NRCME Hypertension Guidelines 3

Question 1

A driver with documented white-coat hypertension consistently shows BP of 155/95 in the clinic but 125/80 on ambulatory monitoring. What should the CME do?

Accepted Answer

Consider ambulatory or home readings in the clinical evaluation

Answer

CMEs may consider validated ambulatory or home BP monitoring data to differentiate white-coat hypertension from true sustained hypertension in clinical decision-making.

Question 2

Under FMCSA hypertension guidelines, a driver with BP controlled to 130/82 mmHg on medication who was previously Stage 2 should receive a certificate of:

Accepted Answer

Up to 12 months to ensure ongoing control

Answer

A driver previously identified as Stage 2 hypertension who achieves controlled BP on medication may be certified for up to one year to confirm sustained control.

Question 3

Which of the following cardiovascular complications of hypertension would most directly disqualify a commercial driver?

Accepted Answer

Hypertensive retinopathy with visual field defects

Answer

Hypertensive retinopathy causing visual field defects directly impairs vision, which is a disqualifying condition under FMCSA standards for commercial drivers.

Question 4

A driver reports taking amlodipine for hypertension and notes ankle swelling. What is the most important safety consideration for the CME?

Accepted Answer

Confirm the swelling is not from cardiac or renal disease before certifying

Answer

Peripheral edema from amlodipine (calcium channel blocker) is usually benign, but the CME must rule out heart failure or renal disease, which may affect driver fitness.

Question 5

How many separate BP measurements should a CME take before documenting the final reading, per best clinical practice?

Accepted Answer

Two readings at least 1 minute apart, using the average

Answer

Best practice is to take at least two readings separated by at least one minute and use the average to reduce measurement variability.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Hypertension Guidelines 3