NRCME Drug Abuse and Alcoholism 3

Question 1

Which substance produces a positive urine immunoassay for opioids and is commonly prescribed for ADHD?

Accepted Answer

Dextromethorphan at high doses, which may cause false-positive opioid screens

Answer

Dextromethorphan (found in many OTC cough preparations) can cause false-positive opioid immunoassay results at high doses.

Question 2

A Substance Abuse Professional (SAP) recommends 'follow-up testing' for a driver who has returned to duty. How long can the employer require this testing?

Accepted Answer

At least 6 tests in the first 12 months, continuing for up to 5 years

Answer

DOT requires at least 6 unannounced follow-up tests within the first 12 months, and the SAP can direct testing for up to 60 months total.

Question 3

Which of the following is a disqualifying condition related to alcohol use under FMCSA medical standards?

Accepted Answer

Current clinical diagnosis of alcoholism

Answer

FMCSA regulations disqualify drivers with a current clinical diagnosis of alcoholism regardless of treatment history.

Question 4

What is the primary pharmacological mechanism by which naltrexone reduces alcohol craving?

Accepted Answer

Opioid receptor blockade, reducing the rewarding effects of alcohol

Answer

Naltrexone blocks mu-opioid receptors, which reduces the euphoric and reinforcing effects of alcohol and decreases craving.

Question 5

A driver's DOT pre-employment urine test is reported as 'dilute negative.' What action is required?

Accepted Answer

The employer may, but is not required to, order an immediate recollection under direct observation

Answer

A dilute negative result permits the employer to require one recollection under direct observation, though this is not mandatory for non-safety-sensitive employers.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Drug Abuse and Alcoholism 3