Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
403 Cards in this Set
- Front
- Back
|
Disqualify immediately if BP is _________
|
180/110
|
|
|
If pt has already gotten a 3 month certificate due to HTN and they return with BP of ___________ they are automatically disqualified.
|
140/90
|
|
|
To pass visual acuity exam a person must have vision of at least what?
If they do not have this, then disqualify. |
20/40 in both eyes AND 20/40 in both eyes
|
|
|
Disqualify if a person does NOT meet what peripheral vision standard?
|
70 degrees or more
|
|
|
Disqualify if unable to differentiate between what colors?
|
red, green, amber
|
|
|
If a patient has retinopathy, cataracts, aphakia, glaucoma, or macular degeneration what must you do?
|
Refer them to a specialist for further testing
|
|
|
If a person uses corrective lenses what must the examiner document?
|
carry an extra pair of glasses with them at all times
|
|
|
What eye specialists are the only ones who can sign the medical examiner report?
|
ophthalmologist or an optometrist
|
|
|
If a person has a valid vision exemption form AND a copy of specialist eye examination report what do you need to put on physical form, and how long do you certify them for?
|
Certify for 1 year
Mark "accompanied by" exemption checkbox and write in "vision" |
|
|
What is an early symptom of cataracts?
|
Glare during night driving in face of oncoming headlights
|
|
|
Gradual loss of peripheral vision should make you suspicious of what eye condition?
|
glaucoma
|
|
|
Disqualify someone based on their hearing if they cannot hear forced whisper of what?
|
At least 5 feet with or without hearing aides in ONE EAR
|
|
|
What 3 hearing conditions automatically disqualify you?
|
Nonfunctioning labyrinth
Labyrinthe fistula Meniere's disease |
|
|
What is the waiting period for labyrinthitis and benign positional vertigo?
|
2 month symptom free waiting period
|
|
|
How do you calculate audiometric hearing loss?
What is passing? |
Add hearing loss at 500, 1000, and 2000 Hz and divide by 3.
Passing is LESS THAN OR EQUAL TO 40dB |
|
|
If a patient is already on BP medication and they come in for recertification with BP less than 140/90 how long can you give a certificate for?
|
1 year
|
|
|
If a patient is NOT taking any BP medication and they come in with a BP 140-159/90-99 how long do you certify them for?
|
1 year
|
|
|
If a patient with history of stage 3 HTN comes in with a current BP < 140/90 how long do you certify them for?
|
6 months
|
|
|
If a patient with stage 1 or 2 HTN comes in and has a current BP of 141-159/91-99 how long can you certify them for?
|
one time 3 month certificate
|
|
|
If you give someone a 3 month BP certificate and they come back with the same BP which is not under better control how long can you certify them for?
|
DISQUALIFY
|
|
|
IF ssomeone who got a 3 month certificate due to BP returns with a normal BP measurement what date do you use when determining expiration date?
|
Date of the original exam done 3 months ago.
|
|
|
What size abdominal aneurysm is disqualifying?
|
5cm (or smaller if symptomatic)
|
|
|
What size thoracic aneurysm is disqualifying?
|
3.5cm (or smaller if disqualifying)
|
|
|
If a patient has a ventricular septal defect WITH PULMONARY HYPERTENSION ______% of Systolic BP they are automatically disqualified.
|
>50%
|
|
|
If the patient has any type of defibrillator how long do you certify for?
|
DISQUALIFY
|
|
|
How long do you certify patient for with dilated or restrictive cardiomyopathy?
|
DISQUALIFY
|
|
|
How long do you certify someone with Brugada syndrome for?
|
Disqualify
|
|
|
After a percutaneous coronary intervention the driver must wait for _________ before being examined. Then they can be certified for what length of time initially?
|
1 week
6 months |
|
|
Lower risk arrhythmias have waiting period of _______
|
1 month
|
|
|
Balloon valve procedures have waiting period of _______
|
1 month
|
|
|
Insertion of pacemaker (without syncope) has wait period of ________
|
1 month
|
|
|
After a MI there is a wait period of _______
|
2 months
|
|
|
After successful surgical repair of aneurysms, heart valves, and coronary arteries there is a wait period of _________
|
3 months
|
|
|
The wait period for someone with angina that is STABLE is _________
|
3 months
|
|
|
After surgical correction of secondary hypertension the wait period is ________
|
3 months
|
|
|
After successful surgery for peripheral vascular disorders the wait period is _________
|
3 months
|
|
|
After pacemaker insertion (due to syncope) the wait period is __________
|
3 months
|
|
|
After heart transplant the wait period is ___________
|
1 year
|
|
|
What are the exercise stress test requirements?
|
Exercise to Bruce 2 or 6 METs
Attain HR of 85% predicted (unless on BB) Have a rise of Systolic BP >20 mmHg WITHOUT angina Have no significant ST segment depression |
|
|
Is a note from the cardiologist saying that a pt is "cleared to drive" sufficient?
|
No, because they may have been referring to ability to drive a personal vehicle.
|
|
|
You see a patient with multiple cardiac risk factors. What should you consider before certifying these drivers?
|
cardiologist evaluation and do not qualify until some success with treatment and risk reduction is documented
|
|
|
Consider disqualifying drivers who have what Framingham risk score?
|
20%+ chance of CHD event in 10 years
|
|
|
After a MI, what qualifications must a driver meet?
|
LVEF 40% or better
no EKG ischemic changes Be completely asymptomatic, NO chest pain Complete 2 month waiting period Pass exercise stress test every 2 years Have clearance from a cardiologist done every 2 years It is ok to use a post-MI echo showing the good LVEF on initial certification. Then they can be certified for a year |
|
|
After a CABG what qualifications must a driver meet?
|
Complete 3 month waiting period
Get cardiologist clearance Be completely asymptomatic Have LVEF 40% or better Have completely healed sterum Have no orthostatic SEs from meds Then they can be certified for a year. They do not need their first stress test for 5 years, but then they will need annual stress tests. |
|
|
After a PCI what qualifications must a driver meet?
|
The wound must be healed
Be completely asymptomatic Have a normal EKG Complete 1 week waiting period Then they can be certified for 6 months. They must have a satisfactory stress test within those 6 months, then have stress test biannually. |
|
|
If a patient has ASYMPTOMATIC CHF WIHTOUT arrhythmia what qualifications must a driver meet?
|
LVEF 40% +
Annual cardiology evaluation with annual echo and annual Holter monitoring |
|
|
If a patient has ASYMPTOMATIC CHF WITH arrhythmia what qualifications must a driver meet?
|
LVEF 50%+
|
|
|
If on coumadin for stable Afib what qualifications must a driver meet?
|
Complete 1 month waiting period
Be asymptomatic Have therapeutic INRs Then can certify for 1 year |
|
|
Drivers with a heart transplant can be certified for how long?
|
6 months at a time after completing a 1 year waiting period and regular cardiology evaluations every 6 months for rejection and stability
|
|
|
How long can you certify a driver with acute DVT?
|
Disqualify if asymptomatic
1 year if no residual DVT and on coumadin for 1 month with therapeutic INR |
|
|
How long can you certify a patient with Pulmonary Embolus?
|
Diqualify if asymptomatic.
1 year if PE has resolved for 3 months and if they are on long term treatment. If on coumadin must be therapeutic for 1 month. |
|
|
What are the criteria to certify a driver with intermittent claudication and PVD
|
Disqualify until etiology determined and treatment is adequate. Symptoms must be stable.
If surgical repair was done there is a 3 month waiting period. If surgery relieved symptoms certify them for 1 year. If there is ANY leg pain at rest then disqualify. |
|
|
What are the criteria to certify a driver with pacemaker for sinus node dysfunction or AV block?
|
complete 1 month waiting period.
Have documented correct function from pacemaker center annually |
|
|
What are the criteria to certify a driver with pacemaker for neurocardiogenic or hypersensitive carotid sinus syncope?
|
Disqualify if symptomatic
If asymptomatic: Complete 3 month waiting period Have pacemaker check documentation annually |
|
|
If an echo has been done what must be present to pass the driver?
|
LVEF 40% +
NO pulmonary HTN |
|
|
If echo results are inconclusive what is the next step?
|
Radionuclide imaging to obtain EF
|
|
|
If a driver reports any history of angina, what are the qualifications to certify?
|
If asymptomatic ok to certify for 1 yeat
If there is angina at rest or if there is a change in angina pattern within the last 3 months then they are disqualified. They must bring an annual cardiology report and exercise stress test results done every 2 years. |
|
|
What are the criteria to certify a driver who had a percutaneous stent placed?
|
Complete 1 week waiting period.
Tolerate all meds No ischemic changes on EKG No injury to access site Ok to certify for 6 months, then they must have ETT between 3-6 months and bring report to you. Cardiac clearance annually Stress test every 2 years routinely |
|
|
What are the criteria to certify someone with aortic regurgitation
|
Mild - certify for 1 year
Moderate - certify for 1 year with normal LV function and no to mild LV enlargement Mild to moderate require echo done every 3 years Severe - certify for 6 months if asymptomatic with echo on file done ever 6 months showing EF 50%+, LVEDD <60, LVESD <50 If hey had surgery on the valve must wait 3 months and get cardiologist clearance to certify for 1 year |
|
|
What are the criteria to certify someone with aortic stenosis?
|
Mild - certify for 1 year with echo every 5 years
Moderate - certify for 1 year if asymptomatic with echo every 1-2 years Severe - Disqualify. They must have surgery then wait 3 months to obtain annual certification with cardiac clearance |
|
|
What are the criteria to certify someone with mitral regurgitation?
|
Mild/moderate - certify for 1 year if asymptomatic with normal LV size, function, and pulm artery pressure. Requires annual echo.
Severe and asymptomatic - Ok to certify for 1 year. Needs exercise stress test and echo every 6-12 months. If valve was surgically repaired must wait 3 months with cardiology clearance. |
|
|
What are the criteria to certify someone with mitral stenosis?
|
Complete waiting period of 1 month if they had a balloon valvotomy.
