Nrcme Exam 65 Questions With Complete Verified Correct Answers By Expert Tutor 2023/2024!!

This study source was downloaded by 100000869410908 from CourseHero.com on 09-08-2023 14:48:13 GMT -05:00https://www.coursehero.com/file/209567933/20230724100318-64be4c6624f33-nrcme-exam-65-questions-with-complete-verified-correct-answers-by-exper/ NRCMEexam65QuestionsWithCompleteVerifiedCorrectAnswersbyExpertTutor2023/2024!!AdriveristakingCelexaforthetreatmentofwhathecallsa"milddepression".Hereportshehasnotconsideredorattemptedsuicide.Theexaminershoulddowhat?-AnswerTemporarilydisqualifythedriveruntilheobtainswrittenclearanceforthedepressionandthemedicationfromthetreatingprovider.Canhearingaidsbewornduringtheforcedwhispertest?-AnswerNOAdriverwithahistoryofdiabetes,whoistakingMetformin,providesanotefromhisprimarycareproviderthatlistshisA1clevelas10.Hisexamisessentiallynormalincludinglaboratoryanalysis,exceptheisveryoverweight.Themedicalexaminershould:-AnswerAdriverhashadhissecondspontaneouspneumothoraxonthesameside3monthsago.Therehasbeennosurgicalintervention.TheFVCis68%.Thecorrectdeterminationinthiscaseis:-AnswerDonotcertifyuntiltheconditionhasbeencorrectedsurgically.Adriverwithahistoryofdiabetes,whoistakingMetformin,providesanotefromhisprimarycareproviderthatlistshisA1clevelas10.Hisexamisessentiallynormalincludinglaboratoryanalysis,exceptheisveryoverweight.Themedicalexaminershould:-Answercertifyfor1yearThedriverreportsasuicideattempt6monthsearlier,followingthebreak-upofhismarriage.HenotedseeingapsychiatristandhetakesCitalopramdailyandhereportshefeelsfinenowandismovingonwithhislife.Heprovidesareleasefromhisdoctorthathemayreturntoworkwithoutrestrictions.Themedicalexaminershould?-AnswerdisqualifythedriverAdriverwithanAbnormalAorticAneurysm(AAA)canbecertified:-AnswerFor1yearifbetween4and5cm,asymptomatic,witharecommendationfromacardiovascularspecialistwhounderstandsthefunctionsanddemandsofcommercialdriving.Ifadriverrespondsyestothehistorysectionoftheexamform,whatdetailsmustheinclude?-Answer1.dateofonset2.diagnosis3.PCPcontactinfo4.anylimitations5.medicationsincludingprescription,OTCandherbalsupplementsUponexaminationofa46year-oldmalesmoker,youdetectanirregularlyirregularheartrhythm.Therateis140bpm.Thisisunknowntothedriverandhedeniesanysymptomsoflightheadedness,shortnessofbreath,dizziness,palpitations,noranycardiachistory.Youwould:-AnswerDisqualifyandrefertohisPMDorcardiologistforfurtherevaluation.This study source was downloaded by 100000869410908 from CourseHero.com on 09-08-2023 14:48:13 GMT -05:00https://www.coursehero.com/file/209567933/20230724100318-64be4c6624f33-nrcme-exam-65-questions-with-complete-verified-correct-answers-by-exper/NRCMEexam65QuestionsWithCompleteVerifiedCorrectAnswersbyExpertTutor2023/2024!!Whichofthefollowingbestdescribesthelengthoftimetocertifyadriverwhohasnon-insulindiabetesmellitustreatedwithoralmedicationandnoothermedicalissues?