NRCME Test Bank Questions 2
Drivers should refrain from driving for _______________ after taking antihistamines (prescription or OTC) or narcotic antitussives A) 6 hours B) 8 hours C) 12 hours D) 24 hours
A minimum of 12 hours is required before driving for a driver that has taken an antihistamine or narcotic antitussive medication
Which of the following is not considered important in determining that a driver who has suffered from TIA's may be certified? A) Clearance from a neurologist who understands the functions and demands of commercial driving B) Completed the appropriate waiting period C) Normal electroencephalogram D) On no oral anticoagulant therapy due to risks associated with excess bleeding
A normal encephalopathy is not a condition for certification. The waiting period for TIAs is one year. Drivers may be certified on anticoagulant therapy for a cardiovascular condition but may not be certified if the driver has a cerebrovascular disorder.
Recertification o the driver disqualifying for alcohol abuse requires the driver to A) Have an evaluation y a substance abuse professional (SAP) B) Have a referral by the driver's primary care physican stating the driver is attending a self-help group C) Have a complete physical examination D) Have a drug test
A) A driver disqualified for alcohol abuse must be evaluated by a substance abuse professional prior to return to duty and complete any rehabilitation program recommended by the substance abuse professional. The driver also must undergo return to duty alcohol testing.
A driver presents for examination with a history of pneumothorax 6 weeks ago. Available medical records indicate that this is the second spontaneous pneumothorax on the same side. The driver's forced vital capacity (FVC) is 68% of predicted forced vital capacity with no surgical intervention. What is the certification determination? A). Do not certify B) Certify for 3 months, pending driver follow up with personal physician and/or specialist C) Certify for one year D) Certify for 2 years
A) A driver with a history of two or more spontaneous pneumothoraxes on the same side must undergo surgical treatment to prevent recurrence prior to certification.
According to regulation, what medical examiner documentation is required when a driver applies for a SPE certificate? 1) The Medication Examination Report 2) Certification from a board certified or eligible physiatrist or orthopedic surgeon that the driver is otherwise qualified to drive 3) The Medical Examiner's certificate, indicating that medical certification must be accompanied by a SPE certificate 4) Results of the functional capacity evaluation (FCE) A) 1,2, and 3 only B) 1 and 3 only C) 2 and 4 only D) 4 only E) all of the above
A) A functional capacity evaluation (FCE) is not a requirement for SPE certificate application
A driver with a history of acute seizure secondary to an acute structural insult requires a waiting period of one-year seizure free and off anticonvulsant medications for: A) Mild insult without early seizures B) Moderate insult without early seizures C) Mild insult with early seizures D) Stroke with risk for seizures
A) A history of seizure secondary to acute structural insult requires a waiting period of one year for mild insult without early seizure, stroke without risk for seizure, or intracerebral hemorrhage without risk for seizure. Moderate insult without early seizures and mild insult with early seizures requires a two-year waiting period, and stroke with risk for seizures requires a five-year waiting period.
A mild head injury has: A) No dural penetration with LOC that lasts fewer than 30 minutes B) Dural penetration with LOC that lasts fewer than 30 minutes C) No dural penetration with LOC that lasts for more than 30 minutes but less than 24 hours D) Dural penetration with LOC that lasts for more than 30 minutes but less than 24 hours
A) A mild head injury has no dural penetration and LOC that lasts fewer than 30 minutes
Levodopa/carbidopa may cause the driver to be disqualified because it is used for the treatment of what neurological condition? A) Parkinson's Disease B) Peripheral neuropathy C) Isaac's Disease or Stiff Man Syndrome D) Epilepsy
A) Although all of the conditions listed are disqualifying, levodopa/carbidopa is used to treat Parkinson's Disease
The most common medications used to treat vertigo are: A) Antihistamines B) Antibiotics C) Aspirin D) Antipsychotics
A) Antihistamines are the most commonly prescribed medication for the treatment of vertigo
Pulmonary conditions that should result in a disqualification decision include: A) Any pulmonary process that is likely to interfere with driver ability to operate a CMV safely, either due to history or clinical diagnosis. B) Chronic obstructive pulmonary disease (COPD) C Asthma D) Pulmonary tuberculosis
A) Any condition, pulmonary or otherwise, likely to interfere with safe driving is disqualifying. COPD and asthma may be disqualifying depending on symptoms and the results of pulmonary function testing. Pulmonary TB is disqualifying until treatment is established as adequate/effective, safe, and stable and the driver is determined not to be contagious.
The waiting period for a driver with a history of acute seizures secondary to a systemic metabolic illness is ____________ and the driver may be certified for up to _________________. A) No waiting period, two years B) One month, one year C) Three months, one year D) One year, one year
A) As long as risk for recurrence of the metabolic illness is low, there is no waiting period. And the driver may be certified for two years.
Which of the following is true? 1) CMV drivers have an increased propensity for the development of hypertension that exceeds the risk seen in other professions 2) There should be at least three BP readings taken and documented during the course of the physical examination A) 1 only B) 2 only C) Both 1 and 2 D) Neither 1 nor 2
A) At least two BP readings should be taken and documented during the driver examination.
Conditions which are usually disqualifying, but which qualification can be considered ona case-by-case basis include: 1) Autonomic neuropathy 2) Congenital myopathy 3) Neuromuscular disorders 4) Carpal tunnel syndrome A) 1, 2, and 3 only B) 1 and 3 only C) 2 and 4 only D) 4 only E) all of the above
A) Carpal tunnel syndrome is not usually disqualifying
The Medical Examiner should be familiar with DOT drug and alcohol testing requirements as outlined in: A) 49 CFR Part 40 B) 40 CFR Part 38 C) 49 CFR Part 66 D) 49 CFR Part 12
A) DOT drug and alcohol testing regulations are described in 49 CFR Part 40
Which of the following is true? A) Cognitive demands of the CMV driver include quick reactions, appropriate behavior, sustained alertness and attention. B) DRiver history does not include OTC medications. C) Fatigue is an uncommon side effect of neurological agents D) The severity of seizure episodes is considered the best predication of future risk for seizures
A) Driver history should include OTC medications. Fatigue is a common side effect of neurological agents. The length of time an individual is seizure free and off anticonvulsant medication is considered the best predictor of the future risk of seizures.
Schedule I drugs, including marijuana or medical marijuana, are disqualifying A) True B) False
A) Driver's taking Schedule I drugs are disqualifying
A driver with a diabetes exemption should check glucose levels when? A) One hour before driving and at least once every four hours while driving
A) Driver's with diabetes exemption should check glucose values one hour before driving and once every four hours while driving
If the Substance Abuse Professional determines that current alcoholism exists, the driver is not qualified to drive a commercial motor vehicle in interstate commerce A) True B) False
A) Drivers with a current diagnosis of alcoholis are disqualified
A driver with monocular vision who has been granted a federal vision exemption or who is qualified by operation of 49 CFR 391.64 must have an annual physical examination. A) True B) False
A) Even though a vision exemption is provided for two years, the driver must undergo annual examinatin
A driver with diabetes mellliktus who uses insulin is determined to be otherwise medically qualified. The medical examiner must indicate that a diabetes exemption is required on the : A) Medical Examination Report status section and Medical Examiners Certificate
A) Exemption requirements must be noted on the Medical Examination Report status section and the Medical Examiners Certificate
PFT results: FEV1 62% of predicted, FEV1/FVC ratio 68%. What is the certification determination? A) Do not certify pending additional testing B) Three-month certification pending additional testing C) Certify one year D) Certify two years
A) FEV1 of less than 65% predicted requires additional testing prior to certification
Which of the following is true? A) Following a TBI behavioral/emotional functioning issues may result in disability and/or psychological impairment B) For a single unprovoked seizure FMCSA guidelines state that the driver should be seizure free and off anticonvulsant medication for 10 years C) Most neurological conditions in which seizures may occur are not associated with future risk for unprovoked seizures D) Most individuals who have experienced a febrile seizure in infancy are at significantly increased risk for seizures as adults
A) FMCSA guidelines require a minimum 5 year waiting period seizure free and off anticonvulsant medication following a single unprovoked seizure. Most neurological conditions associated with any seizure activity present an increased risk for future seizures. Febrile seizures in infants are not associated with significant increased risk for adult seizures.