Complete waiting period of 3 months if had surgical commisuotomy. Annual CXR, EKG, and Echo required Mild/moderate - certify for 1 year Severe - disqualified until successfully treated and have cardiology clearance. |
|
|
What are the criteria to certify someone with mitral valve prolapse?
|
Annual echo and cardiac clearance
Asymptomatic Can certify for 1 year |
|
|
What are the criteria to certify someone with chronic oxygen therapy?
|
Disqualify
|
|
|
What are the criteria to certify someone with chronic TB?
|
Disqualify
|
|
|
What are the criteria to certify someone with untreated recurrent pneumothorax?
|
disqualify
|
|
|
What are the criteria to certify someone with severe asthma or emphysema?
|
disqualify
|
|
|
What are the criteria to certify someone with severe allergies that are incapacitating?
|
disqualify
|
|
|
What are the criteria to certify someone with symptomatic lung cancer?
|
disqualify
|
|
|
What are the criteria to certify someone with significant untreated sleep disorders?
|
disqualify
|
|
|
What is the recommendation for all drivers over 35 yrs old who smoke?
|
PFTs and pulse ox
|
|
|
If a driver has PFTs what is considered to be passing?
|
FEV1> 65%
FEV1/FVC > 65% FVC > 60% |
|
|
When should you do pulse oximetry on a driver?
|
If they have any signs of pulmonary disease during exam or if they smoke and are 35+ yrs old
|
|
|
When should you do ABGs on a driver?
|
if their O2 sat is less than 92%
|
|
|
What is considered to be passing on an ABG?
|
PaO2 > 65 at altitudes below 5000 feet
PaO2 > 60 at altitudes above 5000 feet AND PCO2 < 45 |
|
|
Respiratory apnea occurs when airflow CEASES for more than ____________. If airflow DECREASES for more than _____________ it is considered hypopnea.
Adding the 2 together provides an index. ___episodes/hr = mild ___ episodes/hr = moderate ___ episodes/hr = severe and diagnostic of sleep apnea. |
10 seconds
10 seconds 5+ 15+ 30+ |
|
|
A history of recurrent anaphylaxis from food allergies or insect bites should make you think about what?
|
disqualifying them if the severity and frequency is significant
If not severe you can give them a 2 yr certificate if you make sure they carry an epi pen and have discussed preventative measures and recommendation for allergist consultation. |
|
|
Drivers should not take sedating antihistamines for _____ hours before driving.
|
12 hours
|
|
|
What should you do for drivers with a PROBABLE diagnosis of sleep apnea?
What should you do for drivers with a POSSIBLE diagnosis of sleep apnea? |
temporarily disqualify until diagnosis is either ruled out or successfully treated.
give 3 month certificate to give them time to be evaluated. |
|
|
If a driver is asleep when you enter the room what should you do?
|
disqualify until evaluated further for sleep apnea
|
|
|
What should you do with a patient who has narcolepsy?
|
disqualify regardless of treatment
|
|
|
A patient with asthma can be certified for how long?
|
2 years if stable
|
|
|
A patient with COPD can be certified for how long?
|
2 years if stable.
Must do a spirometry on all COPD patients and they must pass ABG requirements |
|
|
A patient with obstructive sleep apnea has a waiting period of how long?
How long can you certify them for? |
WAIT PERIOD:
1 month after starting CPAP 3 months symptom free after surgical intervention CERTIFY FOR: 1 year if on CPAP and they have had multiple sleep latency tests documented as normal each year. THEY ALSO MUST BE FULLY COMPLIANT WITH CPAP THERAPY. |
|
|
What do you do with drivers who have history of pneumothorax?
|
Get CXR ensuring full recovery - if there is any air in the pleural space or medistinum then you must wait for full resolution.
Ok to certify for 2 years if asymptomatic without chest pain or SOB and fully resolved. Do NOT certify if they have had 2 or more pneumos on the same side unless surgery has been done to correct this. |
|
|
What do you do with drivers who have cor pulmonale?
|
Certify for 1 year as long as they are not dizzy, SOB, or hypotensive. Do PFTs and pass if their FEV1 is 65% predicted.
|
|
|
What do you do with drivers who have been taking anticonvulsants?
|
disqualify
|
|
|
What do you do with drivers who have epilepsy?
|
disqualify
|
|
|
What do you do with drivers who have MS?
|
disqualify
|
|
|
What do you do with drivers who have ALS?
|
disqualify
|
|
|
What do you do with drivers who have any progressive neurological disorder? (Parkinsons, Huntingtons chorea, Creutzfeld Jacob disease)
|
disqualify
|
|
|
What do you do with drivers who have CNS tumors?
|
disqualify
|
|
|
What do you do with drivers who have frontal lobe disorders, amnesia, hemineglect, or ataxia?
|
disqualify
|
|
|
What do you do with drivers who have major psychiatric disorders (schizophrenia, major depression, severe personality disorder)?
|
disqualify
|
|
|
What do you do with drivers who have dementia of any type?
|
disqualify
|
|
|
What do you do with drivers who have meniere's disease or nonfunctioning labyrinth?
|
disqualify
|
|
|
What do you do with most drivers who have had CVA, especially if taking anticoagulant or with residual effects?
|
disqualify
|
|
|
What do you do with drivers who have had severe TBI (dural penetration and LOC> 24 hrs)?
|
disqualify because risk of seizures will always be high
|
|
|
What do you do with drivers who have had moderate TBI (no dural penetration and LOC between 30mins-24hrs)?
|
complete 2 YEAR waiting period
Unless they had a seizure with it, which would make the waiting period 5 years seizure free and off all seizure meds |
|
|
What do you do with drivers who have had mild TBI (no dural penetration and LOC < 30 mins)?
|
complete 1 year waiting period
Unless they had a seizure with it, which would make the waiting period 2 years seizure free and off all seizure meds. |
|
|
What do you do with drivers who have had CVA in the brainstem or cerebellum?
|
low risk of seizure activity so could qualify for 1 year if NOT taking anticoagulants and with neurology clearance
|
|
|
What do you do with drivers who have had CVA in the cortical or subcortical (SUPRATENTORIAL) areas of the brain?
|
high risk of seizures so requires completion of a 5 year period seizure free and off all seizure meds. Even after that waiting period the neuro consequences associated with these injuries can be disqualifying alone.
|
|
|
What do you do with drivers who have had viral or bacterial meningitis?
|
if no seizure there is a 1 year waiting period
If there was a seizure they must wait 5 yrs (if bacterial meningitis) and 10 years (if viral meningitis) |
|
|
What do you do with drivers who have had seizures due to childhood fever or acohol toxicity/electrolyte imabalances?
|
Ok to to certify for 2 years
|
|
|
What do you do with drivers who have had a single unprovoked seizure?
|
Complete 5 year waiting period seizure free and off all seizure meds.
They MUST get neurology clearance |
|
|
What do you do with drivers who have EARLY stage of a neuromuscular disorder?
|
If an expert consultation from neurologit or physiatrist is supportive they can be certified for 3-6 months at a time, or not at all - it is up to your discretion.
|
|
|
What do you do with drivers who gets severe headaches?
|
disqualify
|
|
|
What do you do with drivers who have had embolic or thrombotic stroke OR intracranial/subarachnoid hemorrhage?
|
Wait 1 year if cerebellum or brainstem vascular lesion
Wait 5 years if cortical or subcortical defecits Ok to certify for 1 year if waiting period has been met, there is normal physical and neuro exam INCLUDING neuro-ophthalmologic exam and neuropsychological testing. You must get neuro clearance and there can be no neuro deficits Do NOT certify if on any oral anticoagulant or CNS depressant. |
|
|
What do you do with drivers who have had TIA?
|
Complete waiting period of 1 year.
Get neuro clearance Have no physical or neuro deficits NOT be on any anticoagulants |
|
|
What do you do with drivers who have metabolic muscle disease (Glycogen storage disease, lipid storage disease)?
|
disqualify
|
|
|
What do you do with drivers who have had myasthenia gravis?
|
disqualify
|
|
|
What do you do with drivers who have had BK amputations of the legs or missing limbs?
|
disqualify (unless they passed a SPE)
|
|
|
Who are the skill performance examinations for?
|
drivers with missing limbs
fused joints transected peripheral nerves |
|
|
Can a person with MS or Parkinsons do a SPE?
|
no
|
|
|
To assess grip strength for documentation under "tests" how do you do this?
|
use either a dynanometer designed to measure grip strength OR
use a syphymamonometer by having them repeatedly squeeze the inflated cuff balloon while noting the maximum deflection on the gauge. |
|
|
Is Byetta use disqualifying?
|
no, but they must ger a written statement from examiner describing their tolerance to the med, how frequently they are monitored for adequate glucose control, and efficacy of treatment.
Ok to certify for 1 year |
|
|
If taking insulin what can a driver do to get certified?
|
Apply for the Federal Diabetes Exemption which is valid for 2 years at a time. They MUST be highly motivated with impeccable medical records.
All diabetics with an exemption require the following documentation as well: Carry 20 gram glucose while driving Quarterly endocrine notes Annual ophthalmology note Annual diabetes education completion They are required to monitor and record blood glucose levels 1 hour efore driving and every 4 hours while driving. They can only drive with BS levels between 100 and 400. |
|
|
What is the A1C diabetics are recommended to have to be certified?
|
10% or less gets them a 6 month certificate.
|
|
|
If U/A shows glucose what should you do?
|
fingerstick for random glucose
|
|
|
What do you do with drivers who are on oral hypoglycemics?
|
Certify for 1 year if no side effects from meds that impact driving
|
|
|
What do you do with drivers who have dementia?
|
disqualify
|
|
|
What do you do with drivers who have psychosis?
|
disqualify
|
|
|
What do you do with drivers who have schizophrenia?
|
disqualify
|
|
|
What do you do with drivers who have suicidal behavior?
|
disqualify
|
|
|
What do you do with drivers who is on ECT?
|
disqualify
|
|
|
After a suicide attempt how long is the waiting period?
|
1 year
|
|
|
After being diagnosed with major mood disorder without suicide attempt how long is the waiting perios?
|
6 months
|
|
|
After a significant bipolar episode what is the waiting period?
|
6 months symptom free and psychosis free
|
|
|
After a single successful ECT treatment what is the waiting period?
|
6 months
|
|
|
Severe depression requiring hospitalization might be considered for certification pending what?
|
6-12 month symptom-free waiting period
psychiatrist clearance |
|
|
What do you do with drivers who have ADHD?
|
If compliant with treatment program
Has a psych eval assessing specifically their ability to drive commercial vehicles Ok to certify for 1 year |
|
|
What is the waiting period after a major depressive episode without suicide attempt?
|
6 months
|
|
|
What is the symptoms free wiating period after a manic episode, suicide attempt, or severe depressive episode?
|
1 year
|
|
|
All drivers with mania, depression, or bipolar disorder must meet what criteria?
|
Symptom free waiting period
Compliance with treatment program No sedation from meds Comprehensive psych eval that specifically addresses their ability to drive commercially (every 2 years) Must document that you told them to report any manic or severe depressive episode within 30 days of onset and seek medical attention. |
|
|
If driver is on amitryptyline (Elavil) and imipramine (Tofranil) what should you do with the driver?
|
Disqualify because TCAs interfere with safe driving
|
|
|
How long can patients on second generation antidepressants be certified for?
|
1 year
|
|
|
What do you do with drivers who take :
clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Lalium), flurazepam (Dalmane) |
disqualify as these are long acting
|
|
|
What do you do with drivers who take :
alprazolam, oxazepam (serax), triazolam (Halcion), lunesta, rozerem, sonata, ambien |
Ok to use for less than 2 weeks only as their half life is less than 5 hours.
|
|
|
What do you do with drivers who take Chantix?
|
disqualify
|
|
|
What do you do with drivers who take Provigil (modafinil)?
|
find out why they take it (usually used to treat excessive sleepiness)
|
|
|
What do you do with drivers who take Methadone?
|
disqualify
|
|
|
What do you do with drivers who take medical marijuana?
|
disqualify
|
|
|
All urine specimens are checked for what drugs?
|
Marijuana
Cocaine Amphetamines Opiates PCP |
|
|
If a driver has a positive urine drug test what is the next step?
|
be evaluated by a SAP (substance abuse profession)
Comply with rehab Have a negative result on a return to duty drug test |
|
|
If the driver admits to regular alcohol use what is the next step?
|
Use an alcohol screening test (CAGE questionnaire)
|
|
|
The primary mission of the Federal Motor Carrier Safety Administration (FMCSA) is to _________________________
The FMCSA was established as a separate administration within the U.S. Department of Transportation (DOT) on January 1, 2000, pursuant to the Motor Carrier Safety Improvement Act of 1999. FMCSA is headquartered in Washington, DC and employs more than 1,000 people in all 50 States and the District of Columbia, all dedicated to improving the safety of commercial motor vehicles (CMV) and saving lives. |
reduce crashes, injuries and fatalities involving large trucks and buses.
|
|
|
Each original (paper or electronic) completed Medical Examination Report and a copy or electronic version of each medical examiner's certificate must be retained on file at the office of the medical examiner for at least _____ years from the date of examination.
