NRCME Hypertension Guidelines 2

Question 1

Under FMCSA regulations, a commercial driver with a blood pressure reading of 160/100 mmHg at the time of examination should be:

Accepted Answer

Certified for 1 year with follow-up required

Answer

Stage 2 hypertension (160-179/100-109 mmHg) permits a one-time certification of up to 12 months, requiring treatment and follow-up to confirm BP control.

Question 2

A CME is examining a driver taking a thiazide diuretic for hypertension. Which side effect is most relevant to commercial driving safety?

Accepted Answer

Hypokalemia causing muscle weakness or cramps

Answer

Thiazide diuretics can cause hypokalemia leading to muscle weakness, cramps, and fatigue, all of which can impair a driver's ability to safely operate a commercial vehicle.

Question 3

Which blood pressure threshold constitutes Stage 3 (severe) hypertension requiring disqualification under FMCSA guidelines?

Accepted Answer

≥180 systolic or ≥110 diastolic

Answer

Blood pressure of 180/110 mmHg or higher is Stage 3 hypertension and disqualifies a driver from certification until it is treated and confirmed below that threshold.

Question 4

A driver on beta-blocker therapy reports dizziness when standing quickly. This symptom most likely represents:

Accepted Answer

Orthostatic hypotension

Answer

Beta-blockers can reduce cardiac output and blunt compensatory reflexes, causing orthostatic hypotension with positional dizziness that may impair driving.

Question 5

When a driver's BP is confirmed at 179/109 mmHg after two separate readings, the FMCSA guidance recommends:

Accepted Answer

One-time certificate up to 12 months with treatment initiated

Answer

Stage 2 hypertension (160-179/100-109) allows a single 12-month certificate to allow time for treatment and BP reduction before re-evaluation.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Hypertension Guidelines 2