A driver who has Hepatitis C who is stable and whose condition does not represent a safety risk may be certified A) True
A) Hepatitis C is not disqualifying
Which of the following is true? A) Medical marijuana use if disqualifying
A) If a driver gives a history of recent marijuana use, the driver should be referred for substance abuse professional evaluation regardless of drug test result. Drivers with a history of marijuana use, or a drug test positive for marijuana, must undergo substance abuse professional assessment and complete any recommended rehabilitation prior to returning to driving. Marijuana is a Schedule I drug.
A driver with a successful kidney transplant can be certified A) True
A) Kidney transplants are not disqualifying
The following conditions are disqualifying except: A) Multiple sclerosis B) Congenital myopathies C) Metabolic muscle diseases D) Muscular dystrophies
A) Multiple sclerosis may or may not be disqualifying, depending on whether the driver has symptoms that interfere with safe driving. Congenital myopathies, metabolic muscle diseases, and muscular dystrophies are all disqualifying.
Only ___________________ can grant drivers a Skill Performance Evaluation (SPE) certificate A) The FMCSA B) The Department of Transportation C) A certified medical examiner D) A physiatrist or orthopedic specialist
A) Only the FMCSA can grant waivers/exemptions and SPE certificates
Driver qualification standards include not certifying any individual with which of the following: A) PaCO2 greater than 45 mm Hg B) Diagnosis of asthma C) Smoking history of more than 2 packs per day D) FEV1 < 70%
A) PaCO2 greater than 45 mm Hg disqualifying
Adult ADHD is associated with A) Comorbid antisocial and borderline personality disorder and/or other disorders B) Unlikely adverse effects of medication C) Seizures D) Low incidence of substance abuse
A) Risks to safe driving with adult ADHD include: comorbid antisocial or borderline personality disorder and/or other disorders; adverse effects of medication; and high incidence of substance abuse.
What is the BP range for stage 1 hypertension? A) 140/90 through 159/99 or 140-159/90-99 B) 140/90 through 149/99 or 140-149/90-99 C) 150/90 through 159/99 or 150-159/90-99 D) 160/100 through 179/109 or 160-179/100-109
A) Stage 1 hypertension is SBP/DBP of 140-159/90-99
Supplemental oxygen use is disqualifying A) True B) False
A) Supplemental oxygen use is disqualifying
A driver experienced a pneumothorax four weeks ago. The pneumothorax reduced the driver's forced vital capacity (FVC) to 58% of predicted forced vital capacity. What should the certification decision be? A) Do no certify B) Certify for 3 months, pending driver follow up with personal physician and/or specialist C) Certify for one year D) Certify for 2 years
A) The driver may not be certified until FVC is >60% of predicted
A driver with asthma describes using an albuterol inhaler several times a day. He has not seen his primary care physician in several years but is still getting frequent refills on his inhaler. The driver has been hospitalized twice in the last eight months for asthma. The certification decision should be: A) Do not certify B) Certify for 3 months, pending driver follow up with personal physician and/or specialist C) Certify one year D) Certify 2 years
A) The driver should not be certified until evaluated by his personal physician and/or specialist
Which of the following is true? A) A driver with diabetes who uses insulin does not meet the minimum requirements of 49 CFR Part 391.41
A) The greatest risk for medication use for drivers with diabetes in hypoglycemia, not hyperglycemia. Peripheral neuropathy is disqualifying condition. Diabetes is a CHD equivalent condition.
Which of the following is true with regard to hypertension? A) The higher value of either systolic or diastolic blood pressure determines the stage of hypertension. B) Stage 1 hypertension is BP of 140-149/90-99. C) Stage 2 hypertension is BP of 150-169/100-109. D) Stage 3 hypertension is BP >=170/110
A) The higher value of either systolic or diastolic blood pressure determines blood pressure stage. Stage 1 is 140-159/90-99, Stage 2 is 160-179/100-109, and Stage 3 is >=180/110
Which of the following is considered grounds for additional testing? A) Blurry vision B) Presence of floaters C) Distance vision uncorrected 20/35 in each eye D) Field of vision testing of 70 degrees in each eye
A) The presence of floaters is not in and of itself an indication for additional testing. Distance vision of 20/40 or better is considered acceptable, and field of vision of 70 degrees in each eye meets vision testing requirements.
The waiting period for certification of a driver after removal of an ingrate trial meningioma is: A) One year B) Two years C) Six months D) Five years
A) The waiting period following removal of an infratentorial meningioma is one year seizure free and off anticonvulsant medication
Which of the following is true with respect to bipolar disorder? A) Treatment with lithium has not been shown to increase risk for CMV accidents B) The maximum certification interval is six months C) The Drivers should be advised to report manic or sever depressive episodes within 10 days of onset to the driver's employer, medical examiner, or appropriate health professional and to seek medical intervention D) Onset of manic episodes is uniformly sudden.
A) 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.
Which of the following is a requirement for a driver with a history of alcoholism to be certified? A) No residual disqualifying physical impairment
A) Treatment with naltrexone is not required for driver certification for a driver with a history of alcoholism. A driver with a history of alcoholism must have completed counseling and/or treatment and must not have a current alcohol-related disorder in order to be certified.
Which of the following is true? 1) If a driver wears a hearing aid, the whisper hearing test can be administered 2) According to FMCSA requirements the driver must pass the hearing requirements with both ears using either forced whisper or audiometric testing A) 1 only B) 2 only C) both 1 and 2 D) neither 1 nor 2
A) a driver with a hearing aid may be tested using the whisper test. Hearing requirements must be met in at least one ear for either forced whisper or audiometric tesitng, not both ears
Which of the following is a requirement for drivers with a diabetes exemption? A) Possess a rapidly absorbable form of glucose while driving
A. Drivers with diabetes should self monitor blood glucose before driving and every 4 hours while driving. Blood glucose monitoring logs should be submitted annually. There is no specific requirement for HgA1C level.
Which of the following is a mental health professional that the medial examiner may refer to or consult with? 1) Breath alcohol technician (BAT) 2) Designated employer representative (DER) 3) Medical review officer (MRO) 4) Substance abuse professional (SAP) A) 1, 2, and 3 B) 1 and 3 only C) 2 and 4 only D) 4 only E) all of the above
According to the FMCSA, all of these are defined as mental health professionals
An apnea/hypoapnea index or more than ___ episodes per hour is diagnostic for sleep apnea A) 20 B) 25 C) 30 D) 35
An apnea/hypoapena index or more than 30 episodes per hour is diagnostic for sleep apnea
Which of the following is not a disqualifying condition? A) Peritoneal dialysis B) Hemodialysis C) Hernia D) Peripheral neuropathy
Any type of dialysis is a disqualifying condition. Peripheral neuropathy is usually disqualifying. Although a hernia may be disqualifying, often a driver can be certified if the symptoms and/or examination findings are mild or if the hernia has been surgically repaired and the condition has stabilized (there is no specified waiting period following hernia treatment, including surgery).
Which of the following is true with respect to hearing testing? A) Audometric testing should be done using International Organization for Standardizaation (ISO) standard B) Drivers requiring a hearing aid to meet hearing requirements may wear a hearing aid only in the ear that was tested and passéd with the hearing aid C) Drivers requiring a hearing aid must be tested using specialized audio metric testing equipment if audio metric testing is required D) Drivers requiring a hearing aid to meet standards should be certified for no more than one year
Audiometric testing should be done using American National Standards Institute (ANSI) Z24.5-1951 standard. ISO results should be converted to the ANSI standard. To convert ISO results to ANSI, subtract 14 dB at 500, 10 dBat 1000, and 8.5 dB for 2000. Hearing requirements are for the better ear; a driver may use a hearing aid in only one ear to meet standards. drivers wearing a hearing aid may first be tested with a whisper test; if the driver passes the whisper test, the driver must be referred to an audiologist or otolaryngologist with specialized equipment for performing audio metric testing with use of a hearing aid. Drivers sho require a hearing aid to meet standards may be certified for up to two years.