The medical examiner must make all records and information in these files available to an authorized representative of FMCSA or an authorized Federal, State, or local enforcement agency representative, within _________ after the request is made. |
3 years
48 hours |
|
|
How many administrations are within the DOT?
|
9
|
|
|
What is the mission statement of the FMCSA?
|
reduce crashes, injuries, and fatalities involving large trucks and buses.
|
|
|
What is the mission of the Office of Medical Programs?
|
promote safety through promulgation and implementation of medical regulations, guidelines, and policies to ensure that drivers are physically qualified.
|
|
|
What is the mission of the National Registry of Certified Medical Examiners?
|
improve highway safety by producing trained certified medical examiners
|
|
|
What is the role of medical examiners?
|
to certify that a driver is medically fit for duty
|
|
|
What type of route is most likely to contribute to poor diet, irregular sleeping patterns, and lack of exercise?
|
long routes with team driving
|
|
|
A loaded semi weighs ______ pounds and has _______times the mass of an SUV
|
80 thousand lbs
20x the mass of an SUV |
|
|
What part ofthe CFR covers PHYSICAL qualifications of commerical drivers?
|
49 CFR 391.41
|
|
|
What part of the CFR covers the MEDICAL EXAM AND INSTRUCTIONS FOR PERFORMING AND RECORDING PHYSICAL EXAMS?
|
49 CR 391.43
|
|
|
How often do you have to send the electronic MCSA form to the NAtional Registry ?
|
monthly
|
|
|
How often do you have to complete medical examiner training?
|
5 years
|
|
|
How often do you have to complete certification testing?
|
10 years
|
|
|
True or false? Medical examiner registration may be revoked or suspended for failure to pay annual fees.
|
False.
|
|
|
Medical certification is required if a driver is operating a commercial vehicle in intrastate commerce that:
Is designed to carry ______ passengers for compensation Is designs to carry _____ passengers whether for compensation or more Is transporting ___________. |
9-15
16+ Hazardous material that require placarding |
|
|
What parameters are considered acceptable compliance with CPAP?
|
4 hours 70% of nights
|
|
|
Which brain injuries have the greastest chance of causing seizures?
|
cortical and subcortical hemorrhage
|
|
|
1. Which statement is false about the FMCSA?
a. It is one of nine administrations within the federal Department of Transportation. b. It has offices in 50 states and the District of Columbia. c. Its mandate and mission is to reduce crashes, injuries and fatalities involving large trucks and buses. d. It prohibits employers from requiring drivers to be held to higher standards than outlined in federal regulations. e. It develops and enforces regulations based on expert opinion within the transportation industry |
D
|
|
|
The FMCSA regulates interstate commercial operations that include the following: (Choose all that apply)
a. Commercial vehicles, trucks and buses b.Motor carriers c. Drivers of commercial vehicles d. Truck and bus companies e. All of the above |
E
|
|
|
True or False: The FMCSA does not regulate private, charitable bus operations
|
False
|
|
|
Which statement is false about the Office of Medical Programs?
a. It promotes safety of America’s roadways by the development of regulations, guidelines and policies that ensure commercial vehicle drivers are physically qualified. b. It develops and implements the National Registry Program. c. It is prohibited from active involvement in exemption programs to protect the rights of drivers. d. It oversees medical requirements for commercial drivers operating in interstate commerce. |
C
|
|
|
True or false: It is the Medical Examiner’s responsibility to ensure that the driver speaks and reads English well enough to converse with the public, understand highway traffic signals, respond to official questions and make legible entries on reports.
|
False
|
|
|
True or false: States are prohibited from adopting medical qualifications for intrastate drivers and commerce that are more stringent than those of the FMCSA.
|
False
|
|
|
7. Which statement comes closest to describing the mission of the Federal Motor Carrier Safety Administration?
a. To focus on reducing crashes, injuries and fatalities involving large trucks and buses b. To improve highway safety by producing trained certified Medical Examiners c. To promote safety through the promulgation and implementation of medical regulations, guidelines and policies to ensure that drivers are physically qualified d. To certify that a driver is medically fit for duty |
A
|
|
|
Which statement comes closest to describing the mission of the Office of Medical Programs?
a. To focus on reducing crashes, injuries, and fatalities involving large trucks and buses b. To improve highway safety by producing trained certified Medical Examiners c. To promote safety through the promulgation and implementation of medical regulations, guidelines and policies to ensure that drivers are physically qualified d. To certify that a driver is medically fit for duty |
D
|
|
|
Which statement comes closest to describing the mission of the National Registry of Certified Medical Examiners?
a. To focus on reducing crashes, injuries and fatalities involving large trucks and buses b. To improve highway safety by producing trained certified Medical Examiners c. To promote safety through the promulgation and implementation of medical regulations, guidelines and policies to ensure that drivers are physically qualified d. To certify that a driver is medically fit for duty |
B
|
|
|
Which statement comes closest to describing the role of Medical Examiners?
a. To focus on reducing crashes, injuries and fatalities involving large trucks and buses b. To improve highway safety by producing trained certified Medical Examiners c. To promote safety through the promulgation and implementation of medical regulations, guidelines and policies to ensure that drivers are physically qualified d. To certify that a driver is medically fit for duty |
D
|
|
|
What type of route would be most likely to contribute to poor diet, irregular sleeping patterns and lack of exercise?
a. Turnaround or short relay routes b. Cross-country routes c. Long relay routes d. Long routes with team driving |
D
|
|
|
A loaded semi- truck weighs _____ pounds and has ____ times the mass of an SUV.
a. 60,000 pounds, 10 times the mass b. 80,000 pounds, 10 times the mass c. 60,000 pounds, 20 times the mass d. 80,0000 pounds, 20 times the mass e. 90,000 pounds, 25 times the mass |
D
|
|
|
Which part of the CFR covers the physical qualifications of commercial drivers?
a. 49 CFR 391.41 b. 49 CFR 391.43 c. 49 CFR 391.62 d. 49 CFR 391.64 |
A
|
|
|
Which part of the CFR covers the medical examination and Instructions for performing and recording physical examinations?
a. 49 CFR 391.41 b. 49 CFR 391.43 c. 49 CFR 391.62 d. 49 CFR 391.64 |
B
|
|
|
True or false: If a driver has a BK amputation of one of his lower extremities, the examiner cannot certify the driver.
|
True
|
|
|
What must examiners do to maintain their registration with the NRCME?
a. Submit form MCSA for each driver examined electronically every month via the National Registry website. b. Submit to periodic audits, and continue to be licensed, registered or certified with applicable state laws. c. Report to the FMCSA any information related to any termination, suspension or withdrawal of your license, registration or certificate under state law. d. Complete periodic training every five years and recertification testing every 10 years. e. All of the above |
E
|
|
|
True or false: Medical Examiner registration may be revoked or suspended for failure to pay annual registration fees.
|
False
|
|
|
True or false: After May 21, 2014, all providers who perform DOT examinations must have completed the training, registration and testing requirements set forth in FMCSA regulations.
|
True
|
|
|
Which statement in incorrect or does not apply. Medical certification is required if a driver is operating a commercial vehicle in interstate commerce that:
a. Has a combined gross vehicle weight rating of 5,001 lbs. or more. b. Is designed to transport nine to 15 passengers (including driver) for compensation. c. Is designed to transport 16 or more passengers (including the driver, whether for compensation or not). d. Is transporting hazardous material, in quantities that require placarding under the hazardous materials regulations. |
A
|
|
|
How is the National Registry Certification Examination administered?
a. Open-book Internet test, taken at the provider’s convenience on the National Registry website b. Written test to be taken at testing centers located on the campuses of many colleges and at certain large libraries c. Internet test to be taken only at certified testing centers approved by the FMCSA. |
C
|
|
|
True or false: Medical Examiners cannot register with the NRCME until May 21, 2014.
|
False
|
|
|
True or false: The Medical Examination Form/Report is entered into the National Registry
|
False
|
|
|
True or false: Medical Examiners who inappropriately or fraudulently certify a driver may be removed from the NRCME
|
True
|
|
|
True or false: If a Medical Examiner fraudulently certifies a driver, the Medical Certificate is invalid.
|
False
|
|
|
True or false: There are no fees associated with training or with the certification examination
|
False
|
|
|
True or false: Operators and drivers who operate exclusively within the borders of a single state are not involved in interstate commerce.
|
False
|
|
|
True or false: A driver with a disabling medical condition that prevents certification may apply to the FMCSA for a waiver that allows him/her to drive commercial vehicles.
|
True
|
|
|
True or false: Skill Performance Evaluation Certification can be obtained from a board certified orthopedic surgeon or physiatrist.
|
False
|
|
|
Skill Performance Evaluations could be considered for which of the following conditions? (Choose all that apply)
a. Limb and bone deformity b. Mild multiple sclerosis and Parkinson’s disease c. Brachial plexus injuries d. Amputations |
A, C, D
|
|
|
True or false: Medical Examiners may request accommodations for drivers with disabilities that may be covered under the Americans with Disabilities Act.
|
False
|
|
|
True or false: The FMCSA issues regulations (also called standards) that are to be viewed by examiners as recommendations and guidance in performing the DOT examination.
|
False
|
|
|
True or false: The examiner is responsible for the driver’s identification and evaluating the driver’s health history.
|
True
|
|
|
True or false: A driver who is not truthful about his/her health history may be liable for civil penalties, fines or imprisonment.
|
True
|
|
|
What phrase best describes an exemption?
