1. Which of the following is a requirement for drivers with a diabetes
exemption?
A) Possess a rapidly absorbable form of glucose while driving
B) Self—monitor blood glucose one hour before driving and at least once
every 2 hours while driving
C) Plan to submit blood glucose monitoring logs every 6 months
D) Maintain a Hemoglobin A1C value less than 7: A. Drivers with diabetes
should self monitor blood glucose before driving and every 4 hours while
driving. Blood glucose monitoring logs should be submitted annually. There is
no specific requirement for HgA1C level.
2. Drivers with insulin dependent diabetes:
A) May be certified for a maximum of 6 months
B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certifi-
cation
C) Cannot be certified if they have a history of myocardial infarction
D) May be eligible for a diabetes exemption: D) Drivers with insulin dependent
diabetes cannot be certified but may be eligible for a diabetes exemption 3.
Which of the following is true?
A) A driver with diabetes who uses insulin does not meet the minimum
requirements of 49 CFR Part 391.41
B) The most important concert related to medication use for treating
diabetes is hyperglycemia
C) Peripheral neuropathy is not a disqualifying condition
D) Diabetes is not a coronary heart disease (CHD) equivalent condition: A)
The greatest risk for medication use for drivers with diabetes in hypoglycemia,
not hyperglycemia. Peripheral neuropathy is disqualifying condition. Diabetes is
a CHD equivalent condition.
4. What is the recommended certification interval for a driver with diabetes
mellituse who does not use insulin?
A) Three months
B) Six monthsC) One year
D) Two years: C) Drivers with non-insulin dependent diabetes should be certified
for a maximum of one year
5. A diabetes exemption may be issued by:
A) An endocrinologist
, NRCME Test Bank Questions
B) The Medical Examiner
C) The driver's personal physician
D) The FMCSA: D) Only the FMCSA can grant exemptions
6. A driver with diabetes mellliktus who uses insulin is determined to be
otherwise medically qualified. The medical examiner must indicate that a
diabetes exemption is required on the :
A) Medical Examination Report status section and Medical Examiners
Certifi-
cate
B) Letter to the FMCSA
C) Employer authorization form
D) Endocrinology consultation form: A) Exemption requirements must be noted
on the Medical Examination Report status section and the Medical Examiners
Certificate
7. If glucose is detected on urinalysis in a driver with no history of
diabetes, an appropriate next step is: A) Endocrinology consultation
B) One year clearance and recommendation to see personal physician
C) Fingerstick or blood glucose determination
D) Temporary disqualification: C) The medical examiner should first determine
blood glucose and then make an appropriate certification determination and
referral 8. Drivers with a history of _____________ severe hypoglycemic
reactions in the past year or _____________ severe hypoglycemic
reactions in the past five years should not be certifed.
A) one, three
B) one, two
C) two, three
D) two, five: B) A driver should not be certified if the driver has had one
hypoglycemic reaction in the past year or two in the past five years.
9. Which of the following is not a criteria that the FMCSA uses to define a
severe hypoglycemic reaction?
A) Seizure
B) Dizziness
C) Need of assistance from another person
D) Period of impaired cognitive function that occurred without warning: B)
FMCSA defines severe hypoglycemia as reactions that result in seizure, loss of
, NRCME Test Bank Questions
consciousness, need of assistance from another person, and a period of
impaired congitive function that occurred without warning
10. Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy: C) Although hyperglycemia, peripheral
neuropathy, and metabolic encephalopathy all pose significant risks for safe
driving, hypoglycemia poses the greatest risk. The risk is particularly
pronounced in drivers who use insulin. FMCSA defines a hypoglycemia
episode as one that results in seizure, loss of consciousness, need of
assistance from another person, or a period of impaired cognitive function that
occurs without warning.
11. A driver with a diabetes exemption should check glucose levels when?
A) One hour before driving and at least once every four hours while driving
B) One hour before driving and at least every eight hours while driving
C) Once after four hours of driving
D) Once a day after driving period has ended: A) Driver's with diabetes
exemption should check glucose values one hour before driving and once
every four hours while driving
12. Which of the following is true for diagnosis of a hernia?
A) The driver should be referred to a surgeon to determine whether repair of
a hernia is necessary
B) The waiting period following hernia surgery is two weeks
C) Inguinal hernias have been associated with an increased risk for CMV
accidents
D) The maximum certification interval for a driver with a hernia is two years:
D) The medical examiner can use his/her judgment as to whether a driver
should be referred to a surgeon or other specialist. There is no specified waiting
period following hernia surgery - the driver should not be certified until the
medical examiner determines that treatment is safe and effective, and that the
condition is stable. No evidence has linked hernias of any type to increased
CMV accident risk.
13. Which of the following is true of nephropathy?
A) Nephropathy is a disqualifying condition
B) The maximum certification interval for nephropathy is two years
, NRCME Test Bank Questions
C) A driver with 3+ proteinuria should not be certified
D) A renal specialist should make the certification determination for a driver
with nephropathy: B) Nephropathy is considered on a case-by-case basis.
The medical examiner determines what evaluation or monitoring is necessary
for a driver with 3+ proteinuria and may disqualify the driver. The certification is
always made by the medical examiner and cannot be deferred to a specialist.
14. Drivers with which of the following conditions should be disqualified?
A) Cancer requiring chemotherapy treatment
B) Umbilical hernia not surgically repaired
C) Renal failure on peritoneal dialysis
D) Hemochromatosis: C) Dialysis of any type is disqualifying
15. If a significant abnormal finding for urinalysis specific gravity, protein, or
blood is found, the medical examiner should:
A) Disqualify the driver
B) Request that a renal specialist determine if the driver is medically
qualifiedC) Use clinical expertise to determine a certification decision and
to determine if additional evaluation is required or recommended
D) Obtain blood chemistries for renal function: C) The medical examiner must
determine whether additional evaluation is needed and whether the certification
decision should be postponed or limited
16. A driver with a history of kidney disease with or without transplant:
A) Is medically disqualified
B) Must be assessed regarding the severity, stability, medications used, and
medication side effects/adverse reactions
C) Should not be assessed for functional ability to operate a CMV safelyD)
Should have the medical certificaton determination made by a renal
specialist: B) ASsessment for kidney disease must be ade on a case-by-case
basis. Dialysis of any kind is disqualifying. The medical examiner may choose
to test the driver for functional ability to operate a CMV safely. The medical
certification decision must be made by the medical examiner.
17. Which of the following is not a disqualifying condition?
A) Peritoneal dialysis
B) HemodialysisC) Hernia
D) Peripheral neuropathy: Any type of dialysis is a disqualifying condition.
Peripheral neuropathy is usually disqualifying. Although a hernia may be
disqualifying, often a driver can be certified if the symptoms and/or examination
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