Question 1

A45-year-old male driver informs you that he previously had three (3) incidents of unprovoked seizures in 2009, 2012, and 2013. He is currently taking anti-seizure medication. He has no other health issues.What additional ancillary information is required to include in your examiner's report?
A)Nothing; person is disqualified.
B)A clearance by treating physician that his condition is controlled by medication.
C)Anti-coagulation monitored by monthly INR.
D)Nothing; person is qualified as his condition is controlled.

Accepted Answer

Nothing; person is disqualified.
This is the correct answer because a multiple number ofunprovokedseizures constitutes a medical history of epilepsy. According to FMCSA's guidelines,a person with epilepsy must be disqualified. Conditional certification (for 1 year) is possible if the person has been seizure free for a minimum of 10 years AND is off anti-seizure medication.

Question 2

A 50-year-old male driverpresents for examination with a history of myocardial infarction (MI)6 months before. He is asymptomatic with no angina. What additional reports or information do you need to include/record in your examiner's report that would support the certification decision? A)Post-CABG echocardiogram with LVEF ?40%, tolerance to medication, and asymptomatic status with no angina D)Post-CABG echocardiogram with LVEF >?40% and tolerance to medication

Accepted Answer

A clearance by the treating cardiologist, post-MI echocardiogram with LVEF >?40%, tolerance to medication, and asymptomatic status with no angina
According to FMCSA's guidelines, a person who has had a myocardial infarction (MI) may be certified annually on condition that: 1) at least 2 monthshave passed post-MI, 2) the person demonstrates tolerance to medication, 3) the treating cardiologist provides approval, 4) the person has LVEF of>?40% measured by echocardiogram or ventriculogram, and 5) is asymptomatic with no angina.

Question 3

A34-year-old male driverwith a missingleft-hand index finger presents for examination. The driver is lefthanded. He has no other health issues disqualifying him.What ancillary documents are required to complete the examination of this person?
A)No additional documentation is needed. This person is not qualified as he has an impairment of a finger that interferes with prehension and grasping.
B)A Skill Performance Evaluation (SPE) Certificate by FMCSA.
C)A clearance by the treating orthopedist confirming that the impairment has no effect on the person's prehension and grasping ability.
D)No additional information needed. This person is qualified.

Accepted Answer

A Skill Performance Evaluation (SPE) Certificate by FMCSA.
According to CFR 391.49(a) requirements, a person with a missing body part that interferes with his ability to drive safely, and who has no other disqualifying conditions, requires a Skill Performance Evaluation (SPE) Certificate from FMCSA confirming that he can perform his tasks despite the impairment.

Question 4

According to FMCSA's requirements, how many types of Endocrinologist Evaluation Checklistsexist for a CMV driver who is already qualified under the Federal Diabetes Exemption Program?
A)One; Annual checklist
B)One; Quarterly checklist
C)Two; Annual and quarterly checklists
D)One; Monthly checklist

Accepted Answer

Two; Annual and quarterly checklists
This is the correct answer because according to FMCSA requirements, there are two types of Endocrinologist Evaluation Checklists, one submitted annually at the re-certification examination and one maintained by the driver quarterly and submitted at the re-certification examination time.

Question 5

According to 49 CFR 391.64(a)(1)regulations, who is the only individual authorized to conduct the assessment, complete and sign the Endocrinologist Evaluation Checklist?
A)A board-certified or a board-eligible endocrinologist
B)A board-certified endocrinologist
C)A board-eligible endocrinologist
D)A board-certified ophthalmologist

Accepted Answer

A board-certified or a board-eligible endocrinologist
This is the correct answer because according to 49 CFR 391.64(a)(1) requirements, only a board-certified or board-eligible endocrinologist is authorized to conduct the medical examination annually and quarterly for a CMV driver who is exempt under the Federal Diabetes Exemption Program. A checklist filled in by a physician who does not meet these criteria must be rejected by the medical examiner.