a. Temporary regulatory relief from one or more FMCSA regulations for up to three months b. Temporary regulatory relief from one or more FMCSA regulations for up to two years c. Regulatory relief from the first and/or second medical standard(s) regarding limbs |
B
|
|
|
What observations or findings, found during an examination, may provide information that the driver’s history may be untrue or inadequate?
a. Sternal scar from CABG with no mention of medications in history section b. Scar over lumbar spine with no mention of back injury in history section c. Listing metformin and glyburide with no mention of diabetes in history section d. All of the above. |
D
|
|
|
If the Medical Examiner determines that the driver is “temporarily disqualified,” what information should be included in the record?
a. Reason for disqualification (condition or medication) b. Length of waiting period c. Conditions that could restart the waiting period d. List of documentation driver is to provide to the Medical Examiner e. All of the above |
E
|
|
|
What considerations must the examiner make in determining the length of certification?
a. Nature of medical condition(s) b. Severity of medical conditions(s) c. Number of medical conditions d. All of the above |
D
|
|
|
True or False: Examiners may not disqualify drivers for taking controlled substances if the driver has a legitimate prescription from a licensed provider and a clearance from the provider saying that they are allowed to drive while taking the medications.
|
False
|
|
|
If there are no medical issues, what date is used to determine the expiration date of certification?
a. The date of the examination b. The date the driver becomes qualified after temporary disqualification |
A
|
|
|
If a driver is examined on 4/16/2011 and periodic monitoring is required due to Stage 2 hypertension that is corrected with medication, what should be the expiration date?
a. 4/16/2012 b. 4/16/2013 c. 7/16/2011 |
A
|
|
|
A driver is examined on 4/16/2011 and temporarily disqualified due to not having results of his post-CABG LVEF test for review (having completed the waiting period). He returns to the examiner’s office on 4/25/2011 with satisfactory test results attached to his examination form. What should be the expiration date?
a. 4/25/2012 b. 4/16/2012 c. 7/16/2011 d. 7/25/2011 |
B
|
|
|
A driver is examined on 4/16/2011. He is asymptomatic, but was disqualified due to benign positional vertigo diagnosed by his personal physician on 3/11/11. He returned on 5/20/11 with a note from his physician saying he had been asymptomatic since 3/15/11. The Medical Examiner repeated the examination and found no problems. What should be the expiration date?
a. 4/16/2012 b. 4/16/2013 c. 5/15/2013 d. 5/20/2012 e. 5/20/2013 |
E
|
|
|
True or false: A physician assistant (not registry certified) may perform the examination and have his/her registered supervising physician sign the Medical Form and Certification Card.
|
False
|
|
|
True or false: DOT examinations that are paid for by the driver’s employer are not subject to HIPAA regulations and the Medical Examination Report maybe be sent directly to the employer without a release from the driver.
|
False
|
|
|
True or false: Motor carriers are required to accommodate drivers with disabilities, according to the Americans with Disability Act.
|
False
|
|
|
To pass the vision requirements for certification the driver must have a visual acuity of:
a. 20/20 in both eyes b. 20/40 in each eye, and 20/40 in both eyes c. 20/40 in at least one eye |
B
|
|
|
Which eye conditions must the Medical Examiner ask about, and if indicated request evaluation by a specialist? (Choose all that apply)
a. Astigmatism, conjunctivitis b. Retinopathy, cataracts, aphakia c. Glaucoma and macular degeneration d. All of the above |
B, C
|
|
|
Who are the only other specialists, besides the Medical Examiner, who can perform the vision portion of the medical examination? (Choose all that apply)
a. Ophthalmologist b. Optometrist c. Optician d. All of the above |
A, B
|
|
|
True or false: Drivers who are colorblind should be disqualified
|
False
|
|
|
A driver presents for an annual recertification examination with a valid vision exemption and a copy of the specialist eye examination report. The driver is otherwise qualified. What should the examiner do? (Choose all that apply)
a. Certify the driver for up to one year b. Mark the “accompanied by” exemption checkbox and write “vision” in the space provided c. Certify the driver for up to two years |
A, B
|
|
|
Who is responsible for obtaining consultation from appropriate specialists?
a. The driver b. The examiner c. The driver’s employer? |
A
|
|
|
True or false: The driver must be able to identify the numbers or figures on all 14 plates of the standard Ishihara color vision test.
|
False
|
|
|
Which of these instructions is wrong in regard to conducting a proper field of vision test of the right eye?
a. Stand or sit approximately 2 feet in front of the driver so that your eyes are at about the same level as the eyes of the driver. b. Instruct the driver to use the fingers of the left hand to cover the left eye. c. Ask the driver to fixate on your left eye. |
B
|
|
|
True or false: Standardized colors are required for color vision testing.
|
False
|
|
|
Which of these meet(s) the hearing standard for CMV driver certification? (Choose all that apply)
a. Right ear: 4 feet/Left ear: 4 feet b. Right ear: 5 feet/Left ear: 4 feet c. Right ear: 5 feet/Left ear: 5 feet d. All of the above |
B, C
|
|
|
Which drivers should have audiometric testing based on distance of perception of whispered voice?
a. Right ear: 4 feet/Left ear: 4 feet b. Right ear: 5 feet/Left ear: 4 feet c. Right ear: 5 feet/Left ear: 5 feet d. All of the above |
A
|
|
|
Which drivers, with the following hearing losses in dB, meet the hearing standard for CMV driver certification at 500, 1000, 2000 Hz? (Choose all that apply)
a. Right ear: 20, 45, 50/Left ear: 45, 45, 50 b. Right ear: 40, 40, 45/Left ear: 35, 50, 40 c. Right ear: 25, 45, 65/Left ear: 45, 45, 50 d. Right ear: 10, 40, 45/Left ear: 25, 50, 40 |
A, D
|
|
|
Which problem(s) with the test environment exist with the forced whisper tests that do not exist with audiometric tests?
a. Background noise b. Variability in the voice of the person conducting the test c. Variations caused by using different numbers or letters that have different sound characteristics d. All of the above |
D
|
|
|
What advice and counseling should Medical Examiners give drivers with marginal hearing loss?
a. Hearing protection should be emphasized to help prevent hearing loss and the need for hearing aids in the future. b. Drivers with hearing aids should wear them while driving and have extra batteries with them at all times while driving. c. Avoid exposure to loud noises for several hours before the next hearing test. d. All of the above |
D
|
|
|
True or false: Hearing aids must not be used during the whisper voice test.
|
False
|
|
|
Which of these vestibular disorders should be disqualifying?
a. Nonfunctioning labyrinth b. Labyrinthine fistula c. Meniere’s disease d. All of the above |
D
|
|
|
Drivers with a diagnosis of benign postural vertigo should undergo a _________ waiting period before certification.
a. 1 month b. 2 months c. 3 months d. 12 months |
B
|
|
|
A driver with no previous history of hypertension and no other significant risk factors or problems presents with a BP of 155/95. What should the examiner do?
a. Certify for one year. b. Certify for three months. c. Either a. or b., based on examiner’s discretion. d. Temporarily disqualify until BP is below 140/90. |
A
|
|
|
A driver is taking medications for hypertension with no other significant risk factors or problems. His BP is 159/99. What should the examiner do?
a. Disqualify until BP is at or below 140/90. b. Three-month certification. Advise to consult PMD to get BP under control. c. Certify for six months. d. Certify for one year. |
B
|
|
|
A driver who has been given a three-month certification for stage 2 hypertension returns the day before his certification expires. He is taking medications for hypertension and has a BP of 159/99? What should the examiner do?
a. Disqualify until BP is less than or equal to 140/90. b. Three-month certification. Advise to consult PMD to get BP under control. c. Certify for six months. d. Certify for one year |
A
|
|
|
A driver with Stage 1 hypertension, with a three-month extension, returns for a recheck of his blood pressure. He has a note from his doctor with several readings below 140/90. BP is 135/85. What should the examiner do?
a. Certify for one year from the date he returned with corrected BP. b. Certify for one year from the date of his initial exam. c. Perform another examination, filling out a new Medical Examination Report, and certify for one year. |
B
|
|
|
A driver on medication for hypertension presents for recertification with a BP of 155/ 95. What should the examiner do? (Choose all that apply)
a. If previously given a one-year certification, certify for three months. b. If previously given a one-year certification, certify for one year. c. If previously given a three-month certification, certify for another three months. d. If previously given a three-month certification, disqualify. |
A,D
|
|
|
A driver on medication for hypertension presents for recertification with a BP of 185/115. What should the examiner do?
a. Disqualify. b. Certify for one month because of stage 3 hypertension. c. Certify for three months to allow the driver to remain working while he brings BP under control. d. Certify for six months. |
C
|
|
|
A 45-year-old driver had an initial evaluation and was found to have a blood pressure of 175/ 105 and he was given a three-month certificate He also smokes one and a half packs per day, has a BMI of 38, and has a significant family history of cardiac disease including myocardial infarctions in family members before the age of 50. When he returns the day before his certification is due to expire, his BP is 145/95. He has a note from a physician dated the week before that states, “Patient has started BP medications.” He brings along a sack of sample BP medications that was given to him by the physician who wrote the note. His blood pressure is now 145/95. What should the examiner consider and how should the examiner proceed?
a. Disqualify until BP is at or below 140/90. b. Provide an additional three-month certification and advise him to consult his PMD to get his BP under better control. c. Certify for six months. d. Certify for one year. |
A
|
|
|
A driver presents for evaluation. He is on maximal doses of three different blood pressure medications for stage 3 hypertension, but now has a BP of 138/88 and 2+ protein in his urine. How should the examiner proceed?
a. Certify for two years. b. Certify for one year. c. Certify for six months. Discuss protein in urine and advise driver to follow up with his physician. d. Temporary disqualify until protein in urine is investigated. e. Disqualify |
C
|
|
|
Using current FMCSA guidelines, what is the maximum period of certification for a commercial driver with stage 1 hypertension?
a. One year b. Two years |
A
|
|
|
Using current FMCSA guidelines, what is the proper determination for an interstate CMV driver with a diagnosis of hypertension, who presents with a confirmed BP of 182/ 112?
a. Certify for six months. b. Certify for three months. c. Temporarily disqualify until BP is below 159/99, then may provide three-month certification d. Temporarily disqualify until BP is below 140/90, then may recertify every six months. |
D
|
|
|
Using current FMCSA guidelines, what is the maximum period of certification for a driver disqualified for stage 3 hypertension, but who, at the recertification examination, has a BP less than 140/90?
a. One year b. Six months c. Three months |
B
|
|
|
A driver on medication for hypertension presents for recertification with a BP of 185/115. What should the examiner do?
a. Disqualify b. Certify for one month because of stage 3 hypertension c. Certify for three months to allow the driver to remain working while he brings BP under control. d. Certify for six months |
A
|
|
|
What date is used to determine the one-year expiration date of a driver with a one-time, three-month certificate, who achieves a BP less than or equal to 140/90 before the three-month certificate expires?