When audiometric testing is used, audio metric testing is not required to be performed at which of the following Hz levels? A) 500 B) 1000 C) 2000 D) 3000
Audiometric testing, when used, must be performed at 500, 1000, and 2000 Hz
Drivers with a history of _____________ severe hypoglycemic reactions in the past year or _____________ severe hypoglycemic reactions in the past five years should not be certified. B) one, two
B) A driver should not be certified if the driver has had one hypoglycemic reaction in the past year or two in the past five years.
A driver who requires a hearing aid to meet certification requirements must be examined annually. A) True B) False
B) A driver who needs a hearing aid to meet requirements may be certified for up to two years.
Do not certify a driver who: A) Has Stage 1 hypertension not on therapy B) Has had Stage 2 hypertension on initial examination and on reexamination three months later still has stage 2 hypertension C) Has stage 2 hypertension currently on therapy D) Has stage 1 hypertension currently on therapy
B) A driver with Stage 2 hypertension who has not been able to reduce her/his blood pressure to 140/90 or less after three months should be disqualified until achieving a blood pressure of 140/90 or less
Arterial blood gas (ABG) testing is indicated if pulse oximetry is less than ___________ A) 90% B) 92% C) 94% D) 95%
B) ABG testing is required for pulse oximetry less than 92%
Arterial blood gas (ABG) testing should be performed on drivers with a FEV1 of less than _____________ on spirometry testing? A) 60% of predicted B) 65% of predicted C) 70% of predicted D) 80% of predicted
B) ABG testing is required with FEV1 of less than 65% of predicted
A driver with a history of kidney disease with or without transplant: B) Must be assessed regarding the severity, stability, medications used, and medication side effects/adverse reactions.
B) ASsessment for kidney disease must be ade on a case-by-case basis. Dialysis of any kind is disqualifying. The medical examiner may choose to test the driver for functional ability to operate a CMV safely. The medical certification decision must be made by the medical examiner.
Drivers must be able to meet minimum hearing requirements in both ears in order to be medically certified. A) True B) False
B) Adequate hearing in only one ear is required.
A driver with monocular vision who has been granted a federal vision exemption or who is qualified by operation of 49CFR391.64 must have a physical examination every ________________________? A) Six months B) Year C) Two years D) Within six onths of the date of renewal of the vision exemption
B) Although a federal vision exemption is usually granted for two years, the driver must be examined annually.
Ongoing attendance at self-help groups A) Fulfills the requirement to complete a rehabilitation program B) Is not disqualifying when used for maintenance of recovery C) Eliminates the need for follow-up testing D) Is mandated by the FMCSA
B) Attendance at self-help groups is to disqualifying but does not fulfill the requirement for participation ina rehabilitation program. Follow-up testing must be performed according to FMCSA guidelines, regardless of participation in a self-help group. The Substance Abuse Professional (SAP) determines the need for attendance at self-help groups as a condition of return to work as a CMV driver.
The stage of BP elevation should be based on the lower of the systolic or diastolic BP result (e.g. if systolic equals Stage 1 and diastolic equals Stage 2, the driver should be certified according to Stage 1 guidelines.) A) True B) False
B) Blood pressure stage is based on the highest level of either systolic or diastolic blood pressure.
What date is used to determine the expiration date for a driver with a one-time, three month certificate who achieves a BP less than or equal to 140/90 before the three-month certificate expires, and what is the certification period? A) Two-year certification based on date of initial certification examination. B) One-year certification based on the date of the initial certification examination. C) One-year certification based on date of documented BP <=140/90. D) If the medical examiner performs a complete recertification examination, in addition to the following up on BP, then two-year expiration would be based on the current date.
B) Certification is determined from the last date of complete examination. If a new complete certification examination was performed on the date of the confirmation of acceptable blood pressure, then a one-year certification would have been based on the date of that last complete certification examination.
For a driver to be certified without a waiver for color recognition, they must ________________ A) Correctly identify the true colors of signs and traffic lights B) Sufficiently recognize traffic signals and devices showing the standard red, amber and green traffic signal colors C) Be able to identify the different signs and traffic lights through shape and positional analysis D) Pass an Ishahara color vision test
B) Drivers must be able to recognize red, yellow, and green traffic signal colors
A driver takes Benadryl 25 mg, 2 to 3 times per day, to treat nasal congestion. The medical examiner should: A) Advised the driver to use diphenhydramine nor more than twice daily B) Advise the driver to consult with PCP to evaluate chronic congestion and obtain treatment that does not interfere with safe driving C) Prescribe a non-sedating inhaler D) Contact DOT to advise of a safety concern
B) Drivers should be advised to follow up with their treating physicians to obtain treatments that are not sedating
The maximum period of certification for a driver disqualified for Stage 3 hypertension, but who has, at the certification examination, a BP less than or equal 140/90, is: A) One year B) Six months C) Three months D) Two years
B) Drivers with Stage 3 hypertension are certified for maximum six-month intervals.
An audio metric test results in the following results: L ear: 500 Hz, 35 dB loss 1000 Hz, 35 dB loss 2000 Hz, 45 dB loss R ear: 500 Hz 40 dB loss 1000 Hz 45 dB loss 2000 Hz, 40 dB loss What is the certification determination? A) Certify for one year B) Certify for two years C) Do not certify D) Certify only when accompanied by a hearing aid.
B) 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.
Episodic neurological conditions that are usually disqualifying include: 1) Epilepsy 2) Multiple sclerosis 3) Narcolepsy 4) Headaches A) 1, 2, and 3 only B) 1 and 3 only C) 2 and 4 only D) all of the above
B) Epilepsy and narcolepsy are usually disqualifying. Multiple sclerosis may be disqualifying but is not usually so. Headaches are occasionally, but not usually, disqualifying — disqualification would occur if there were symptoms or medication effects that interfere with safe driving.
Which of the following is not a criteria that the FMCSA uses to define a severe hypoglycemic reaction?
B) FMCSA defines severe hypoglycemia as reactions that result in seizure, loss of consciousness, need of assistance from another person, and a period of impaired congitive function that occurred without warning
A driver taking methadone for substance abuse treatment may be certified for three months. A) True B) False
B) False, methadone is disqualifying
FMCSA vision testing standards require field of vision of at least _______ in the horizontal meridian of _____________ eye (s). A) 50, one B) 70, both C) 85, one D) 85, both
B) Field of vision should be performed on both eyes, and adequate field of vision of at least 70 degrees in each eye must be demonstrated
What is the maximum certification period for drivers with hypertension? A) Three months B) One year C) Two years D) Six months
B) For a driver diagnosed with hypertension, the maximum certification interval is one year.
The driver diagnosed with COPD may be certified if the driver has: A) Hypoxemia at rest B) FEV1>=65% C) Chronic respiratory failure D) History of continuing cough with cough syncope
B) Hypoxemia at rest, chronic respiratory failure, and cough syncope are all disqualifying
A driver with Meniere's Disease may be certified A) True B) False
B) Meniere's Disease is a disqualifying condition
The Medical Examiner should recommend do not certify if the driver has the following: A) Acute otitis media B) Ménière's disease C) A history of TIA's three years ago D) Multiple sclerosis
B) Meriere's disease is disqualifying
To pass the interstate CMV driver vision exam, a visual acuity of ___________________ corrected or I corrected is required. A) 20/20 in each eye individually and both eye combined B) 20/40 in each eye individually and both eyes combined C) 20/20 in at least one eye D) 20/40 in at least one eye
B) Monocular vision is disqualifying. Drivers must be able to see at least 20/40 in each eye and both eyes combined.
Required vision testing does not include: A) Distance visual acuity B) Near visual acuity C) Peripheral horizontal visual fields D) Color
B) Near vision testing is not required.
Which of the following is true of nephropathy? B) The maximum certification interval for nephropathy is two years
B) Nephropathy is considered on a case-by-case basis. The medical examiner determines what evaluation or monitoring is necessary for a driver with 3+ proteinuria and may disqualify the driver. The certification is always made by the medical examiner and cannot be deferred to a specialist.