-AnswerWhilesuchdriversmaybecertifiedfor2years,theFMCSAprefersthatsuchdriversshouldhaveannualre-certificationexaminations.Adriverwasdischargedfromthehospital10weeksagoafteranMI.HeisasymptomaticandhasanotefromthecardiologistthathehadasatisfactoryinofficeETTtheweekpriortoyourexaminationandthathemaydrive.Hispre-dischargeECHOshowsanEFof45%.Hisexaminationisnormal.Yourdetermination:-Answercertifyfor1yearbecausewaitingperiodisatleast2monthsafterMI,nosypmtoms,ETTpass,LVEFgreaterthan40andnoECGchangesWhatarethe3thingsthatMEanddrivermustdowiththecertificate?-Answer1.MEmustretaincopyforatleast3years2.MEmustprovideacopytoprospectiveorcurrentemployeruponrequest3.drivermustcarrycertificatewhileoperatingCMVA69year-oldmaledriverhadafemoral-poplitealbypass4monthsagowithresolutionofchroniclegpainduetoclaudication.Hissurgeonclearshimfordriving.HeisoncoumadinwithINRsconsistentlyinthetherapeuticrangesincedischarge.Thecorrectdeterminationis:-AnswerMeetsstandards,qualifiedforoneyear.Whatphysicalabilitiesmustdrivershave?-Answergripstrength,upperbodystrengthandbalanceandflexibilityAdriverreturnstoworkafteratwoweekabsenceduetoarespiratoryillness.Hepresentsanotefromhisphysicianthathewasunabletoworkasatruckdriverbecauseoftheillnessandisnowclearedforreturningtowork.Hismedicalcertificateexpiresin3months.Thedriver:-AnswershouldundergoanewexaminationAdriverisfoundtohavediminishedcentralacuityduringSnellenchartacuitytesting.Thisissuggestiveof:-AnswermaculardegenerationAsthemedicalexamineryounoticeapatient'surinalysisispositivefor3+protein.Youshould:-AnswerDetermineifadditionalevaluationisrequiredandrequestorrecommendprimarycareproviderfollow-up.Whataretheregulatorynon-discretionarystandards?-AnswerE-HIVEpilepsy,Hearing,Insulin,VisonA47year-olddriverwithaFixedDeficitofanExtremityshouldhaveaphysicalexam-AnswerBiannuallyormorefrequentlyifindicated.This study source was downloaded by 100000869410908 from CourseHero.com on 09-08-2023 14:48:13 GMT -05:00https://www.coursehero.com/file/209567933/20230724100318-64be4c6624f33-nrcme-exam-65-questions-with-complete-verified-correct-answers-by-exper/NRCMEexam65QuestionsWithCompleteVerifiedCorrectAnswersbyExpertTutor2023/2024!!CanyouprovideacopyoftheMedicalExaminationCertificatetothedriverandacopytotheemployer?-AnswerYESA50year-oldmalesmokerhadapercutaneouscoronaryinterventionprocedure2weeksagoafteranabnormalstresstest.Heisasymptomatic,stage2HTNcontrolledonramaprilandlabetolol.Whatisthecertificationperiod?-AnswerCertify6months.AdvisetohaveETTbefore6monthfollowup.IfheremainsstablewithanormalETT,certifyforoneyear.CAnadriverwithahearingaiduseittopasshearingtest?-AnswerYeshecanusehearingaidtoundergotheforcedwhispertest.AlsoheshouldcarryasparepowersourceforhishearingaidswhiledrivingAdriverisunabletopickoutthenumbersinanIshiharacolorblindnesstest.However,heisabletodistinguishred,green,andamberstoplights.Canhebecertified?-AnswerHemaybefullyqualifiedfor2years.WhatisthewaitingperiodforablationforAfib?-Answer1monthAllergicRhinitisinvolvinginflammationofthenasalportionoftheupperrespiratorytractrarelyrendersadriverincapableofoperatingacommercialvehicle.Adrivermaybecertifiedwithallergicrhinitisandonwhatkindsofmeds?-Answernasalsteroidspraysandnon-sedatingantihistaminesAdriverwitharecentdiagnosisofcongestiveheartfailureandknownventriculararrhythmiasmaybecertifiedfordrivingifhisleftventricularejectionfractionisatleast:-Answer50%WhichistrueofFMCSADriverExemptionPrograms?