Practice Test GeeksNRCME - National Registry of Certified Medical Examiners Practice Test
← All NRCME Flashcard Decks

Respiratory Health and Sleep Apnea 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 Respiratory Health and Sleep Apnea flashcards as text

  1. A commercial driver reports using a CPAP machine but admits to removing it during the night. What is the most appropriate action for the medical examiner?

    Answer: Request objective CPAP compliance data before certifying

    Objective CPAP data (download showing ≥4 hours/night on ≥70% of nights) is required to verify therapeutic compliance before certification.

  2. Which Apnea-Hypopnea Index (AHI) range classifies obstructive sleep apnea as MODERATE?

    Answer: AHI 15–29 events/hour

    Moderate OSA is defined as an AHI of 15–29 events per hour on polysomnography.

  3. A driver with well-controlled asthma on inhaled corticosteroids reports no exacerbations in the past 12 months and normal spirometry. Which certification is appropriate?

    Answer: Certify for 2 years if clinically stable

    Well-controlled asthma with normal pulmonary function and no recent exacerbations does not preclude 2-year certification.

  4. Which medication used to treat OSA side effects is most likely to impair a commercial driver's alertness?

    Answer: Sedating antihistamines taken at bedtime

    Sedating antihistamines can cause next-day drowsiness and impair driving performance even when taken at bedtime.

  5. During an NRCME physical exam, a driver with a BMI of 40 and neck circumference of 18 inches denies snoring or witnessed apneas. What is the best next step?

    Answer: Perform the Epworth Sleepiness Scale and refer for sleep study if score ≥10

    High BMI and large neck circumference are risk factors for OSA; the ESS and potential referral are warranted regardless of symptom denial.

  6. Which finding on spirometry would most concern a medical examiner regarding a driver's fitness for commercial vehicle operation?

    Answer: FEV1 of 45% predicted

    An FEV1 of 45% predicted indicates severe obstruction and raises significant concern about hypoxic or hypercapnic episodes during driving.

  7. A driver diagnosed with central sleep apnea is treated with adaptive servo-ventilation (ASV). What additional concern must the medical examiner investigate?

    Answer: Whether the driver has underlying heart failure, which is a contraindication to ASV

    ASV is contraindicated in patients with predominant central sleep apnea and reduced ejection fraction heart failure due to increased mortality risk.