Examples of adapting clinical evaluation of the musculoskeletal system to ensure applicability when assessing CMV driver fitness for duty could include all of the following except: A) Using resistive force or a dynamometer to have the driver demonstrate grip strength B) Nerve conduction study testing C) Have the driver simulate the range of motion and coordination of hands and legs required for steering and changing gears when operating a CMV and/or have the driver demonstrate shoulder joint mobility, arm and leg muscle strength. Required to enter and exit the cab, and other driver-related duties. D) Have driver perform activities that demonstrate the ability to maneuver and maintain balance while under the trailer and having the driver demonstrate cervical range of motion sufficient to look in either side mirror of an oversized CMV
B) Nerve conduction study testing is not a clinical evaluation of musculoskeletal function
Which of the following is an adverse effect of neuroleptic? A) Hyperactivity B) Motor dysfunction that affects coordination and response time C) Auditory hallucinations D) Migraines
B) Neuroleptics can cause a variety of adverse effects that can interfere with driving, such as motor dysfunction that affects coordination and response time, sedation, and visual disturbances (especially at night).
Medical examiners may grant vision exemptions for drivers that do not meet vision qualification standards A) True B) False
B) Only the FMCSA may grant exemptions of any type
Which of the following is true with regard to horizontal field of vision testing include: A) Passing parameters are 75 degrees in left and right eye visual fields B) Medial examiners may use a variety of methods in the clinical setting to measure field of vision, including reasonably reliable and accurate tests C) Telescopic lenses that redirect peripheral vision to compensate for loss of central vision are acceptable corrective lenses for meeting commercial driving qualificatin requirements D) Specialized ophthalmological equipment should not be used for precise measurement to determine if vision meets the 70 degree requirement
B) Passing parapets for field of vision are 70 degrees in left and right visual fields. Telescopic lenses that redirect peripheral vision to compensate for loss of central vision are not acceptable. Specialized ophthalmological equipment may be used to measure vision parameters.
Driver qualification standards include not certifying an individual with which of the following? A) PaCO2 greater than 40 mm Hg B) Diagnosis of pulmonary hypertension, with or without cor pulmonale, accompanied by symptoms of dyspnea, dizziness, or hypotension C) Cough D) FEV1< 75%
B) Pulmonary hypertension is usually disqualifying regardless of the underlying condition, especially when symptomatic
Drivers with chronic pulmonary tuberculosis (tB) should be disqualified regardless of disease severity A) True B) False
B) Pulmonary tuberculosis is not automatically disqualifying
During the neurological examination the Medical Examiner should note the following: A) Range of motion B) Gait disorders, sensory or positional abnormalities C) Prior fractures D) Weight gain/loss
B) Range of motion and prior fractures should be noted on the musculoskeletal examination. WEight gain or loss is noted int he general examination.
Spirometry testing should be performed on drivers who smoke who are over _________ years of age: A) 30 B) 35 C) 40 D) 45
B) Spirometry is recommended for current smokers over 35 years of age
The maximum certification period for a driver with Stage 1 hypertension is: A) Three months B) One year C) Two years D) Do not certify
B) Stage 1 hypertension (SBP 140-159, DBP 90-99) has a maximum certification interval of one year. This interval is used when the driver has no history of or treatment for hypertension. If the driver has a history of or treatment for hypertension, the driver should be certified for a maximum of three months.
Which of the following is true? A) Bipolar disorder effects usually manifest immediately after disease onset B) Manic or depression symptoms may impair judgment or function and make it impossible for the driver to function effectively C) Rapid onset of debilitating symptoms of depression are unlikely to be triggered by personal, social, financial, or job-related difficulties D) Schizophrenia is not a progressive condition
B) Symptoms of bipolar disorder often do not manifest for months or years but can be progressive and severe symptoms may then occur with relatively sudden onset. Debilitating symptoms associated with depression may be triggered by a variety of conditions or circumstances. Schizophrenia is usually a progressive condition, so certification of a driver even with mild symptoms is usually not warranted.
Which of the following is true? A) One of the requirements for the CMV drier physical examination is testing for controlled substances B) A driver taking multiple medications reports daily, regular or moderate use of alcohol. The Medical Examiner should evaluate the possibility of medication interactions with alcohol that may cause impairment C) Even in remission, alcoholism is disabling for the CMV driver D) Use of Schedule I drugs is not disqualifying
B) Testing for controlled substances if not required for the CMV driver examination. Alcoholism in remission is not a disqualifying condition. Use of Schedule I drugs is disqualifying.
Driver examination 3/14/2012. Driver describes dizziness with last symptoms 2/18/12. The driver was advised to return after a 2-month symptom free interval. The driver returned on 7/12/12 with medical records documenting last dizziness symptoms on 5/4/2012, and the driver confirms he has been symptom free since that date. The medical examiner determines that the driver should be certified for a two year certification interval. What is the expiration date of that certificate? A) 2/18/2014 B) 3/14/2014 C) 5/4/2014 D) 7/12/2014
B) The certification interval should be determined from the date of the last full driver examination. Unless the examiner performed another full driver examination on 7/12/2012, the appropriate expiration date for a two-year certification is 3/14/2014. If the examiner had performed a full examination on 7/12/2012, then the certification date would have been 7/12/2014.
What is the certification for a driver with a one-time, three month certificate, who achieves a BP<=140/90? A) Six-month certification from the date of the initial certification examination B) One-year certification from the date of the initial certification examination C) One-year certification from the date of the documented BP<=140/90 D) Two-year certification from the date of the documented BP<=140/90
B) The date of the last complete examination is always used as the basis for the certification interval. A driver with a one-time three-month certificate may be certified for one year after documentation of a BP <=140/90.
A driver with a history of major depression should be evaluated at least every _______________ by an appropriate mental health specialist who understands the functions and demands of commercial motor vehicle driving. A) Six months B) One year C) Two years D) Such evaluation is not required
B) The maximum certification interval for a driver with a history of major depression is one year. Regulatory guidance is somewhat confusing: guidance recommends annual evaluation by a mental health professional who understands the functions and demands of commercial driving, but requires evaluation every two years by a specialist, such as psychiatrist or psychologist who understands the functions and demands of comical driving
The maximum period for which a driver with a history of a psychological disorder should be certified is: A) Three months B) One year C) Six months D) Nine months
B) The maximum period for which a driver with a history of psychological disorder should be certified is one year.
An audio metric test yields the following results: Left ear: 500 Hz, 35 dB loss 1000 Hz, 35 dB loss 2000 Hz, 55 dB loss Right ear: 500 Hz, 40 dB loss 1000 Hz, 45 dB loss 2000 Hz, 40 dB loss What is the certification determination? A) Certify only when accompanied by a hearing aid. B) Do not certify C) Certify for two years D) Certify for one year
B) The passing requirements for audio metric testing are an average loss in the better ear of not more than 40 dB for when averaged across 500, 1000, 2000 Hz
FMCSA guidance includes: A) A driver may be cleared after a single unprovoked seizure after a two-year seizure free interval off anticonvulsant medication B) A driver with a history of childhood febrile seizures may be cleared C) A driver may be cleared with a diagnosis of epilepsy (2 or more unprovoked seizures) after a 5-year seizure free period off anticonvulsant medication D) the minimum waiting period after a TIA is six months
B) The seizure free interval off anticonvulsant medication is five years for a driver with a history of a single unprovokeseizure. The waiting period for epilepsy is 10 years seizure free and off anticonvulsant medication. The waiting period for TIA is one year.
The symptom free waiting period for acute and chronic vestibulopathy and benign positional vertigo is ________________. A) One month B) Two months C) Three months D) There is no waiting period; drivers with these conditions should not be certified.
B) The waiting period for these conditions is two months symptom free
Categories of risk associated with psychological disorders include: 1) The mental disorder including symptoms and/or disturbances in performance that are in integral part of the disorder and may pose hazards fro driving 2) The type of treatment provider who is treating the condition. 3) Psychopharmacology, as many psychotropic medications can comprise performance to the degree that CMV driving would be hazardous 4) Physical disorders which may be compromised by the mental disorder and may increase risk of CMV accidents A) 1, 2, and 3 only B) 1 and 3 only C) 2 and 4 only D) 4 only E) All of the above
B) Type of treatment provider is unrelated to driving risk. Physical disorders are not noted by the FMCSA to increase risk related to psychological disorders.
