1.
What is the ME Certificate expiration for this driver?
Stan came in for exam on 2/1/2011 – Disqualified due to diagnosis of benign positional vertigo on 3/10/2011. 4/3/2011– Returns to ME’s office for Certification Exam. (Note: asymptomatic since 3/8/2011 but periodic.) Driver qualified for 2 years.
Correct Answer
A. Expiration date 4/3/2013
Explanation
The driver was qualified for 2 years after the certification exam on 4/3/2011. Therefore, the Medical Examiner Certificate (ME Certificate) would expire 2 years later, on 4/3/2013. The calculation is based on the date the driver was qualified, not the date of the initial disqualification or the earlier exam date.
2.
What is the minimum vision acuity requirement, measured in Snellen fractions, for a commercial driver to pass the DOT vision test?
Correct Answer
A. 20/40
Explanation
20/40: This is the correct answer. In many jurisdictions, the minimum vision acuity requirement for a commercial driver to pass the DOT vision test is 20/40. This means that the driver can see at 20 feet what a person with normal vision can see at 40 feet.
3.
According to medical guidance, a driver can be certified while taking methadone for chronic pain management.
Correct Answer
A. True
Explanation
According to medical guidance and regulations in many countries, a person who is taking methadone for chronic pain management can be certified as fit to drive if they meet certain criteria and are under appropriate medical supervision. The key factors in such cases often include the stability of the patient's condition, compliance with the prescribed methadone regimen, absence of impairment due to medication, and a case-by-case assessment by a healthcare professional. However, it's important to note that the specific rules and regulations related to driving while taking methadone can vary by jurisdiction, so it's essential to consult with a healthcare provider and be aware of local laws and regulations.
4.
A driver with acute or chronic cor pulmonale must meet standards of PaO2 greater than 65 and no dyspnea at rest to be certified.
Correct Answer
B. True
Explanation
To be certified, a driver with acute or chronic cor pulmonale must meet certain standards. They should have a PaO2 level greater than 65, which indicates adequate oxygenation in the blood. Additionally, they should not experience dyspnea, or difficulty breathing, at rest. These criteria ensure that the driver's respiratory function is stable and does not pose a risk while operating a vehicle. Therefore, the statement is true.
5.
Using cardiovascular medical guidance, for each driver, is the driver medically qualified or medically disqualified?Coronary artery bypass graft (CABG) surgery four months ago; echo at three months showed LVEF 55%; driver was cleared by cardiologist and has no chest pain.
Correct Answer
A. Medically Qualified
Explanation
The driver is medically qualified because they underwent CABG surgery four months ago, and their echo at three months showed a left ventricular ejection fraction (LVEF) of 55%. Additionally, the driver has been cleared by a cardiologist and does not experience chest pain. These factors indicate that the driver's cardiovascular health is stable and they are fit to drive.
6.
Who can perform the vision portion of the interstate CMV driver physical examination? Check all that apply.
Correct Answer(s)
A. Medical Examiner
D. Ophthalmologist/Optometrist
Explanation
Both a Medical Examiner and an Ophthalmologist/Optometrist are qualified to perform the vision portion of the interstate CMV driver physical examination. The Medical Examiner assesses general health and vision, while an Ophthalmologist/Optometrist specializes in evaluating visual acuity and detecting eye disorders.
7.
According to regulation, only FMCSA can grant drivers a SPE certificate.
Correct Answer
A. True
Explanation
According to regulation, only the Federal Motor Carrier Safety Administration (FMCSA) has the authority to grant drivers a Special Permit Exemption (SPE) certificate. This means that no other entity or organization has the power to issue these certificates to drivers. Therefore, the statement is true.
8.
Using cardiovascular medical guidance, for each driver, is the driver medically qualified or medically disqualified? Driver with CHF having dyspnea at rest.
Correct Answer
A. Medically Disqualified
Explanation
The driver with CHF (Congestive Heart Failure) experiencing dyspnea (shortness of breath) at rest would be medically disqualified. This is because dyspnea at rest indicates that the individual's heart is not functioning properly, leading to inadequate blood flow and oxygen supply to the body. In such a condition, it would be unsafe for the driver to operate a vehicle as it could potentially lead to a medical emergency or loss of consciousness while driving, endangering both the driver and others on the road.
