NRCME Exam Questions and answers. Questions and answers. Predictor Quizzes!!

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NRCME Exam Questions and answers. Questions and answers. Predictor Quizzes!! What are regulations? - ✔✔-Laws that must be followed What are disqualifying medical conditions? - ✔✔-Epileps... y monocular vision hearing loss What are guidelines? - ✔✔-Recommendation to follow but can have raptor ale for variation FMCSA medical program responsibilities include: Oversee the Department of Transportation. Regulation of intrastate commercial motor vehicle operations. Conduct and oversee the agency's medical exemption and certificate programs. Provide commercial motor vehicle driver examinations. - ✔✔-Conduct and oversee the agency's medical exemption and certificate programs. Which of the following is true? The FMCSA does not consider feasibility or impact in the rule-making process. Only the Medical Review Board can provide advice and opinions on FMCSA rulemaking. FMCSA medical standards and guidelines are subject to public notice and comment rulemaking. The Code of Federal Regulations provide guidance that the medical examiner may or may not follow.examiner may or may not follow. - ✔✔-FMCSA medical standards and guidelines are subject to public notice and comment rulemaking. FMCSA content sources rules and regulations include 49 CFR Part 16 DOT Procedures for Drug and Alcohol Testing. 49 CFR 391.41 Physical Qualifications for Drivers. 49 CFR 391.82 Medical examination; certificate of physical qualification. 49 CFR Part 73: Medical Review Board procedures. - ✔✔-49 CFR 391.41 Physical Qualifications for Drivers. Which of the following is true regarding why regulation is needed to protect public safety? There is little environmental risk from crashes involving hazardous materials. There is greater risk of injury and fatalities to individuals in smaller vehicles from crashes involving commercial motor vehicles. The economic cost of crashes involving commercial vehicles is relatively low. Commercial vehicles do not carry members of the public. - ✔✔-There is greater risk of injury and fatalities to individuals in smaller vehicles from crashes involving commercial motor vehicles. Which of the following is true? By May 21, 2015, medical providers that perform medical examinations for commercial motor vehicle drivers must have completed an approved training program and passed a national certification examination. The Medical Examiner may request that an appropriate specialist provider make the driver certification determination. The purpose of the commercial motor vehicle driver examination is for treatment of driver medical conditions. FMCSA guidance recommendations may or may not be followed by the Medical Examiner. - ✔✔-FMCSA guidance recommendations may or may not be followed by the Medical Examiner.` What is the role of the medical examiner? - ✔✔-to determine medical fitness for duty. What are the differences between the medical standards and the medical guidelines - ✔✔-Medical Standards - regulations that are non-discretionary - the medical examiner cannot use judgment to certify a driver who does not meet a regulatory standard Medical Guidelines are discretionary - Medical Examiners may decide to certify drivers who do not meet medical guidelines. Most recommendations related to certification of specific medical conditions are guidance What are some medical standards for certifications that need to be done? - ✔✔-Vision requirements, including distant visual acuity, horizontal vision, and color vision. Drivers who do not meet standards cannot be certified unless accompanied by a vision exemption/waiver. Diabetes requirements: drivers using insulin cannot be certified unless special procedures for evaluation and certification of such drivers are followed. Epilepsy: drivers with a diagnosis of epilepsy cannot be certified unless accompanied by an epilepsy waiver/exemption. Hearing: drivers who cannot meet whisper test or audiometric test requirements cannot be certified unless accompanied by a hearing waiver/exemption. What are Turn around or short relay drivers? - ✔✔-drivers return to their home base each evening what are Long relay drivers? - ✔✔-drivers drive 9 to 11 hours and then have at least a 10-hour off duty period) What are Straight through haul drivers? - ✔✔-cross country What are Team drivers? - ✔✔-drivers share the driving by alternating their 5-hour driving periods and 5- hour rest periods What are the instructions for completion of a DOT physical? - ✔✔-Driver arrives at medical examiner's office Driver may bring paperwork -Verify driver identification with photo ID Driver completes formsMCSA 5875 - Medical