a. The date that the driver’s BP is brought under control. b. The date from the initial examination. |
B
|
|
|
Ms. Hall, a 38-year-old driver, returns for recertification. Previous certification had been for one year because of stage 1 hypertension. She says she forgot to take her medications today All other aspects of her history and examination are unremarkable. UA is negative for protein. BP is 151/94 after several measurements. What is the certification decision in this scenario?
a. Certify for one year and advise her to take her medication regularly. b. Temporary three-month certification to get BP under control. c. Disqualify since she has a history of BP and it is not under control. |
B
|
|
|
Ms. Donovan, a 62-year-old driver, comes in for recertification with a BP of 138/88. She smokes two packs per day and has a BMI of 30. She has a positive family history of heart disease with both mother and father having cardiac events in their 50s. She does not exercise, but denies any symptoms of fatigue or shortness of breath while sitting or working. The rest of the examination was unremarkable. What is the certification decision in this scenario.
a. Certify for two years because she is not hypertensive and advise her on risk factor reduction. b. Certify for one year because of multiple risk factors and advise her on risk factor reduction. c. Temporary three-month certification. d. Temporary disqualification until she is cleared by her physician and takes steps to decrease risk factors. |
B
|
|
|
True or false: The examiner should record information on the Medical Examination Report regarding medical conditions of the driver, even though they are not a cause for disqualification.
|
True
|
|
|
True or false: The examiner is not required to provide information or counseling to the driver in regard to modifiable risk factors.
|
False
|
|
|
Mr. Feldstein presents for certification 6 weeks after a CABG. He says he feels great and has a note from a cardiologist that says “OK to drive.” He denies angina, shortness of breath, and tolerates low dose aspirin with no problem. No other laboratory results are provided. What to medical clearances are required, and how much time must pass after his CABG before he may be qualified? (Choose all that apply)
a. Cardiology clearance and two-month waiting period b. Cardiology clearance and three-month waiting period c. Postsurgical LVEF of greater than 40% d. Postsurgical stress test |
B, C
|
|
|
Mr. Gray is a 45-year-old driver with no cardiac history except a single episode of chest pain two weeks ago while roofing his home. He gave a “yes” response in his health history regarding heart disease or heart attack. His pain was in his left pectoral area, not radiating, and aggravated by movement, and was sore for about 24 hours. It has not returned. He saw his primary care physician who referred him to a cardiologist. The EKG at the cardiologist’s office was normal, and his BP is 112/ 70. A cardiac stress test is scheduled in two weeks. He continues to run 2-3 miles three times a week without symptoms. Everything else during his examination was normal. What is the certification decision in this scenario?
a. Temporary disqualification pending results of tests b. Three-month certification c. One-year certification d. Two-year certification |
B
|
|
|
What questions should an examiner consider when a driver presents with a negative pharmacologic stress test instead of an exercise stress test?
a. What medical or physical problem caused the need for the pharmacologic test? b. Would the necessity for the pharmacologic test be disqualifying? c. Both of the above |
C
|
|
|
Which of these exercise stress test parameters is FALSE, in regard to what must be achieved in order to consider certification of a driver with a diagnosis of coronary artery disease?
a. Reach a workload capacity of 6 METS (Bruce stage II, or equivalent) b. No significant ST segment depression or elevation c. A rise in SBP > 20 mm Hg without angina d. A heart rate >75% of predicted |
D
|
|
|
What echocardiogram parameter must be achieved to consider certification of a driver with congestive heart failure?
a. Ejection fraction > 50% b. Ejection fraction > 60% c. Ejection fraction > 40% |
C
|
|
|
What sonogram parameters must be considered in regard to certification with a diagnosis of abdominal aneurism?
a. If > 5 cm, disqualify b. If between 4.0 and 5.0 cm., may certify for one year if asymptomatic and cleared by a surgeon. c. All of the above |
C
|
|
|
When an exercise stress test¸ required by medical guidance for certification, does not achieve a satisfactory result, what additional tests could qualify a driver for certification?
a. Stress echocardiogram b. Stress radionuclide test c. Cardiac catheterization d. All of the above |
D
|
|
|
What are the recommendations for certification following CABG? (Choose all that apply)
a. Two-month waiting period and approval by a cardiologist b. Three-month waiting period and approval by a cardiologist c. An exercise stress test d. An ejection fraction of > 40% |
B, D
|
|
|
When is an exercise stress test required for certification after CABG?
a. Three months b. Two months c. Six months d. Every two years e. Five years, then annually |
E
|
|
|
When is an exercise stress test required for certification after surgical repair of abdominal aneurysm?
a. Three months b. Two months c. Every two years d. Not required |
D
|
|
|
When is an exercise stress test required after percutaneous coronary intervention (PCI)?
a. Three months b. Within 3-6 months, then annually c. Within 3-6 months, then biannually d. Every two years e. Annually |
C
|
|
|
When is an exercise stress test required for certification after a myocardial infarction?
a. Three months b. Before certification, then annually c. Before certification, then biannually d. Every two years e. Annually |
C
|
|
|
True or false: An exercise stress test is recommended prior to certification for drivers who have angina.
|
TRUE
|
|
|
True or false: Studies to determine LVEF are recommended prior to certification for drivers who have mild or moderate aortic stenosis.
|
TRUE
|
|
|
True or false: Studies to determine LVEF are recommended prior to certifications for drivers who have had a myocardial infarction.
|
TRUE
|
|
|
True or false: Studies to determine LVEF are recommended prior to certification for drivers who have had percutaneous coronary intervention (PCI).
|
FALSE
|
|
|
True or false: Studies to determine LVEF are recommended prior to certification for drivers who have had coronary artery bypass surgery.
|
TRUE
|
|
|
True or false: A driver provides the examiner with records that show a diagnosis of CHF and an ejection fraction of 38%. He also has a medical release to drive from a cardiologist. This driver can be certified.
|
FALSE
|
|
|
Using cardiovascular medical guidance, which of the following drivers would be qualified to drive, assuming there are no other disqualifying conditions?
a. Driver with a percutaneous coronary intervention (PCI) nine months ago; he has not followed up with a cardiologist and has not had an exercise tolerance test (ETT) since the procedure. b. Driver with a recent coronary artery bypass graft (CABG) four months ago: Echo at three months showed LVEF 55%, has no symptoms and was cleared by a cardiologist. c. Driver with CHF having dyspnea at rest. d. Driver has recently had increasing angina that lasted 20 minutes after tarping a load. His angina is unresponsive to nitroglycerine. |
B
|
|
|
Using cardiovascular medical guidance, which of the following drivers would be qualified to drive, assuming there are no other disqualifying conditions?
a. Driver with an implantable defibrillator b. Driver with a combined pacemaker/defibrillator c. Driver with an abdominal aneurism 6 cm in diameter, who has declined surgery until his insurance kicks in d. Driver who presents with medical records from a vascular surgeon indicating that he had a surgical repair of a 9 cm abdominal aortic aneurysm four months previously, and is now cleared to resume all activities |
D
|
|
|
True or false: According to FMCSA recommendations, a driver on oxygen therapy can be qualified to drive in interstate commerce.
|
FALSE
|
|
|
According to FMCSA guidelines, when is pulmonary function testing or pulmonary consultation recommended?
a. Clubbing of the fingers, cyanosis, prolonged expirations b. Tachypnea at rest, absent or decreased breath sounds, c. Pleural friction rub, use of accessory muscle of ventilation at rest d. Cigarette smoking in drivers 35 or older e. All of the above |
E
|
|
|
Which tests are recommend for pulmonary function testing (spirometry)?
a. FEV1 and FVC b. Peak expiratory flow c. All of the above |
A
|
|
|
What pulmonary function testing values are used to make determinations on certification?
a. FEV1 less than 70% FEV1/FVC ratio less than 65%, FVC less than 70% b. FEV1 less than 60% FEV1/FVC ratio less than 60%, FVC less than 60% c. FEV1 less than 65% FEV1/FVC ratio less than 65%, FVC less than 60% d. FEV1 less than 65% FEV1/FVC ratio less than 65%, FVC less than 65% |
C
|
|
|
A driver has the following results from pulmonary function testing: FEV1 less than 50%, FEV1/FVC ratio less than 60%, FVC less than 60%. What is the simplest test the examiner should request to evaluate respiratory status?
a. Full pulmonary function testing of all major parameters b. Arterial blood gas c. Pulse oximetry |
C
|
|
|
What level of oxygen saturation requires additional testing, according to medical guidelines?
a. 94% b. 92% c. 90% d. 88% |
B
|
|
|
What are the correct cutoff values for medical certification in regard to arterial blood gas testing?
a. PaO2 65 mm Hg below 5000 feet altitude, 60 mm Hg above 5000 feet, PaCO2 >45% b. PaO2 65 mm Hg and PaCO2 >45% at any altitude c. PaO2 60 mm Hg and PaCO2 >45% at any altitude |
A
|
|
|
True or false: A driver with active tuberculosis can be certified
|
FALSE
|
|
|
Which respiratory conditions may be unstable and medically disqualifying?
a. Chronic oxygen therapy b. Chronic tuberculosis c. Untreated recurrent pneumothorax d. Severe asthma and emphysema e. All of the above |
E
|
|
|
Which respiratory conditions may be unstable and medically disqualifying?
a. Allergies that may cause incapacitation b. Symptomatic lung cancer c. Significant untreated sleep disorders d. All of the above |
D
|
|
|
True or False: The medical examiner should discuss the side effects of any over-the-counter or prescribed medications, especially those that can cause sedation. If appropriate, recommend less sedating alternatives and advise them not to take medicines that make them drowsy while driving. This discussion should be documented in the Medical Examination Report.
|
TRUE
|
|
|
True or false: This driver should be certified. The examiner notes that the driver has marked in the history section that he uses albuterol regularly for asthma. He has wheezes. He has not seen a physician in two years but keeps getting regular refills. He has been hospitalized twice in the last six months for asthma, ending up on a ventilator on the last visit. His O2 saturation is 93%.
|
FALSE
|
|
|
True or false: This driver should be certified. A driver presents for examination with a history (last month) of a pneumothorax. The records provided by the driver indicate that the pneumothorax reduced the driver’s forced vital capacity (FVC) to 58% of predicted.
|
FALSE
|
|
|
True or false: This driver should be certified. A driver presents for examination with a history of a spontaneous pneumothorax. The records provided indicate that this is the second spontaneous pneumothorax on the same side in the past three years. The driver’s FVC is 68% of predicted with no surgical intervention
|
FALSE
|
|
|
True or false: This driver should be certified. A driver presents for examination with a history of a single spontaneous pneumothorax last year. He has had no reoccurrences and medical records show that he had normal PFTs six months ago. His O2 saturation is 96% with no other problems.
