NRCME DOT MEDICAL EXAM
- The driver was recently prescribed insulin for the control of his diabetes. The
examiner would?
a. Certify the driver for 2 years with medical clearance provided by their treating
physical.
b. Certify the driver for 1 year with medical clearance provided by their treating
physician.
c. Permanently disqualify the driver.
d. The driver is disqualified until the driver obtains a diabetic exemption.
Explanation:
Correct answer is “d”. An insulin dependant diabetic is disqualified until they obtain a
diabetic exemption. - The driver first perceives a whispered voice at 5 feet in his right ear and 4 feet in his
left ear. All other aspects of his physical examination are unremarkable. The examiner
would?
a. Permanently disqualify the driver because he “failed” the whispered voice test.
b. Certify the driver for 2 years.
c. Certify the driver for 1 year.
d. Require an audiometric test to determine the extent of hearing loss in his left ear.
Explanation:
Correct answer is “b”. The driver is qualified to drive without restriction as long as he is
able to perceive a whispered voice at 5 feet in 1 ear. - The medical examiner notices that the driver has recently been prescribed “Chantix”
to help him stop smoking while reviewing the drivers history. The driver is?
a. Qualified for 2 years if the rest of his exam is within normal limits. b. Provided a 1-
time, 3-month certificate so that the examiner can monitor how well the driver is doing
with smoking cessation.
c. Disqualified until it has been confirmed he is no longer taking Chantix and that he has
suffered no ill effects from withdrawal from the medication.
d. Qualified for only 1 year while taking Chantix, and then he may be qualified for 2
years once he no longer needs the medication.
Explanation:
Correct answer is “c”. A driver may not use Chantix and drive a CMV and it must be
confirmed that they are no longer taking the medication and that there are no effects
from withdrawal, by the treating provider.
- The driver reports for an examination 6 weeks after suffering a mild heart attack and
presents a note from the cardiologist stating that he is able to return to work
immediately without restriction. Included within the note, the cardiologist provides recent
testing
information showing that the driver had an ETT that showed that the driver was able to
reach 12 METS during the test. His ECG showed an ejection fraction of 65%. The
examination of the driver was unremarkable. The examiner should?
a. Temporarily disqualify the driver.
b. Qualify the driver for 1 year.
c. Qualify the driver for 2 years.
d. Consult with the cardiologist to determine if the driver suffers from angina.
Explanation:
Correct answer is “a”. The driver has not completed the required 2-month waiting
period, but all other requirements for medical clearance and required testing have been
met. The driver would be certified for 1 year at the completion of the remaining for the
waiting period (2 weeks). The date of the certification would be from the date of the
original examination. - A driver provides an audiometric test listing the following findings: 500 Hz: 35 Right
ear; 40 Left ear
1000 HZ: 40 Right ear; 45 Left ear
2000 HZ: 40 Right ear; 45 Left ear
4000 Hz: 50 Right ear; 50 Left ear
The medical examiner should:
a. Disqualify the driver because he does not meet minimum hearing requirements to
drive.
b. Certify the driver for 2 years.
c. Certify the driver for 1 year.
d. Require the driver to obtain a hearing exemption.
Explanation:
Correct answer is “b”. The examiner would average the results from 500 Hz, 1000 Hz
and 2000 Hz (required). This average is 38.33 in the Right and 43.33 in the Left ear. A
driver must have an average hearing loss of les than or equal to 40 in the better ear.
They do not have to meet this in both ears.
- The medical examiner notes that the driver is taking Metformin for the treatment of
diabetes, Antabuyse, and Crestor to reduce serum cholesterol levels. He reports no
side effects from any of the medications. The rest of the examination is unremarkable.
The examiner should:
a. Disqualify the driver.
b. Request clearance for all medication due to side effects.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years.
Explanation:
Correct answer is “a”. The driver is taking Antabuse which is used to treat alcohol
addiction. This indicates that the driver currently suffers from a current clinical diagnosis
of alcoholism. - The following are symptoms of Congestive Heart Failure EXCEPT:
a. Shortness of breath on exertion or at rest in severe cases.
b. Need to urinate at night.
c. Headache.
d. Swelling in the ankles and the abdomen.
Explanation:
Correct answer is “c”. Headache is not a typical symptom of congestive heart failure.
Additional symptoms include wheezing, enlargement or prominent neck and facial
veins, raised jugular venous pulse, bluish discoloration of face, presence of abnormal
heart sounds, fatigue, weight gain and more. - During the examination, the examiner notices that the driver’s peripheral vision is 70
degrees to the left and 80 degrees to the right. The examiner should?
a. Qualify the driver for 2 years.
b. Require the driver to obtain a vision exemption because of the limitation in the driver’s
left peripheral field.
c. Disqualify the driver.
d. Have the driver consult with an Ophthalmologist to determine if the driver’s peripheral
vision meets minimum standards.
Explanation:
Correct answer is “a”. A driver must exhibit a minimum peripheral vision of 70 degrees
bilaterally.
- During the examination, the examiner notices that the driver is distant, lacks eye
contact and shows absolutely no emotional response during the exam. The examiner’s
best response should be?
a. Provide the driver with a “CAGE” questionnaire to determine if they suffer from
alcoholism.
b. Disqualify the driver and refer them to a mental health profession prior to
consideration for certification.
c. Certify the driver with a 1-time, 3-month certificate to determine if there is any effect
on the driver’s ability to drive a CMV.
d. Require a skill performance evaluation to ascertain if the driver has any limitations
with driving
Explanation:
Correct answer is “b”. The driver exhibits what may be considered a “Flat affect” which
is seen in schizophrenia and in severe depression. The driver should be evaluated by a
mental health expert to make a diagnosis prior to certification. - The driver reports that he had surgery on his cervical spine 2 years ago. It involved
a fusion of C4, 5 and 6. He has recovered fully and been provided a release to return to
work without restriction. He reports no pain and does not require medication of any kind.
During the examination, the examiner notices that the driver exhibits only 30 degree of
cervical rotation to both the right and the left. The examiners best decision would be to?
a. Disqualify the driver.
b. Certify the driver for 1 year.
c. Certify the driver for 2 years.
d. Request additional information and clearance from the specialist who performed the
surgery relating to any possible limitations the driver may have and provide the job
description for a truck driver.