Question 6

Which of the following ancillary document(s) is/are required to be reviewed and recorded as part of the medical examination of a person who has a history of atypical tuberculosis?
A)Chest x-ray
B)Chest x-ray and arterial blood gas analysis
C)Echocardiogram
D)Chest x-ray (radiogram) and spirometry test

Accepted Answer

Chest x-ray (radiogram) and spirometry test
According to FMCSA guidelines, persons with atypical tuberculosis can be certified only after confirming normal lung function, stable conditions and symptoms, and tolerance to medication.Chest x-ray findings will assist in defining the etiology of any symptoms and the extent of the disease. While the spirometry test will help the medical examiner determine the respiratory function.

Question 7

For which one of the following health conditions is a sleep study needed as ancillary information to be included in the medical examination for CMV drivers?
A)Stage-3 hypertension
B)Chronic bronchitis
C)Emphysema
D)Obstructive sleep apnea (OSA)

Accepted Answer

Obstructive sleep apnea (OSA)
As per FMCSA guidelines,one of the conditions to certify a person with obstructive sleep apnea (OSA) is that successful resolution of apneas is confirmed by repeated sleep studies during the course of treatment.In this regard, sleep studies are essential ancillary information for the certification decision by the medical examiner.

Question 8

Drug/controlled substance level tests are not required as ancillary information during the medical examination process of CMV drivers because:
A)The medical examiner is not capable of interpreting the test results.
B)It is the responsibility of the CMV driver's employer to conduct these tests pre-employment.
C)The medical examiner must not rely on these tests solely to determine the drug abuse problem.
D)They do not provide any evidence that the CMV driver has a drug abuse problem.

Accepted Answer

It is the responsibility of the CMV driver's employer to conduct these tests pre-employment.
This is the correct answer because according to 49 CFR 382 regulations, employers must conduct drug testing for CMV drivers pre-employment and post-accident. According to FMCSA guidelines,the fundamental obligation of a medical examiner in this regard is only to evaluate and confirm that a CMV driver has no effects/side effects, as a result of drug abuse, that may interfere with their ability to drive safely.

Question 9

For which one of the following vision disordersis an ophthalmologist evaluationreport NOT required as ancillary information?
A)Monocular vision
B)Visual acuity of 19/40 (Snellen) in both eyes
C)Field of vision of 50° in the horizontal meridian in left eye
D)None of the above

Accepted Answer

Monocular vision
This is the correct answer because according to FMCSA guidelines,monocular vision is a disqualifying condition, thus an ophthalmologist or optometrist evaluation is not required. Vision disorders in answers B & C require further evaluation by a specialist. A vision examination by a specialist can be requested by the medical examiner whenever an accurate evaluation of a CMV driver's vision is needed.

Question 10

According to FMCSA guidelines, in relation to documentation of urinalysis, whose responsibility is it to record the test results on the Medical Examiner'sReport?
A)The CMV driver
B)The medical examiner only
C)The medical laboratory technician where tests were done
D)The medical examiner or a trained assistant

Accepted Answer

The medical examiner or a trained assistant
This is the correct answer because according to FMCSA guidelines,in relation to urinalysis either the medical examiner or a trained assistant may record the test results on the Medical Examiner's Report; however, the medical examiner is responsible for signing the report in order to undertake and attest the validity of the urinalysis test results.

Question 11

When a medical examiner, or a trained assistant, documents the audiometric test results on the Medical Examiner's Report, they must convertISO units to ANSI units by:
A)Subtracting 10 dB from ISO for the test performed at 500 Hz.
B)Subtracting 10 dB from ISO for the test performed at 1,000 Hz.
C)Subtracting 14 dB from ISO for the test performed at 1,000 Hz.
D)Subtracting 8.5 dB from ISO for the test performed at 1,000 Hz.

Accepted Answer

Subtracting 10 dB from ISO for the test performed at 1,000 Hz.
This is the correct answer because according to FMCSA guidelines,when recording hearing test results according to the American National Standards Institute (ANSI), the following decibels (dB) are subtracted from the International Organization for Standardization (ISO) hearing loss values: 14 dB for 500Hz, 10 dB for 1,000Hz, and 8.5 dB for 2,000Hz.