-AnswerAnexemptionisvalidfor2years,withanannualmedicalexamination.A43year-oldgenerallyhealthyfemalebusdriverindicatessheisallergictoaspirin.Uponfurtherquestioning,sherelatesthatshehadfebrileseizuresatage2,andhermotherwastoldnottogiveheraspirinafterwards.Sheneverhadrecurrenceoftheseizuresnoranyotherneurologicalsequelae.Herexaminationisnormal.Youdetermine:-AnswerCertifyfor2years.A43year-oldmaledriverhasanotherwisenormalexamexceptforamputationoftheringandlittlefingersofthelefthand.Thedriver:-AnswerCanbeclearedfortwoyearsifhisgripstrengthisnormal.A22year-oldmalecontractedmeningococcalmeningitisfromhiscollegeroommate,dischargedfromthehospital3monthsago.Hebringsnorecordswithhim.Heisonnomedications,isotherwisehealthy,andhisphysicalexaminationisentirelynormal.Thecorrectdeterminationwouldbe:-AnswerObtainhospitalrecords.IftherewasThis study source was downloaded by 100000869410908 from CourseHero.com on 09-08-2023 14:48:13 GMT -05:00https://www.coursehero.com/file/209567933/20230724100318-64be4c6624f33-nrcme-exam-65-questions-with-complete-verified-correct-answers-by-exper/NRCMEexam65QuestionsWithCompleteVerifiedCorrectAnswersbyExpertTutor2023/2024!!noseizureactivity,hemustundergoaoneyearwaitingperiodbeforehecanbequalified,iftherewasseizureactivity,hemustundergoa5yearwaitingperiodseizurefreeandoffanticonvulsantmedicationbeforehecanbequalified.YoudisqualifiedadriverduetoStage3hypertension.HeisbacktodayandhisBPislessthan140/90.Whatdoyoudo?-AnswerCertifyfor6monthsonlyYoucertifiedadriverwithhistoryofstage3hypertensionfor6monthsandnowheisbackforrecertification.Whatdoyoudo?-Answerfilloutanewform,checkrecertificationanddoafullphysicalexamWhendoyouissuea3monthcertificate?-AnswerIssuedforthefirsttimeadriverexhibitsstage2hypertensionHowlongistheSPEorskilledPerformanceevaluationcertificatevalidfor?-Answer2yearsA35year-oldpatientpresentsforinitialcertification.Hehasnoknownmedicalhistory.Hisurinalysisreveals3+glycosuria.Whichofthefollowingnextstepsismostreasonable?-AnswerAssignhimastatusof"DeterminationPending"untilfurtherevaluationbyhisprimarycarephysician.ADOTdriverpresentsforhismedicalexam.OnhishistoryheadvisedthatheregularlytakesDextromethorphan.ThisshouldprompttheMEtodothefollowing?-AnswerCounselthedriveraboutnotconsumingthemedicationwithin12hoursofdriving.DuringtheDOTexamadriverperceivesawhisperedvoiceat5feetinhisleftearand4feetinhisrightear.Thisisanotherwisenormal/unremarkableexam.Allotheraspectsofhisphysicalexaminationareunremarkable.Astheexaminerwhatwouldyoudonext?-AnswerCertifythedriverfor2years.AdriverpresentsforhisDOTexam.OnthemedicalhistorythedrivernotesthatithasbeenamonthsincehehassmokedandhasbeentakingChantixtohelphimwithefforts.Whichofthefollowingshouldthemedicalexaminerdonext?-AnswerDisqualifythedriveruntilithasbeenshownthatheisnolongertakingthemedicationandnoresidualsideeffectsarepresent.Whatare2examplesofsleepinesssurveys?-AnswerEpworthsleepinessscaleandStanfordsleepinessscaleWhatkindofbrainlesionsareNOTassociatedwithanincreasedriskforseizures?Whatisthewaitingperiod?Whatismaxcertification?