Drug Abuse and Alcoholism Flashcards
7 cards from real NRCME practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Drug Abuse and Alcoholism flashcards as text
Which of the following best describes the role of the Medical Review Officer (MRO) in DOT drug testing?
Answer: A licensed physician who reviews positive lab results and contacts the driver to verify alternative medical explanations
The MRO is a licensed physician who receives lab results, contacts drivers to evaluate legitimate medical explanations, and reports final results to employers.
Which physiological effect of alcohol intoxication most directly increases the risk of a CMV accident on a highway?
Answer: Increased reaction time and impaired divided-attention performance
Alcohol prolongs reaction time and degrades the ability to simultaneously monitor multiple driving cues, directly increasing collision risk.
A driver with a past opioid use disorder has been in full sustained remission for 4 years, is no longer on any medications, and has no relapses. What is the FMCSA's stance on certification?
Answer: The driver may be certified if the medical examiner determines the condition is well-controlled and poses no driving safety risk
FMCSA advisory criteria allow certification when a history of substance use disorder is in full remission and the medical examiner determines there is no current safety risk.
Which cannabinoid is responsible for the psychoactive effects of marijuana and is the primary analyte measured in DOT urine testing?
Answer: Delta-9-THC metabolite (11-nor-9-carboxy-THC)
DOT urine drug tests detect 11-nor-9-carboxy-THC (THC-COOH), the primary urinary metabolite of delta-9-THC that indicates marijuana use.
Which clinical sign most strongly suggests methamphetamine intoxication in a driver undergoing reasonable suspicion evaluation?
Answer: Dilated pupils, elevated heart rate, pressured speech, and diaphoresis
Methamphetamine is a stimulant causing sympathomimetic signs including mydriasis, tachycardia, pressured speech, and sweating.
Under 49 CFR Part 382, how many substances are included in the standard DOT urine drug testing panel?
Answer: Five drug classes: marijuana, cocaine, opioids, amphetamines, and phencyclidine
The standard DOT 5-panel urine test covers marijuana (THC), cocaine, opioids, amphetamines/methamphetamine, and phencyclidine (PCP).
A driver discloses that they drink two glasses of wine each night to 'wind down' before sleep. What is the most appropriate medical examiner action?
Answer: Screen further using a validated tool (e.g., AUDIT-C) to assess for alcohol use disorder
Nightly alcohol use warrants structured screening with validated tools like the AUDIT-C to determine whether the pattern meets criteria for alcohol use disorder before making a certification decision.