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NRCME Exam With Latest Updated And Complete Solutions 2024, Exams of Nursing

Rasmussen College - IllinoisNursing

NRCME Exam With Latest Updated And Complete Solutions 2024.

Typology: Exams

2024/2025

Available from 07/15/2025

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NRCME Exam With Latest Updated And
Complete Solutions 2024
1. An unrestricted Commercial Motor Vehicle Driver Medical Certificate must be
renewed:
A. Annually
B. Every Two Years
C. Every Four Years
D. Whenever the State Issued Driver's License is renewed - correct answer.B
2. A driver presents with history of an isolated TIA 6 months ago. He has a return to
work letter from his primary care
provider (PCP) and neurologist. He is taking and tolerating well hydrochlorothiazide and
simvastatin. All other aspects of
the exam and history were normal. What should the medical examiner do next?
A. Certify driver for 1 year
B. Disqualify driver for now
C. Certify driver for 3 months
D. Certify driver for 2 years - correct answer.B
3. FMCSA regulates interstate commercial operation including the:
A. Driver
B. Vehicle
C. Motor Carrier
D. All of above - correct answer.D
4. During the CMV exam a driver perceived a whispered voice at 5 feet in his left year
and 4 feet in his right year. Exam
was otherwise normal. What do you do as the medical examiner?
A. Required audiometric test to determine the extent of hearing loss in left ear
B. Certify driver for 2 years
C. Certify driver for 1 year
D. Disqualify driver - correct answer.B
5. Which of the following is an assessment of L4 nerve root pathology?
A. Plantar flexion
B. Patellar reflex
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Partial preview of the text

Download NRCME Exam With Latest Updated And Complete Solutions 2024 and more Exams Nursing in PDF only on Docsity!

NRCME Exam With Latest Updated And

Complete Solutions 2024

  1. An unrestricted Commercial Motor Vehicle Driver Medical Certificate must be renewed: A. Annually B. Every Two Years C. Every Four Years D. Whenever the State Issued Driver's License is renewed - correct answer.B
  2. A driver presents with history of an isolated TIA 6 months ago. He has a return to work letter from his primary care provider (PCP) and neurologist. He is taking and tolerating well hydrochlorothiazide and simvastatin. All other aspects of the exam and history were normal. What should the medical examiner do next? A. Certify driver for 1 year B. Disqualify driver for now C. Certify driver for 3 months D. Certify driver for 2 years - correct answer.B
  3. FMCSA regulates interstate commercial operation including the: A. Driver B. Vehicle C. Motor Carrier D. All of above - correct answer.D
  4. During the CMV exam a driver perceived a whispered voice at 5 feet in his left year and 4 feet in his right year. Exam was otherwise normal. What do you do as the medical examiner? A. Required audiometric test to determine the extent of hearing loss in left ear B. Certify driver for 2 years C. Certify driver for 1 year D. Disqualify driver - correct answer.B
  5. Which of the following is an assessment of L4 nerve root pathology? A. Plantar flexion B. Patellar reflex

C. Hip extension D. Babinski reflex - correct answer.B

  1. A driver presents for medical exam and reports being a smoker and having frequent shortness of breath. What do you do next? A. Order an ECG B. Refer to a pulmonologist C. Order a spirometer test D. Provide 1 year certification - correct answer.C
  2. According to regulation, which of the following must be evaluated as part of the eye exam? A. Pupil reaction B. Iris symmetry C. Conjunctiva injection D. Tonometry pressure - correct answer.A
  3. Continued certification of NRCE Medical Examiners requires all EXCEPT which of the following? A. Periodic training at least every five years B. Completion of recertification test every five years C. Completion of certification test every 10 years D. Electronic transmission to FMCSA CMV Medical Examination Results at least monthly - correct answer.B
  4. A driver presents for recertification. The only condition he lists is GERD, for which he takes OTC omeprazole. He says that when he is driving and eating fast foods, he is more likely to have heartburn than when off‐duty. You should: A. Request recent UGI results B. Correlate history with abdominal exam C. Certify for one year with restricted diet D. Discuss alternative employment - correct answer.B
  5. Which of the following findings is disqualifying? A. Oxygen saturation 90% B. LVEF 40% C. FEV 68% predicted D. All of the above - correct answer.A
  6. The driver presents for recertification and submits an ultrasound report indicating an abdominal aortic aneurysm from two months ago, shortly before he had surgical correction. He has surgical clearance and says he is doing well, has no symptoms. You should:

B. 6 months C. 1 year D. 2 years - correct answer.B

  1. The driver presents for examination with a recent history (five weeks ago) of pneumothorax. He has no prior history of pneumothorax. In order to be considered medically qualified, his forced vital capacity (FVC) should be greater than: A. 40% B. 55% C. 65% D. 90% - correct answer.C
  2. The recommended waiting period (WP) and certification period (CP) for a driver following surgical correction for intermittent claudication are: A. WP 1 month, CP 6 months B. WP 3 months, CP 1 year C. WP 3 months, CP 2 years D. WP 6 months, CP 2 years - correct answer.B
  3. Which of the following are disqualifying? A. Pacemaker B. Implanted defibrillator C. Both a and b D. Neither - correct answer.B
  4. Five years post‐CABG, the driver must provide a copy of _________ in order to qualify for recertification A. Ultrasound B. EKG C. Lipid profile D. ETT - correct answer.D
  5. The driver has a 5‐year history of asthma, described as "well‐controlled". He carries rescue inhaler for the times when he becomes short of breath, but says this is rare. He provides pulmonary functions performed last week and his FEV1 is 62% of predicted and his Pa02 is 62 mm. You should: A. Qualify for 1 year B. Qualify for 2 years C. Disqualify and recommend that he return to his personal provider D. Disqualify and recommend that he pursue a chronic respiratory exemption - correct answer.C
  6. What is the Primary mission of FMCSA?

A. To improve the quality of the highways. B. To promote the safety of the roadways. C. To regulate the performance of medical exams. D. To ensure state regulations coincide with federal regulations - correct answer.B

  1. During a driver's history, she describes her role and responsibilities as limited to the driving component and excluding strenuous activities. You should: A. Limit the examination to those qualifications associated with driving B. Contact her employer for verification of this history prior to proceeding with the physical examination C. Disqualify Ms. Jeffries for her limited understanding of the driver role D. Conduct the full and standard physical examination - correct answer.D

  2. During the examination, a driver reveals, "I had a touch of sugar" two years ago, but stopped taking the prescribed medication when it ran out, the name of which was forgotten. Driver did not indicate "yes" on the medical history for diabetes. The examination and urinalysis are unremarkable. What is the appropriate action you would take to complete this examination? A. Perform a capillary blood test to determine the current blood glucose level B. Ask the driver to amend the medical history; list driver as temporarily unqualified until medical records are reviewed C. The normal examination and lack of glycosuria enables the driver to be issued a two‐ year unrestricted medical certificate D. Correct the medical history in your narrative and discuss the signs, symptoms and health impact of diabetes and the need for regular follow‐up in certifying the driver - correct answer.D

  3. Which of the following tests is not recommended as medical guidance for initial pulmonary function testing? A. Forced expiratory volume in 1 second (FEV1) B. Peak flow spirometry, best effort C. Forced vital capacity (FVC) D. FEV1/FVC ratio - correct answer.B

  4. A 60 year old driver reveals a 6 month history of progressive worsening of dizziness and ringing in the ears. It is worse when he bends over. He denies hearing loss, no trauma or recent infections, and takes no chronic medications, but was told by another driver to try meclizine. He did try and it seemed to help. Which of the following routine screening tests may help you best decide on the severity of the symptoms during this CDL medical examination? A. Audiogram

B. Employers who pay for the exam as part of the employee's conditions of employment are entitled to a copy of the CMV Medical Examination Report without a signed release by the driver C. The CMV Medical Examination Report is treated the same as any other confidential medical information and must have a signed release by the driver. D. The Driver is never permitted to have a copy of the CMV Medical Examination Report due to the increase in fraudulent documents being circulated. - correct answer.C

