NRCME Study Guide
What are the 5 drugs tested with random drug screening? - ✔ ✔
Cocaine, Marijuana, Opiates, PCP, Amphetamines
Are substance abuse, drugs, and alcohol a part of the NRCME
examination? - ✔ ✔ NO
Drivers cannot take any Schedule __ drugs, no __ drugs, or any ___ for
any reason. - ✔ ✔ Schedule I, illicit, Methadone
In the area of narcotics, the underlying ____ is the primary concern.
Drivers CANNOT take narcotic based meds while performing safety
sensitive functions; these meds would include - ✔ ✔ Oxycodone,
Hydrocodone
If a driver is taking narcotics, he must have a primary __; the examiner
may override the primary __ - ✔ ✔ Prescription
If a driver has a mood disorder, he can be certified if he has been
symptom free for how long? - ✔ ✔ 1 year, if suicide has been
attempted. Certify if symptom free for 6 months if no hx of suicide. In
either case, certification is for 1 year.
If a driver has progressive dementia, what happens to him? Metabolic
dementia may be treated how? - ✔ ✔ DQ, case by case
If a driver is taking anxiolytics, he can take what kind? - ✔ ✔ Non-
sedative only
,A driver can take hypnotics if: the half life is less than __ hours, it is a __
dose, and if the driver is taking it __ term, meaning less than __ weeks.
- ✔ ✔ less than 5 hours, low dose, short term (less than 2 weeks)
If a driver is taking 1st gen antidepressants, such as Elavil, what is the
policy? - ✔ ✔ DQ
If a driver is taking 2nd gen antidepressants, such as Zoloft, Welbutrin,
or Prozac, what is the policy? - ✔ ✔ OK
If a driver has had ECT, he must wait how long before getting a
certification? - ✔ ✔ 6 months, then it is a 1 year certification
If a driver has insulin dependent DM, he must be disqualified. UNLESS
he has a - ✔ ✔ diabetes waiver
If a driver has insulin dependent diabetes, he must have a new exam __
with exemption - ✔ ✔ Annually...
The driver must have been on Insulin at least one __ if on previous
NIDDM meds, and two __ if first time taking insulin for any DM
treatment. - ✔ ✔ Insulin 1 month if previous meds or 2 months if a
first timer
If a driver has Diabetic Neuropathy/Paresthesis (loss of positional
awareness) they are automatically - ✔ ✔ DQ
DO NOT CERTIFY IF: a driver has, in the previous __ months,
experienced a hypoglycemic reaction that resulted in a seizure, LOC,
Needed assistance from another person, or had a period of __ cognitive
function that occurred without warning. - ✔ ✔ 12
,Do not certify a driver if he has had in the past __ years, 2 or more
(recurring) hypoglycemic reactions , loss of __ sensation, loss of
sensation in the feet, resting __, orthostatic ___, or a dx of peripheral
neuropathy or proliferative retinopathy. - ✔ ✔ 5: position,
tachycardia, hypotension,
To pass the audiometric test, you must average the __ frequencies for
each ear (__ Hz, 1000Hz, and 2000Hz) - ✔ ✔ 3 - 500, 1k, 2k
To convert from ISO standards to ANSI, subtract what number from 500
Hz? - ✔ ✔ 14 dB
To convert from ISO standards to ANSI, subtract what number from
1000 Hz? - ✔ ✔ 10 dB
To convert from ISO standards to ANSI, subtract what number from
2000 Hz? - ✔ ✔ 8.5
To pass the audiometric portion of the hearing test, one ear must show
an average hearing loss that is less than or equal to what dB? - ✔ ✔
40
If this is the first exam at which the driver has a BP Between 140-
159/90-100, driver has no HX of HTN, and doesn't take medications, he
is certified for how long? - ✔ ✔ 1 Year...
If a driver has a 1 yr certification for untreated stage I HTN, and doesn't
take meds (ie HTN driver wants recert after 1 year, no meds) certify for
how long? - ✔ ✔ 3 months
, Waiting period and maximum certification for CABG if the driver is
asymptomatic, LVEF >/40%, healed sternum and cleared by cardiology -
✔ ✔ 3 months after CABG and 1 year
5 years post-CABG, what routine tests need to be completed - ✔ ✔
Annual ETT and imaging stress test if indicated
What is the maximum certification period for driver with heart failure
who is asymptomatic, has ETT >6 METS and LVEF >/40% - ✔ ✔ 1
year
Heart failure disqualifications are: - ✔ ✔ Symptomatic,
asymptomatic with LVEF </ 50% and has ventricular arrhythmias or
asymptomatic with LVEF <40%
Driver with heart failure should obtain - ✔ ✔ ETT every 2 years,
annual evaluation and clearance from cardiologist, echocardiogram and
holter monitoring
What is the waiting period and maximum certification for PCI if patient
is asymptomatic and vascular access site is healed? - ✔ ✔ 1 week
and initial certification of 6 months followed by 1 year if ETT is
satisfactory
What follow up testing is required in driver undergoing PCI? - ✔ ✔
ETT 3 to 6 months post-PCI and bring results to 6 month follow up
appointment (if inconclusive, imaging stress test may be indicated)
Define Ebstein anomaly - ✔ ✔ Congenital heart disease resulting in
downward displacement of the tricuspid valve.
