Which of the following is a requirement for drivers with a diabetes exemption?
A) Possess a rapidly absorbable form of glucose while driving - ANSWER-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.
Drivers with insulin dependent diabetes:
D) May be eligible for a diabetes exemption - ANSWER-D) Drivers with insulin
dependent diabetes cannot be certified but may be eligible for a diabetes exemption
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 - ANSWER-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.
What is the recommended certification interval for a driver with diabetes mellituse who
does not use insulin? C) One year - ANSWER-C) Drivers with non-insulin dependent
diabetes should be certified for a maximum of one year
A diabetes exemption may be issued by:
D) The FMCSA - ANSWER-D) Only the FMCSA can grant exemptions
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 -
ANSWER-A) Exemption requirements must be noted on the Medical Examination
Report status section and the Medical Examiners Certificate
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 - ANSWER-C) The medical examiner
should first determine blood glucose and then make an appropriate certification
determination and referral
Which of the following is not a criteria that the FMCSA uses to define a severe
hypoglycemic reaction? - ANSWER-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
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 - ANSWER-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.
Which diabetes mellitus risk poses the greatest threat to public safety C) Hypoglycemia
- ANSWER-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.
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 - ANSWER-A) Driver's
with diabetes exemption should check glucose values one hour before driving and once
every four hours while driving
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 - ANSWER-
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.
Drivers with which of the following conditions should be disqualified? C) Renal failure on
peritoneal dialysis - ANSWER-C) Dialysis of any type is disqualifying
Which of the following is true of nephropathy? B) The maximum certification interval for
nephropathy is two years - ANSWER-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.
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 -
ANSWER-C) The medical examiner must determine whether additional evaluation is
needed and whether the certification decision should be postponed or limited
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. - ANSWER-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.
Which of the following is not a disqualifying condition?
A) Peritoneal dialysis
B) Hemodialysis
C) Hernia
D) Peripheral neuropathy - ANSWER-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).
Urinalysis is required for the driver physical examination and the results must include C)
Specific gravity, protein, blood, and glucose - ANSWER-C) Specific gravity, protein,
blood, and glucose should be checked at every driver examination
Disqualifying conditions include: D) Dialysis - ANSWER-D) Dialysis of any type of
disqualifying
A driver who has Hepatitis C who is stable and whose condition does not represent a
safety risk may be certified A) True - ANSWER-A) Hepatitis C is not disqualifying
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 - ANSWER-D)
Drivers with bleeding ulcers should not be certified until the underlying cause has been
identified and the recurrence risk is low
A driver with a successful kidney transplant can be certified A) True - ANSWER-A)
Kidney transplants are not disqualifying
Which of the following is true?
A) Medical marijuana use if disqualifying - ANSWER-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.
Which of the following is a requirement for a driver with a history of alcoholism to be
certified? A) No residual disqualifying physical impairment - ANSWER-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 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 - ANSWER-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.
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. -
ANSWER-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.
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 - ANSWER-According to the FMCSA, all of these are defined as
mental health professionals
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 - ANSWER-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?
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