Free NRCME Medical Conditions and Guidelines Questions and Answers — Questions and Answers
Question 1: When conducting a vision examination, a driver must have at least what distant visual acuity in each eye with or without correction?
- 20/60
- 20/40 (Correct answer)
- 20/20
- 20/10
Correct answer: 20/40
Explanation: <br> The driver must have at least 20/40 distant visual acuity in each eye with or without correction. 20/20 and 20/10 are higher standards than necessary. Lastly, 20/60 is not a high enough acuity standard.
Question 2: All but which of the following are respiratory conditions that interfere with oxygen exchange and could result in gradual or sudden incapacitation?
- Carcinoma
- Chronic bronchitis
- Mitral regurgitation (Correct answer)
- Asthma
Correct answer: Mitral regurgitation
Explanation: <br> Asthma, carcinoma, and chronic bronchitis are all respiratory conditions that interfere with oxygen exchange and could result in gradual or sudden incapacitation. Mitral regurgitation is actually a heart condition, not a respiratory condition.
Question 3: Which of the following colors is not necessary to be able to distinguish and recognize in traffic signals and devices?
- Red
- Amber
- Blue (Correct answer)
- Green
Correct answer: Blue
Explanation: <br> Due to specifically the colors of a stoplight and most road signs, it is necessary for a driver to be able to recognize the colors amber, red, and green. Blue is not a necessary color to recognize in traffic signals and devices.
Question 4: An implantable cardioverter-defibrillator is:
- A type of arrhythmia that is usually not considered a risk for sudden death
- An implantable device designed to treat bradycardia
- A type of arrhythmia categorized as ventricular fibrillation and ventricular tachycardia and is responsible for the majority of instances of cardiac sudden death
- An electronic device that treats cardiac arrest, ventricular fibrillation, and ventricular tachycardia through the delivery of rapid-pacing stimuli or shock therapy (Correct answer)
Correct answer: An electronic device that treats cardiac arrest, ventricular fibrillation, and ventricular tachycardia through the delivery of rapid-pacing stimuli or shock therapy
Explanation: <br> An implantable cardioverter-defibrillator is An electronic device that treats cardiac arrest, ventricular fibrillation, and ventricular tachycardia through the delivery of rapid-pacing stimuli or shock therapy. A pacemaker is an implantable device designed to treat bradycardia. Also, supraventricular tachycardia is a type of arrhythmia that is usually not considered a risk for sudden death. Lastly, ventricular arrhythmia is a type of arrhythmia categorized as ventricular fibrillation and ventricular tachycardia and is responsible for the majority of instances of sudden cardiac death.
Question 5: Which of the following is not true about the risk of headaches?
- Most headaches, vertigo, and dizziness are consequential, causing danger for drivers that experience such conditions (Correct answer)
- Headache and chronic "nagging" pain may be present to such a degree that certification for driving is inadvisable
- Medication used to treat headaches may further interfere with safe driving
- Disorders with incapacitating symptoms, even if periodic or in the early stages of the disease, warrant the decision to not certify the driver
Correct answer: Most headaches, vertigo, and dizziness are consequential, causing danger for drivers that experience such conditions
Explanation: <br> The symptoms of headaches, vertigo, and dizziness are typically inconsequential, but they still constitute a problem for a driver. Headache and chronic “nagging” pain may be present to such a degree that certification for driving is inadvisable. Also, medication used to treat headaches may further interfere with safe driving. Lastly, disorders with incapacitating symptoms, even if periodic or in the early stages of disease, warrant the decision to not certify the driver.
Question 6: Which of the following is a medical examiner required to inquire about from a driver with diabetes mellitus?
- If the driver has glycosuria (Correct answer)
- If the driver carries rescue glucose while driving
- If the driver routinely monitors his or her blood glucose level
- If the driver uses incretin mimetic
Correct answer: If the driver has glycosuria
Explanation: <br> While all of the questions are recommended to ask, the only question that is necessary is to see if the driver has glycosuria (dip stick urinalysis). It is recommended, though, to ask about carrying rescue glucose while driving, using incretin mimetic, and routinely monitoring his or her blood glucose level.
Question 7: Which of the following is true in regard to an implantable cardioverter-defibrillator?
- Combination ICD/pacemaker devices are also effective in preventing incapacitation cardiac and arrhythmia events
- Management of the underlying disease is effective enough for the driver to meet cardiovascular qualification requirements
- ICDs treat and prevent arrhythmias
- Drivers are at a risk for syncope (Correct answer)
Correct answer: Drivers are at a risk for syncope
Explanation: <br> ICDs do treat arrhythmias, but they do not prevent them. So, the driver remains at risk for syncope. The management of the underlying disease is in fact not effective enough for the driver to meet cardiovascular qualification requirement. Lastly, combination ICD/pacemaker devices are also ineffective in preventing incapacitation of cardiac and arrhythmia events.
Question 8: If a medical examiner uses the number 1 during the physical examination, the medical examiner is indicating which of the following parts of the body system?
- Abdomen and viscera
- Heart
- Ears
- General Appearance (Correct answer)
Correct answer: General Appearance
Explanation: <br> 1 refers to General Appearance, 3 refers to Ears, 5 refers to Heart, and 7 refers to Abdomen and viscera.
Question 9: Which of the following is not a concern that predisposes commercial drivers to an increased risk of cardiovascular disease?
- Obesity and a sedentary lifestyle increase the risk of such a disease
- Exposed to environmental stressors that are detrimental to the cardiovascular system
- Long hours and rotating work schedules (Correct answer)
- Driving stressors can lead to increased neurosympathetic and adrenocortical catecholamine and cortisol release
Correct answer: Long hours and rotating work schedules
Explanation: <br> Obesity and a sedentary lifestyle increase the risk of cardiovascular diseases. Driving stressors can lead to increased neurosympathetic and adrenocortical catecholamine and cortisol release. Also, exposed to environmental stressors that are detrimental to the cardiovascular system. However, the long hours and rotating work schedules do not predispose a driver to increased risks of cardiovascular disease.
Question 10: Types of vertigo and dizziness with incapacitating symptoms can interfere with all but which of the following?
- Judgment
- Concentration
- Cognitive abilities
- Staying awake (Correct answer)
Correct answer: Staying awake
Explanation: <br> Types of vertigo and dizziness with incapacitating symptoms interfere with cognitive abilities, judgment, attention, concentration, and sensory or motor functions. However, it does not necessarily interfere with staying awake.
Question 11: Which of the following is not true in regard to antidepressant therapy?
- Second-generation antidepressants, including fluoxetine and venlafaxine, have fewer side effects than first-generation antidepressants and are generally safe
- Guidelines recommend a case-by-case assessment of drivers treated with antidepressant medication
- With long-term use of antidepressants, most drivers never develop a tolerance to the sedative effects (Correct answer)
- First-generation antidepressants, which include tricyclics such as amitriptyline and imipramine, have consistently been shown to interfere with safe driving
Correct answer: With long-term use of antidepressants, most drivers never develop a tolerance to the sedative effects
Explanation: <br> Guidelines recommend a case-by-case assessment of drivers treated with antidepressant medication. With long-term use of antidepressants, most drivers tend to develop a tolerance to the sedative effects. First-generation antidepressants, which include tricyclics such as amitriptyline and imipramine, have consistently been shown to interfere with safe driving. Lastly, second-generation antidepressants, including fluoxetine and venlafaxine, have fewer side effects and are generally safe.
Free NRCME Medical Conditions and Guidelines Questions and Answers
When conducting a vision examination, a driver must have at least what distant visual acuity in each eye with or without correction?