What are the 5 drugs tested with random drug screening? - ✔ ✔
Cocaine, Marijuana, Opiates, PCP, Amphetamines
Are substance abuse, drugs, and alcohol a part of the NRCME
examination? - ✔ ✔ NO
Drivers cannot take any Schedule __ drugs, no __ drugs, or any ___ for
any reason. - ✔ ✔ Schedule I, illicit, Methadone
In the area of narcotics, the underlying ____ is the primary concern.
Drivers CANNOT take narcotic based meds while performing safety
sensitive functions; these meds would include - ✔ ✔ Oxycodone,
Hydrocodone
If a driver is taking narcotics, he must have a primary __; the examiner
may override the primary __ - ✔ ✔ Prescription
If a driver has a mood disorder, he can be certified if he has been
symptom free for how long? - ✔ ✔ 1 year, if suicide has been
attempted. Certify if symptom free for 6 months if no hx of suicide. In
either case, certification is for 1 year.
If a driver has progressive dementia, what happens to him? Metabolic
dementia may be treated how? - ✔ ✔ DQ, case by case
If a driver is taking anxiolytics, he can take what kind? - ✔ ✔ Non-
sedative only
,A driver can take hypnotics if: the half life is less than __ hours, it is a __
dose, and if the driver is taking it __ term, meaning less than __ weeks.
- ✔ ✔ less than 5 hours, low dose, short term (less than 2 weeks)
If a driver is taking 1st gen antidepressants, such as Elavil, what is the
policy? - ✔ ✔ DQ
If a driver is taking 2nd gen antidepressants, such as Zoloft, Welbutrin,
or Prozac, what is the policy? - ✔ ✔ OK
If a driver has had ECT, he must wait how long before getting a
certification? - ✔ ✔ 6 months, then it is a 1 year certification
If a driver has insulin dependent DM, he must be disqualified. UNLESS
he has a - ✔ ✔ diabetes waiver
If a driver has insulin dependent diabetes, he must have a new exam __
with exemption - ✔ ✔ Annually...
The driver must have been on Insulin at least one __ if on previous
NIDDM meds, and two __ if first time taking insulin for any DM
treatment. - ✔ ✔ Insulin 1 month if previous meds or 2 months if a
first timer
If a driver has Diabetic Neuropathy/Paresthesis (loss of positional
awareness) they are automatically - ✔ ✔ DQ
DO NOT CERTIFY IF: a driver has, in the previous __ months,
experienced a hypoglycemic reaction that resulted in a seizure, LOC,
Needed assistance from another person, or had a period of __ cognitive
function that occurred without warning. - ✔ ✔ 12
,Do not certify a driver if he has had in the past __ years, 2 or more
(recurring) hypoglycemic reactions , loss of __ sensation, loss of
sensation in the feet, resting __, orthostatic ___, or a dx of peripheral
neuropathy or proliferative retinopathy. - ✔ ✔ 5: position,
tachycardia, hypotension,
To pass the audiometric test, you must average the __ frequencies for
each ear (__ Hz, 1000Hz, and 2000Hz) - ✔ ✔ 3 - 500, 1k, 2k
To convert from ISO standards to ANSI, subtract what number from 500
Hz? - ✔ ✔ 14 dB
To convert from ISO standards to ANSI, subtract what number from
1000 Hz? - ✔ ✔ 10 dB
To convert from ISO standards to ANSI, subtract what number from
2000 Hz? - ✔ ✔ 8.5
To pass the audiometric portion of the hearing test, one ear must show
an average hearing loss that is less than or equal to what dB? - ✔ ✔
40
If this is the first exam at which the driver has a BP Between 140-
159/90-100, driver has no HX of HTN, and doesn't take medications, he
is certified for how long? - ✔ ✔ 1 Year...
If a driver has a 1 yr certification for untreated stage I HTN, and doesn't
take meds (ie HTN driver wants recert after 1 year, no meds) certify for
how long? - ✔ ✔ 3 months
, Waiting period and maximum certification for CABG if the driver is
asymptomatic, LVEF >/40%, healed sternum and cleared by cardiology -
✔ ✔ 3 months after CABG and 1 year
5 years post-CABG, what routine tests need to be completed - ✔ ✔
Annual ETT and imaging stress test if indicated
What is the maximum certification period for driver with heart failure
who is asymptomatic, has ETT >6 METS and LVEF >/40% - ✔ ✔ 1
year
Heart failure disqualifications are: - ✔ ✔ Symptomatic,
asymptomatic with LVEF </ 50% and has ventricular arrhythmias or
asymptomatic with LVEF <40%
Driver with heart failure should obtain - ✔ ✔ ETT every 2 years,
annual evaluation and clearance from cardiologist, echocardiogram and
holter monitoring
What is the waiting period and maximum certification for PCI if patient
is asymptomatic and vascular access site is healed? - ✔ ✔ 1 week
and initial certification of 6 months followed by 1 year if ETT is
satisfactory
What follow up testing is required in driver undergoing PCI? - ✔ ✔
ETT 3 to 6 months post-PCI and bring results to 6 month follow up
appointment (if inconclusive, imaging stress test may be indicated)
Define Ebstein anomaly - ✔ ✔ Congenital heart disease resulting in
downward displacement of the tricuspid valve.
