2023 DOT: Comprehensive Review for NRCME Exam Questions and A nswers Corrective lenses that are prohibited by the FMCSA, including: ✔✔ lenses that correct distance vision in one eye and near vision in the other. telescopic lenses Medical guidelines for the driver with diabetes mellitus include: ✔✔ Annual medical examination. Annual ophthalmologist or optometrist eye evaluation. Disqualification for a diagnosis of unstable proliferative retinopathy. Monocular Visio n ✔✔ Monocular vision is disqualifying. However, the driver who has monocular vision that with the better eye meets all vision qualification requirements may be considered for a Federal Vision Exemption if the Medical Examiner finds the driver otherwise me dically fit for duty. Monocular vision is defined as vision that is at least 20/40 for distance in one eye with or without correction and vision that is less than 20/40 for distance in one eye with or without correction. The driver must meet other vision r equirements in each eye, including visual fields (horizontal field of vision). Federal Vision Exemption: the driver with monocular vision who is applying for or has a federal exemption or is qualified by operation of 49 CFR 391.64 must have an annual physi cal examination. Drivers with vision loss who meet standards may be certified for up to two years. A driver who wears contact lenses which correct farsightedness in one eye and nearsightedness in the other, but has no other visual impairments can be certi fied under what additional conditions? Only if the driver wears prescription glasses which provide the same correction as the contact lenses. FMCSA guidance indicates that a driver should not be certified under these circumstances. Only by federal exempti on. The driver is always certifiable under these conditions. ✔✔ FMCSA guidance indicates that a driver should not be certified under these circumstances. Explanation: FMCSA guidance indicates that contact lenses that correct one eye for distance and one eye for near vision are not acceptable. Guidance recommends not to certify with ear problem diagnoses of: ✔✔ a) Uncontrolled vertigo. b) Ménière's diseas e. c) Nonfunctioning labyrinth. d) Nonfunctioning fistula. The medical examiner's role in the exemption process includes _________. Issuing the exemption. Issuing the prescription for the driver's contact lenses and/or glasses. Providing the driver w ith contact information for the Federal Vision Exemption Program. Assuring that the driver has peripheral vision of at least 110 degrees in each eye. ✔✔ Providing the driver with contact information for the Federal Vision Exemption Program. Explanation: T he medical examiner's role in the exemption process is limited to performing the driver examination and providing the driver with contact information for the FMCSA related to the exemption process. An audiometric test produces the following results: Left ear: 500 Hz, 35dB Loss; 1,000 Hz, 35 dB loss; 2,000 Hz 45 dB loss. Right ear: 500 Hz, 40 dB loss; 1,000 Hz, 45 dB loss; 2,000 40 dB loss. What is the certification? Certify for one year. Certify for two years. Do not certify. Certify only when accompanied by hearing aid. ✔✔ Certify for two years. Explanation: Drivers with an average hearing loss of < 40 decibels averaged across 500, 1000, and 2000 Hz in the better ear may be certified for two years. What eye conditions must the medical examiner ask the d river about? Cataracts, color deficiencies, retinitis pigmentosa, aphakia, glaucoma. Lazy eye, cataracts, aphakia, floaters, retinopathy. Glaucoma, macular degeneration, retinitis pigmentosa, color deficiencies. Retinopathy, cataracts, aphakia, glaucoma, macular degeneration. ✔✔ Retinopathy, cataracts, aphakia, glaucoma, macular degeneration. Explanation: These are the "ask about" vision conditions. The medical examiner may ask the driver about any eye conditions , but should ask the driver about these specified conditions. Which of the following drivers' tests meet hearing certification standards? Whisper test 4 feet right ear, 3 feet left ear. Whisper test 5 feet right ear with hearing aid, 3 feet left ear with out hearing aid. Audiogram left 30/500 Hz, 40/1000 Hz, 60/2000 Hz; right 25/500 Hz, 35/1000 Hz, 80/2000 Hz. Audiogram left 35/500 Hz, 50/1000 Hz, 40/3000 Hz; right 35/500 Hz, 35/1000 Hz, 60/3000 Hz. ✔✔ Whisper test 5 feet right ear with hearing aid, 3 feet left ear without hearing aid. Explanation: Whisper test results require 5 feet in at least one ear for passing, with or without a hearing aid. Audiometric testing results require an average of 40 dB loss in the better ear for results averaged across 500, 1000, and 2000 Hz. Although testing may be performed at 3000 Hz, results obtained are not used to determine whether the driver meets hearing requirements. A driver has loss of hearing in the better ear of 25 dB loss at 500 Hz, 40 dB loss at 1000 Hz, and 60 dB loss at 2000 Hz. With respect to the hearing requirement for medical certification, the driver __________. May be certified for one year. May be certified for two years. May not be certified. May be certified if examined by an otolaryngologist who i s familiar with the CMV driving duties who certifies the driver as medically qualified to drive a CMV. ✔✔ May not be certified. Explanation: An average hearing loss of 41.7 decibels averaged across 500, 1000, and 2000 Hz in the better ear is disqualifying . The driver should be referred to obtain a hearing aid and may be certified if the driver passes while wearing a hearing aid. A specialist cannot determine certification, and a specialist cannot override medical qualification standards such as the minimum hearing requirement. Which of the following is acceptable for a driver who wears a hearing aid? Testing of the driver's hearing is waived if the driver presents a letter from a qualified specialist. Testing of the driver's hearing may be performed by the medical examiner using audiometric testing equipment. Testing of the driver's hearing may be performed by an audiologist or otolaryngologist using specialized audiometric testing equipment. Testing of the driver's hearing may be performed at 1,000 Hz only. ✔✔ Testing of the driver's hearing is waived if the driver presents a letter from a qualified specialist. Testing the hearing of a driver who wears a hearing aid may be accomplished in three ways: 1) whisper test, 2) audiometric testing by an otolaryngologist using specialized audiometric testing equipment, or 3) audiometric testing by an audiologist using specialized audiometric testing equipment. Audiometric testing is required to be conducted at 50 0 Hz, 1000 Hz, and 2000 Hz. Passing Requirements for Vision Tests ✔✔ Corrective lenses, eye glasses and/or contact lenses may be used. Distance binocular acuity of at least 20/40 (Snellen) in each eye with or without corrective lenses. Field of vision of at least 70º in the horizontal meridian in each eye. Monocular vision - vision meeting requirements in only one eye - is disqualifying by regulation. The ability to recognize the colors of traffic signals and devices showing standard red, green, and amber . Contact lenses that correct vision in one eye for distance and the other eye for near are not acceptable. Results must be converted to Snellen values if another test is used. Measured in each eye individually and both eyes. Drivers who wear corrective le nses should be advised to carry spare glasses. In general, any vision condition, such as lazy eye, glaucoma, cataract, and others, is not disqualifying as long as the driver meets minimum vision testing parameters . FMCSA is ✔✔ Federal Motor Carrier Safety Administration. Is overseen by the DOT. The FMCSA creates standards for driver examinations. Regulates Interstate commercial operations, including the driver. Many states use federal FMCSA standards to govern intrastate commercial operations, including th e driver, but the FMCSA does not directly regulate any intrastate functions. a division of the US Department of Transportation (DOT). Conditions which are usually disqualifying, but for which qualification can be considered on a case -by-case basis include __________. Autonomic neuropathy. Methadone use. Monocular vision. Carpal tunnel syndrome. ✔✔ Correct Answer: Autonomic neuropathy. Explanation: Methadone use and monocular vision are always disqualifying. Carpal tunnel syndrome is not usually disqualif ying. A driver experienced a pneumothorax four weeks ago. The medical examiner tests the driver's respiratory function and the forced vital capacity (FVC) is 58% of predicted. What should the certification decision be? Do not certify pending additional testing. Certify for three months, pending driver follow up with personal physician and/or specialist. Certify one year. Certify two years. ✔✔ Correct Answer: Do not certify pending additional testing.