9.
According to regulation, 3 years is the maximum certification period when medical certification must be accompanied by a SPE certificate?
Correct Answer
B. False
Explanation
The given answer "False" is correct because according to the regulation, a medical certification must be accompanied by a Special Purpose Examination (SPE) certificate every 6 years, not 3 years. Therefore, the statement that 3 years is the maximum certification period when medical certification must be accompanied by an SPE certificate is incorrect.
10.
Which of the following is a requirement for becoming a certified DOT Medical Examiner?
Correct Answer
C. Attending a training course provided by the Federal Motor Carrier Safety Administration (FMCSA)
Explanation
To become a certified DOT Medical Examiner, healthcare professionals must attend a training course provided by the Federal Motor Carrier Safety Administration (FMCSA) and pass an examination based on the DOT's regulations and guidelines. This certification allows them to perform medical examinations for commercial motor vehicle (CMV) drivers in accordance with DOT regulations.
11.
What is the purpose of the Interstate CMV driver physical examination?
Correct Answer
A. The purpose of the CMV exam is to detect the presence of physical, mental, or organic conditions of such character & extent as to affect driver ability to operate a CMV safely
Explanation
The purpose of the Interstate CMV driver physical examination is to identify any physical, mental, or organic conditions that could potentially impact a driver's ability to safely operate a commercial motor vehicle (CMV). This examination aims to ensure that drivers are in good health and do not have any conditions that could pose a risk to themselves or others on the road. By detecting any conditions that could affect driver ability, the examination helps to maintain the safety of CMV operations.
12.
What is the mission of FMCSA?
Correct Answer
B. The FMCSA is focused on reducing crashes, injuries & fatalities involving large trucks & buses.
Explanation
The mission of FMCSA is to reduce crashes, injuries, and fatalities involving large trucks and buses. This means that their main goal is to improve the safety of commercial vehicles on the road and protect both drivers and passengers from accidents and harm. They likely achieve this by implementing and enforcing regulations, conducting inspections and audits, and promoting safety education and awareness among drivers and companies in the industry.
13.
Using cardiovascular medical guidance, for each driver, is the driver medically qualified or medically disqualified? Driver has recently had increasing angina which lasted 20 minutes after tarping a load; he or she is unresponsive to nitroglycerin.
Correct Answer
B. Medically Disqualified
Explanation
The driver is medically disqualified because they have recently experienced increasing angina, which is a symptom of reduced blood flow to the heart. The fact that the angina lasted for 20 minutes after tarping a load indicates that it was a significant episode. Additionally, the driver's lack of response to nitroglycerin suggests that their condition is not easily managed or controlled. Therefore, based on cardiovascular medical guidance, the driver is considered medically disqualified.
14.
- Who and what does FMCSA regulate?
Correct Answer
A. The FMCSA regulates interstate commercial operation, including driver, vehicle, motor carrier, & transport of hazardous materials.
Explanation
The FMCSA, or Federal Motor Carrier Safety Administration, regulates interstate commercial operation, which includes overseeing the drivers, vehicles, motor carriers, and the transportation of hazardous materials. This regulation is in place to ensure the safety and compliance of these operations, protecting both the drivers and the public from any potential risks or accidents. The statement about the FMCSA regulating pilots, aircraft carriers, and safety airline employees is incorrect and not mentioned in the given information.
15.
What eye conditions must the medical examiner ask the driver about and if indicated request specialist evaluation? Select all that apply.
Correct Answer(s)
A. Glaucoma
B. Retinopathy
C. Aaphakia
D. Macular degeneration
E. Cataracts
Explanation
The medical examiner must ask the driver about and request specialist evaluation for all of the above eye conditions, including glaucoma, retinopathy, aaphakia, macular degeneration, and cataracts. This suggests that these conditions are important to consider when assessing a driver's ability to safely operate a vehicle.
16.
Does this driver meet hearing standards for interstate CMV driver certification? Whisper test results | Rt. Ear: 4 Feet | Lt. Ear: 4 Feet.