|
TRUE
|
|
|
Mr. Johnson admits to a 40-year smoking history. He continues to smoke. He reports no loss of breath except with exertion. He has a chronic productive cough. BP, vision, hearing are normal. He takes no medication. FEV1 is 64%, FEV1/FVC is 66%. He is barrel-chested, has expiratory wheezes and rales, and decreased diaphragm excursion. No clubbing or cyanosis is noticed. What is the recommended certification decision?
a. Disqualify pending additional pulmonary testing, . . ABG or O2 saturation b. One-time-only, three-month certificate to allow driver to get under adequate treatment c. Obtain pulmonary consultation d. All of the Above |
A
|
|
|
Mr. Johnson’s pulse oximetry 02 saturation is 90%. Arterial blood gas Pa02 is 60 m Hg at an altitude less than 5000 feet, and his PaC02 is 42 mm HG. What do Mr. Johnson’s tests results indicate?
a. Pulse oximetry does not meet standard, it must be > 92%. b. PaO2 meets does not meet standard, it must be > 65% at altitudes less than 5000 feet. c. He should be disqualified. d. All of the above |
D
|
|
|
Mr. Katz is a 65-year-old driver with positive responses for HBP, lung disease, emphysema, asthma and chronic bronchitis. He takes Spiriva, Advair and albuterol daily and smokes two packs per day. He brought records from an echocardiogram showing mild right ventricular hypertrophy and mild pulmonary hypertension, and a recent chest X-ray report that showed COPD changes. The trained assistive staff noted that walking to the examination room caused the driver to “huff and puff.” The examiner noticed shortness of breath during the musculoskeletal examination, mild pretibial edema, a grade II/IV S4, and questionable ascites. Pulse oximetry showed an O2 saturation of 87%. Which of these actions by the examiner would NOT be appropriate?
a. Disqualify pending pulmonary testing (ABG and consultation). b. Verify staff comment by independent observations, having him jog in place or engage in any mild activity that duplicates the stress level of walking to the examination room. c. Prescribe a course of steroids and have him return in a week to repeat O2 saturation. d. Provide relevant FMCSA recommendations to consulting physician or the driver’s primary care physician, to expedite the driver’s care and return to work. |
C
|
|
|
True or false: The examiner should always make independent observations regarding staff comments to provide a more accurate and higher-quality medical record.
|
TRUE
|
|
|
Mr. Lopez is an obese driver with sleep apnea who has used his CPAP machine nightly for the last three years. He reports that he awakes well-rested and has a recording device that shows consistent use of the CPAP machine almost every night. He has not seen his treating physician for three years. He has two months remaining on his current certification. He has no other problems or disqualifying conditions. What is the certification decision in this scenario?
a. Disqualify until evaluated by treating physician. b. Certify for two months and instruct driver to have sleep disorder evaluated by his treating physician. c. Certify for one year. |
B
|
|
|
True or false: According to medical guidelines, a driver with well-controlled narcolepsy could be qualified for commercial driving.
|
FALSE
|
|
|
What level of the apnea-hypoxia index is considered diagnostic of sleep apnea?
a. 5+ episodes per hour b. 15+ episodes per hour c. 20+ episodes per hour d. 30+ episodes per hour |
D
|
|
|
True or false: Self-reported sleepiness does not always correlate with objective testing.
|
TRUE
|
|
|
In regard to fatigue, sleep disorders and excessive daytime somnolence (EDS), a driver should not be disqualified or denied certification for which conditions?
a. Driver admits to experiencing excessive sleepiness during majority of time while driving. b. Driver experienced a crash associated with falling asleep. c. Driver reports excessive or loud snoring. d. Driver has been found noncompliant with treatment recommendations. |
C
|
|
|
What medical history and physical findings are not significant risk factors for obstructive sleep apnea?
a. Small or recessed jaw, enlarged tonsils b. Small airway (Mallampati Scale score of class 3 or 4) c. Neck size > 17 inches (male) or 15.5 inches female d. Arthritic conditions affecting cervical spine e. Hypertension, hypothyroidism, and type 2 DM |
D
|
|
|
What medical history and physical findings are other risk factors for obstructive sleep apnea?
a. BMI greater than or equal to 28 b. Age 42 or older c. Family history d.Male, or postmenopausal female e. Experienced a single-vehicle crash f. All of the above |
F
|
|
|
True or false: The minimal waiting period prior to certification after starting CPAP is one month.
|
TRUE
|
|
|
True or false: Mallampati scores are well-correlated with different degrees of sleep apnea.
|
FALSE
|
|
|
True or false: Approximately 70% of the cases of excessive daytime sleepiness (EDS) are caused by narcolepsy and obstructive sleep apnea (OSA).
|
TRUE
|
|
|
According to FMCSA recommendations which drivers should not be certified?
a. Hypoxemia at rest b. Untreated symptomatic OSA and/or narcolepsy c. Primary (idiopathic) alveolar hypoventilation syndrome d. Idiopathic CNS hypersomnolence and Restless leg syndrome associated with EDS e. All of the above |
E
|
|
|
What is the apnea-hypopnea index?
a. Ratio of apnea episodes/hour and hypopnea episodes/hour b. Ratio of apnea episodes and hypopnea episodes/hour c. Ratio of apnea episodes, multiplied by hypopnea episodes/hour |
B
|
|
|
True or false: Hypopnea is when airflow ceases for more than 10 seconds.
|
FALSE
|
|
|
True or false: Apnea is when airflow decreases for more than 10 seconds.
|
FALSE
|
|
|
True or false: Drivers with mild or moderate sleep apnea may be certified if they have an apnea-hypopnea index of less than or equal to 20 (mild to moderate SA), and they do not admit to experiencing excess sleepiness during the major wake period, or if the driver OSA is being effectively treated.
|
TRUE
|
|
|
What parameters are considered as acceptable compliance with CPAP or PAP treatment of sleep apnea?
a. 4 hours per day on 50% of nights b. 6 hours per day on 50% of nights c. 4 hours per day on 70% of nights d. 6 hours per day on 70% of nights |
C
|
|
|
Mr. Smith is an obese 45-year-old driver with no known medical conditions. His BMI is 42. When the examiner enters the examination room, Mr. Smith is asleep in a chair and has to be aroused. He did not mention, in his history, “Sleep disorder, pauses in breathing while asleep, daytime sleepiness, loud snoring.” Upon further questioning, Mr. Smith admits that he has a difficult time staying awake while inactive and sitting, and that he occasionally wakes himself up gasping for breath at night. He also mentioned that he has almost fallen asleep at stop signs while driving.
a. Disqualify, until evaluated for sleep apnea b. Certify for two months and instruct driver to have sleep disorder evaluated c. Certify for one year |
A
|
|
|
True or false. People can usually tell when they are going to fall asleep.
|
FALSE
|
|
|
True or false: The largest at-risk group for sleep-related crashes is commercial drivers.
|
FALSE
|
|
|
True or false: Overall, sleep-related crashes have certain characteristics that set them apart from other types of crashes.
|
TRUE
|
|
|
Which neurologic conditions are static or fixed? (Choose all that apply)
a. Cerebral vascular accidents and traumatic brain injury b. Brachial plexus injuries c. Multiple sclerosis |
A,B
|
|
|
Which neurologic conditions are progressive?
a. ALS and MS b. CNS tumors c. Dementias, Alzheimer’s d. Parkinson’s e. All of the above |
E
|
|
|
Which neurologic conditions are episodic?
a. Seizures due to injury or metabolic illness b. Childhood febrile seizures and single unprovoked seizures c. Epilepsy d. Headaches, vertigo, and dizziness e. All of the above |
E
|
|
|
True or false: After surgery requiring dural penetration, or severe traumatic brain injury with dural penetration, drivers can be cleared for certification after a two-year waiting period and absence of seizures and physical and mental impairments.
|
FALSE
|
|
|
What tasks and requirements of commercial driving are affected by neurologic disorders?
a. Cognitive demands, vigilance and attention b. Quick reactions and coordinated movements of all extremities c. Communication skills and behavior d. Equilibrium and balance e. All of the above |
E
|
|
|
What physical and mental demands of commercial driving expose seizure-prone individuals to conditions that may increase the risk of seizures or interfere with the management of seizures?
a. Inconsistent access to medical evaluation and care of acute problems b. Delays in replacement of anticonvulsant medication if lost or forgotten c. Irregular hours upsetting schedules for eating and sleeping d. All of the above |
D
|
|
|
Which of the following medications would be clues that the driver has a neurologic condition that he/she may not have reported in his/her history?
a. Sinemet /levodopa b. Anti-platelet drugs c. Anticonvulsant drugs, CNS stimulants d. All the above |
D
|
|
|
True or false: Drivers with severe uncontrolled headaches associated with visual distortion and neurologic impairments should be disqualified.
|
TRUE
|
|
|
True or false: Early childhood seizures are not disqualifying.
|
TRUE
|
|
|
Which of the following brain injuries or diseases have the greatest chance of causing seizures?
a. Cerebellar hemorrhages b. Cortical and subcortical hemorrhages c. Brain stem hemorrhages |
b
|
|
|
Following a TIA, it is recommended that a driver can be certified if he meets which of the following criteria?
a. Completed a waiting period of one year and is off anticonvulsant medication b. Has a normal physical and psychological examination and meets all general requirements c. Clearance from a neurologist who is familiar with the demands of commercial driving d. All of the Above |
D
|
|
|
What is the waiting period before certification of a driver following benign postural vertigo and/or acute peripheral vestibulopathy?
a. One month b. Two months c. Six months d. One year |
B
|
|
|
What observations can give the examiner important clues regarding the neurologic status of a driver?
a. Speech clarity and patterns b. Gait and movement within the examiner’s office c. Tremors, twitches, spasticity, and/or nystagmus d. All of the above |
D
|
|
|
Ms. Miller is a 44-year-old driver who was diagnosed with mild multiple sclerosis three months ago. She denies any side effect of medicine (interferon SQ ever). She denies vision and sensory symptoms, loss of balance, or headaches. She occasionally has an itch or tingling in her left upper arm. MRI shows plaques suspicious for demyelinating disease. Lumbar puncture was normal. Her neurologist states that he is treating her for possible MS and that her neurological status has remained stable. The examiner notes that her left arm strength is 4/5, right arm 5/5. All other aspects of her history and examination are normal. What should be the determination of this examination?
a. Disqualify b. Meets standards, but periodic monitoring needed due to “possible” diagnosis. One year certification. c. Meets standards, but examiner should note on certificate that must be accompanied by a Skill Performance Evaluation (SPE) Certificate. True or false: If Ms. Miller had only 2/5 strength in her left upper extremity, she could be certified by means of a Skill Performance Evaluation (SPE)? |
B
FALSE |
|
|
True or false: Recommendations advise disqualification for drivers with Meniere’s disease, labyrinthitis fistula, and/or nonfunctioning labyrinths.