A driver may use telescopic lenses that redirect peripheral vision to compensate for loss of central vision as corrective lenses for meeting CMV qualification requirements A) True B) False
B) Use of such lenses is prohibited
A driver with bipolar disorder must meet a waiting period of ______________ following a nonpsychotic episode of major depression unaccompanied by suicidal behavior or a waiting period of __________________ following a nonpsychotic episode of major depression with suicidal behavior. A) One year, two years B) Six months, one year C) Three months, six months D) Three months, one year
B) Whatever the underlying medical condition, nonpsychotic episodes of major depression unaccompanied by suicidal behavior require a waiting period of six months and nonpsychotic episodes of major depression with suicidal behavior require a one year waiting period.
If a driver has whisper test results of : |Rt. Ear: 4 feet| Lt. Ear 4 Feet| s/he meets hearing standards for CMV driver certification. A) True B) False
B) Whisper test minimums are at least 5 feet in at least one ear.
Ongoing voluntary attendance at self-help groups (e.g. 12 step programs) for maintenance of recovery from alcoholism: A) Is required for all drivers recovering from alcoholism B) Is disqualifying C) Is allowed but not required for drivers recovering from alcoholism D) Fulfills the requirement for rehabilitation following a violation of alcohol rules.
C) 12-step or similar programs do not fulfill rehabiliation requirements for drivers with a violation of alcohol (or drug) regulations. Participation in such programs is allowed, but not required, and is not disqualifying.
The one-time use of a 3-month certificate for blood pressure greater than 140/90 can be provided to a drivers: A) Only once in the driver's lifetime B) On consecutive examinations until the driver's blood pressure is less than or equal to 140/90 C) When the driver has no previous history of the hypertension and has a blood pressure of 162/84 D) When the driver has a blood pressure of 182/84
C) A 3-month certificate may be issued more than once in a driver's lifetime. A 3-month Certificate may not be issued consecutively - a driver may not receive consecutive 3-month certificates. A blood pressure of 182/84 is disqualifying, and the driver may not be certified until the driver has a blood pressure of <=140/90.
The maximum certification period for Skill Performance Evaluation (SPE) certificate is ____________ A) six months B) one year C) two years D) determined on a case-by-case basis
C) A SPE certificate is granted for a maximum of two years
A Skill Performance Evaluatioin (SPE) certificate: A) Is valid for one year from the date of issuance B) May be renewed 60 days prior to expiration C) Is required when the severity of a fixed deficit of an extremity includes the loss or impairment of a hand, arm, foot or leg D) Is issued by the medical examiner
C) A SPE certificate is valid for 2 years, may be renewed 30 days prior to expiration, and is required for a fixed deficit of an extremity includes of loss or impairment of a hand, arm, foot or leg. A SPE certificate is issued by the FMCSA, not the medical examiner. The medical examiner determines that the driver is otherwise medically qualified and meets the criteria for a SPE.
ABG testing is required if pulse oximetry is less than A) 96% B) 94% C) 92% D) 90%
C) ABG testing is indicated with pulse oximetry less than 92%
Which diabetes mellitus risk poses the greatest threat to public safety C) Hypoglycemia
C) Although hyperglycemia, peripheral neuropathy, and metabolic encephalopathy all pose significant risks for safe driving, hypoglycemia poses the greatest risk. The risk is particularly pronounced in drivers who use insulin. FMCSA defines a hypoglycemia episode as one that results in seizure, loss of consciousness, need of assistance from another person, or a period of impaired cognitive function that occurs without warning.
An apnea/hypoapnea index of more than _________ episodes per hours is diagnostic for sleep apnea A) 20 B) 25 C) 30 D) 35
C) An apnea/hypoapena index of more than 30 episodes per hour is diagnostic for sleep apnea
Driver qualification standards include not certifying an individual with which of the following: A) PaCO2 greater than 40 mm Hg B) Diagnosis of COPD C) Paroxysms of cough leading to cough syncope D) FVC < 75%
C) Any condition involving syncope is disqualifying
Drivers with which of the following conditions should be disqualified? C) Renal failure on peritoneal dialysis
C) Dialysis of any type is disqualifying
The driver requiring vision correction may be certified for up to A) Six months B) One year C) Two years D) Five years
C) Drivers requiring vision correction may be certified for up to two years.
The maximal certification internal for a driver with a history of drug abuse or alcoholism is A) Six months B) One year C) Two years D) Do not certify
C) Drivers with a history of drug abuse or alcoholism may be certified forup to two years. Drivers may be subject to drug and/or alcohol testing more frequently, but such testing is performed under 49 CFR Part 40 drug and alcohol testing regulations, not under 49 CFR Part 391.41 driver qualification standards
Which of the following is true with respect to drivers with psychological disorders? A) 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. B) The waiting period for a brief reactive psychosis or schizophreniform disorder is three months C) Alcohol and drug dependency and abuse are profound risk factors in the presence of personality disorders D) The waiting period following electroconvulsive therapy for treatment of depression is one year
C) Drivers with chronic schizophrenia are disqualified. The waiting period for a brief reactive psychosis or schizophreniform disorder is six months as is the waiting period for electroconvulsive therapy treatment.
The maximum certification period for a driver with cystic fibrosis is __________ A) 6 months B) 1 year C) 2 years D) Do not certify
C) Drivers with cystic fibrosis may be certified for up to 2 years
Under what conditions may a driver diagnosed with lazy eye be certified? A) Under any conditions — lazy eye is not considered a visual impairment for CMV operators B) Only if the driver has a visual acuity of 20/70 or better, or a federal exemption C) Only if the driver has a visual acuity of 20/40 or better, or a federal exemption D) Only by federal exemptoin
C) Drivers with lazy eye must meet federal vision standards for certification (20/40 visual acuity in both eyes) or seek a federal exemption
A driver with monocular vision who has been grandfathered must provide proof of grandfathered status at what time? A) Within three oaths of certification B) When the certification is issued C) Before the certification process is complete D) Never
C) Drivers with monocular vision who have grandfathered status must provide proof of such status before the medical examiner may issue certification
What is the recommended certification interval for a driver with diabetes mellituse who does not use insulin? C) One year
C) Drivers with non-insulin dependent diabetes should be certified for a maximum of one year
A driver with a history of moderate traumatic brain injury with early seizures, stroke with risk for seizures, or intracerebral or subarachnoid hemorrhage with risk for seizures requires a waiting period of ___________ seizure free and off anticonvulsant medications. A) One year B) Two years C) Five years D) Ten years
C) Each of these conditions requires a symptom free waiting period of five years
The impairment benchmark for FMCSA for alcohol is A) 0.01 B) 0.03 C) 0.04 D) 0.08
C) FMCSA recommendations use the degree of imipairment produced by a 0.04 percent food alcohol concentration as a benchmark for impairment
Which of the following is true? A) A diagnosis of multiple sclerosis is permanently medically disqualifying for interstate CMV driver certification B) Drivers with a history of dementia (metabolic) should be considered permanently medically disqualified for driving C) TIAs are automatically disqualifying for one year; after one year, the certification would depend on the interval history, general health, neurological examination, and compliance with the treatment program. D) Acute seizures due to systemic metabolic illness is considered a permanently disqualifying condition.
C) Multiple sclerosis may or may not be disqualifying. Dementia (metabolic) and seizures secondary to metabolic illness are not permanently disqualifying.
Urinalysis is required for the driver physical examination and the results must include C) Specific gravity, protein, blood, and glucose
C) Specific gravity, protein, blood, and glucose should be checked at every driver examination
Which of the following is true? A) Stage 1 hypertension is associated with immediate safety risks. B) Stage 2 hypertension is associated with immediate safety risks. C) Stage 3 hypertension is associated with unacceptable risk for sudden incapacitation of the driver. D) All stages of hypertension are associated with immediate safety risks.
C) Stage 1 and 2 hypertension's are not associated with immediate safety risks.
