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Good questions Part I

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show When taking medication for treatment post cerebrovascular accident (CVA)  
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How long should a driver status-post permanent pacemaker (PPM) insertion secondary to sinus node dysfunction wait before certification/recertification for duty can be considered?   show
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show Uh, no. Disqualify.  
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show History of any specific lung disease Symptoms of shortness of breath, cough, chest tightness, or wheezing Cigarette smoking in drivers 35 years of age or older  
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True or false....With polysomnogram, diagnosis of obstructive sleep apnea (OSA) is based on the apnea/hypopnea index with over 30 episodes per hour.   show
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Comorbid conditions common in bipolar disorder include....   show
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show Yes! BPPV recommendations are that they are asymptomatic for at least 2 months and you can certify for two years.  
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The driver candidate with a history of transient ischemic attack (TIA) is subject to a ___ symptom free waiting period prior to certification.   show
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show If they are on anti-coagulant medications.  
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show FALSE  
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The risk of an acute incapacitating event for a CMV driver with Hypertension is more likely to be caused by?   show
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A driver presents for medical examination with two blood pressure readings >140/80. The driver claims no previous history of HTN. How long should the driver be certified for?   show
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show Certify the driver for a one time 3 month certificate, advising the driver that blood pressure must be equal to or less than 140/90 mmHg during follow up  
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A driver who has previously tested positive on a drug test would like to be considered for recertification. When can this driver be re-certified?   show
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Employers must randomly test what percentage of drivers unannounced yearly for alcohol use?   show
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A driver with DM has had two hypoglycemic episodes within the past 12 months. Should this driver be qualified to drive?   show
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True or false: A Federal Diabetes Exemption/Waiver is no longer required in order for the insulin-treated CMV driver to operate a commercial vehicle.   show
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According to FMCSA regulation 49 CFR 391.45 (e), what is the maximum certification period for the driver who requires insulin for glucose control?   show
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Discuss the AAA guidelines for driver qualification.   show
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show *Sx regardless of size *There has been recommendation for surgical repair regardless of AAA size from a CV specialist *The AAA is 4 to <5 cm and the driver does not have clearance. * Is greater ≥5 cm *Has increased >0.5 cm in a 6 month period.  
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When a CMV driver completes an exercise tolerance test (ETT), successful results are:   show
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show The driver can be certified every 6 months, if he or she is asymptomatic, tolerates medications, and has completed a minimum waiting period of one year  
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show Driver with a LVEF of 45%, is asymptomatic, sternum incision is completely healed, and has clearance from a cardiologist  
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show Completes a minimum 2 month waiting period post MI, has a LVEF of 40% or greater, able to tolerate medications, and has clearance from a cardiologist  
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A CMV driver has been diagnosed with severe Aortic Stenosis (AS) but he denies symptoms of dyspnea, chest pain, dizziness, or syncope. The FMCSA medical examiner should certify the driver for how long?   show
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show 6 months NOTE: if driver has had a severe depressive episode, a suicide attempt, or a manic episode, they have to wait 1 year.  
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show ●A copy of the medical certificate completed ●A copy of the results of the medical examination performed ●A medical evaluation summary completed by r a board qualified or board certified physiatrist (doctor of physical medicine) or orthopedic surgeon  
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show False  
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For a driver candidate with a history of syncope the maximum certification period is:   show
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What is the minimum certification waiting period for a CMV driver status post permanent pacemaker insertion secondary to Neurocardiogenic Syncope?   show
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show Pupil reactivity.  
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show Distant visual acuity of 20/40 in each eye (with/without corrective lens) and distant binocular acuity of at least 20/40. Must also have a field of vision of at least 70 degrees in the horizontal meridian in each eye.  
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Discuss the hearing test requirements for passing certification.   show
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show No! Recommended not to certify the driver.  
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show •Exercise to a workload capacity greater than 6 METs •Attain a heart rate greater than or equal to 85% of predicted maximum (unless on BB) •Have a rise in SBP greater than or equal to 20 mm Hg without angina. •Have no significant ST segment depression.  
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True or False: A driver presents to the medical examiner for initial evaluation. On the health history form the driver indicates he takes methadone for treatment of chronic back pain. The medical examiner may qualify this patient.   show
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A driver presents to the medical examiner for recertification. The driver reports deteriorating peripheral vision and decreased night vision over the past 2 years. The medical examiner suspects these may be symptoms of:   show
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show Thyroid panel  
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A commercial motor vehicle driver is taking coumadin. What is the minimum interval at which their International Normalized Ratio (INR) must be checked?   show
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show Diabetes Mellitus  
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According to FMCSA regulations, which of the following must a medical examiner evaluate when examining a driver’s ear?   show
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A driver's urine must be tested for....   show
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show Deficits in peripheral vision  
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A common visual complaint in patients with cataracts is that of?   show
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show The driver has: •Hypoxemia at rest. •Chronic respiratory failure. •History of continuing cough with cough syncope.  
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Discuss the federal exemption program and provisions.   show
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A driver should have an annual echocardiogram in the presence of?   show
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A 66 year old female driver presents for certification. She has a history of exposure to silica dust. She is without sxs and PE is benign. Chest-x ray reveals bilateral interstitial infiltrates. Which of the following should the medical examiner do next?   show
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show •Seizure. •Loss of consciousness. •Need of assistance from another person. •Period of impaired cognitive function that occurred without warning.  
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The medical examiner must include the following information on the medical examination report form:   show
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show 40% or higher  
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show An ETT every year.  
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show One week  
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show 140/90  
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show One year. Starting the date of the initial examination.  
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show None! Disqualified.  
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What should you obtain from the driver who uses Insulin for glucose control?   show
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show Nope. Methadone is disqualifying.  
