INPE NRCME EXAM QUESTIONS
WITH CORRECT ANSWERS
Childhood Febrile Seizures - Answer-Febrile seizures occur in up to 5% of children
before age 5 and seldom
occur after that age. Most increased risk of unprovoked seizures occurs in
first 10 years of life.
Waiting period: No recommendation. ME should not certify until etiology
confirmed and treatment shown to be effective, safe, stable
Maximum certification = 2 years
Certify if seizure history limited to childhood febrile seizures
Not to certify if ME believes nature and severity of condition endangers
Follow‐up: at least biennial exams
Epilepsy - Answer-Unlike earlier examples, epilepsy is chronic functional disease that
involves
episodes without warning and resulting in loss of voluntary control, LOC,
and/or seizures
The following drivers are disqualified:
• Driver with medical history of epilepsy
• Driver with current clinical diagnosis of epilepsy
• Driver taking anti‐seizure medications
2007 Advisory on epilepsy - Answer-Opened door for drivers with history of epilepsy to
become certified:
If there is an epilepsy diagnosis, applicant should be seizure‐free for 8
years, on or off medication. (recent notice said off meds, 10 years).
If taking anti‐seizure medication(s), the plan for medication should be
stable for2 years.
Stable=no changes in medication, dosage, or frequency
Recertification for drivers with an epilepsy diagnosis should be annually
with neurologist clearance
Seizure Exemption - Answer-Drivers requests seizure exemption
Will submit physician neurologist evaluation and statement, driving record x 3
yrs, description of driving activities
May qualify for slightly shorter waiting period that includes time on anti‐seizure
medications
Exemption requests involve name and relevant medical information published in
Federal Register with 30‐day public comment period.
,Single Unprovoked Seizure - Answer-Unprovoked seizure defined as having no
identifiable acute alteration of
systemic metabolic function or acute insult to brain—there may be a
known or distant cause of seizure
Individuals in this category do not meet criteria of epilepsy but do have
higher risk for future seizures, particularly up to 5 years (35%).
A second unprovoked seizure would constitute history of epilepsy
Recommendations are based on decreasing risk over longer period of time
without second seizure and off anticonvulsants
Waiting period= 5 years seizure free and off anticonvulsants*
Maximum certification = 1 year
Certify w/ waiting period and clearance from neurologist
Not to certify if waiting period not met and/or no clearance from neurologist as
above
Monitoring should be determined on case‐by‐case basis
Follow‐up requires at least biennial exam
*2007 Advisory opened door for drivers with single unproved seizure to seek
certification with 4 years seizure‐free on/off medications with same stable
stipulations and clearances
headaches guidelines - Answer-HAs such as migraines, tension HA, cluster HA, post‐
traumatic HA, cranial
neuralgia, and atypical facial pain are all identified as having potential to
interfere with CMV driver ability.
Carefully consider frequency and severity, as well as potential for effects
such as visual disturbance.
Waiting period: None recommended. ME should not certify until etiology
confirmed and treatment effective, safe, stable
Certification: 2 years, if ME believes nature and severity not endangering
No certification if ME believes nature and severity endangers...
Vertigo & Dizziness guidelines - Answer-Problems with the vestibular, visual, and/or
proprioception systems and
CNS may produce unsafe degrees of vertigo or dizziness, endangering
health/safety of driver/public.
Further, medications most commonly used to treat vertigo include
antihistamines, benzodiazepines, and phenothiazines. Antihistamines are
potentially sedative and cannot be used during driving. Benzodiazepine
and phenothiazine usage disqualifies drivers.
• The following are disqualifying: Meniere's disease, Labyrinthine fistula,
Nonfunctioning labyrinths
Minimum waiting period 2 month asymptomatic period in driver with diagnosis
of benign positional vertigo (BPV) or acute or chronic peripheral vestibulopathy.
Maximum certification = 2 years. However 1 year is appropriate
,Certify if: diagnosis of
• BPV, acute/chronic peripheral vestibulopathy and completed appropriate symptomfree
period; ME believes no endangerment
• Not to certify if:
BPV/vestibulopathy symptom‐free period not met
• Meniere's disease
• Labyrinthine fistula
• Nonfunctioning labyrinths
CNS Infections Guidelines - Answer-Includes bacterial meningitis, viral encephalitis.
Determinations vary based
on seizure activity associated with diagnosis.
Minimum waiting period:
• 1 year seizure free and off anticonvulsants if
Bacterial meningitis or viral encephalitis without early seizures
• 5 years seizure free and off anticonvulsants if
Bacterial meningitis with early seizures
• 10 years seizure free and off anticonvulsants if
Viral encephalitis with early seizures
Maximum certification = 2 years
Certify if: aseptic meningitis or either bacterial meningitis or viral
encephalitis meeting waiting period criteria
Not to certify with current CNS infection
Monitoring and follow‐up are case‐by‐case but annual exam is appropriate
Embolic & Thrombotic Strokes;
Intracerebral & Subacrachnoid Hemorrhages; TIAs guidelines - Answer-Minimum
waiting period:
1 year if not at risk of seizures (cerebellum or brainstem vascular lesions)
5 years if risk for seizures (cortical or subcortical deficits)
Maximum certification=1 year
Certify if: Completed waiting period; normal PE, neuro exam including
neuro‐ophthalmological eval and neuropsychological testing; no neuro
residuals (or none of severity to interfere with CMV driving); clearance from
a neurologist familiar with CMV driver responsibilities
which vehicles drivers require CMV exam - Answer-weighs more than 26,00 lbs OR
is paid to transport more than 8 passengers OR
transports more than 15 passengers OR
is transporting hazardous material
which drivers dont need CMV exam - Answer-Driver of farm vehicle
Firefighter with certificate of authorization
Recreational motor home drivers
how to become a CME - Answer-1) training course + certificate
, 2) national exam passed (>70% correct)
you have 3 years to take the test
to keep CME status - Answer-keep NP license and update records
NRCME training monthly
submit form for every driver examined
adhere to driver certification standards and record keeping
(Keep original records of exams and certifications at least 3 years)
submit to periodic monitoring and audits
Complete periodic training, at minimum refresher at 5 years
Successfully pass ME certification every 10 years
Removal from Registry - Answer-• Failure to comply with requirements
• Errors, omissions, or other indications of improper certifications of drivers
• Issuance of ME certificate to driver not meeting standards
• Failure to comply with examination requirements
• Falsely claiming to have completed training
CMV Driver Requirements - Answer-(1) Is at least 21 years old;
(2) Can read and speak the English language sufficiently to converse with the general
public, to understand
highway traffic signs and signals in the English language, to respond to official inquiries,
and to make entries
on reports and records;
(3) Can, by reason of experience, training, or both, safely operate the type of
commercial motor vehicle
he/she drives;
(4) Is physically qualified to drive a commercial motor vehicle in accordance with
subpart E—Physical
Qualifications and Examinations of this part;
(5) Has a currently valid commercial motor vehicle operator's license issued only by one
State or jurisdiction;
(6) Has prepared and furnished the motor carrier that employs him/her with the list of
violations or the
certificate as required by § 391.27;
(7) Is not disqualified to drive a commercial motor vehicle under the rules in § 391.15;
and
(8) Has successfully completed a driver's road test and has been issued a certificate of
driver's road test in
accordance with § 391.31, or has presented an operator's license or a certificate of road
test which the motor
carrier that employs him/her has accepted as equivalent to a road test in accordance
with § 391.33.
Driver Functions and Work Environment Involved in Safe
Operation of CMV - Answer-• Unique occupation