Correct Answer
B. No minimum distance in one ear must be 5 ft
Explanation
The correct answer is "No minimum distance in one ear must be 5 ft." This means that for the driver to meet hearing standards for interstate CMV driver certification, there should be no ear with a minimum distance less than 5 ft. The given whisper test results show that both ears have a distance of 4 ft, which does not meet the requirement of having a minimum distance of 5 ft in at least one ear. Therefore, the driver does not meet the hearing standards for certification.
17.
The recommended certification interval for a driver with diabetes mellitus who does not use insulin 1 year.
Correct Answer
B. False
Explanation
For drivers with diabetes mellitus who do not use insulin, the recommended certification interval is typically up to 2 years, not 1 year, provided they are well-controlled and have no disqualifying complications related to their diabetes. Certification intervals may vary depending on the individual's health condition and the medical examiner's assessment, but 2 years is the usual recommendation for those managing diabetes without insulin. If the driver uses insulin or has other medical complications, a shorter interval, such as 1 year, may be required.
18.
- Give some examples of CMV driver stress factors. (Choose all that apply)
Correct Answer(s)
A. Interruption of normal sleep, exercise, & eating patterns
B. Limited access to social support networks resulting in fatigue
C. Environment that may have excessive vibration, noise, & extremes temperature
Explanation
CMV (Commercial Motor Vehicle) drivers may experience stress due to factors such as disrupted sleep, exercise, and eating patterns caused by demanding schedules, limited access to social support networks leading to isolation and fatigue, and challenging working environments with excessive vibration, noise, and temperature extremes. These stress factors are common in the profession and can impact the well-being of CMV drivers. Obesity, without a health program, is not directly considered a CMV driver stress factor but can be a health concern for some drivers.
19.
Hypoglycemia is the greatest diabetes mellitus risk posing the greatest threat to public safety.
Correct Answer
A. True
Explanation
Hypoglycemia, which refers to low blood sugar levels, is indeed a significant risk for individuals with diabetes mellitus. When blood sugar levels drop too low, it can lead to various symptoms such as confusion, dizziness, and even loss of consciousness. If left untreated, severe hypoglycemia can be life-threatening. Therefore, it poses a significant threat to public safety, especially for those with diabetes. Hence, the statement "Hypoglycemia is the greatest diabetes mellitus risk posing the greatest threat to public safety" is true.
20.
What would the medical examiner do next if a significant abnormal finding for urinalysis specific gravity, protein, and blood is found?
Correct Answer
C. Medical examiners use their clinical knowledge to decide if referral is needed for further evaluation
Explanation
When a significant abnormal finding for urinalysis specific gravity, protein, and blood is found, the medical examiner would use their clinical knowledge to determine if further evaluation is necessary. This may include referring the driver to a specialist or conducting additional tests to investigate the abnormal findings. Conducting a drug test on the driver or certifying them regardless of the abnormal findings would not be appropriate actions in this situation.
21.
What is ME certificate expiration date for this driver? Joe came in for exam on 2/1/2011 – met standards in 49 CFR 391.41; qualifies for 2 year certificate.
Correct Answer
B. Expiration date 2/1/2013
Explanation
The ME certificate expiration date for this driver is 2/1/2013. Joe came in for an exam on 2/1/2011 and met the standards in 49 CFR 391.41, which qualifies him for a 2-year certificate. Since the exam was conducted on 2/1/2011, the expiration date would be 2/1/2013, which is two years from the date of the exam.
22.
According to medical guidelines, what are three areas of risk when a driver has a mental disorder? Check all that apply.
Correct Answer(s)
A. Symptoms of the disease itself
B. Recurrence of the disease
C. Side effects from the medications
Explanation
When a driver has a mental disorder, there are three areas of risk according to medical guidelines. Firstly, symptoms of the disease itself can pose a risk as they may impair the driver's ability to operate a vehicle safely. Secondly, there is a risk of the disease recurring, which can lead to sudden changes in behavior or cognition while driving. Lastly, side effects from the medications used to treat the mental disorder can also impact driving ability, causing drowsiness, dizziness, or other impairments.
23.
What is the expiration date for this driver? Pat came in for exam on 2/1/2011 – met standards but periodic monitoring required due to hypertension – driver qualified 1 year.
