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NRCME Exam With Correct Solutions 2024., Exams of Nursing

Rasmussen College - IllinoisNursing

NRCME Exam With Correct Solutions 2024.

Typology: Exams

2024/2025

Available from 07/15/2025

annie-wanjiru
annie-wanjiru 🇺🇸

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NRCME Exam With Correct Solutions 2024
FMCSA Mission Statement - correct answer.To reduce crashes, injuries, fatalities
involving large trucks/buses
Medical Examiner - correct answer.Licensed, certified, registered provider who can
perform PEs in accordance with laws and regulations ; registered through NRS ; has
unique identifier ; passes MEC test
FMCSA - correct answer.Federal Motor Carrier Safety Administration
NRCME - correct answer.National Registry of Certified Medical Examiners
Commerical Motor Vehicle - correct answer.Weight >1000 lb ; or transports >8 people
for compensation ; or >15 people without compensation ; transports hazardous
materials requiring placarding
Interstate commerce
vs.
Intrastate commerce - correct answer.Interstate: multiple states or international
Intrastate: within 1 state
Who regulates treatment/management and aftercare of substance abuse for drivers? -
correct answer.SAP (Substance Abuse Professional)
Who determines the origin of abnormal drug test results, determining whether the driver
has violated drug use regulations? - correct answer.Medical Review Officer
Title 49 CFR 391.41 - correct answer.Medical Examiner Report Form
- Paperwork completed during DOT physical
- Physical exam requirements for driver
- Determines if Certificate is granted
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NRCME Exam With Correct Solutions 2024

FMCSA Mission Statement - correct answer.To reduce crashes, injuries, fatalities involving large trucks/buses Medical Examiner - correct answer.Licensed, certified, registered provider who can perform PEs in accordance with laws and regulations ; registered through NRS ; has unique identifier ; passes MEC test FMCSA - correct answer.Federal Motor Carrier Safety Administration NRCME - correct answer.National Registry of Certified Medical Examiners Commerical Motor Vehicle - correct answer.Weight >1000 lb ; or transports >8 people for compensation ; or >15 people without compensation ; transports hazardous materials requiring placarding Interstate commerce vs. Intrastate commerce - correct answer.Interstate: multiple states or international Intrastate: within 1 state Who regulates treatment/management and aftercare of substance abuse for drivers? - correct answer.SAP (Substance Abuse Professional) Who determines the origin of abnormal drug test results, determining whether the driver has violated drug use regulations? - correct answer.Medical Review Officer Title 49 CFR 391.41 - correct answer.Medical Examiner Report Form

  • Paperwork completed during DOT physical
  • Physical exam requirements for driver
  • Determines if Certificate is granted

Title 49 CFR 391.43 - correct answer.Describes responsibilities of Medical Examiner, instructions for exam, and requirements for medical certification

  • Supporting information to explain 391. When was DOT established? - correct answer. Became separate entity on Jan 1, 2000 Motor Carrier Safety Improvement Act of 1999 - correct answer.Established DOT as separate federal entity Omnibus Transportation Employee Testing Act of 1991 - correct answer.Required drug testing for drivers The driver must always keep a copy of ____________________ with them while driving
  • correct answer.Medical Certificate SPE if applicable Does the driver need to sign a medical release before you release their Medical Certification? - correct answer.No. Certificate is provided to employer. (Release is required for a copy of medical report form) How many standards are used to determine driver fitness for duty? - correct answer. How many standards of "driver fitness for duty" are discretionary? - correct answer. (according to my review course)
  • Other sources say 10 and say that T2DM is discretionary How many standards of "driver fitness for duty" are NON- discretionary? - correct answer.
  • Vision
  • Hearing
  • Epilepsy
  • T2DM (Some sources say 3 and do not include T2DM) Age requirement for drivers - correct answer.21+ Language requirement for drivers - correct answer.Must be able to read/speak English well enough to read signs, communicate Height/weight requirement for drivers - correct answer.There is none

Blood pressure requirement for 2-year certification - correct answer.<140/90 with no HTN therapy No previous diagnosis of HTN Blood pressure requirement for 1-year certification - correct answer.First finding of Stage 1 hypertension (140-159/90-99) or History of Hypertension or taking 1+ HTN med and BP is controlled at <140/ BP requirement for 3-month certification - correct answer.- Has not yet had antihypertensive therapy

