NRCME Drug Abuse and Alcoholism 5

Question 1

Which of the following best describes the role of the Medical Review Officer (MRO) in DOT drug testing?

Accepted Answer

A licensed physician who reviews positive lab results and contacts the driver to verify alternative medical explanations

Answer

The MRO is a licensed physician who receives lab results, contacts drivers to evaluate legitimate medical explanations, and reports final results to employers.

Question 2

Which physiological effect of alcohol intoxication most directly increases the risk of a CMV accident on a highway?

Accepted Answer

Increased reaction time and impaired divided-attention performance

Answer

Alcohol prolongs reaction time and degrades the ability to simultaneously monitor multiple driving cues, directly increasing collision risk.

Question 3

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?

Accepted Answer

The driver may be certified if the medical examiner determines the condition is well-controlled and poses no driving safety risk

Answer

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.

Question 4

Which cannabinoid is responsible for the psychoactive effects of marijuana and is the primary analyte measured in DOT urine testing?

Accepted Answer

Delta-9-THC metabolite (11-nor-9-carboxy-THC)

Answer

DOT urine drug tests detect 11-nor-9-carboxy-THC (THC-COOH), the primary urinary metabolite of delta-9-THC that indicates marijuana use.

Question 5

Which clinical sign most strongly suggests methamphetamine intoxication in a driver undergoing reasonable suspicion evaluation?

Accepted Answer

Dilated pupils, elevated heart rate, pressured speech, and diaphoresis

Answer

Methamphetamine is a stimulant causing sympathomimetic signs including mydriasis, tachycardia, pressured speech, and sweating.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Drug Abuse and Alcoholism 5