelines, none are required as part of 49 CFR Part 391.46.
A driver with a history of bacterial meningitis with early seizures or a single unprovoked
seizure requires a waiting period of __________ seizure free and off anticonvulsant
medications.
One year.
Two years.
Five years.
Ten years. - answer- Correct Answer: Five years.
, Explanation: The waiting period for a history of bacterial meningitis with early seizures
or single unprovoked seizure is five years seizure free and off anticonvulsant
medications.
To apply for an exemption - answer- the driver with monocular vision must demonstrate
that he or she meets all other medical certification requirements, and must submit the
Medical Examination Report and the Medical Examiner's certificate with the exemption
application to the FMCSA.
NRCME - answer- Created by the Federal Motor Carrier Safety Administration
(FMCSA),
The NRCME establishes a registry of health care providers who may perform medical
examinations on commercial motor vehicle (CMV) drivers (DOT examinations).
National Registry of Certified Medical Examiners (NRCME)
Which of the following is a disqualifying condition?
A past clinical diagnosis of alcoholism.
A breath alcohol result of 0.019%.
An alcohol-related stable physical condition.
Use of methadone. - answer- Correct Answer: Use of methadone.
Explanation: A current diagnosis of alcoholism is disqualifying, a past history is not. A
breath alcohol result of 0.02% or higher renders the driver unqualified to drive. Just
because a condition is alcohol-related does not make it disqualifying.
Which of the following is true with respect to bipolar disorder?
Treatment with lithium has not been shown to increase risk for CMV accidents.
The maximum certification interval is six months.
The driver should be advised to report manic or severe depressive episodes within 10
days of onset to the driver's employer, medical examiner, or appropriate health
professional and to seek medical intervention.
Onset of manic episodes is uniformly sudden. - answer- Correct Answer: Treatment with
lithium has not been shown to increase risk for CMV accidents.
Explanation: Treatment with lithium has not been shown to increase CMV driving risk.
The maximum certification interval for a driver with bipolar disorder is one year. The
driver should be advised to report manic or depressive episodes within 30 days. Manic
episode onset may be gradual or sudden.
Which of the following drivers' tests meet hearing certification standards?
Whisper test 4 feet right ear, 3 feet left ear.
Whisper test 5 feet right ear with hearing aid, 3 feet left ear without hearing aid.
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