Which of the following symptoms are characteristic of major depression? A) Manic episodes B) Improved concentration and memory C) Relentless and fatigue D) Increased interest in personal environment
C) Symptoms of major depression include depressed or irritable mood, loss of interest or pleasure, social withdrawal, appetite and sleep disturbance, weight change and fatigue, restlessness and agitation or malaise, impaired concentration and memory functioning, poor judgment, and suicidal thoughts or attempts
Certification of vision testing results may be performed by any of the following except: A) An ophthalmologist B) The medical examiner C) Automated vision testing equipment D) An optometrist
C) The FMCSA allows the medical examiner, an ophthalmologist, or an optometrist to perform and certify vision testing results.
Driver suicide attempts could result in: A) Temporary three-month loss of certification and start of minimum six month waiting period for consideration of certification B) Temporary six month loss of certification and start of minimum nine month waiting period for consideration of certification C) Loss of certification and start of minimum one year waiting period for consideration of certification D) Temporary six month loss of certification and start of minimum one year waiting period for consideration of certification
C) The Medical Examiner should advise the driver that suicide attempts will result in loss of certification and create the starting of a minimum one year waiting period for consideration of certification.
Under what circumstances is an ophthalmologist and only an ophthalmologist qualified to perform an examination? A) Under no conditions — optometrist and medical examiners are always qualified to perform vision testing B) Only when the driver is diagnosed with aphakia C) Only when specialized testing is required to resolve an inconclusive examination D) Under no conditions — ophthalmologists are not qualified to examine CMV drivers
C) The assistance of an ophthalmologist is only required if specialized testing is necessary
The expiration date for one-year certification, following issuance of a one-time, three month certificate: A) Should be noted on the Medical Examiner's Certificate B) Should be noted in the comments section or elsewhere in the Medical Examination Report C) Both a and b D) Neither a and b
C) The expiration date must be noted on both the Medical Examiners Certificate and in the Medical Examination Report
How often should a driver who had a meningioma removed be examined? A) Every six months B) Every two years C) Annually D) Every three months
C) The maximum certication interval for a driver following the removal of a meningioma is one year
When a driver has a BP equivalent to Stage 2 hypertension a medical certification for what time period can be issued? A) One time, six months B) One time, one year C) One time, three months D) One time, two years
C) The maximum certification interval for Stage 2 hypertension is three months. This is intended to allow the driver to follow up with his/her treating physician to be placed on medication for hypertension treatment
Which of the following is true with regard to Adult Attention Deficit Hyperactivity Disorder? A) The maximum certification interval is two years. B) The driver should be disqualified if the driver has another psychological disorder, such as depression. C) Risk related to adult ADHD include comorbid antisocial or borderline personality disorders and a high incidence of substance abuse D) Treatment with amphetamines and amphetamine derivatives is disqualifying
C) The maximum certification interval is one year. As long as other psychological conditions are stable, a driver with adult ADHD may be certified. Treatment with amphetamines and amphetamine derivatives is not disqualifying.
On examination, a BP of 140/90 is obtained. A follow up BP is 140/90. What certification option may bee considered? A) The medial examiner should certify for 6 months if the driver is not taking antihypertension medications. B) If the driver is taking antihypertensive medications, 6 months should be the maximum certification period. C) The medical examiner may obtain additional BP readings and/or use his/her clinical judgment ad consider BP and overall driver fitness for duty to determine certification status and certification period. D) The medial examiner should not certify based not the BP readings.
C) The medical examiner may use additional BP readings and/or clinical judgment to make an appropriate certification determination.
If a significant abnormal finding for urinalysis specific gravity, protein, or blood is found, the medical examiner should: C) Use clinical expertise to determine a certification decision and to determine if additional evaluation is required or recommended
C) The medical examiner must determine whether additional evaluation is needed and whether the certification decision should be postponed or limited
If glucose is detected on urinalysis in a driver with no history of diabetes, an appropriate next step is: C) Fingerstick or blood glucose determination
C) The medical examiner should first determine blood glucose and then make an appropriate certification determination and referral
The medical examiner's role in the exemption process is _______________ A) Issuing the exemption B) Advising the FMCSA on the severity of the driver's impairment C) Providing the driver contact information for the Federal Vision Exemption Program D) Performing vision testing
C) The medical examiner's role in securing a vision exemption is to help the driver get in contact with the Federal Vision Exemption Program
What is the minimum waiting period for certification for a driver following a viral encephalitis with early seizures? A) Two years seizure free and off anticonvulsant medication B) Ten years seizure free and off anticonvulsant medication C) Five years seizure free and off anticonvulsant medication D) One-year seizure free and off anticonvulsant medication
C) The minimum waiting period for certification of a driver following an episode of viral encephalitis with early seizures is five years seizure free and off anticonvulsant medication
Which of the following is true? 1) Acute and chronic peripheral vestibulopathy do not require a symptom free waiting period. 2) Benign positional vertigo requires a symptom free waiting period. 3) Uncontrolled vertigo requires a symptom free waiting period. 4) Meniere's Disease is disqualifying. A) 1, 2 and 3 only B) 1 and 3 only C) 2 and 4 only D) 4 only E) all of the above
C) The minimum waiting period is two month symptom free for both acute and chronic vestibulopathy and for benign positional vertigo. Uncontrolled vertigo is disqualifying.
A driver with a history of bacterial meningitis with early seizures or a single unprovoked seizure requires a waiting period of _____________ seizure free and off anticonvulsant medications. A) One year B) Two years C) Five years D) Ten years
C) The waiting period for a history of bacterial meningitis with early seizures or single unprovoked seizure is five years
Driver examination 6/18/2011. Drivers disqualified due to benign positional vertigo, last symptoms 5/15/2011. Driver advised to return after a _____________ symptom free interval for a maximum _____________ certification interval. A) 1 month, 1 year B) 2 months, 1 year C) 2 months, 2 years D) 3 months, 1 year
C) The waiting period for benign positional vertigo, as well as dizziness and acute or chronic vestibulopathy, is 2 months symptom free with a maximum certification interval of 2 years.
Drivers with schizophreniform disorder, brief reactive psychosis, schizoaffective disorder, or delusional disorder may be certified after a _____________________ waiting period for a brief reactive psychosis or schizophreniform disorder and after a _________________ waiting period for any other psychotic disorder. A) Six weeks, three months B) Three months, six months C) Six months, one year D) One year, two years
C) The waiting period is six on this for a brief reactive psychosis or schizophreniform disorder and one year for any other psychotic disorder
The FMCSA considers ___________________ elevated BP readings at consecutive examinations as readings that confirm elevated BP. A) Three B) Four C) Two D) Five
C) Two consecutive blood pressure readings, either at the same examination or on consecutive examinations, are considered by the FMCSA as an indication of elevated blood pressure.
Who of the following is not qualified to perform the vision testing portion of the interstate CMV driver physical examination? A) An optometrist B) The medical examiner C) A licensed vision testing technician D) An ophthalmologist
C) Vision testing must be performed by the medical examiner, an optometrist, or ophthalmology
Which of the following will always disqualify a driver from being certified without federal exemption? A) Abnormal reactivity to light B) 70 degrees horizontal field of vision in each eye C) Monocular vision D) Floaters
C) Without a federal exemption or grandfathered status, monocular vision will always disqualify a driver from being certified.
Which of the following conditions is not disqualifying? A) Meniere's Disease B) Cochlear Implant C) Labyrinthine Fistula D) Nonfunctioning Labyrinth
Cochlear implants are not disqualifying
Which of the following is a disqualifying condition? A) A past clinical diagnosis of alcoholism B) A breath alcohol result of 0.019% C) An alcohol-related stable physical condition, regardless of the time element D) Use of methadone
D) A current diagnosis of alcoholism is disqualifying. A breath alcohol result of 0.02% or higher renders the driver unqualified to drive. An alcohol-related unstable physical condition is disqualifying.