  • Previously had a 1-year certificate for uncontrolled Stage 1 BP
  • OR: first finding of Stage 2 HTN Required Echocardiography criteria - correct answer.- LVEF >40%
  • No Pulm HTN (Right heart pressure < 50 mmHg) When is Echo required? - correct answer.- Aortic Regurg
  • Aortic stenosis (Q1 year moderate, Q5 years mild)
  • Mitral stenosis (annual)
  • MVP (annual) One time: Eval of CHF, CHD Post CABG, MI Which conditions require an annual Echo? - correct answer.- Mitral stenosis
  • MVP
  • Moderate aortic stenosis Exercise Tolerance Test (ETT) requirements - correct answer.- Attain >85% max HR
  • SBP >20 mmHg increase without sx
  • Tolerate 6 METs
  • No ST depression or ischemic changes When is an ETT (stress test) required? - correct answer.- Unstable angina (Biennial)
  • CABG (annual starting 5 years after surgery)
  • Congenital heart defect (x1)
  • CHF (x1)
  • PCI (6 months post-procedure, then biennial)
  • MI (prior to re-certification)
  • Severe mitral regurg (Q6 months) Which conditions result in a max recertification period of 6 months? - correct answer.- Heart transplant
  • Stage 3 hypertension without surgical correction
  • Severe Aortic regurg or Aortic stenosis without surgical correction PFT requirements - correct answer.- FVC >60%
  • FEV1 >65%
  • FEV1/FVC ratio > 65%
  • Pulse ox > 92% If above are not met, do an ABG and PaO2 must be > 1 week waiting period: - correct answer.Post PCI 4 week waiting period: - correct answer.Post mitral balloon valvuloplasty 1 month waiting period: - correct answer.- A-fib, stabilized
  • Anticoagulation, stabilized (a-fib)
  • SVT
  • Post-pacemaker for AV block or SV arrythmia 2 month waiting period: - correct answer.- Post MI
  • BPPV or vertigo 3 month waiting period: - correct answer.- Post surgery (CABG, CV, aneurysm repair, PVD, PAD, OSA, 2ry hypertension)
  • PE
  • Unstable angina
  • Syncopal episode
  • Post-pacemaker for carotid hypersensitivity or neurogenic syncope 6 month waiting period: - correct answer.ECT therapy 1 year waiting period: - correct answer.- TIA or Stroke with no seizure/risk
  • Acute provoked seizure, mild/no insult
  • Heart transplant
  • Brain tumor resection with no seizure 2 year waiting period: - correct answer.- TBI with moderate insult (such as LOC)
  • Acute seizure, unprovoked, mild 5 year waiting period: - correct answer.- Seizure with moderate insult
  • TBI with seizure
  • Stroke/TIA with seizure 10 year waiting period: - correct answer.- Epilepsy
  • Febrile seizures AAA requirements - correct answer.<4 cm

Requirements for MI - correct answer.- 2 month waiting

  • Asymptomatic, tolerating all therapy
  • Cardiac clearance
  • ETT
  • Echo meets requirements
  • No CAD
  • ECG with no ischemic changes ECG, ETT, Echo What testing is required for driver with Mitral Valve Prolapse? - correct answer.Echo annually What testing is required for driver with Mitral stenosis? - correct answer.Annual CXR, Echo, ECG Waiting period for PE - correct answer.3 months Warfarin is disqualifying if it is used for... - correct answer.History of CVA/TIA Post-PCI requirements - correct answer.- 1 week waiting
  • ETT 3-6 months later
  • Asymptomatic, tolerating therapy
  • ECG with no ischemic changes
  • Cardiac clearance Which conditions require an ECG? - correct answer.- MI
  • Post-PCI
  • Mitral stenosis Waiting period for an acute, provoked seizure with no risk for recurrence - correct answer.1 year (seizure free, off meds, neuro clearance) Waiting period for an UNprovoked seizure, mild insult - correct answer.2 years (seizure free, off meds, neuro clearance) Waiting period for a moderate TBI (with LOC) but NO seizure - correct answer.2 years (seizure free, off meds, neuro clearance) Waiting period for TBI with seizure - correct answer.5 years (seizure free, off meds, neuro clearance) Waiting period for unprovoked seizure with moderate insult - correct answer.5 years (seizure free, off meds, neuro clearance) Visual disqualifiers - correct answer.- Monocular vision (without federal exemption)
  • Telescopic lens
  • Failure to meet vision requirements Cervical ROM must be - correct answer.>45 degrees both directions Points of contact for entering a truck - correct answer.Hand, arm, leg Regulations vs. Guidelines - correct answer.Regulations are law Guidelines are based on expert panel, are "best practice" - document if you make alternative decision Injury severity = - correct answer.Relative velocity change Can a driver be certified with medical marijuana use? - correct answer.No - Schedule I drugs are disqualifying Can a driver take Methadone? - correct answer.No - Schedule 1 is disqualifying Stage 2 hypertension (per FMCSA) - correct answer.160-179 / 100- 109
  • Requires 3 month certification while BP is controlled, f/u in 3 months What generation of antidepressants has fewer side effects and is preferred for drivers? - correct answer.2nd Gen Smoking/tobacco use requirements - correct answer.None
  • Not required to ask about tobacco use Visual acuity is measured in: - correct answer.In each eye separately, and together and if corrective lens are worn, both with and without corrective lens What should always be discussed the driver regarding their medications? - correct answer.- Tolerance
  • AEs
  • Frequency of monitoring (if applicable) What do you do if you cannot assess a driver's visual acuity or visual fields in the office?
  • correct answer.Disqualification and referral to specialist for precise visual measurements. What do you do if a driver is missing fingers on a hand? - correct answer.- Assess grip strength
  • Document the effect that this has on driving ability
  • Determine if driver requires SPE/renewal of SPE

True or false: Anticonvulsant use for seizure disorder is disqualifying - correct answer.True. (Anticonvulsants used for OTHER diagnoses are not necessarily disqualifying) The federal vision exemption program is only for ____________ - correct answer.monocular vision

  • Requires annual ophthalmologist exam
  • Renewable q2Y
  • Max cert 1 year Physical abilities required by driver: - correct answer.- Grip strength
  • Upper body strength
  • Balance
  • Flexibility
  • Cervical spine rotation >45 degrees bilaterally A 3 month certificate: - correct answer.Is issued for the first time a driver exhibits stage 2 hypertension. What are reasons for biannual ETT? - correct answer.Post-PCI History of Unstable angina Which heart murmur requires Echo Q6 months if not surgically repaired? - correct answer.mitral regurgitation