|
TRUE
|
|
|
Mr. Nelson is a 57-year-old driver who presents for “renewal of my DOT card.” When asked about illness in the last five years, he stated that he had “a bleed in my head that caused a little stroke eight months ago, but I’m OK now.” On further inquiry, the examiner finds that he had a left-sided brain stroke due to a bleed from an arteriovenous malformation (AVM). He has not yet returned to work but he did not want his CDL and medical certification to expire. He has not had any intervention, surgical or embolic, to repair the AVM. He is not sure if surgery has been scheduled or not and he cannot recall if he has an appointment with a neurosurgeon. He is also attending occupational and physical therapy. On examination, he slightly drags his right leg, and his right upper extremity is markedly weak. He has sensory and motor deficits consistent with a right-sided hemiplegia. Other aspects of the examination are unremarkable. What should be the determination of this examination?
a. Disqualify b. Temporarily disqualify pending waiting period and completion of therapy. c. Three-month certification to allow him to remain on the job while completing therapy. |
A
|
|
|
True or false: Once Mr. Nelson completes his therapy and an appropriate waiting period, he will be eligible for certification.
|
FALSE
|
|
|
True or false: With proper accommodations, a driver with paraplegia may be qualified.
|
FALSE
|
|
|
True or false: Following a TIA, a driver could be certified after one year with a normal physical examination and neurologic clearance, even though he/she is taking oral anticoagulant therapy.
|
FALSE
|
|
|
True or false: A driver may be certified with a clinical diagnosis of epilepsy.
|
FALSE
|
|
|
True or false: For purposes of certification, all seizure disorders are to be treated the same.
|
FALSE
|
|
|
Unprovoked seizures will occur within the next five years in what percentage of individuals with an occlusive vascular insult?
a. 5% b. 12% c. 16% d. 20% |
C
|
|
|
Seizures occur initially in what percent of individuals with an occlusive cerebrovascular insult?
a. 5% b. 12% c. 16% d. 20% |
B
|
|
|
What conditions have the greatest risk for seizure reoccurrence and require a 10-year, seizure-and anticonvulsant-free waiting period, before certification?
a. Moderate traumatic brain injury with early seizures, stroke with risk for seizure b. History of epilepsy, and viral encephalitis with early seizures. c. Intercerebral or subarachnoid hemorrhage with risk for seizures d. Surgically removed supratentorial tumors |
B
|
|
|
What conditions have a substantial risk for seizure reoccurrence and require a five-year, seizure-and anticonvulsant-free waiting period before certification? (Choose all that apply)
a. Bacterial meningitis with early seizures b. Moderate traumatic brain injury with early seizures, stroke with risk for seizure c. Intercerebral or subarachnoid hemorrhage with risk for seizures d. Surgically removed supratentorial tumors e. All of the above |
A,B,C
|
|
|
Following a TIA with “no functional residual” or risk of seizures, how long should a driver be disqualified?
a. Six months b. One year c. Two years d. Five years |
B
|
|
|
What conditions have a lower risk for seizure occurrence or reoccurrence and require a two-year, seizure- and anticonvulsant-free waiting period before certification? (Choose all that apply)
a. Bacterial meningitis with early seizures b. Moderate traumatic brain injury without early seizures c. Intercerebral or subarachnoid hemorrhage with risk for seizures d. Surgically removed supratentorial tumors |
B
|
|
|
What conditions have a low risk of seizures, but require a one-year, seizure- and anticonvulsant-free waiting period before certification? (Choose all that apply)
a. TIA, stroke, or intracerebral or subarachnoid hemorrhages with no risk for seizures b. Surgically repaired AV malformations or aneurysm with no risk for seizures c. Infection of the CNS (bacterial meningitis, viral encephalitis without early seizures) d. Moderate TBI without early seizures e. All of the above |
A,B,C
|
|
|
What duties of commercial drivers can be adversely affected by musculoskeletal disorders? (Choose all that apply)
a. Coupling and uncoupling trailers b. Loading or unloading several thousand pounds of freight c. Installing and removing tire chains d. Manipulating oversize steering wheel and gear shifts e. All of the above |
e
|
|
|
True or false: According to 49 CFR 391.41, a commercial vehicle driver with the loss of a leg, foot, hand or arm is qualified to operate a CMV.
|
false
|
|
|
True or false: According to regulations, only board-certified orthopedic surgeons or physiatrists can grant Skill Performance Evaluation (SPE) certification.
|
FALSE
|
|
|
When issued, the SPE certificate is valid for how long?
a. Initially six months, then annually thereafter b. One year c. Two years |
C
|
|
|
How long should the Medical Examiner certify a driver with a SPE certificate?
a. Initially six months, then annually thereafter b. One year, if there are no other medical concerns. c. Two years, if there are no other medical concerns |
C
|
|
|
True or false: A driver missing the fourth and fifth fingers of his right hand, even though he has a strong grasp with the remaining fingers, would require a Skill Performance Evaluation.
|
FALSE
|
|
|
True or false: A driver missing his right foot since age 2 who uses a prosthesis and runs marathons would require a Skill Performance Evaluation.
|
TRUE
|
|
|
True or false: A driver with status post-crush injury to his right arm that has caused atrophy and weakness in the ulnar and medical nerve distribution and has 1/5 grip strength would require a Skill Performance Evaluation for certification.
|
TRUE
|
|
|
True or false: A driver who is suffering from carpal tunnel syndrome for several months and has weak grip strength would require a Skill Performance Evaluation.
|
FALSE
|
|
|
According to regulations, what documentation is required from the Medical Examiner when a driver applies for a SPE certificate? (Choose all that apply)
a. Clearance from an orthopedic specialist or physiatrist b. A satisfactory evaluation of driving skills by qualified physical therapist c. Copies of the Medical Examination Report and the Medical Examiners Certificate indicating that medical certification must be “accompanied by SPE certificate.” d. All of the above. |
C
|
|
|
True or false: A driver presents for clearance to return to driving a CMV six weeks after carpal tunnel repair of his right hand. His examination is otherwise normal and he has normal grip and hand function. Which is the correct response?
a. Temporarily disqualify pending two-month waiting period then certify for one year. b. Certify for one year. c. Certify for two years. d. Temporarily disqualify pending two-month waiting period then certify for two years. |
C
|
|
|
What should the examiner look for during the examination of the spine? (Choose all that apply)
a. Surgical scars b. Tenderness and muscle spasms c. Loss in range of motion and painful motion d. Kyphosis, scoliosis or other spinal deformities e. All of the above |
E
|
|
|
True or false: Skill Performance Evaluation (SPE) can be requested for any musculoskeletal disorder
|
FALSE
|
|
|
True or false: It is recommended that drivers with a muscular dystrophy disease not be certified
|
TRUE
|
|
|
True or false: Drivers with motor neuron diseases may be certified with a SPE if symptoms are mild and stable.
|
FALSE
|
|
|
True or false. Recommendations are not to certify drivers with myotonia, Isaac’s syndrome or stiff-man syndrome.
|
TRUE
|
|
|
True or false: Recommendations are not to certify drivers with autonomic neuropathy that causes resting tachycardia and significant orthostatic blood pressure changes.
|
TRUE
|
|
|
True or false: Recommendations are not to certify drivers with a diagnosis of peripheral neuropathy..
|
TRUE
|
|
|
True or false: Recommendations allow certification of drivers with myasthenia gravis or myasthenic syndrome if accompanied by a SPE
|
FALSE
|
|
|
What diabetes mellitus risk poses the greatest threat to public safety?
a. Peripheral neuropathy b. Hyperglycemia c. Chronic kidney failure d. Hypoglycemia |
D
|
|
|
Which oral medications used to treat diabetes pose a greater risk for hypoglycemia?
a. Sulfonylureas … glyburide, glipizide b. Metformin c. Sitagliptin (Januvia, glitazones and thiazolidinediones, and meglitinides (Systlix and Prandin) |
A
|
|
|
What is the recommended interval of certification for a driver with well-controlled diabetes mellitus who does not take insulin?
a. Three months b. Six months c. One year d. Two years |
C
|
|
|
True or false: A diabetic driver taking insulin was otherwise qualified for certification, and given a one-year certification when “accompanied by a diabetic waiver/exemption.” The driver is now qualified to drive a commercial vehicle.
|
FALSE
|
|
|
True or false: Injectable diabetic medications, such as Byetta, are disqualifying.
|
FALSE
|
|
|
Which of the following is not considered a symptom of hypoglycemia?
a. Seizure b. Loss of consciousness c. Sudden impairment of cognitive function d. Acute renal failure |
D
|
|
|
At what level of HbA1c should the examiner require further evaluation?
a. 7% b. 8% c. 9% d. 10% e. 12% |
D
|
|
|
FMCSA recommends not to certify a driver with diabetes mellitus who has which of the following complications? (Choose all that apply)
a. Experienced a severe hypoglycemic reaction in the past 12 months, or two episodes in five years b. Diagnosis of peripheral neuropathy or proliferative retinopathy c. Loss of position or pedal sensation d. Orthostatic hypotension e. All of the above |
E
|
|
|
Mr. Peters presents for recertification. He was diagnosed with diabetes by his primary care physician two years ago when sugar was found in his urine. He recalls his initial HgbA1c was “about 8” and he was placed on a strict diet by a dietitian. He has lost about 50 pounds to date and remains “only on diet control.” He brought records for his last HgbA1c which was 7.2, two months ago. He has no other disqualifying conditions. What is the best determination outcome of this examination?
a. Certify for one year b. Certify for two years c. Certify for three months and repeat HgbA1c to be sure it is under 7. |
A
|
|
|
A driver with a diabetic waiver is responsible for all but which of the following?
a. Measuring blood sugars before driving and every two to four hours while driving b. Having annual endocrine and vision evaluations by specialists c. Carrying a source of rapidly absorbable glucose while driving d. Wearing an arm bracelet or necklace labeled “Diabetes” |
D
|
|
|
According to the Medical Examiner Handbook, what range of glucose levels (mg/dL) is generally considered safe for commercial driving?
a. 100-300 b. 100-400 c. 90-350 d. 80-300 |
B
|
|
|
For what period of time can a driver with a federal diabetic exemption be certified?
a. Three months b. Six months c. One year d. Two years |
C
|
|
|
A diabetic exemption, issued by the FMCSA, must be renewed every …
a. Year b. Two years c. Three years d. Four years |
B
|
|
|
True or false: Diabetic drivers who have documented good control of their glucose may be disqualified or have their duration of certification shortened because of target organ damage
|
TRUE
|
|
|
Who issues diabetic exemptions?
a. Medical Examiner b. Endocrinologist c. FMCSA d. State motor vehicle departments or agencies |
C
|
|
|
What physical findings might be discovered during physical examination that would provide clues to underlying conditions that may affect certification? (Choose all that apply)
a. Enlarged liver or spleen b. Bruises, telangiectasia, and hemangiomas c. Carotid or abdominal bruits d. Peripheral edema e. All of the above |
E
|
|
|
Mrs. Robinson presents for certification. She is 42 and has no medical problems. The only significant abnormality during her examination was a finding of 4+ blood in her urine. She was in the second day of her menses. What is the recommended outcome of this examination?
