DOT Medical Examiner NRCME Exam 20252026

DOT Medical Examiner (NRCME) Exam 2025–2026 Accurate Real Exam Questions and Verified Correct Answers JUST RELEASED If a medical examiner has a reasonable suspicion that a driver has violated federal guidelines

regarding alcohol consumption, the driver:

• Must be disqualified.
• May be certified following residential substance abuse treatment.
• May be certified following a one-month waiting period.
• Must submit to alcohol testing. - answer>>>Correct answer is "D". Must submit to alcohol

testing. If a medical examiner has a reasonable suspicion that a driver has violated federal guidelines regarding alcohol consumption, the driver must submit to alcohol testing.

When a medical examiner performs a forced whisper test, he/she should avoid using only words that begin with only what letter?

• B
• T
• P
• S - answer>>>Correct answer is "D". When a medical examiner performs a forced whisper test,

he/she should stand at a distance of no less than five feet and whisper a sequence of letters and numbers. The medical examiner should avoid repeatedly using words that begin with an "S" sound.

Drug testing is the responsibility of which of the following?

• The state in which a driver resides.
• The Department of Transportation.
• The driver.
• The employer. - answer>>>Correct answer is "D". Employer responsibilities include:

implementing and conducting drug and alcohol testing programs, providing a list of substance abuse professionals (SAPs), ensuring that the driver who is returning to a safety-sensitive position has complied with SAP recommendations, and conducting follow-up testing to monitor that the driver is compliant with DOT alcohol conduct guidelines and abstaining from unauthorized drug use.

A driver presents who has suffered a stroke. The driver has brainstem vascular lesions. Can the driver be certified?

• The driver cannot be certified.
• The driver can be certified after a one-year waiting period.
• The driver can be certified after a one-month waiting period.
• The driver can be certified with no restrictions. - answer>>>Correct answer is "B". A driver who

has suffered a stroke may or may not be at increased risk for seizures, depending on the location of the lesions. A driver with brainstem vascular lesions is not at an increased risk for seizures, and may be certified following a one-year waiting period.

A driver who has been diagnosed with depression and is prescribed lithium may be certified if:

• The driver is asymptomatic.
• Has no impairment that interferes with safe driving.
• Has lithium levels that are maintained in the therapeutic range
• All of the above. - answer>>>Correct answer is "D". Studies show there is little evidence to link

lithium to driving accidents. A driver who currently takes lithium should be certified provided that: the driver is asymptomatic, the driver has no impairment that interferes with safe driving, and the driver has lithium levels that are maintained in the therapeutic range.

A 44-year-old male presents for examination. He has undergone a surgery for repair of a 5.0 cm abdominal aortic aneurysm 1 year ago. He provides a clearance report by a cardiovascular specialist indicating he is asymptomatic. Is this person qualified? If yes, for how long?

• Yes, for 6 months.
• No.
• Yes, for one year.
• Yes, for two years. - answer>>>Correct answer is "C". Per FMCSA's guidelines, persons who

have undergone repair of an abdominal aortic aneurysm may be certified annually if more than three months have passed since surgery, they are asymptomatic, and are cleared by a cardiovascular specialist.

A 41-year-old male presents for examination. He has a history of thoracic aortic aneurysm which is reported by his treating cardiovascular specialist to be 2.9 cm. How would you handle this case and what is the medical certification period for this medical history?

• Request a cardiologist report; biennial certification.
• Query and evaluate digestive system disorders; annual certification.
• Disqualify the person.
• Query and evaluate for other associated cardiovascular diseases; annual certification. -

answer>>>Correct answer is "D". Per FMCSA's guidelines, persons with a thoracic aortic aneurysm of less than 3.5 cm may be certified annually after thorough evaluation and ruling out of any associated cardiovascular diseases.

A driver with a prosthetic valve who also has LV dysfunction may not be certified if he/she has ejection fraction of less than what?

• 80%
• 75%
• 50%
• 40% - answer>>>Correct answer is "D". A driver with a prosthetic valve and LV dysfunction of

less than 40% may not be certified.

A driver presents with atrial fibrillation. The major risk associated with this condition is which of the following?

• Blindness
• Aortic Dissection
• Dementia
• Stroke - answer>>>Correct answer is "D". The major risk associated with atrial fibrillation is an

embolus, which can lead to stroke. The most effective means to treating the condition is anticoagulant therapy.

. A driver who admits to using controlled substances also attends a self-help program, such as Alcoholics Anonymous. How should this driver's case be handled?

• The self-help group cannot substitute for completion of an SAP-required drug rehabilitation

program.

• The driver should be reported to the appropriate authorities.

• The driver should be certified without any restrictions.
• The driver should be certified after six months of attending the self-help group. -

answer>>>Correct answer is "A". For drivers who use narcotics or habit-forming drugs, certification may require successful completion of a substance abuse professional (SAP)-required drug rehabilitation program. Participation in a self-help program cannot be substituted for completion of an SAP-required drug rehabilitation program. Voluntary, ongoing participation in a self-help program to support recovery is not disqualifying.

If a driver tests positive on a DOT drug test for the use of a controlled substance, he/she must do all of the following EXCEPT before the driver can be a candidate for recertification?

• Write a personal statement regarding his/her history of drug use
• Be evaluated by a substance abuse professional
• Have a negative result on a return-to-duty drug test
• Comply with recommended rehabilitation - answer>>>Correct answer is "A". A driver who tests

positive for the use of a controlled substance can be considered for recertification. The driver must meet certain conditions. In order to be a candidate for recertification, the driver must be evaluated by a substance abuse professional, have a negative result on a return-to-duty drug test, and comply with recommended rehabilitation.

What responsibility does a medical examiner have to a driver who requires contact lenses to pass the vision exam? a. To inform the driver to keep a pair of glasses while driving.

• To disqualify the driver.
• To refer the driver to an optometrist.
• To certify the driver after a six-month waiting period. - answer>>>Correct answer is "A". One of

the responsibilities of the medical examiner is to provide health education counseling. In the case of drivers who wear contact lenses, this includes advising the driver to keep a pair of glasses in the vehicle while driving.

A driver with a heart transplant must be reexamined and recertified by a cardiovascular specialist how often?

• Every three months
• Every two months
• Every six months