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show A urine specimen!  
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Who is responsible for implementing and conducting drug and alcohol testing programs?   show
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show Three months.  
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show To closely monitor the driver for signs and/or symptoms of a medical condition that can affect safe driving  
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show 6 months.  
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show Cognitive demands: o Sustained vigilance and attention. o Quick reactions. o Communication skills. o Appropriate behavior. Physical demands: o Coordination.  
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Recommend not to certify the driver when ABG measurement reveals:   show
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show •Exercise to a workload capacity greater than 6 (METs) •Attain a HR greater than or equal to 85% of predicted maximum (unless on BB). •Have a rise in SBP > or = to 20 mm Hg without angina. •Have no significant ST segment depression.  
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A driver suffering from Angina pectoris may be certified to drive a commercial vehicle if:   show
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show The driver needs to have their treating clinician fill out MCSA-5870 (ITDM) to certify that their insulin treatment is adequate and stable. The form is only valid for 45 days after issue, so the driver needs to be examined before the form expires!  
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How often does the driver with a major mood disorder need to be evaluated by a mental health specialist?   show
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What would be reasons why a driver with MVP should NOT be certified?   show
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A driver diagnosed with a blood pressure equal to or greater than 180/110 can be certified for how long?   show
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show This driver is disqualified for not having BP below 140/90. For the driver with a first time episode of Stage 2 HTN, a one-time three month certificate  
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A 45 yo male presents for certification. He has a hx of asthma & is currently using Albuterol and Qvar. The driver appears somewhat breathless with exertion. PE reveals a RR of 22 & wheezes in lung fields. What should the medical examiner do next?   show
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A 72 year old male driver presents for certification. He mentions in his history that he had a heart attack 18 months ago. What would lead to a recommendation to not to certify the driver?   show
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In a driver with angina pectoris, what are the recommendations for what a driver should obtain for evaluation?   show
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show The driver has: •Hypoxemia at rest. •Chronic respiratory failure. •History of continuing cough with cough syncope. If driver appears to have difficulty breathing on exam, there is the need for further testing! (PFT)  
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show Obvious symptoms are present! And if driver is on Coumadin, they need to be regulated monthly.  
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show Obtain documentation from the drivers cardiologist explaining why the pacemaker was inserted. Note: if the patient had the pacemaker inserted for a specific cause, this changes the waiting period.  
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An incretin mimetic, such as exenatide (Byetta), is used to improve glycemic control in people with Type 2 diabetes by reducing fasting and postprandial glucose concentrations. FMCSA recommends that a driver taking an incretin mimetic must also:   show
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Why would you NOT certify a driver that is taking Lithium?   show
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A 56 year old male driver presents for recertification. He has a past history of alcohol abuse. The driver can be recommended for certification if:   show
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The minimum waiting period for the driver with a history of bacterial meningitis with early seizures is?   show
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What is the waiting period for a driver with the diagnosis of vertigo 2/2 BPPV?   show
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show Biennial ETT (every 2 years)  
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The minimum waiting period for the CMV driver with a past medical history of stable angina is:   show
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Mr. Charleston has a history of heart disease and gives you the results of his ETT performed 4 months ago. The test results were inconclusive and the driver denies having any sxs. His PE findings are normal. What should the medical examiner do next?   show
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The driver with a history of Coronary Artery Bypass Graft (CABG) surgery should have an annual exercise tolerance test 5 years post-CABG surgery. Why?   show
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Mr. Webster’s forced whispered voice test results are as follows: 3 feet in the right ear and 5 feet in the left ear. Based on these findings, the certified medical examiner should certify the driver for:   show
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The CMV driver with a medical history of Labyrinthine Fistula can be certified for a period of:   show
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What is the waiting period for the driver with a-fib?   show
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According to FMCSA guidelines, a driver with stage I HTN (140/90 to 159/99) being seen for initial examination can be certified for a period of?   show
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A driver with intermittent claudication who is status-post femoral bypass graft surgery of the left lower extremity must complete a minimal waiting period of?   show
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What is the minimum waiting period for a driver newly diagnosed with diabetes mellitus who requires insulin for blood glucose control and was not on any prior oral hypoglycemic agents/treatment?   show
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FMCSA recommends not to certify a driver when his or her ABG measurements reveal:   show
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show The medical examiner should first perform a thorough physical examination and pulse-ox screening in his or her office before sending the driver for ABG’s, chest x-ray, or to a pulmonologist for further work-up.  
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show TRUE  
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The CMV driver with monocular vision should be disqualified unless the driver has a current federal vision exemption.   show
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show 2 years  
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What is the recommended maximum certification period for the driver with a diagnosis of Syncope?   show
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The ME can certify a driver for 1 year post-MI after they have waited the appropriate 2 months and the driver is (list five things!)   show
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How often should the driver who has had an MI obtain an ETT?   show
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The driver post-CABG surgery must complete a minimum waiting period of at least __________ before certification can be considered.   show
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show 1. Asx 2. Tolerates medications without side effects 3. LVEF greater than or = to 40% 4. Healed sternum 5. Cleared by cardiologist  
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The CMV driver post heart transplant must wait a period of ______ and can be certified for a period of ________.   show
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Which heart conditions (cardiomyopathy) are considered disqualifying?   show
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The minimum waiting period for a driver status-post Commissurotomy is_________________.   show
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show 1 month  
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show 3 months  
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show 1. Is stabilized on medications for at least one month 2. Provides a copy of his/her INR results at examination 3. Has INR checked and monitored at least on a monthly basis.  
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What are the recommendations to NOT certify the driver with a AAA (cannot list symptomatic. Give 3 other reasons why).   show
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show 3.5 cm  
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