NRCME Neurological Disorders Evaluation 3

Question 1

A driver had a transient ischemic attack (TIA) 4 months ago with full neurological recovery. What is the minimum waiting period before recertification as a CMV driver per FMCSA guidelines?

Accepted Answer

At least 1 year symptom-free after TIA

Answer

FMCSA guidance recommends a minimum 1-year waiting period after a TIA before recertification, with neurological clearance confirming no residual deficits.

Question 2

Which of the following best characterizes narcolepsy in the context of FMCSA medical certification?

Accepted Answer

Disqualifying condition regardless of treatment

Answer

Narcolepsy is considered a disqualifying condition for CMV drivers under FMCSA regulations due to unpredictable sleep attacks and cataplexy that cannot be reliably prevented.

Question 3

During neurological evaluation of a CMV driver, the Romberg test is performed. A positive Romberg sign (marked sway with eyes closed) is most indicative of:

Accepted Answer

Proprioceptive or posterior column dysfunction

Answer

A positive Romberg sign indicates loss of proprioceptive input, reflecting posterior column dysfunction, as the patient can compensate with visual input but not without it.

Question 4

A driver with well-controlled multiple sclerosis (MS) in remission for 3 years is applying for CMV certification. The examiner should:

Accepted Answer

Evaluate current neurological function and certify only if no disqualifying deficits are present

Answer

MS is not an automatic disqualifier; the examiner must assess current functional status, and if no disqualifying deficits exist, certification may be granted with appropriate follow-up.

Question 5

Which medication used for migraine prophylaxis is most likely to cause side effects that could impair driving performance and should be discussed during NRCME evaluation?

Accepted Answer

Topiramate (cognitive slowing, word-finding difficulty)

Answer

Topiramate is associated with cognitive slowing and word-finding difficulties that can impair driving, requiring careful assessment during CMV medical evaluation.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Neurological Disorders Evaluation 3