  1. Which of these statements about drinking alcohol is true. A. Alcohol first affects judgment and self‐control, which are essential for safe driving. B. Statistics show that drivers who have been drinking have a much greater chance of being in a motor vehicle crash. C. A commercial motor vehicle driver can lose his / her CDL for driving while under the influence of alcohol. D. All of the above are true - correct answer.D
  2. What level of risk is acceptable when qualifying CDL drivers? A. 0% B. 1% C. 10% D. 11% - correct answer.B
  3. Which of the following is TRUE concerning discretionary qualification standards? A. It is the examiner's discretion whether to assess these standards B. It is the CDL employer's discretion whether to accept the medical examiner's determination C. It is up to the examiner's discretion and clinical judgment regarding the driver's qualifications in these areas D. All of the above are true - correct answer.C
  4. The driver marks history of high blood pressure, shortness of breath, lung disease, emphysema and chronic bronchitis. His medications include tiotropium bromide, salmeterol/fluticasone propionate inhaler, and albuterol inhaler. As he walks into the exam room, he is short of breath, but says he recently cut down to ½ PPD cigarettes after smoking two PPD for 45 years and is improved. During his last PCP visit a year ago, he was diagnosed with borderline hypertension and COPD with cor pulmonale. He is tolerating his medications well and takes them as prescribed, using his albuterol no more than twice a day, depending on his level of activity. His PCP record shows mild right ventricular hypertrophy, mild pulmonary hypertension. He had a CXR 6 months ago which confirmed COPD. His blood pressure

today is 138/88, with regular pulse at 88. He is slightly flushed. Chest exam reveals grade II/VI murmur and S4. During the - correct answer.A

  1. According to 49 CFR391.41(b)(8) regarding neurological conditions, which is considered unequivocal grounds for medical disqualification for the interstate CMV driver medical certification: A. Migraine Headache B. Active Seizure Disorder C. Cervical Spinal Stenosis D. Transient Ischemic Attack - correct answer.B
  2. The purpose of the commercial driver physical exam includes which of the following? A. Determine "medical fitness for duty" B. Detect the presence of any physical, mental, or organic conditions of such character and extent as to affect the ability of the driver to operate a CMV safely C. Both of the above D. Neither of the above - correct answer.C
  3. Driver(s) of which of the following vehicles DO NOT require a CDL certificate? A. Vehicle weighs over 26,000 lb B. Vehicle weighs less than 26,000 lb and designed to transport up to 12 passengers (including driver) without compensation C. Vehicle weighs less than 26,000 and transports hazardous material D. Drivers of all of the above must be certified - correct answer.B
  4. The driver presents for recertification following a recent diagnosis with pulmonary TB. She recently completed a 4 ‐month course of streptomycin. You should assess: A. Rapid alternative movement B. Rhomberg C. EKG D. LVEF - correct answer.C
  5. A driver who has a history of ____ or more episode(s) of spontaneous pneumothorax requires ______ before qualifying. A. 1, CXR B. 1, surgical correction C. 2, CXR D. 2, surgical correction - correct answer.D

C. One year certification D. Two year certification - correct answer.C

  1. The driver provides documentation of recent diagnosis of Stage 4 chronic kidney disease. Which of the following findings would be disqualifying? A. History of diabetes B. Abnormal ECG C. Ejection fraction 45% D. BP 146/92 - correct answer.B
  2. The driver presents for recertification. He discloses a head injury sustained 4 months ago in a bike accident. His biking companion said that he "passed out" for about 15 minutes, but did not have any seizure activity. Which of the following waiting period (WP) and certification period (CP) are recommended? A. WP 0 year, CP 2 years B. WP 1 year CP 1 year C. WP 2 years, CP 1 year D. WP 5 years, CP 1 year - correct answer.A
  3. The new driver has a history of bacterial meningitis with early seizures. However, he has been seizure free and otherwise symptomatic since recovery six years ago. He has been off of anticonvulsants for approximately 5.5 years. With adequate documentation, you may certify this driver for up to: A. 6 months B. 1 year C. 2 years D. Is disqualified - correct answer.C
  4. Many neuromuscular conditions are disqualifying. For which of the following can a driver be certified? A. Myotonia B. Parkinson's C. Autonomic neuropathy D. Muscular dystrophy - correct answer.C
  5. The driver has held a commercial driving license for 40 year. He shows up 2 months early for recertification. When you point this out, he says he just thought he'd come in because he saw your sign. He volunteers that using his new GPS system is really confusing and he has ended up in the wrong town more than once lately, requiring added hours on the road. So he thought he might as well take advantage of the opportunity rather than miss the expiration date as

he also has trouble staying on schedule. For many of the history questions, he provides flippant responses rather than specifics and is unable to recall three words five minutes later. You should: A. Order a brain scan B. Contact the motor carrier for recent drug test results C. Indicate "determination pending" and tell him he must return within 45 days with medical clearance in order to continue driving when his current certification expires D. Disqualify th - correct answer.D

