NRCME Respiratory Health and Sleep Apnea 2

Question 1

A commercial driver reports using a CPAP machine but admits to removing it during the night. What is the most appropriate action for the medical examiner?

Accepted Answer

Request objective CPAP compliance data before certifying

Answer

Objective CPAP data (download showing ≥4 hours/night on ≥70% of nights) is required to verify therapeutic compliance before certification.

Question 2

Which Apnea-Hypopnea Index (AHI) range classifies obstructive sleep apnea as MODERATE?

Accepted Answer

AHI 15–29 events/hour

Answer

Moderate OSA is defined as an AHI of 15–29 events per hour on polysomnography.

Question 3

A driver with well-controlled asthma on inhaled corticosteroids reports no exacerbations in the past 12 months and normal spirometry. Which certification is appropriate?

Accepted Answer

Certify for 2 years if clinically stable

Answer

Well-controlled asthma with normal pulmonary function and no recent exacerbations does not preclude 2-year certification.

Question 4

Which medication used to treat OSA side effects is most likely to impair a commercial driver's alertness?

Accepted Answer

Sedating antihistamines taken at bedtime

Answer

Sedating antihistamines can cause next-day drowsiness and impair driving performance even when taken at bedtime.

Question 5

During an NRCME physical exam, a driver with a BMI of 40 and neck circumference of 18 inches denies snoring or witnessed apneas. What is the best next step?

Accepted Answer

Perform the Epworth Sleepiness Scale and refer for sleep study if score ≥10

Answer

High BMI and large neck circumference are risk factors for OSA; the ESS and potential referral are warranted regardless of symptom denial.

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME - National Registry of Certified Medical Examiners Practice Test

NRCME Respiratory Health and Sleep Apnea 2