NRCME - National Registry of Certified Medical Examiners Hypertension Guidelines Questions and Answers

Question 1

A commercial driver presents for a recertification exam. His blood pressure is measured at 164/102 mmHg. He has a history of Stage 1 hypertension and has been on medication for the past year. According to FMCSA guidelines, what is the most appropriate action for the medical examiner to take?

Accepted Answer

Issue a one-time 3-month certificate and advise him to follow up with his primary care provider.

Answer

The driver's blood pressure falls into the Stage 2 hypertension range (160-179/100-109 mmHg). For a driver with Stage 2 hypertension, the examiner should issue a one-time, 3-month certificate to allow the driver to seek treatment to lower their blood pressure to 140/90 mmHg or less.

Question 2

A 52-year-old driver is found to have a blood pressure of 182/114 mmHg during his initial DOT physical exam. Which of the following is the correct determination?

Accepted Answer

Disqualify the driver.

Answer

A blood pressure reading at or above 180/110 mmHg is considered Stage 3 hypertension. According to FMCSA guidelines, a driver with Stage 3 hypertension must be medically disqualified. The driver cannot be certified, even for a short period, until their blood pressure is reduced to 140/90 mmHg or less and the treatment is well-tolerated.

Question 3

A driver was disqualified for Stage 3 hypertension. He returns to your office two months later, and his blood pressure is now 138/88 mmHg with treatment. What is the maximum certification period for which this driver is now eligible?

Accepted Answer

6 months

Answer

After a driver has been disqualified for Stage 3 hypertension (BP ≥ 180/110 mmHg), once their blood pressure is reduced to 140/90 mmHg or less and treatment is well tolerated, they may be certified for a maximum of 6 months. Recertification is required every 6 months thereafter.

Question 4

A new applicant for a commercial driver's license has a blood pressure of 148/94 mmHg on their first examination. The driver is not on any antihypertensive medication. What is the appropriate certification period?

Accepted Answer

1 year

Answer

This blood pressure reading (140-159/90-99 mmHg) is classified as Stage 1 hypertension. For a first-time finding of Stage 1 hypertension, the driver may be certified for a maximum of one year.

Question 5

Which of the following blood pressure readings allows for a 2-year medical certification, assuming the driver has no other disqualifying conditions and is not on any antihypertensive medication?

Accepted Answer

136/84 mmHg

Answer

To qualify for a 2-year medical certificate, a driver must have a blood pressure reading of less than 140/90 mmHg and not be on medication for hypertension. A reading of 136/84 mmHg meets these criteria. The other readings are either at or above the 140/90 mmHg threshold.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Hypertension Guidelines Questions and Answers