  1. The driver had a CABG 3 months ago. His echo dated last week showed LVEF 50% and his cardiologist has submitted medical clearance. He should be: A. Disqualified due to not completing the necessary waiting period B. Disqualified due to the elevated LVEF C. Disqualified until he provides results of an ETT D. Qualified - correct answer.D
  2. The driver has been impatient awaiting his CMV exam, saying he will not tolerate "this disrespect" and threatening to sue if he is not seen immediately. He is agitated and pacing. He should be: A. Disqualified and encouraged to seek mental health B. Informed that your determination is pending submission of SPE C. Informed that your determination is pending submission of SAP D. Asked to provide his employer's contact so that you can discuss his presentation - correct answer.A
  3. Which diabetes risk poses the greatest threat to public safety? A. Hypoglycemia B. Hyperglycemia C. Macular degeneration D. Peripheral neuropathy - correct answer.A
  4. The driver with a history of depression presents taking SSRI. He has been on the same drug and dose for 6 months and is tolerating it well. He appears depressed with a flat affect and monotone voice. On questioning, admits that he has been very depressed lately. He has two weeks left on his current CMV driver certification. What certification decision should be made? A. Qualify with contract to see his PCP within two weeks. B. Adjust his SSRI and have him return for reevaluation in two weeks. C. Mark determination pending with a return date in two weeks D. Disqualify the driver - correct answer.D

B. Do not certify as seizure history is always disqualifying C. Provide a conditional 30 day medical certification giving him time to bring in proof of medical clearance from his PCP D. Certify for one year as your examination shows no neurological deficits and he is not taking anti‐seizure medications - correct answer.A