a. Three-month temporary certification pending evaluation b. One-year certification c. Two- year certification d. Temporary disqualification pending evaluation |
C
|
|
|
How would an examiner determine whether a gastrointestinal condition would potentially disqualify a driver? (Choose all that apply)
a. Risk of sudden death or incapacitation b. Inability to perform tasks required of commercial drivers c. Risk of progression of disease or condition d. All of the above |
D
|
|
|
What urine tests are required for driver certification?
a. Specific gravity, ketones, glucose, protein and blood b. Blood, glucose, protein and bilirubin c. Specific gravity, ketones, glucose, protein and blood d. Blood, glucose, protein and specific gravity |
D
|
|
|
A driver has a very thin, 4-inch by 6-inch umbilical hernia that has grown over the past six months. The driver is also noted to have a very distended abdomen and fluid waves on examination. What should the examiner’s decision be regarding certification?
a. Disqualify pending evaluation and treatment b. Three-month certification pending evaluation c. One-year certification d. Two-year certification |
A
|
|
|
A driver admits to having irritable bowel syndrome, which is controlled well with 20 mg of Bentyl QID. He denies any drowsiness or other side effects from the medication. What should the be the examiner’s decision regarding certification?
a. Disqualify b. Three-month certification pending evaluation c. One-year certification d. Two-year certification |
D
|
|
|
True or false: A driver may be qualified to drive following a successful kidney transplant that shows no sign of rejection
|
TRUE
|
|
|
True or false: According to medical recommendations, a driver on chronic renal dialysis should not be certified to drive a commercial vehicle
|
TRUE
|
|
|
True or false: Seasonal allergies and allergic reactions should never be grounds for disqualification
|
FALSE
|
|
|
True or false: Sneezing and coughing may be grounds for disqualification.
|
TRUE
|
|
|
Which of the following represent a risk associated with mental and psychological disorders? (Choose all that apply)
a. The nature of the mental disorder b. The residual symptoms c. The pharmacologic effects of treatment d. All of the above |
D
|
|
|
When evaluating a driver with a psychological disorder that might interfere with safe operation of a CMV, what behaviors should an examiner look for, and if present, document? (Choose all that apply)
a. Suspicious, evasive, threatening or hostile behaviors b. Signs of being easily distracted. c. Signs of flat affect or lack of emotional response d. Displays of unusual or bizarre ideas, auditory or visual hallucinations, dishonesty, or tendency to omit important information. e. All of the above |
E
|
|
|
True or false: In determining certification of a driver with a possible mental disorder, the examiner should ask special questions that relate directly to driving a commercial vehicle.
|
FALSE
|
|
|
True or false: According to medical guidance from the FMCSA, a driver undergoing maintenance electroconvulsive therapy (ECT) may be certified.
|
FALSE
|
|
|
Mr. Smith, on his health history, checks that he has a “nervous or psychiatric disorder” and “regular, frequent alcohol use. He takes Paxil 40 mg daily. Two years ago he had a suicide attempt following the drowning of his 2-year old son. He has a clearance from a psychiatrist to return to work and normal activities. He had a suicide attempt 10 months ago. He admits to excessive guilt, but denies current suicidal or homicidal ideation. He has no hallucinations or psychotic episodes. No side effects from Paxil. Admits to one or two beers on weekends. He has a clean driving record and says he needs to be certified or he will lose the job he has had with his employer of 10 years. He has a family history of depression. His affect, appearance, and hygiene or good. Everything else is normal. What is the certification decision in this scenario?
a. Certify for three months and re-evaluate. b. Certify for one year. c. Certify for two years. d. Temporarily disqualify until driver is symptom-free for one year. |
D
|
|
|
Regarding Mr. Smith, what would be appropriate actions for the medical examiner? (Choose all that apply)
a. Explain to the driver the FMCSA guidelines which state a driver should complete one-year waiting period before recertification consideration. b. Have Mr. Smith get a current evaluation by a psychiatrist. c. Contact the employer (after release) and explain the conditions of the temporary disqualification. d. Provide the driver with a copy of the Medical Examination Report that documents the reason for temporary disqualification, and states when the driver may be certified if he meets FMCSA qualifications at that time. e. All of the above |
E
|
|
|
Mr. Taylor presents for the first time for CMV driver certification. He states that he feels fine and did not check any boxes in the medical history section of the examination form. He smokes two packs per day, denies alcohol, but drinks 10 “Jolt” colas per day. He presents with poor eye contact and flat affect. The examiner made the following observations in Section 7 of the examination form: 1. Slight tremor. 2. Left eyelid tic. 4. Dry mouth. 9. Refused hernia exam, became agitated and said “I can’t undress.” 12. Mild ataxia. Rhomberg positive. Declined to participate in mini mental status exam, saying, “These questions are dumb.” What is the certification decision in this scenario?
a. Disqualify pending mental health evaluation and completion of medical examination b. Three-month certification c. One-month certification |
A
|
|
|
According to the FMCSA, a driver with attention deficit hyperactivity disorder (ADHD) should not be certified if the driver has: (Choose all that apply)
a. An active psychosis b. Prominent negative symptoms, including compromised judgment, suicidal ideation, and/or personality disorder manifested by overt, inappropriate acts c. Side effects that interfere with safe driving d. All of the above |
D
|
|
|
According to the FMCSA, a driver with ADHD could be certified if the driver: (Choose all that apply)
a. Complies with a treatment program. b. Tolerates treatment without disqualifying side effects. c. Has a comprehensive evaluation from an appropriate mental health professional. d. All of the above |
D
|
|
|
According to the FMCSA, a driver with bipolar mood disorder should not be certified if the driver has: (Choose all that apply)
a. An active psychosis. b. Prominent negative symptoms, including compromised judgment, suicidal ideation, and/or personality disorder manifested by overt, inappropriate acts. c. Side effect that interfere with safe driving. d. All of the above |
D
|
|
|
According to the FMCSA, a driver with bipolar mood disorder could be certified if the driver has been: (Choose all that apply)
a. Symptom-free for six months following a nonpsychotic major depression unaccompanied by suicidal behavior. b. Symptom-free for one year following a severe depressive episode, a suicide attempt or manic episode. c. All of the above |
C
|
|
|
At a minimum, after a non-psychotic major depressive episode without a suicide attempt, how long should a driver be symptom-free before certification?
a. Three months b. Six months c. One year d. Two years |
B
|
|
|
True or false: A driver taking methadone can be certified.
|
FALSE
|
|
|
True or false: Participation in a 12 Step Alcoholics Anonymous program is evidence of a current diagnosis of alcoholism according to the FMCSA.
|
FALSE
|
|
|
True or false: A driver with a current diagnosis of alcoholism may be certified for driving a commercial vehicle after being evaluated by a substance abuse professional (SAP).
|
FALSE
|
|
|
What screening tests might an examiner use to help determine the significance of a driver’s alcohol use? (Choose all that apply)
a. TWEAK b. Epworth Scale and/or Stanford Scale c. AUDIT d. All of the above |
A,C
|
|
|
True or false: The medical examiner should educate the driver on the potential side effects of the medications, when and how they should be used, and document the discussion.
|
TRUE
|
|
|
According to the FMCSA recommendations, what conditions should be met before an examiner certifies a driver on anticoagulation (warfarin) therapy? (Choose all that apply)
a. Stabilized on medication for one month b. Provides a copy of INR results at the examination c. Has at least monthly INR monitoring d. All of the Above |
D
|
|
|
According to the FMCSA recommendations, an examiner should disqualify a driver on anticoagulation (warfarin) therapy if which of the following apply? (Choose all that apply)
a. INR is not being monitored b. INR is not therapeutic c. Underlying disease is disqualifying d. All of the above |
D
|
|
|
What advice should medical examiners provide drivers who take first generation antihistamines?
a. There is no need for medical examiners to advise drivers regarding over-the-counter medications. b. Drivers should not take these medications for 12 hours prior to operating a CMV. c. Drivers should not take these medications for six hours prior to operating a CMV. |
B
|
|
|
If there is a significant question about a driver with possible drug abuse or alcoholism, who should examine the driver prior to certification?
a. Substance abuse professional b. Psychiatrist or psychologist c. Medical Review Officer d. Medical Examiner |
A
|
|
|
True or false: According to FMCSA recommendations, a driver taking Suboxone cannot be qualified.
|
TRUE
|
|
|
True or false: Testing for controlled substances is a requirement of the CMV physical examination.
|
FALSE
|
|
|
Which medications have not been found to significantly interfere safe driving? (Choose all that apply)
a. First generation antihistamines b. Amitiptyline and iimipramine c. Benzodiazepines d. Narcotic antitussive therapy e. None of the above |
E
|
|
|
True or false: The Medical Examiner may require a driver to be evaluated by a SAP and successfully complete a rehabilitation course if the driver has a current diagnosis of alcoholism
|
TRUE
|
|
|
Ms. Valdez comes in for recertification after completing her “first ever” 30-day alcohol rehabilitation that was court-mandated after a DUI conviction. She has not had a SAP evaluation but admits to seeing “rehab counselors and alcohol doctors” within the rehab facility. She is taking no medications and has no alcohol on her breath. Her affect is appropriate and she has no physical signs of chronic alcohol use. The rest of the examination is unremarkable. What is the certification decision in this scenario?
A. Three-month certification pending evaluation by a SAP B. Disqualify, pending an evaluation by a SAP C. One-year certification because she has undergone treatment and admits to her past problem |
B
|
|
|
Mr. Wolf is 22 and presents for a certification examination. He has three weeks left on his current certification. He did not check any boxes in the history section of the medical examination form. Medical staff report that during ancillary testing, Mr. Wolf was acting “silly” and not always following verbal commands well. When questioned, he admits to past use of illicit drugs and overuse of prescription medication. He has no history of arrests or any rehabilitation treatment. Physical examination comments: 1. No odor of alcohol. Poor response to verbal commands during exam. 2. Pupils myotic and not responsive. 10. Distal upper extremities with apparent needle track marks of various ages, some appear recent. 12. Lost balance during heel-toe exam. What is the certification decision in this scenario? (Choose all that apply)
a. Disqualify. b. Advise Mr. Wolf that he should not be driving and find alternative transportation for him. c. Notify employer that Mr. Wolf should not be driving until evaluated, treated and re-examined. d. The medical examiner signs the report form and is accountable for its accuracy. e. All of the above |
E
|
|
|
True or False: Drivers who take Schedule II medications may not be disqualified from driving a commercial vehicle if they have valid prescriptions from a licensed physician.
|
FALSE
|
|
|
True or False. Any injected medications used to treat Diabetes are disqualifying.
|
FALSE
|
|
|
True of False. Drivers cannot be certified if taking Provigil for excessive daytime somnolence.
|
FALSE
|
