NRCME DOT Exam iner Test Practice Questions with correct solutions.
According to FMCSA regulations, which of the following must the medical examiner evaluate when examining a driver's eyes?
A. Pupil reactivity
B. Iris symmetry
C. Conjunctival injection
D. Corneal thickness correct answers Correct Response:
A. Pupil reactivity
Incorrect Responses:
B. Iris symmetry
This is incorrect because determining iris symmetry is not required by FMCSA.
C. Conjunctival injection
This is incorrect because most causes of conjunctival injection would not be disqualifying. Causes that are suspicious for a disqualifying condition need additional evaluation. While this
abnormal finding should be explained, with determination of possible effects on safe driving before making a certification decision, it is not a condition that is specified in FMCSA regulations.
D. Corneal thickness
This is incorrect because it is not measured in an office examination except by an eye specialist.
According to FMCSA regulations, medical qualification for two years can be given to a driver who has... ?
A. An SPE certificate for a left below the knee amputation (BKA).
B. Hypertension.
C. A recent diagnosis of Lewy body dementia.
D. Documented medical marijuana use for pain control. correct answers Correct Response:
A. An SPE certificate for a left below the knee amputation.This is the correct response because in order to obtain the SPE certificate, the driver had to demonstrate the ability to perform all tasks for the commercial driver job description.
Incorrect Responses:
B. Hypertension.
This is not the correct response because drivers with hypertension are only given a medical certificate that is good for one year.
C. A recent diagnosis of Lewy body dementia.
This is not the correct response because this is a progressive, degenerative condition with no known treatment. The effects of Lewy body dementia impact the ability to operate a CMV safely.
D. Documented medical marijuana use for pain control.
This is not the correct response because marijuana remains a drug listed in Schedule I of the Controlled Substances Act. It remains unacceptable for any safety-sensitive employee subject
to drug testing under the drug testing regulations of DOT to use marijuana. Also, FMCSA medical guidelines state that "driving impairment due to marijuana use is well substantiated." During his visit to the medical examiner, a driver complains of severe pain in his finger for the last two weeks after it was punctured. The examination reveals an infected, swollen finger. After the medical examiner inquiries, the driver states that the pain is made worse when he grips the steering wheel. Which of the following should the medical examiner do next?
A. Obtain a hand X-ray.
B. Assess capillary refill in the hand.
C. Obtain a culture and sensitivity.
D. Assess the driver's grip strength. correct answers Correct Response:
D. Assess the driver's grip strength.This is the correct response because the condition does not present a safety risk unless it interferes with the ability of the driver to hold and control the steering wheel.
Incorrect Responses:
A. Obtain a hand X-ray. This is not the correct response because this is a diagnostic test that a healthcare provider or specialist would perform or order. Your role as a medical examiner is to determine if the condition interferes with the ability of the driver to safely operate a CMV.
B. Assess capillary refill in the hand.
This is not the correct response because given the information in the question it is not the primary consideration for determining if the driver can safely operate a CMV.
C. Obtain a culture and sensitivity.
This is not the correct response because this is an action that a treating healthcare provider or specialist would do in the course workup and treatment- Your role as a medical examiner is to determine if the condition interferes with the ability of the driver to safely operate a CMV.
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 monitoring intervals?
Recertification / Exercise tolerance
A. Every year / Every year
B. Every two years / Every year
C. Every year / Every two years
D. Every two years / Every two years correct answers Correct Response:
C. Every year / Every two years
This is the correct response because according to FMCSA medical guidelines, when a myocardial infarction is part of the medical history, there is a significant increased risk for another myocardial infarction to occur within six months to a year; therefore, a maximum of one-year certification is the guideline. Myocardial infarction guidelines also recommend exercise tolerance testing at least every two years to demonstrate continued ability to safely operate a CMV.
Incorrect Responses:
A. Every year / Every year
This is not the correct response because the FMCSA medical guidance is to obtain an exercise tolerance test every two years. In this question, there is nothing to indicate that more frequent testing is necessary.