  1. 54 year old female is divorced and recently had a break‐up in a 10‐year relationship. She is a delivery driver with no reported past health problems in all past CMV examinations. Always issued a 2 year license and is 6 years accident free commercial driver. You are the CME for her carrier and know she is well‐liked by employer and fellow workers. She volunteers she also works as part time as a bartender trying to "make ends meet". She discloses that she recently became despondent and depressed while driving her delivery route, stopped the vehicle on side of road, and "simply fell apart". She called the dispatcher for help and was involuntarily committed for psychiatric evaluation. Following discharge, she was off work 3 months and is under care of her family provider. She continued taking medications prescribed by the crisis center but decided to stop as she feels over the emotional stressors. It is now 3 m - correct answer.B
  2. The driver presents for his recertification. He has "always been hard of hearing on the left side" after having repeated ear infections as a child, but has never worn a hearing aid. His hearing test (Whisper) results are: right ear 5 fee, left ear 2 feet. On examination, his left TM is scarred, otherwise exam is normal. You should: A. Disqualify the driver B. Qualify the driver for 1 year to more closely monitor hearing C. Qualify the driver for 2 years D. Mark determination pending until hearing aid obtained - correct answer.C
  3. A patient presents with history of recently diagnosed bipolar condition bringing her mental health and medical records to demonstrate her stable condition and the medications prescribed. Which of the following, would be considered automatic disqualifying for CMV driver? A. Lamictal (Lamotrigine)‐(Antiseizure but Tx Bipolar) B. Welbutrin (Bupropion) C. Antabuse (Disulfiram) D. Calan SR (Verapamil) - correct answer.C
  1. A driver who wears corrective contact lenses has the following uncorrected visual acuity: right eye 20/80, left eye 20/40, both eyes 20/60. He has the following corrected visual acuity: right eye 20/40, left eye 20/20, both eyes 20/40. Which of the following advice should the examiner provide? A. Driver should obtain completed Vision Evaluation Form prior to seeking certification B. Driver should carry a spare pair of contact lenses at all times C. Driver should carry a spare pair of eye glasses at all times D. Driver may drive distances up to 30 miles without corrective lenses since the vision in the better eye is 20/40 - correct answer.C
  2. Vision testing may be performed and certified by which of the following? A. Licensed ophthalmologist B. Licensed optometrist C. Certified medical examiner D. All of the above - correct answer.D
  3. Which of the following is the medical examiner NOT required to ask about during the history? A. Retinopathy B. Cataracts C. Macular degeneration D. Amaurosis fugax - correct answer.D
  4. Which of the following visual acuity charts are acceptable alternatives to the Snellen chart during the CDL medical examination when the driver has limited English‐speaking skills? A. Rosenbaum handheld chart B. Tumbling E chart C. Patti Pics picture chart D. None of the above are acceptable - correct answer.D
  5. To convert International Organization for Standardization (ISO) test results to the ANSI standard, subtract from the ISO test results: A. 14 dB for 500 Hz, 10 dB for 1,000 Hz, and 8.5 dB for 2,000 Hz B. 8.5 dB for 500 Hz, 10 dB for 1,000 Hz, and 14 dB for 2000 Hz C. 10 dB, for each of the following: 500, 1000, and 2000 Hz D. None of the above as the ANSI standard MUST be used - correct answer.A
  6. The driver's corrected visual acuity is: right eye 20/40, left eye 20/80, both eyes 20/40. The examiner should: A. Inform driver of the process to qualify with monocular vision under Alternate Vision Standard B. Refer driver to seek vision exemption C. Qualify the driver since better eye acuity is 20/
  1. The driver was disqualified on the examination date 4/16/2017 due to diagnosis of an benign positional vertigo episode 3/15/2017. He returns to medical examiner for certification exam on 5/20/ and has been asymptomatic since 3/16/2017. He is qualified for two years. What date should be noted as ME certificate expiration? A. 3/11/ B. 3/15/ C. 4/15/ D. 5/20/2019 - correct answer.D
  2. What criteria must be met for the ME to qualify a driver with history of CHF? A. Have a LVEF >50% B. Have no ventricular arrhythmias C. Have no related symptoms D. All of the above - correct answer.D
  3. Which of the following are not allowable, resulting in disqualification of driver? A. Warfarin B. Methadone C. Loratadine D. Paroxetine - correct answer.B
  4. A driver presents for medical certification with history of COPD. His findings suggest need for pulmonary function tests. According to FMCSA, he should be disqualified if his FEV1 is: A. Greater than 65% predicted value B. Less than 65% predicted value C. Less than 85% predicted value D. The FEV1 is not used for this determination - correct answer.B
  5. Which of the following is NOT specifically identified as an indicated assessment during the neurological examination? A. Equilibrium B. Deep tendon reflexes C. Coordination D. Mini Mental Status Exam - correct answer.D
  6. Which of the following may warrant disqualification? A. Excessively antagonistic behavior B. Severe personality disorder C. Severe depression D. All of the above - correct answer.D
  1. A driver checks "yes" for "regular, frequent alcohol use". What should the medical examiner do? A. Disqualify the driver for alcoholism B. Refer the driver to a substance abuse professional C. Encourage the driver to locate a convenient self‐help program D. Ask about the timing and quantity of alcohol intake - correct answer.D
  2. A 22 year old new driver has a history of witnessed febrile seizure at age 5 and was never prescribed anticonvulsant therapy. No further seizures reported after age 5 and his last neurological evaluation was done at age 15 for his teenage driving permit. He has an old negative EEG report. His history and examination are otherwise normal. You should A. Qualify the driver for two years B. Disqualify the driver due to the seizure history C. Refer the driver to FMCSA for a seizure exemption D. Temporarily disqualify pending a full review of medical records - correct answer.A
  3. Following electroconvulsive therapy (ECT) for depression, the FMCSA recommended waiting period is: A. 1 month symptom free B. 3 months symptom free C. 6 months symptom free D. 1 year symptom free - correct answer.C
  4. According to medical guidance, which of the following diagnosed neurological conditions is considered disqualifying? A. Progressive dementia B. Febrile seizures C. Transient ischemia within one year D. Both a and c - correct answer.D
  5. If a driver fails the 5' whisper test, what audiogram threshold levels should the examiner test per the regulation? A. All pure tones, 250 Hz to 8,000 Hz for baseline B. 1,000 Hz, 2,000 Hz, and 3,000 Hz C. 4000 Hz, 6000 Hz, and 8000 Hz D. 500 Hz, 1000 Hz, and 2000 Hz - correct answer.D
  6. A 55 year old CDL driver presents for recertification. Since the last exam 2 years ago, the driver was diagnosed with diabetes and started on metformin 500 mg three times a day. The physical examination was unremarkable. What test does FMCSA require for this exam? A. Glycohemoglobin A1C B. Urinalysis
  1. Jake, a 46 year driver with chronic health issues has a BMI measured at 38. He has hypertension controlled on two medications and returns for yearly exam. Neck size is 18.25" and he responds "yes" to all sleep apnea screening questions. He was advised to get a Sleep Study but he has no insurance as an owner‐ operator. Out of concern for driver and public safety, the medical examiner must: A. Note determination pending until he seeks medical follow‐up B. Disqualify due to his morbid obesity and obvious symptoms of Sleep Apnea C. Certify him one year as his BP is controlled and he does not yet have a diagnosis of SA D. Certify him for 3 months giving him time to find an affordable medical provider - correct answer.A
  2. Which two of the following are FMCSA regulation defined in federal standards and NOT discretionary by the medical examiner? A. Vision and Hypertension B. Loss of limb and Drug Use C. Epilepsy and Hearing D. Diabetes and Alcoholism - correct answer.C
  3. A trucking company sends two drivers for recertification. Driver A is the company supervisor. Both present their current CMV medical card to you where you note the drivers were examined in another state and were issued a 2 year card expiring this day. Driver B does not have his driver's license with him. According to FMCSA regulations, what must the examiner do to confirm identity of the driver? A. Require form of government Identification before examining a driver. B. Allow the Supervisor to sign an affidavit stating the employee has a valid driver's license. C. Do not perform the exam, drivers must present a current state issued driver's license to the examiner. D. Allow the company to fax a copy of Driver B's license, and perform the medical exam, as it's due to expire. - correct answer.A
  4. A driver wears binaural in‐canal hearing aids and has had a restriction to drive with them since his last medical card was issued. In the interest of roadway and driver safety, what must the examiner do to ensure the driver complies with the hearing standard? A. Advise driver not to play the AM‐FM radio while actively driving on the roadway so to avoid missed radio calls B. Remind driver to carry a spare battery for the hearing aids while driving.