Correct Answer
A. Expiration date 2/1/2012
Explanation
The expiration date for this driver is 2/1/2012 because the driver qualified for 1 year on 2/1/2011.
24.
A driver takes diphenhydramine (Benadryl), 25 mg, two or three times per day, to treat nasal congestion. A medical examiner should warn the driver that they must be off antihistamines 12 hr before driving.
Correct Answer
A. True
Explanation
Diphenhydramine is an antihistamine that can cause drowsiness as a side effect. Taking this medication multiple times a day can increase the likelihood of drowsiness, which can impair driving abilities and increase the risk of accidents. Therefore, it is recommended for a medical examiner to warn the driver to be off antihistamines for 12 hours before driving to ensure their safety on the road.
25.
According to medical guidance, a driver can be certified if he/she is taking amitriptyline for depression even without approval from a physician.
Correct Answer
B. False
Explanation
Answer: Should not be certified unless has permission from the doctor as to the safety of the medicine
26.
Which of the following conditions would most likely disqualify a commercial driver from obtaining a DOT Medical Examiner's Certificate?
Correct Answer
C. Severe obstructive sleep apnea
Explanation
Severe obstructive sleep apnea can disqualify a commercial driver from obtaining a DOT Medical Examiner's Certificate because it poses significant risks, including excessive daytime sleepiness and increased likelihood of accidents. If untreated or inadequately managed, sleep apnea impairs alertness and reaction times, crucial for safe driving. In contrast, conditions like controlled hypertension and well-managed diabetes, if under control, typically do not disqualify a driver.
27.
Can an interstate CMV driver who has had an acute myocardial infarction (AMI) be qualified to drive?
Correct Answer
C. Yes, if AMI was at least 2 mos ago and driver meets all requirements
Explanation
An acute myocardial infarction (AMI), commonly known as a heart attack, can have serious implications for a person's ability to drive safely. However, if the AMI occurred at least two months ago and the driver meets all other requirements, they can be qualified to drive. This suggests that there is a period of recovery and evaluation that needs to be completed before the driver can be considered fit to drive again. It is important to note that this answer assumes that the driver has undergone appropriate medical evaluations and has been deemed fit to drive by healthcare professionals.
28.
The examiner notices that the driver has marked that he has asthma and lists an albuterol [Proventil, Ventolin] inhaler among his medications. On questioning, the driver admits to using it several times a day, especially during the spring and fall; he admits that he has not seen his primary care physician in several years but is still getting frequent refills on his inhaler. The driver also admits that he has been hospitalized twice in the last six months for his asthma, ending up on a ventilator on the last visit. Should the medical examiner certify the driver, if so, for how long?
Correct Answer
A. Do not certify but refer to a primary care physician (PCP) or pulmonary specialist
48. Answer: Do not certify but refer to PCP or pulmonary specialist
Explanation
The driver's admission of using the albuterol inhaler several times a day, being hospitalized twice in the last six months, and needing a ventilator on the last visit indicates that his asthma is not well-controlled. The fact that he has not seen his primary care physician in several years but continues to get frequent refills on his inhaler suggests that he is not receiving proper medical supervision and treatment. Therefore, the medical examiner should not certify the driver and instead refer him to a primary care physician or pulmonary specialist for further evaluation and management of his asthma.
29.
What are the differences between the medical standards and the medical guidelines? The regulations are law and are mandatory. The medical examiner must use the standards found in 49 CFR 391.41 to determine interstate CMV driver medical fitness for duty.
Correct Answer
A. True
Explanation
The given answer is true because the statement mentions that the medical examiner must use the standards found in 49 CFR 391.41 to determine interstate CMV driver medical fitness for duty. This indicates that the medical standards are mandatory and must be followed by medical examiners. Therefore, the answer is true.
30.
The driver provides the medical examiner with a copy of records, including a cardiologist’s report indicating a diagnosis of congestive heart failure and that the driver’s ejection fraction is 38%. Can the driver be certified?
Correct Answer
A. No, the EF must be at least 40% to certify the driver
Explanation
The driver cannot be certified because the ejection fraction (EF) must be at least 40% to certify the driver. In this case, the driver's EF is only 38%, which does not meet the minimum requirement.