B. Every two years / Every year
According to FMCSA regulations, which of the following must the medical examiner evaluate when examining a driver's eyes?
A. Pupil reactivity
B. Iris symmetry
C. Conjunctival injection
D. Corneal thickness correct answers Correct Response:
A. Pupil reactivity
Incorrect Responses:
B. Iris symmetry
This is incorrect because determining iris symmetry is not required by FMCSA.
C. Conjunctival injection
This is incorrect because most causes of conjunctival injection would not be disqualifying. Causes that are suspicious for a disqualifying condition need additional evaluation. While this
abnormal finding should be explained, with determination of possible effects on safe driving before making a certification decision, it is not a condition that is specified in FMCSA regulations.
D. Corneal thickness
This is incorrect because it is not measured in an office examination except by an eye specialist.
According to FMCSA regulations, medical qualification for two years can be given to a driver who has... ?
A. An SPE certificate for a left below the knee amputation (BKA).
B. Hypertension.
C. A recent diagnosis of Lewy body dementia.
D. Documented medical marijuana use for pain control. correct answers Correct Response:
A. An SPE certificate for a left below the knee amputation.This is the correct response because in order to obtain the SPE certificate, the driver had to demonstrate the ability to perform all tasks for the commercial driver job description.
Incorrect Responses:
B. Hypertension.
This is not the correct response because drivers with hypertension are only given a medical certificate that is good for one year.
C. A recent diagnosis of Lewy body dementia.
This is not the correct response because this is a progressive, degenerative condition with no known treatment. The effects of Lewy body dementia impact the ability to operate a CMV safely.
D. Documented medical marijuana use for pain control.
This is not the correct response because marijuana remains a drug listed in Schedule I of the Controlled Substances Act. It remains unacceptable for any safety-sensitive employee subject
to drug testing under the drug testing regulations of DOT to use marijuana. Also, FMCSA medical guidelines state that "driving impairment due to marijuana use is well substantiated." During his visit to the medical examiner, a driver complains of severe pain in his finger for the last two weeks after it was punctured. The examination reveals an infected, swollen finger. After the medical examiner inquiries, the driver states that the pain is made worse when he grips the steering wheel. Which of the following should the medical examiner do next?
A. Obtain a hand X-ray.
B. Assess capillary refill in the hand.
C. Obtain a culture and sensitivity.
D. Assess the driver's grip strength. correct answers Correct Response:
D. Assess the driver's grip strength.This is the correct response because the condition does not present a safety risk unless it interferes with the ability of the driver to hold and control the steering wheel.
Incorrect Responses:
A. Obtain a hand X-ray. This is not the correct response because this is a diagnostic test that a healthcare provider or specialist would perform or order. Your role as a medical examiner is to determine if the condition interferes with the ability of the driver to safely operate a CMV.
B. Assess capillary refill in the hand.
This is not the correct response because given the information in the question it is not the primary consideration for determining if the driver can safely operate a CMV.
C. Obtain a culture and sensitivity.
This is not the correct response because this is an action that a treating healthcare provider or specialist would do in the course workup and treatment- Your role as a medical examiner is to determine if the condition interferes with the ability of the driver to safely operate a CMV.
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 monitoring intervals?
Recertification / Exercise tolerance
A. Every year / Every year
B. Every two years / Every year
C. Every year / Every two years
D. Every two years / Every two years correct answers Correct Response:
C. Every year / Every two years
This is the correct response because according to FMCSA medical guidelines, when a myocardial infarction is part of the medical history, there is a significant increased risk for another myocardial infarction to occur within six months to a year; therefore, a maximum of one-year certification is the guideline. Myocardial infarction guidelines also recommend exercise tolerance testing at least every two years to demonstrate continued ability to safely operate a CMV.
Incorrect Responses:
A. Every year / Every year
This is not the correct response because the FMCSA medical guidance is to obtain an exercise tolerance test every two years. In this question, there is nothing to indicate that more frequent testing is necessary.
B. Every two years / Every year