-AnswerCerebellumandbrainstemvascularlesions.1yearwaitingperiod.Maxcertification1yearThis study source was downloaded by 100000869410908 from CourseHero.com on 09-08-2023 14:48:13 GMT -05:00https://www.coursehero.com/file/209567933/20230724100318-64be4c6624f33-nrcme-exam-65-questions-with-complete-verified-correct-answers-by-exper/NRCMEexam65QuestionsWithCompleteVerifiedCorrectAnswersbyExpertTutor2023/2024!!WhatkindofbrainlesionsAREanincreasedriskforseizures?Whatisthewaitingperiod?Whatisthemaxcertification?-AnswerCorticalandSubcortical.5yearswaitingperiodifatriskforseizures.Maxcertification1yearAdriverpresentsforhisDOTexam.Hehadamyocardialinfarction5weekprevioustotheexam.Hepresentswithareturntoworkletterfromhiscardiologistwithnorestrictions.Testinginformationincludedrevealedthatthedriverwasabletoreach12METSandhisleftventricularejectionfractionwas65%.Basedoffofthisinformationwhatcertificationdecisionshouldbemadebytheexaminer?-AnswerTemporarilydisqualifythedriverbecausethewaitingperiodis2monthsAdriverpresentsforherDOTmedicalexam.DuringtheexamhistoryitisrevealedthatthedriveristakenLisinoprilforhypertension,Simvastatin,andAntabuse.Allotheraspectsofhistoryandexamwerenormal.Whatshouldtheexaminerdonext:-AnswerDisqualifythedriver.Whatarethe3classesofTBI?-Answer1.Severe,penetratestheDura,causeslossofconsciousnessandlastslongerthan24hours2.Moderate,doesnotpenetratedura,LOClongerthan30minutesbutlessthan24hours.3.Mild,noduralpenetration,noLOC,lessthan30minsAdriverdescribeshalosaroundlightsatnightandoccasionalmildheadaches.Thisissuggestiveofwhatdisease?-AnswerglaucomaAdriverwhopresentstakingthefollowingmedicationshouldnormallybedisqualified,butmaybecertifiediftheprescribingphysiciannotifiestheMedicalExaminerthatthedriverissafetobeaCMVdriverwhilehe/sheisbeingprescribedthismedication:AMethotrexate.BHydrocodone.CMethadone.DProzac.-AnswerhydrocodoneAdriverpresentspostoperationofthecervicalspine.Whichofthefollowingmaybeareasonfordisqualification?-Answerlessthan45degreecervicalrotation.thewaitingperiodforcertificationofadriverisaminimumofoneyearafterwhichofthefollowing?SelectanAnswer:ABacterialmeningitiswithoutearlyseizures.BViralencephalitiswithearlyseizures.CPost-surgicalremovalofaspinaltumor.This study source was downloaded by 100000869410908 from CourseHero.com on 09-08-2023 14:48:13 GMT -05:00https://www.coursehero.com/file/209567933/20230724100318-64be4c6624f33-nrcme-exam-65-questions-with-complete-verified-correct-answers-by-exper/NRCMEexam65QuestionsWithCompleteVerifiedCorrectAnswersbyExpertTutor2023/2024!!DModeratetraumaticbraininjury.-Answerbacterialmeningitiswithoutearlyseizures.WHYbecauseviralencephalitiswithearlyseizuresis5years.Postsurgicalis3months.ModerateTBIwithoutearlyseizuresormildTBIwithseizuresis2yearsAdriverpresentswithahistoryofanisolatedTIA6monthsprevious.Hepresentswithareturntoworkletterfromhisprimarycarephysicianandhisneurologist.ThedriveristakingHydrochlorothiazideandSimvastatin.Allotheraspectsoftheexamandhistorywerenormal.Whatshouldtheexaminerdonext?