31.
A commercial driver with a history of insulin-treated diabetes mellitus is automatically disqualified from obtaining a DOT medical card.
Correct Answer
B. False
Explanation
While insulin-treated diabetes was previously a disqualifying condition, recent regulatory changes allow for some drivers with well-controlled insulin-treated diabetes to obtain a DOT medical card, provided they meet specific criteria and receive an exemption.
32.
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 forced vital capacity. Can this driver be certified? If not, when can the driver be certified?
Correct Answer
B. Do not certify until complete resolution of pneumothorax on chest x-ray and FVC greater or equal to 65%
Explanation
The driver cannot be certified until there is complete resolution of the pneumothorax on a chest x-ray and their forced vital capacity (FVC) is greater than or equal to 65% of the predicted forced vital capacity. This is because a pneumothorax can significantly reduce lung function, and it is important to ensure that the condition has resolved and lung function has returned to an acceptable level before certifying the driver.
33.
What does the term "DOT" refer to in the context of the "DOT Medical Examiner Certification Practice Test"?
Correct Answer
B. Department of Transportation
Explanation
In the context of the "DOT Medical Examiner Certification Practice Test," "DOT" stands for the Department of Transportation. This test is related to the certification process for medical examiners conducted by the Department of Transportation.
34.
Using current FMCSA guidelines, what is the proper determination for an interstate CMV driver, with a diagnosis of hypertension, who presents with a confirmed blood pressure of 182/112?
Correct Answer
B. A driver with Stage 3 hypertension should be immediately disqualified until BP is less than 140/90
Explanation
According to current FMCSA guidelines, a driver with Stage 3 hypertension, as indicated by a confirmed blood pressure of 182/112, should be immediately disqualified until their blood pressure is less than 140/90. This means that the driver is not fit to operate a CMV until their blood pressure is within the acceptable range to ensure their safety and the safety of others on the road.
35.
- According to regulation, Epilepsy is a neurological condition is medically disqualifying for the interstate CMV driver certification?
-
Correct Answer
A. True
Explanation
Epilepsy is a neurological condition that can cause seizures, loss of consciousness, and other impairments that can be dangerous for a commercial motor vehicle (CMV) driver. Due to the potential risks and safety concerns, regulations state that individuals with epilepsy are medically disqualified for interstate CMV driver certification. Therefore, the correct answer is true.
36.
According to medical guidance, for which of the following diagnosed neurological conditions is the driver considered medically unqualified for driving?
A. Febrile seizure.
B. Dementia (severe)
C. Dementia (metabolic)
D. Transient ischemic attacks (within one year)
E. Transient ischemic attacks (greater than one year ago)
Correct Answer
B. B & D
Explanation
These conditions can significantly impair a person's ability to drive safely and may pose a danger to themselves and others on the road. It's important for individuals with these medical conditions to follow medical advice and regulations regarding driving restrictions or qualifications.
37.
A commercial motor vehicle (CMV) driver has been diagnosed with stage 1 hypertension. According to DOT regulations, what is the maximum duration for which the medical examiner can issue a certificate before a re-evaluation of the driver's blood pressure is required?
Correct Answer
A. 1 year
Explanation
DOT regulations stipulate that a driver with stage 1 hypertension (blood pressure reading 140-159/90-99 mmHg) can be medically certified to drive for a one-year period from the date of the examination. The driver should undergo blood pressure re-evaluation after this period. If the hypertension progresses or is not under control, certification intervals may change based on the medical examiner's discretion and DOT guidelines.
38.
A driver is taking levodopa/carbidopa (Sinemet) Levodopa/carbidopa may cause the driver to be disqualified because it is used for the treatment of Parkinsonism.
Correct Answer
A. False
Explanation
Levodopa/carbidopa (Sinemet) is used for the treatment of Parkinsonism. However, taking this medication does not automatically disqualify a driver. The decision to disqualify a driver depends on the individual's specific health condition and how well the symptoms are managed, rather than the use of the medication itself. It's essential for drivers to be evaluated by a healthcare professional to determine their fitness to drive.
39.
