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Free NRCME Practice Questions

10 free, exam-style National Registry Certified Medical Examiner (NRCME) practice questions with answers and explanations. No signup required. Work through them below, then take the full free NRCME practice test to study every exam domain.

Question 1

A 52-year-old driver has corrected distant visual acuity of 20/40 in the right eye and 20/50 in the left eye, with normal fields and normal color recognition. Based on the federal vision standard, what is the medical examiner's correct action?

  1. Do not certify under the standard requirement; the driver may pursue the alternative vision standard
  2. Certify the driver for two years and note that corrective lenses are required while driving
  3. Certify for one year because at least one eye independently meets the 20/40 requirement
  4. Certify the driver, since the combined binocular acuity taken together is still better than 20/40 overall
Show answer & explanation

Correct answer: A - Do not certify under the standard requirement; the driver may pursue the alternative vision standard

Question 2

A driver does not meet the vision standard in the left eye (worse eye), but the medical examiner is considering the alternative vision standard. Which professional must complete the Vision Evaluation Report (Form MCSA-5871) for the driver?

  1. Any certified medical examiner currently listed on the National Registry
  2. The driver's own primary care physician during a routine office visit
  3. A licensed optician who professionally fits and dispenses corrective lenses
  4. An ophthalmologist or optometrist who evaluates the driver's vision
Show answer & explanation

Correct answer: D - An ophthalmologist or optometrist who evaluates the driver's vision

Question 3

At the initial examination, a driver's blood pressure is 165/98 mmHg, confirmed on repeat readings on the same day. There are no other disqualifying findings. According to the medical advisory criteria, what is the appropriate certification action?

  1. Issue a one-time certificate valid for three months to allow treatment to be initiated
  2. Do not certify the driver at all until the blood pressure has been reduced below 140/90
  3. Certify the driver for a full year and simply recheck at the next annual examination
  4. Certify for two years because the reading remains below the 180/110 threshold
Show answer & explanation

Correct answer: A - Issue a one-time certificate valid for three months to allow treatment to be initiated

Question 4

A driver asks whether the urinalysis required during the examination will detect recent use of illegal drugs. What is the most accurate response from the medical examiner?

  1. Yes, it routinely screens for the common controlled substances as a standard part of every examination
  2. No, a separate blood specimen is what is used to detect drug use during the examination
  3. No, the urinalysis checks for protein, blood, sugar, and specific gravity and is not a drug test
  4. Yes, and any result positive for drugs of abuse will result in immediate disqualification
Show answer & explanation

Correct answer: C - No, the urinalysis checks for protein, blood, sugar, and specific gravity and is not a drug test

Question 5

A driver with insulin-treated diabetes mellitus presents an ITDM Assessment Form (MCSA-5870) that was signed by the treating clinician 50 days before today's examination. The form is otherwise complete and favorable. What is the medical examiner's correct action?

  1. Certify the driver for up to twelve months on the basis of the completed assessment form
  2. Do not certify on this form; the assessment must have been completed within the prior 45 days
  3. Certify the driver for three months and separately request updated laboratory glucose values
  4. Certify for two years, because insulin-treated diabetes is no longer a disqualifying condition
Show answer & explanation

Correct answer: B - Do not certify on this form; the assessment must have been completed within the prior 45 days

Question 6

A driver cannot perceive a forced whispered voice at five feet, so audiometric testing is performed. When calculating the average hearing loss in the better ear, which three frequencies must the medical examiner use?

  1. 250 Hz, 500 Hz, and 1000 Hz, averaged for the better ear
  2. 1000 Hz, 2000 Hz, and 3000 Hz, averaged for the better ear
  3. 500 Hz, 1000 Hz, and 4000 Hz, averaged for the better ear
  4. 500 Hz, 1000 Hz, and 2000 Hz, averaged for the better ear
Show answer & explanation

Correct answer: D - 500 Hz, 1000 Hz, and 2000 Hz, averaged for the better ear

Question 7

A driver in a state where recreational marijuana is fully legal reports occasional use and provides a state-issued medical marijuana card. The examination is otherwise normal. How should the medical examiner proceed?

  1. Certify the driver, because the use is fully legal under that state's current law
  2. The driver does not qualify; marijuana remains a Schedule I substance under federal law
  3. Certify the driver, because a valid state medical card documents a legitimate underlying medical need
  4. Certify for three months and require the driver to discontinue use before any renewal
Show answer & explanation

Correct answer: B - The driver does not qualify; marijuana remains a Schedule I substance under federal law

Question 8

A driver reports one single unprovoked seizure several years ago, has had no recurrence, and takes no antiseizure medication. Under FMCSA guidance for a single unprovoked seizure, the driver must be seizure-free and off antiseizure medication for at least how long before being considered for certification?

  1. At least one year, seizure-free and off antiseizure medication
  2. At least three years, seizure-free and off antiseizure medication
  3. At least five years, seizure-free and off antiseizure medication
  4. At least ten years, seizure-free and off antiseizure medication
Show answer & explanation

Correct answer: C - At least five years, seizure-free and off antiseizure medication

Question 9

After completing a driver's examination today, by when must the certified medical examiner transmit the results to FMCSA through the National Registry?

  1. By midnight, local time, of the next calendar day after the examination
  2. By the final day of the calendar month in which the examination occurred
  3. Within ten business days of the date the examination was completed
  4. Within forty-eight hours of the time the examination was completed
Show answer & explanation

Correct answer: A - By midnight, local time, of the next calendar day after the examination

Question 10

A driver has a below-the-knee amputation with a well-fitted prosthesis and demonstrates good functional ability, and the rest of the examination is normal. What must be in place before this driver can operate a commercial motor vehicle in interstate commerce?

  1. A signed note from the treating physician clearing the driver to operate safely
  2. A three-month trial certification followed by a mandatory functional re-evaluation
  3. A Skill Performance Evaluation certificate issued for the loss of the limb
  4. An alternative vision standard road test administered by the employing carrier
Show answer & explanation

Correct answer: C - A Skill Performance Evaluation certificate issued for the loss of the limb

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