NRCME EXAM 2023-2024 ACTUAL EXAM 300 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
(100% VERIFIED ANSWERS) |AGRADE(BRAND NEW!!)
During the examination, a driver is found to have a positive “Babinski”
reflex. The examiner should:
a. Certify the driver for 1 year.
b. Certify the driver for 2 years.
c. Council the driver to obtain an SPE.
d. Disqualify the driver until s/he has a neurological consultation. –
ANSWER- Correct answer is “D”.
Rationale: A positive Babinski reflex is indicative of abnormalities in
the motor control pathways leading from the cerebral cortex and is
widely used as a diagnostic aide in disorders of the central nervous
system. The examiner should obtain clearance from a neurologist prior
to reconsidering the driver for certification.
All of the following are required components of all DOT medical
examinations EXCEPT?
a. Vision
b. Hearing
c. Blood Pressure
d. Ophthalmoscopic examination – ANSWER- Correct answer is “D”.
Rationale: There are four required components of every examination:
vision, hearing, blood pressure and urinalysis. Ophthalmoscopic
examination is not required but may be done if deemed necessary.
A driver reports in his history that he was treated for epilepsy 14 years
ago but stopped taking anti-epileptic medication on his own since his
move to your area 11 years ago. He has not seen a neurologist nor a
health care provider in over 10 years and reports no seizures during this
period. The examiner should:
a. Request medical clearance, and if obtained the driver may be certified
for 1 year.
b. Request medical clearance, and if obtained the driver may be certified
for 2 years.
c. Refer the driver to the epilepsy/seizure exemption program.
d. Disqualify the driver. – ANSWER- D. Disqualify
Rationale: Comment: Even though the driver reports exceeding the 10-
year waiting period, it was not under medical supervision and the driver
discontinued medication use and treatment outside of medical oversight.
Since the driver cannot a documented medical history this driver does
not meet the non- discretionary epilepsy standard until it is established
that the driver is 10 years seizure-free while off anti-convulsants.
A driver reports for a re-certification examination 8 weeks after having
triple coronary artery bypass surgery. He presents a note from his
treating provider stating that he is able to return to driving without
restriction. Additionally, the note mentions that the driver’s results of his
ETT were normal, and his echo showed a left ventricular ejection
fraction of 75%. The examiner should?
a. Temporarily disqualify the driver until he has completed the required
waiting period.
b. Permanently disqualify the driver because his ejection fraction is too
low.
c. Certify the driver for 1 year only.
d. Certify the driver for 2 years because he has medical clearance. –
ANSWER- Correct answer “A”.
Rationale: Following CABG, there is a 3-month waiting period. Since
the driver is only at 8 weeks post-op, he would have to wait 4 more
weeks until he can certify. Once he completes his waiting period, he
would be certified for 1 year from the date of the original examination.
What is the maximum number of hours a CMV driver can drive in 7
consecutive days?
a. 50.
b. 60.
c. 70.
d. 80. – ANSWER- Correct answer “B”.
Rationale: 60-70 Hour Limit: A driver may not drive after 60/70 hours
of duty in 7/8 consecutive days. Many versions of the NRCME exam
will have one question about the 60/70 rule.
A blood pressure of 166/92 mm Hg would be?
a. Considered normal
b. Stage 1 hypertension.
c. Stage 2 hypertension.
d. Stage 3 hypertension. – ANSWER- Correct answer is “C”.
Rationale: The driver has Stage 2 hypertension (160 – 179/100 – 109).
The driver is taking “Sinemet” for the treatment of Parkinson’s disease.
The medical examiner should:
a. Disqualify the driver.
b. Obtain medical clearance from a neurologist.
c. Counsel the driver to obtain a neurologist waiver.
d. Certify the driver for 1 year. – ANSWER- Correct answer is “A”
Rationale:. A driver who is diagnosed with Parkinson’s is permanently
disqualified.
The driver uses hearing aids during the whisper test. He is able to hear at
5 feet on the right and 4 feet on the left.
a. Send the driver for an audiometric test.
b. Disqualify the driver.
c. Certify the driver for 1 year.
d. Certify the driver for 2 years. – ANSWER- Correct answer is “D”.
Rationale: The driver is able to use hearing aids during the whisper test
(and this should be marked on the form). A driver must only qualify in 1
ear to certify and there is no limitation of certification time.
The minimum acceptable spirometry values required to certify a driver
are:
a. FEV1 70%, FVC 65%, FEV1/FVC ratio 65%
b. FEV1 65%, FVC 60%, FEV1/FVC ratio 65%
c. FEV1 65%, FVC 65%, FEV1/FVC ratio 65%
d. FEV1 60%, FVC 60%, FEV1/FVC ratio 60% – ANSWER- Correct
answer is “B”.
Rationale: The minimum acceptable values are 65%, 60%, and 65%
(FEV1, FVC, FEV1/FVC ratio).
A driver presenting to your office marks down that he is taking
“nitroglycerin” for angina and he has been doing so for a few years.
Upon questioning he indicates that he has needed more nitroglycerin
recently because his episodes have become more frequent. Your best
course of action is to:
a. Council the driver to increase his dose of medication.
b. Certify the driver for 1 year.
c. Provide a 1-time, 3-month certificate to monitor his condition.
d. Disqualify the driver and refer him to his cardiologist for further
evaluation. – ANSWER- Correct answer is “D”.
Rationale: Disqualify the driver because his angina is not stable.
The longest the medical examiner would certify a driver with a history
of Stage 3 hypertension is:
a. 3 months
b. 6 months
c. 12 months
d. 24 months – ANSWER- Correct answer is “B”.
Rationale: The driver may only be certified for a maximum of 6 months
for the rest of his/her driving career.
A driver is taking Wellbutrin to help him stop smoking. He has provided
a note from his PCP stating that he has no side effects and confirms that
he is taking the medication for smoking cessation.The examiner would?
a. Certify the driver for 2 years.
b. Certify the driver for 1 year.
c. Disqualify the driver because the medication is not allowed.