C. Ask driver the frequency range of the hearing aids to determine if it interferes with truck communications. D. Perform a whisper test inside the noisy cab to determine if the driver can hear ambient noise. - correct answer.B

  1. A 46 year old female driver has been screened by the medical assistant and is awaiting the physical examination. The urine dipstick revealed 2+ blood. What is the next appropriate step for the medical examiner? A. Review the medical history, inquiring about menses dates, menopausal symptoms. B. Refer the driver to urology for further evaluation C. Inform the driver they cannot be qualified until the urinalysis is normal D. Repeat the urinalysis to check for nitrites and leukocytes - correct answer.A
  2. A driver with a history of mild Traumatic Brain Injury, with no dural penetration and a 20 ‐minute loss of consciousness can be deemed medically qualified to drive if the following conditions are confirmed: A. Seizure free, no neurological deficits and no anticonvulsant medication prescribed B. Only if the EEG is normal and no seizure activity in the past year C. Has no recent neurological deficits and provides current neuropsychological test reports D. Free of all clinical symptoms and passes a mini mental status test during the examination - correct answer.A
  3. Headaches can interfere with driver alertness and concentration. Which of the following headaches would be, in the interest of highway safety and potentially endangering the health and safety of the driver and the public, of grave concern to the examiner and be medically unqualified? A. Migraine headache history treated since puberty, but with recent increase in frequency and intensity. B. History of tension headaches that usually respond to OTC analgesics and quiet rest. C. History of atypical facial pain that is associated with intermittent unilateral vision loss. D. Headache that is associated with myalgia and low grade fever over a period of two days. - correct answer.C
  4. According to FMSCA, the whisper test is sufficient to screen for hearing acuity at what MINIMUM distance? A. 12 FEET B. 15 FEET C. 8 FEET D. 5 FEET - correct answer.D
  5. If the medical examiner questions the Whisper Test hearing acuity at the tested minimum distance, an audiogram is