A Skilled Performance Evaluation (SPE) certificate pursuant to 49 CFR 391.49 is granted under the following conditions except: A) the driver has a fixed deficit of an extremity B) the driver meets all the other standards C) The driver has a medical evaluation summary completed by a board qualified or certified physicatrist or orthopedic surgeon D) The driver has completed a driving evaluation per FMCSA standards
D) A driving evaluation is not required for issuance of an SPE certificate
If audiometric testing is performed, testing should include which of the following frequencies? A) 1000, 2000, 3000 Hz B) 500, 2000, 4000 Hz C) 500, 1000, 3000 Hz D) 500, 1000, 2000 Hz
D) Although additional testing frequencies may be used, minimum FMCSA audio metric testing requirements include testing at 500, 1000, and 2000 Hz. The driver may be certified if the driver does not have more than 40 dB of hearing loss averaged across the three frequencies in the better ear.
The maximum certification period for a driver with diagnosis of autonomic neuropathy is: A) Do not certify B) Six months C) One year D) Two years
D) As long as the autonomic neuropathy does not cause orthostatic hypertension, resting tachycardia, or other organ autonomic neuropathy that interferes with driving ability, the driver may be certified for two years. Note that while FMCSA guidelines state that drivers with neurological conditions should be certified for a maximum of one year, FMCSA guidelines for several neurological conditions indicate a maximum certification interval of two years. Since these inconsistencies appear in the FMCSA guidelines themselves, this leaves medical examiners with unclear guidelines for those conditions.
Which of the following is true? A) Cerebellum and brain stem vascular lesions are associated with an increased risk for seizures. B) Drivers with emboli or thrombotic cerebral infractions are unlikely to have residual intellectual or physical impairments C) Intracerebral hemorrhage results from bleeding primarily into the spaces around the brain and subarachnoid hemorrhage reflects bleeding into the substance of the brain D) Cortical and subcortical hemorrhages are associated with an increased risk for seizures
D) Cerebellum and brainstem vascular lesions are not associated with increased risk for seizures. Emboli and thrombotic cerebral infractions often have residual intellectual or physical impairments. Intracerebral hemorrhage reflects bleeding into the substance of the brain while subarachnoid hemorrhage reflects bleeding into the spaces around the brain.
Drivers with sleep apnea should have all of the following except: A) multiple sleep latency testing values within the normal range B) Resolution of apneas confirmed by a sleep study D) Certification by a sleep apnea specialist
D) Certification by a sleep apnea specialist is not a requirement for drivers diagnosed with sleep apnea
Disqualifying conditions include: D) Dialysis
D) Dialysis of any type of disqualifying
The driver should remain under the supervision of a treating physician to: A) Monitor weight fluctuation with medications B) Monitor driver nutritional modifications C) Monitor possible medication side effects D) Monitor attitudinal/behavioral changes
D) Drivers using prescription medications should be monitored by a supervising or treating physician for possible medications side effects
A driver with a history of acute bleeding ulcer may be certified if: D) The underlying cause has been identified and recurrence risk is low following treatment
D) Drivers with bleeding ulcers should not be certified until the underlying cause has been identified and the recurrence risk is low
Drivers with insulin dependent diabetes: D) May be eligible for a diabetes exemption
D) Drivers with insulin dependent diabetes cannot be certified but may be eligible for a diabetes exemption
Which of the following is not considered a secondary cause of hypertension? A) Sodium consumption B) Alcohol consumption C) Tobacco use D) Thyroid disease
D) Hypertension may be affected by sodium and alcohol consumption, tobacco use, use of NSAIDS, and renal artery disease, a month other conditions. Thyroid disease is not considered a secondary cause of hypertension.
Guidelines for obstructive sleep apnea A) Are regulatory B) Require a waiting period of 2 months after initiation of CPAP treatment C) Include a 2 month waiting period after surgical treatment D) Require disqualification if the driver has restless leg syndrome (RLS) associated with excessive daytime sleepiness (EDS)
D) OSA guidelines are not regulatory, so the medical examiner may choose not to follow the guidelines but should document the rational for doing so The waiting period after CPAP treatment is one month and after surgical treatment is three months
A diabetes exemption may be issued by: D) The FMCSA
D) Only the FMCSA can grant exemptions
Which of the following is disqualifying? A) PaCO2 less than 45 mm Hg B) PaO2 less than 70 mm Hg at altitudes less than 5000 feet C) PaO2 less than 65 mm Hg at altitudes above 5000 feet D) PaCO2 greater than 45 mm Hg
D) PaCO2 of more than 45 mm Hg is disqualifying. PaO2 of less than 65 mm Hg at altitudes less than 500 feet or less than 60 mm Hg above 5000 feet are disqualifying
Pulse oximetry O2 saturation - 90%; ABG - PaO2=60 mm Hg, PaCO2 = 42 mm Hg. What is the certification determination? A) Do not certify B) Certify three months pending additional testing C) Certify for one year D) Certification depends on whether the testing is performed at altitudes of > 5000 feet.
D) PaO2 of less than 65 mm Hg is disqualifying unless the testing is conducted at altitudes above 5000 feet. At altitudes above 5000 feet, a PaO2 of less than 60 mm Hg is disqualifying. Note that FMCSA guidelines use the altitude at which the testing is performed to determine driver certification, but also recommend that medical examiners may consider the history of whether the driver has recently been above 5000 feet in making certification determinations based on PaO2 results
Indications for pulse oximetry and/or ABG include: A) FEV1 less than 70% of predicted B) FEV1/FCVC ratio less than 70% of predicted C) Restrictive impairment present and FVC less than 70% predicted D) If oximetry is less than 92%, the driver must have ABG analysis
D) Pulse oximetry should be performed if FEV1 is less than 65% predicted, if FEV1/FVC ratio is less than 65% predicted, and if restrictive impairment is present and the FVC is less than 60% predicted.
Common medications used to treat vertigo include: A) Sedative hyponotics B) Beta blockers C) Narcotics D) Phenothiazines
D) Sedative hypnotics, beta blockers, and narcotics are not commonly used to treat vertigo. Medications commonly used to treat vertigo include antihistamines, benzodiazepines, and phenothiazines.
Which of the following is true? A) Stage 1 hypertension is systolic BP 140-149 and/or diastolic BP 90-99 B) Stage 2 hypertension is systolic BP 150-169 and/or diastolic BP 100-109. C) Stage 3 hypertension is systolic BP 170 or greater and/or diastolic BP 110 or greater. D) FMCSA considers two elevated blood pressures, whether follow-up or recertification, as readings that confirm elevated blood pressure.
D) Stage 1 hypertension is systolic BP 140-159 and/or diastolic BP 90-99, Stage 2 is systolic BP 160-179 and/or diastolic BP 100-109, and Stage 3 hypertension is systolic BP>=180 and or diastolic BP>=110.
If there is any doubt in the Medical Examiner's mind regarding driver certification related to mental health issues, the Medical Examiner should: A) Certify for only three months B) Certify for only six months C) Request medical records from the treating physician D) Not certify the driver
D) The Medical Examiner should not certify the driver and should require additional evaluation by an appropriate mental health professional who is advised of the nature of commercial motor vehicle driving and concerns identified by the Medical Examiner
The driver on anticoagulant treatment for a neurological condition can be certified for a maximum of ______________________ A) Six months B) One year C) Two years D) Do not certify
D) The driver on anticoagulant therapy for a cardiovascular condition may be certified for up to one year. The driver on anticoagulant therapy for a neurological condition should not be certified due to a risk of cerebrovascular hemorrhage.
The maximum certifcation interval for. Driver diagnosed with asthma is: A) 3 months B) 6 months C) 1 year D) 2 years
D) The maximum certifcation interval for a driver with asthma is 2 years
The maximum period for which a driver with a neurological condition should be certified is: A) two years B) Three months C) Six months D) One year
D) The maximum certification interval for a driver with a neurological condition is one year. Note that while FMCSA guidelines state that drivers with neurological conditions should be certified for a maximum of one year, FMCSA guidelines for several neurological conditions indicate a maximum certification interval for two years. Since these inconsistencies appear in the FMCSA guidelines themselves, this leaves medical examiners with unclear guidelines for these conditions.