-Answertemporarilydisqualifythedriverbecausethewaitingperiodis1yearafterTIAUponexaminationofacommercialdriver,younotescarringofthetympanicmembranes.Youshould:-AnswerdocumentthefindingAccordingtoFMCSAregulations,medicalqualificationfortwoyearscanbegiventoadriverwhohas:-AnswerAnSPEcertificateforaleftbelowthekneeamputation.Duringhisvisittothemedicalexaminer,adrivercomplainsofseverepaininhisfingerforthelasttwoweeksafteritwaspunctured.Theexaminationrevealsaninfected,swollenfinger.Afterthemedicalexaminerinquires,thedriverstatesthatthepainismadeworsewhenhegripsthesteeringwheel.Whichofthefollowingshouldthemedicalexaminerdonext?-AnswerAssessthedriver'sgripstrength.AcommercialdriverwasdiagnosedwithanacuteDVT3monthsago.HehasbeenonwarfarinandhismonthlyINRhasbeenbetween2.0and3.0.Youshould:-AnswerAdvisethatheshouldmoveandstretchhislegsregularlywhiledriving.A46-year-oldmaledriverpresentsforrecertification.Hehasahistoryofchronicgastroesophagealrefluxdisease.Hetakesesomeprazole(Nexium)andover-the-countercimetidine(Tagamet).Hestatesthathefeelsfine,buthastroublefindingfoodsthatdonottriggerhisGERDwhenheisontheroad.Whichofthefollowingshouldthemedicalexaminerdofirst?-AnswerCorrelatetheGIhistoryfindingswiththeabdominalexamination.AdriverpresentsforclearancetoreturntodrivingaCMVsixweeksafterarthroscopiccarpaltunnelrepaironhisrighthand.Canheberecertifiedifhepassesthegripstrengthtest,and,ifso,forhowlong?-Answer2yearsAdriverisdisqualifiedon3-11-13duetobenignpositionalvertigo.Shereturnson6-20-13withanotefromherENTthatshehasbeensymptomfreesince4-16-13.Youwould:-Answererformarecertificationexam.Ifqualifiedissueatwoyearcertification.AdriverwithAtrialFibrillationandgoodratecontrol:-AnswerCanbecertifiedfor1yearafteronemonthwaitingperiodforstableanticoagulationtherapy.This study source was downloaded by 100000869410908 from CourseHero.com on 09-08-2023 14:48:13 GMT -05:00https://www.coursehero.com/file/209567933/20230724100318-64be4c6624f33-nrcme-exam-65-questions-with-complete-verified-correct-answers-by-exper/Powered by TCPDF (www.tcpdf.org)NRCMEexam65QuestionsWithCompleteVerifiedCorrectAnswersbyExpertTutor2023/2024!!AfteraTIAadrivermaynotbecertifiedifhe/she:-AnswerHasnotcompletedaoneyearwaitingperiodseizurefreeandoffanticoagulants.Followingacutemyocardialinfarction,thewaitingperiodisaminimumof2monthsbeforethecommercialdrivercanbeconsideredforcertification.Thedrivermusthaveapost-MIechocardiogramdemonstratinganEFofatleast:-Answer40%A45year-oldmanpresentsforinitialcertification.Hestatesthatatonetimehe"may"havebeendiagnosedwithdiabetes,butisnottakinganymedication.Whichofthefollowingmandatoryinthispatienttodeterminecertification?-AnswerUrineforglucose.TheFederalDiabetesExemptionProgramguidelinesforbloodglucosemonitoringincludeusingadevicethatrecordstheresultsforlaterreviewandmeasuringbloodglucoselevelbeforedrivingand:-AnswerEvery2to4hourswhiledriving.Themedicalexaminershouldeducatethedrivertorefrainfromoperatingavehicleforatleasthowlongaftertakingamedicationwithsedatingsideeffects?-Answer12hoursRegulation49CFR391.64allowsdrivingwithinanexemptintracityzone,whichreferstowhichtypeofgeographicalarea:-AnswerMinicipalityWhichregulationdescribesyourdutiesasamedicalexaminer?-Answer49CFR391.43DrivercertificationisdeterminedbasedonwhetherornotthedrivermeetstherequirementsoftheFMCSAphysicalqualificationsstandardscitedinwhatCFR?-Answer49CFR391.41