Examination Report Form driver history -Confirm driver signature and date -Recommend driver sign HIPAA compliant release form(s) Driver testing then completed by medical examiner and/or staff -Vision testing -Hearing - whisper test or audiometry -Dipstick urinalysis -Blood pressure - pulse -Height and weight Medical Examiner examination =Review driver historyAcknowledge driver "Yes" answers and clarify with questions and additional information -Ask if driver has ever received less than a 2-year certification at any prior DOT medical examination Physical examination - driver should be in medical gown or equivalent -Medical Examiner notes abnormal findings with comments Medical Examiner completes forms (MCSA 5875 and MCSA 5876) Provide copy of Driver Certificate to driver and, if requested, to employer Complete online completion of driver certification information no later than midnight (local time) of the calendar day following the date of the examination When does the online completion of driver certification information have to be done? - ✔✔-no later than midnight (local time) of the calendar day following the date of the examination An individual diagnosed with Stage 1 hypertension (BP is 140/90-159/99) may be certified for how long? - ✔✔-1 year At recertification, an individual with a hx of HTN; BP is greater than 140/90 but less than 160/100, - ✔✔- 3 months An individual diagnosed with Stage 2 (BP is 160/100-179/109) should be treated and given certificate for how long? - ✔✔-3 months An individual diagnosed with Stage 3 hypertension (BP equal to or greater than 180/110) should - ✔✔- not be certified until his or her BP is reduced to 140/90 or less, and may be recertified every 6 months What are the four required tests for DOT exam? - ✔✔-Vision Hearing Blood pressure/pulse Urinalysis What should you tell a driver with contact lenses and/or glasses? - ✔✔-that he or she should carry extra contacts/pairs of glasses while driving. What should you tell a driver who wears a hearing aide? - ✔✔-that he/she should possess a spare power source for the device while driving. What are some reasons to disqualify a driver? - ✔✔-Who is currently using methadone. Who has a current clinical diagnosis of alcoholism or who uses a controlled substance including a narcotic, an amphetamine, or another habit-forming drug without a prescription from the treating physician. Who has a diagnosis of a regulatory disqualifying condition such as epilepsy, monocular vision, or hearing loss. When evidence shows a condition exists that will likely interfere with the safe operation What are the only conditions that a driver is medically qualified "only when" - ✔✔-Wearing corrective lenses Wearing a hearing aid. Accompanied by a ______ waiver/exemption. (E.g. federal vision). Driving within an exempt intracity zone (49 CFR 391.62). Accompanied by a Skill Performance Evaluation (SPE) certificate. (SPE certificates are issued by the FMCSA for fixed extremity deficits if the driver demonstrates the ability to meet FMCSA safe driving requirements). Qualified by operation of 49 CFR 391.64 (grandfathering for a limited number of drivers who participated in diabetes and vision waiver study programs). When a Determination Pending status was previously chosen, and the driver returns with the required information that establishes that the driver meets certification requirements what is the certification date? - ✔✔-the date that the driver provided the required information is used as the date from which certification is determined. Can someone be certified if they are taking a schedule 1 drug? - ✔✔-no Should you certify someone of a controlled medication? - ✔✔-prescribing doctor can write that the driver is safe to be a commercial driver while taking the medication is anti-seizure medication used for the prevention of seizures disqualifying? - ✔✔-yes is methadone dysqualifying? - ✔✔-yes Should a driver be certified while using chantix? - ✔✔-no is marijuana use disqualifying? - ✔✔-yes schedule I drug Is the use of insulin dysqualifying? - ✔✔-yes unless they have a wavier Is the use of anticoagulant medications neurological conditions disqualifying? - ✔✔-yes due to the risk of hemorrhage causing a cerebrovascular accident. Which of the following is true? Regulations are advisory and are not mandatory. Driver qualification standards are found in 49 CFR 391.43. Medical guidelines are regulatory and must always be followed by the medical examiner. Medical guidelines are based on expert review and intended to assist the medical examiner in determining driver certification. - ✔✔-Medical guidelines are based on expert review and intended to assist the medical examiner in determining