NRCME EXAM
- Driver 6 weeks post-MI, has cardio cleared to return to work without restrictions. ETT
12 METs, echo EF 65%. Examiner should:
Temporarily disqualify driver until driver meets waiting period of 2 months - Driver is distant, lacks eye contact and shows absolutely no emotional response
during the exam. The examiner’s best response should be:
Disqualify and refer to SAP prior to consideration (flat affect seen in severe depression
and schizophrenia) - A driver has a blood pressure of 136/92 mm Hg. This is what stage of HTN?
Stage I. BP 140-159/90-99 - A driver is taking Celexa for the treatment of what he calls a “mild depression.” He
reports he has not considered or attempted suicide. The examiner should?
-Temporarily disqualify the driver until he obtains written clearance for the depression
and the medication from the treating provider.
-Medical clearance is required for all mental health disorders - A driver reports that he had a hunting accident wherein he suffered a left orbital
fracture. He presents a note at the time of the examination from an ophthalmologist
stating “may drive”. His exam is unremarkable except for a limitation in peripheral vision
in his left eye, which was inconclusive. His distance vision was 20/20 right and 20/40
left. The medical examiner should?
Disqualify the driver pending vision exam to determine if meets peripheral vision
requirements - A driver is taking Topamax for the treatment of migraine headaches. He reports good
management of his headaches and they never seem to interfere with his driving ability
with the medication. The medical examiner should
Obtain medical clearance for the condition and the medication
-Topamax is a medication that is used for seizure control. The examiner should confirm
with the prescribing provider that the driver does not take it to control seizures. - Positive Babinski”reflex indicates what? What is examiner’s next step?
Indicative of abnormalities in the motor control pathways leading from the cerebral
cortex; obtain clearance from a neurologist prior to reconsidering the driver for
certification - Epilepsy 14 years ago but stopped taking antiepileptic medication on his own 11
years ago. Has not seen a neurologist nor a health care provider in over 10 years and
reports no seizures during this period. The examiner should:
Disqualify driver. Even though the driver reports exceeding the 10-year waiting period, it
was not under medical supervision and the driver discontinued medication use and
treatment outside of medical oversight. - Waiting period following MI
2 months - Waiting period following CABG
3 months - The driver uses hearing aids during the whisper test. He is able to hear at 5 feet on
the right and 4 feet on the left. Certification or no?
Certify x 2 yrs.
-The driver is able to use hearing aids during the whisper test (and this should be
marked on the form). A driver must only qualify in 1 ear to certify.
- Moderate TBI that occurred 3 years ago. neurologist confirmed no seizures and
cleared driver. Examiner should
Certify x 1 yr
-Waiting period is 2 years, max cert for mod TBI without seizure is 1 yr. - Waiting period and max cert in driver with depression with suicide attempt 10
months ago. Reports feeling fine now and compliant with meds. Examiner should
Disqualify.
-Waiting period is 1 yr, max cert 1 yr - History a back injury that had occurred 4 years earlier. He states that he was out of
work following back surgery for over a year, but since has returned to driving and his
last certification was good for 2 years. He lists as his only medication Oxycodone, which
he takes only as needed. He reports seeing his “pain doctor” every few months for
evaluation. He also reports he has had a steroid injection (series of 3) about a year ago,
which “helped a lot.” The examiner should:
Request medical clearance - Waiting period for ECT
6 months; maintenance ECT is disqualifying - SPE for below knee amputation, max cert for?
2 years - MI 6 months ago. How often for recertification? How often for ETT for monitoring?