NRCME Test Bank Questions with
Correct Answers
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 - Answer-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
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 - Answer-D) A
driving evaluation is not required for issuance of an SPE certificate
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 - Answer-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.
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 - Answer-B) Nerve
conduction study testing is not a clinical evaluation of musculoskeletal function
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 - Answer-A) A functional capacity evaluation (FCE) is not a
requirement for SPE certificate application
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 - Answer-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.
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 - Answer-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.
Which of the following is a requirement for drivers with a diabetes exemption?
A) Possess a rapidly absorbable form of glucose while driving
B) Self—monitor blood glucose one hour before driving and at least once every 2 hours
while driving
C) Plan to submit blood glucose monitoring logs every 6 months
D) Maintain a Hemoglobin A1C value less than 7 - 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:
A) May be certified for a maximum of 6 months
B) Must maintain a hemoglobin A1C level of less than 7 to qualify for certification
C) Cannot be certified if they have a history of myocardial infarction
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
B) The most important concert related to medication use for treating diabetes is
hyperglycemia
C) Peripheral neuropathy is not a disqualifying condition
D) Diabetes is not a coronary heart disease (CHD) equivalent condition - 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?
A) Three months
B) Six months
C) One year
D) Two years - Answer-C) Drivers with non-insulin dependent diabetes should be
certified for a maximum of one year
A diabetes exemption may be issued by:
A) An endocrinologist
B) The Medical Examiner
C) The driver's personal physician
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
B) Letter to the FMCSA
C) Employer authorization form
D) Endocrinology consultation form - 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:
A) Endocrinology consultation
B) One year clearance and recommendation to see personal physician
C) Fingerstick or blood glucose determination
D) Temporary disqualification - Answer-C) The medical examiner should first determine
blood glucose and then make an appropriate certification determination and referral
Drivers with a history of _____________ severe hypoglycemic reactions in the past year
or _____________ severe hypoglycemic reactions in the past five years should not be
certifed.
A) one, three
B) one, two
C) two, three
D) two, five - 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 of the following is not a criteria that the FMCSA uses to define a severe
hypoglycemic reaction?
A) Seizure
B) Dizziness
C) Need of assistance from another person
D) Period of impaired cognitive function that occurred without warning - 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
Which diabetes mellitus risk poses the greatest threat to public safety
A) Hyperglycemia
B) Peripheral neuropathy
C) Hypoglycemia
D) Metabolic encephalopathy - 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