driver certification. What is the medical examiner certificate expiration date? Examination 11/16/2011; disqualified due to diagnosis of benign positional vertigo last episode 10/11/2011; return to medical examiner's office for complete new certification examination on 1/2/2012. Note asymptomatic since 10/11/2011 - driver qualified for two years. - ✔✔-Expiration date 1/2/2014. Additional tests above and beyond what are necessitated by the examination process should be performed only when ____________. - ✔✔-The examination was unable to determine if the driver passed one or more requirements. The FMCSA directly regulates __________. - ✔✔-Interstate commercial operations, including the driver. Driver Examination 2/17/2012, blood pressure 144/102. Driver given three month certification to 5/17/12. The driver returns on 3/16/12 and is noted with blood pressure of 124/82. The next step for the medical examiner will be to: - ✔✔-Perform a complete examination and certify the driver for one year if the driver passes the examination. What is the sx free waiting period for BPPV? - ✔✔-two months What are the "Ask about" vision conditions? - ✔✔-aphakia, retinopathy, cataracts, glaucoma, and macular degeneration. What type of corrective lenses are prohibited by the FMCSA? - ✔✔-lenses that correct distance vision in one eye and near vision in the other telescopic lenses What is the min vision requirements using snellen chart? - ✔✔-20/40 What is the minimum peripheral vision needed? - ✔✔-70 degrees is monocular vision disqualifying? - ✔✔-yes Additional testing should be obtained when the CMV driver has the following visual symptoms - ✔✔- Blurred vision. Floaters. Restriction in visual field. Vision testing results that do not meet standards. Can someone with monoocular vision apply for an exemption waiver? - ✔✔-yes as long as they meet all other vision and physical requirements Drivers who must wear a hearing aid may be certified for - ✔✔-2 years What are the minimum hearing requirements? - ✔✔-be better ear greater than 40 decibels at 500 Hz, 1,000 Hz, and 2,000 Hz, with or without a hearing aid. How do you do a hearing eval on someone who uses hearing aides? - ✔✔-whispered word or audiologist or otolaryngologist with specialized equipment for testing. What is the minimum symptom free waiting period for drivers with dizziness or vertigo? - ✔✔-2 months What otic conditions should you not certify? - ✔✔-a) Uncontrolled vertigo. b) Ménière's disease. c) Nonfunctioning labyrinth. d) Nonfunctioning fistula.` The medical examiner's role in the exemption process includes _________. Issuing the exemption. Issuing the prescription for the driver's contact lenses and/or glasses. Providing the driver with contact information for the Federal Vision Exemption Program. Assuring that the driver has peripheral vision of at least 110 degrees in each eye. - ✔✔-Providing the driver with contact information for the Federal Vision Exemption Program. What eye conditions must the medical examiner ask the driver about? - ✔✔-Retinopathy, cataracts, aphakia, glaucoma, macular degeneration A driver who wears contact lenses which correct farsightedness in one eye and nearsightedness in the other, but has no other visual impairments can be certified under what additional conditions - ✔✔- FMCSA guidance indicates that a driver should not be certified under these circumstances. Which of the following drivers' tests meet hearing certification standards? Whisper test 4 feet right ear, 3 feet left ear. Whisper test 5 feet right ear with hearing aid, 3 feet left ear without hearing aid. Audiogram left 30/500 Hz, 40/1000 Hz, 60/2000 Hz; right 25/500 Hz, 35/1000 Hz, 80/2000 Hz. Audiogram left 35/500 Hz, 50/1000 Hz, 40/3000 Hz; right 35/500 Hz, 35/1000 Hz, 60/3000 Hz. - ✔✔- Whisper test 5 feet right ear with hearing aid, 3 feet left ear without hearing aid. An audiometric test produces the following results: Left ear: 500 Hz, 35dB Loss; 1,000 Hz, 35 dB loss; 2,000 Hz 45 dB loss. Right ear: 500 Hz, 40 dB loss; 1,000 Hz, 45 dB loss; 2,000 40 dB loss. What is the certification? - ✔✔-2 years A driver has loss of hearing in the better ear of 25 dB loss at 500 Hz, 40 dB loss at 1000 Hz, and 60 dB loss at 2000 Hz. With respect to the hearing requirement for medical certification, the driver __________. - ✔✔-do not certify What BP readings are considered stage I HTN? - ✔✔-140-159/90-99 What BP readings are considered stage II HTN? - ✔✔-160-179/100-109 Is stage II HTN an indication for anti-hypertensive drug therapy? - ✔✔-yes What BP readings are considered stage III HTN? - ✔✔-BP > 180/110 If the drivers BP is > 180/110? - ✔✔-t [Show More]

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