When evaluating a driver with a psychological disorder that might interfere with safe operation of a CMV, what behaviors should an examiner look for? Check all that apply
Correct Answer(s)
B. Any suspicious, evasive, threatening, or hostile behaviors
C. Signs of flat affect or lack or emotional response
E. Displays of unusual or bizarre ideas, auditory or visual hallucinations, dishonesty
Explanation
When evaluating a driver with a psychological disorder that might interfere with safe operation of a CMV, the examiner should look for any suspicious, evasive, threatening, or hostile behaviors. These behaviors could indicate potential issues with anger management or aggression that could pose a risk on the road. Additionally, signs of flat affect or lack of emotional response should be observed, as this could indicate a lack of emotional regulation or an inability to appropriately respond to stressful situations. Displays of unusual or bizarre ideas, auditory or visual hallucinations, and dishonesty are also red flags that suggest the presence of a psychological disorder that could impact safe driving.
40.
Ms. Miller’s left arm has mild symptoms and is weaker than the right. At what level of left arm strength would the medical examiner certify Ms. Miller, using the provisions of alternate standard 49 CFR 391.49, which would require Ms. Miller to obtain a Skill Performance Evaluation (SPE) certificate?
Correct Answer
B. 40% or lower strength compared to the right arm.
Explanation
According to the provisions of alternate standard 49 CFR 391.49, a Skill Performance Evaluation (SPE) certificate is typically required when an individual's left arm strength falls to 40% or lower compared to the right arm. This is an important criterion for determining the need for an SPE certificate.
41.
The Medical Examiner can as for an alcohol or drug test during a CMV driver exam if the Examiner is suspicious that the driver is abusing drugs or alcohol.
Correct Answer
A. True
Explanation
During a Commercial Motor Vehicle (CMV) driver examination, if the Medical Examiner suspects that the driver is abusing drugs or alcohol based on observable signs, symptoms, or behaviors, they have the authority to request or require an alcohol or drug test. This is part of ensuring that all CMV drivers meet the necessary physical and medical standards to operate commercial vehicles safely, as substance abuse can significantly impair a driver's ability to perform safely on the road.
42.
Using current FMCSA guidelines, what is the maximum period of certification for a driver disqualified for Stage 3 hypertension, but who has, at the certification examination, a blood pressure less than 140/90?
Correct Answer
A. 6 months if no side effects from treatment
Explanation
According to current FMCSA guidelines, a driver disqualified for Stage 3 hypertension can be certified for a maximum period of 6 months if they have no side effects from treatment. This means that if the driver's blood pressure is less than 140/90 at the certification examination and they have no side effects from treatment, they can be certified for a period of 6 months.
43.
Using cardiovascular medical guidance, for each driver, is the driver medically qualified or medically disqualified?Driver with percutaneous coronary intervention (PCI) nine months ago; he or she has not followed up with cardiologist and has not had exercise tolerance test (ETT) since procedure.
Correct Answer
B. Medically Disqualified
Explanation
Answer: Medically disqualified. According to current CVD recommendations, the driver who had PCI should have cardiology follow-up to include ETT three to six months post-PCI.
44.
The Advisory Criteria for “Drug Use” definition of “habit forming” is defined as and includes any drug or medication generally recognized as becoming habitual; and which may impair the user’s ability to operate a CMV safely.
Correct Answer
A. True
Explanation
The given statement is true. According to the Advisory Criteria for "Drug Use" definition, a drug or medication is considered "habit forming" if it is generally recognized as becoming habitual and if it may impair the user's ability to operate a CMV (Commercial Motor Vehicle) safely. This means that any drug or medication that meets these criteria can be classified as habit forming and may pose a risk to the safe operation of a CMV.
45.
A CMV driver with a diagnosis of hypertension presents with a BLOOD PRESSURE of 182/112. This is Stage ____.
Correct Answer
C. 3
Explanation
A CMV driver with a blood pressure reading of 182/112 is classified as Stage 3 hypertension. Stage 3 hypertension is characterized by a systolic blood pressure reading of 180 or higher and a diastolic blood pressure reading of 110 or higher. This level of hypertension is considered severe and requires immediate medical attention and treatment to prevent further complications.