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2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
Corrective 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.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
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
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
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.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
A driver has loss of hearing in the better ear of 25 dB loss at 500 Hz, 40 dB loss at 1000 Hz, and 60 dB loss at 2000 Hz. With respect to the hearing requirement for medical certification, the driver. May be certified for one year. May be certified for two years. May not be certified. May be certified if examined by an otolaryngologist who is familiar with the CMV driving duties who certifies the driver as medically qualified to drive a CMV. - Answer May not be certified. Explanation: An average hearing loss of 41.7 decibels averaged across 500, 1000, and 2000 Hz in the better ear is disqualifying. The driver should be referred to obtain a hearing aid and may be certified if the driver passes while wearing a hearing aid. A specialist cannot determine certification, and a specialist cannot override medical qualification standards such as the minimum hearing requirement. Which of the following is acceptable for a driver who wears a hearing aid? Testing of the driver's hearing is waived if the driver presents a letter from a qualified specialist.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
Testing of the driver's hearing may be performed by the medical examiner using audiometric testing equipment. Testing of the driver's hearing may be performed by an audiologist or otolaryngologist using specialized audiometric testing equipment. Testing of the driver's hearing may be performed at 1,000 Hz only. - Answer Testing of the driver's hearing is waived if the driver presents a letter from a qualified specialist. Testing the hearing of a driver who wears a hearing aid may be accomplished in three ways: 1) whisper test, 2) audiometric testing by an otolaryngologist using specialized audiometric testing equipment, or 3) audiometric testing by an audiologist using specialized audiometric testing equipment. Audiometric testing is required to be conducted at 500 Hz, 1000 Hz, and 2000 Hz. Passing Requirements for Vision Tests - Answer Corrective lenses, eye glasses and/or contact lenses may be used. Distance binocular acuity of at least 20/40 (Snellen) in each eye with or without corrective lenses. Field of vision of at least 70ยบ in the horizontal meridian in each eye. Monocular vision - vision meeting requirements in only one eye - is disqualifying by regulation. The ability to recognize the colors of traffic signals and devices showing standard red, green, and amber.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
Methadone use. Monocular vision. Carpal tunnel syndrome. - Answer Correct Answer: Autonomic neuropathy. Explanation: Methadone use and monocular vision are always disqualifying. Carpal tunnel syndrome is not usually disqualifying. A driver experienced a pneumothorax four weeks ago. The medical examiner tests the driver's respiratory function and the forced vital capacity (FVC) is 58% of predicted. What should the certification decision be? Do not certify pending additional testing. Certify for three months, pending driver follow up with personal physician and/or specialist. Certify one year. Certify two years. - Answer Correct Answer: Do not certify pending additional testing. Explanation: The driver may not be certified until FVC is > 60% predicted or additional testing reveals acceptable respiratory parameters - e.g., pulse oximetry with O2 > 92%.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
Stage 1 Hypertension Two certification options: - Answer One Year: recommend to certify for one year if it is the first examination at which the driver has blood pressure equivalent to Stage 1 hypertension, and the driver has no history of hypertension and does not use medication for blood pressure control. Three Months: recommend to certify for a three month certification if the driver has been given a one-year certificate for untreated Stage 1 hypertension in the past, whether or not the driver is taking medication to lower blood pressure. If the driver is on blood pressure medication, the medication should be well-tolerated with no side effects that could affect safe driving. Do not certify the driver with Stage 1 hypertension if the driver has been given a three-month certificate related to blood pressure within the past three months. Do not certify a driver with Stage 1 hypertension who has a history of Stage 3 hypertension (> 180/110). The driver with Stage 1 hypertension is at low risk for hypertension- related acute incapacitation. Recertification:
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NRCME Exam Already Graded A+
Passed a drug test. - Answer Correct Answer: Successfully completed counseling and/or treatment. Explanation: A driver certification examination is not a requirement for return to driving. Treatment with naltrexone is not required for driver certification for a driver with a history of alcoholism. Passing a drug test is not a requirement, although passing an alcohol test is a requirement. 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.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
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.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
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.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
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. Stage 1 hypertension blood pressure - Answer 140-159/90- 99 Drivers with initial Stage 1 hypertension should be advised that the condition will allow one-year certification and may or may not require medication treatment for control of the condition.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
Which of the following is true? A driver with diabetes who uses insulin must be evaluated according to the procedures specified in 49 CFR Part 391.46. The most important concern related to medication use for treating diabetes is hyperglycemia. Peripheral neuropathy is not a disqualifying condition. Diabetes is not a coronary heart disease (CHD) equivalent condition. - Answer Correct Answer: A driver with diabetes who uses insulin must be evaluated according to 49 CFR Part 391.46. Explanation: The greatest risk for medication use for drivers with diabetes is hypoglycemia, not hyperglycemia. Peripheral neuropathy is a disqualifying condition. Diabetes is a coronary heart disease (CHD) risk equivalent condition. For mild aortic stenosis, an echocardiogram should be repeated every years. For moderate aortic stenosis, an echocardiogram should be repeated every years. Two, two. Five, one to two. One, one.
2023 DOT: Comprehensive Review for
NRCME Exam Already Graded A+
Five, five. - Answer Five, one to two. Explanation: An echocardiogram is recommended every five years for mild aortic stenosis, every one to two years for moderate aortic stenosis.
- Pulse oximetry O2 saturation = 90%. Arterial blood gas (ABG): PaO2 = 60 mm Hg, PaCO2 = 42 mm Hg. What is the certification determination? Do not certify. Certify three months pending additional testing. Certify for one year. Certification depends on whether testing is conducted at altitudes above or below 5,000 feet. - Answer Correct Answer: Certification depends on whether testing is conducted at altitudes above or below 5,000 feet. Explanation: The certification determination related to arterial blood gas (ABG) testing depends on the altitude at which testing is performed. A PaO2 of less than 65 mm Hg is disqualifying at altitudes of less than 5,000 feet; a PaO2 of less than 60 mm Hg is disqualifying at altitudes of greater than 5,000 feet.
