NRCME Neurological Disorders Evaluation 4

Question 1

A driver with a history of traumatic brain injury (TBI) 18 months ago reports no seizures and has returned to work in a non-driving capacity. What factor is MOST important for the NRCME examiner to assess?

Accepted Answer

Severity of initial injury and current neurological function including cognitive status

Answer

Current neurological function and severity of initial TBI determine residual risk; post-TBI seizure risk, cognitive deficits, and reaction time must all be evaluated.

Question 2

Which of the following neurological findings would be considered an absolute disqualifying condition for CMV certification under FMCSA standards?

Accepted Answer

Current diagnosis of epilepsy with breakthrough seizure in the past year

Answer

A current diagnosis of epilepsy with a breakthrough seizure within the past year is disqualifying under FMCSA regulations regardless of antiepileptic treatment.

Question 3

During evaluation of a CMV driver candidate, the examiner notes an absent corneal reflex on one side. This finding suggests involvement of which cranial nerve?

Accepted Answer

Both CN V (afferent) and CN VII (efferent) — loss of either can abolish the reflex

Answer

The corneal reflex requires intact CN V (afferent sensation) and CN VII (efferent blink); loss of either limb abolishes the reflex, so the examiner must distinguish which is affected.

Question 4

A driver reports intermittent double vision (diplopia) that resolves spontaneously. Which condition causing diplopia would be MOST concerning for CMV safety?

Accepted Answer

Transient diplopia from vertebrobasilar TIA

Answer

Transient diplopia from vertebrobasilar TIA indicates high near-term stroke risk and is an urgent disqualifying concern requiring neurological workup before any certification.

Question 5

The NRCME examiner is reviewing a driver who takes gabapentin 600 mg three times daily for diabetic neuropathy pain. The primary safety concern is:

Accepted Answer

Sedation and dizziness that may impair driving ability

Answer

Gabapentin commonly causes dose-dependent sedation and dizziness, which can significantly impair a driver's alertness and reaction time while operating a CMV.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Neurological Disorders Evaluation 4