The maximum certification interval for a driver diagnosed with asthma is ______________________. A) Three months B) Six months C) One year D) Two years
D) The maximum certification interval for asthma is two years
Which of the following is true for diagnosis of a hernia? D) The maximum certification interval for a driver with a hernia is two years
D) The medical examiner can use his/her judgment as to whether a driver should be referred to a surgeon or other specialist. There is no specified waiting period following hernia surgery - the driver should not be certified until the medical examiner determines that treatment is safe and effective, and that the condition is stable. No evidence has linked hernias of any type to increased CMV accident risk.
Transient ischemic attacks (TIA's) are automatically disqualifying for ________ months; after the minimum waiting period the certification depends on the interval history, general health, neurological examination, and compliance with the treatment program. A) 3 B) 6 C) 9 D) 12
D) The minimum waiting period for TIA's is 12 months or one year
What is the minimum waiting period for certification following a moderate TBI with early seizures? A) Two years seizure free and off anticonvulsant medication B) one-year seizure free and off anticonvulsant medication C) Six months seizure free and off anticonvulsant medication D) Five years seizure free and off anticonvulsant medication
D) The minimum waiting period for a moderate TBI with early seizures is five years seizure free and off anticonvulsant medicatin
A driver treated for hypertension presents on September 8, 2012 with a blood pressure of 142/96. The driver is given a three-month certification until December 8, 2012. On blood pressure check one month later, on October 14, 2012, the driver's blood pressure is 144/72. The driver should be certified for __________________. A) Do not certify B) Three months to January 14, 2013 C) One year to September 8, 2018 D) The driver remains certified for the three month-interval until December 8, 2012
D) The three month certification reminds valid. The driver did not qualify for a one-year certification, nor did the driver's blood pressure disqualify the driver. If the driver fails to meet the requirement to lower blood pressure to >=140/90 by December 8, 2012,, the driver will be disqualified until blood pressure is stabilized at <=140/90
A driver presents for clearance to return to driving a CMV four weeks after arthroscopic carpal tunnel repair to his left hand. The certification decision should be: A) The driver must complete a two-month waiting period for carpal tunnel surgery B) The driver may be certified if he completes a functional capacity evaluation C) The driver may be certified for a maximum of one year, as long as he meets all the other qualification standards D) The driver may be certified for a maximum of two years, as long s he meets all the other qualification standards
D) Ther is no waiting period following carpal tunnel surgery. The driver may be certified for up to two years if the medical examiner considers the driver to have recovered sufficiently from surgery
What eye conditions must the medical examiner ask the driver about? A) Cataracts, color deficiencies, retinitis pigmentosa, aphasia, glaucoma B) Lazy eye, cataracts, aphasia, floaters, retinopathy C) Glaucoma, macular degeneration, retinitis pigmentosa, color deficiencies D) Retinopathy, cataracts, aphasia, glaucoma, macular degeneration
D) These "ask about" eye conditions require referral to an eye specialist if the driver indicates a history of these conditions
The certification determination for a driver with a diagnosis of hypertension who presents with a confirmed BP of 182/112 is: A) Qualify 3 months B) Disqualify until BP is <=180/110 C) Disqualify until BP is <=160/100 D) Disqualify until BP is <=140/90
D) This is Stage 3 hypertension and the driver is disqualified until blood pressure less than or equal to 140/90 is attained.
The maximum duration of a federally-granted waiver or exemption is _______________ A) Three months B) Six months C) One year D) Two years
D) Waiver durations may vary, although they cannot exceed two years
The certification determination for a driver who presents with a confirmed BP of 182/86 is A) Qualify for 3 months B) Disqualify until BP is <180/110 C) Disqualify until BP is <160/100 D) Disqualify until BP is <=140/90
Drivers with Stage 3 hypertension are disqualifying until blood pressure is stabilized at <=140/90.
Which of the following conditions are disqualifying? 1) Acute or chronic vestibulopathy after a one-month symptom free interval. 2) Nonfunctioning labyrinths after a three-month free interval. 3) Labyrinthe fistula after a six month symptom free interval. 4) Meniere's disease After a one-year symptom free interval. A) 1, 2 and 3 only B) 1 and 3 only C) 2 and 4 only D) 4 only E) all of the above
E) Nonfunctioning labyrinths labyrinthine fistula, and Ménière's disease are all disqualifying and there is no symptom free interval that allows certification. The waiting period for acute and chronic vestibulopathy is two months symptom free.
Medical guidance does not recommend which of the following tests for initial pulmonary function testing? A) Forced expiration volume in one second (FEV1) B) FEF 25%-75% C) Forced vital capacity (FVC) D) FEV/FVC ratio
FEF 25%-75% is not a recommended pulmonary function test for certification determination
Hearing must be tested using audio metric testing equipment. A) True B) False
Of a driver passes a whisper test in at least a one ear, audiometric testing is not required.
A driver with peripheral neuropathy: A) may be certified for one year B) may be certified for two years C) should not be certified D) may be certified for 3 months pending specialist evaluation
Peripheral neuropathy is a disqualifying condition.
Pulse oximetry or ABG testing is indicated when the driver has an obstructive respiratory condition and results of spirometry testing are _________: A) FEV1 <70% predicted B) FEV1/FVC ratio less than 65% C) FVC <80% predicted D) FEF 25/75<80% predicted
Pulse oximetry or ABG testing is indicated if FEV1/FVC ratio is less than 65%
The risk of recurrent events following a TIA falls to less than 5% in what time frame? A) the first 24 hours B) the first year C) The first few weeks D) The first 12 hours
TIA risk falls to less than 5% after one year.
Which of the following is true with regard to TIA's? A) A driver on anticoagulant therapy for a cardiovascular disorder may not be certified if the driver has a history of TIA's B) The rate of recurrence for TIA's is highest in the first six months, declining after six months to less than 5% per year C) TIA's are not considered warning signs for a cerebrovascular accident (CVA). D) The maximum certification interval for a driver with a history of TIA's is six months.
The rate of recurrence for TIA's is highest in the first year, declining after one year to less than 5% per year. TIA's are considered warning signs for a CVA. The max certification interval for a driver with a history of TIA's is one year.
A driver previously diagnosed and treated for hypertension presents on April 4, 2014 with blood pressure of 150/84. The driver is given a three-month certification until July 4, 2014. At follow-up two months later, on June 4, 2014, a complete driver examination is performed, and the driver's blood pressure is 124/74. The driver should be certified for _______________________. A) Three months until September 4, 2014 B) One year until April 4, 2015 C) One year until June 4, 2015 D) Two years until April 4, 2016
Which of the following is true with respect to drivers with psychological disorders? A) With some exceptions (e.g. schizophrenia), exclusion from CMV driving is not based solely on diagnosis. B) Recommendations related to effects and/or side effects of medication use the degree of impairment produced by a 0.08 percent blood alcohol concentration as a benchmark. C) Medical examiners may not request medical records related to treatment of psychological disorders due to HIPAA regulation. D) Treatment with antipsychotic medications is disqualifying A) The degree of of impairment produced by a 0.04 percent blood alcohol level is considered the impairment benchmark by the FMCSA. HIPAA regulations do not preclude a medical examiner from requesting records related to treatment of psychological disorders. The medical examiner requesting such records should have the driver sign a HIPAA-compliant consent form for the release of such records. Treatment with antipsychotic medications is not in and of itself disqualifying, although the underlying diagnosis for which such medications are used may be disqualifying.
Which of the following drivers meets hearing certification standards? A) Whisper test 4 feet right ear, 3 feet left ear. B) Whisper test 5 feet right ear with hearing aid, 3 feet left ear without hearing aid C) Audiogram left 30/500 Hz, 40/1000 Hz, 60/2000 Hz; right 25/500 Hz, 35/1000 Hz, 80/2000 Hz D) Audiogram left 25/500 Hz, 50/1000 Hz, 40/3000 Hz; right 25/500 Hz, 35/1000 Hz, 60/3000 Hz
Whisper test results require 5 feet in at least one ear for passing, with or without a hearing aid. Audiometric testing results require an average of 40 dB loss in the better ear for results averaged from 500, 1000, and 2000 Hz. Although testing may be performed at 3000 Hz, results obtained are not used to determine whether the driver meets hearing requirements.