Question 12

When documenting the hearing test results, if a CMV driver must use a hearing aid to meet the standard, you must indicate the same on the Medical Examiner's Report Form by checking which one of the following boxes?
A)"Check if hearing aid used for tests" box
B)"Wearing hearing aid" box
C)"Check if hearing aid required to meet standard" box
D)"Ear disorders, loss of hearing or balance" box

Accepted Answer

"Check if hearing aid required to meet standard" box
This is the correct answer because according to FMCSA guidelines, when recording hearing test results for a driver who must use a hearing aid to qualify as a CMV driver, the "Check if hearing aid required to meet standard" box must be checked. Answer B is checked at the end of the examination in order to note the certification status of the driver.

Question 13

What ancillary information documentationmust the medical examiner obtain before certifyinga driver with a history of alcoholism?
A)A Substance Abuse Professional (SAP) evaluation and clearance report
B)Evidence of participation in a self-help program or support group
C)None of the above
D)All of the above

Accepted Answer

A Substance Abuse Professional (SAP) evaluation and clearance report
This is the correct answer because according to FMCSA guidelines,a driver who has a history of alcoholismmust demonstrate successful completion of counseling and/or treatment under a SAP-required rehabilitation program before she/he is certified by the medical examiner.Participation in a self-help program cannot be a substitutefor the SAP-required program.

Question 14

According to FMCSA guidelines, what ancillary information document(s)is/are required for a driver who is certified under the Federal Diabetes Exemption Program and who is applying for re-certification?
A)Endocrinologist Evaluation Checklist
B)Ophthalmologist/Optometrist Evaluation Checklist
C)Oncologist and Cardiovascular Specialist Evaluation Checklists
D)Endocrinologist and Ophthalmologist/Optometrist Evaluation Checklists

Accepted Answer

Endocrinologist and Ophthalmologist/Optometrist Evaluation Checklists
This is the correct answer because according to FMCSA guidelines for a CMV driver who is exempted under the Diabetes Exemption Program, and who seeks re-certification, the medical examiner must obtain an endocrinologist and ophthalmologist/optometrist evaluation checklistsfor inclusion with a driver's medical documentation.

Question 15

What ancillary information documentation is/are required to be included in the medical examination of a driver who has an implantable cardiac defibrillator (ICD)?
A)Echocardiogram and ETT
B)A cardiologist clearance report
C)Cardiovascular specialist report
D)None of the above

Accepted Answer

None of the above
This is the correct answer because according to FMCSA guidelines,persons with ICDs are not to be qualified as interstate CMV drivers. These persons are at high risk of sudden death or incapacitation and thus, they pose a risk to public safety.

Question 16

What ancillary information documentation must you obtain,and include in your medical examiner report, for a driver with a history ofcongestive heart failure (CHF)?
A)Echocardiogram, Holter monitor results, and ETT results
B)A cardiologist clearance report and ETT results
C)Clearance by the treating cardiologist, echocardiogram, and Holter monitor results
D)None of the above

Accepted Answer

Clearance by the treating cardiologist, echocardiogram, and Holter monitor results
This is the correct answer because for a medical examiner to be able to determine whether a driver with a history of congestive heart failure (CHF) can be certified, she/he must confirm that the person is asymptomatic, tolerant to medication, has no ventricular arrhythmias, and a LVEF of 40% to 50%. The consultation with the treating cardiologist will provide evidence concerning the person's symptoms, while the results of the echocardiogram and the Holter monitor will help determining the LVEF value and any possible arrhythmias, respectively.

Question 17

For which one of the following health conditions must spirometry test results be obtained by the medical examiner and included in the report?
A)Meningitis
B)Obstructive sleep apnea (OSA)
C)Pneumothorax
D)Epilepsy

Accepted Answer

Pneumothorax
This is the correct answer because according to FMCSA guidelines, persons with a history of pneumothoraxmust demonstrate FVC >?65% in order to be certified as interstate CMV drivers. Spirometry will help the medical examiner note the pulmonary functions of the driver and include the results in the medical examiner report.

Question 18

What ancillary information documentation must you obtain, and include in your medical examiner report, for a CMV driver who has acute deep vein thrombosis (DVT)?
A)The medication prescription issued by the treating physician
B)Urinalysis results
C)A monthly INR test result indicating regulation of the prothrombin time (PT) within range
D)A cardiologist clearance report

Accepted Answer

A monthly INR test result indicating regulation of the prothrombin time (PT) within range
This is the correct answer because the medical examiner needs to review and include the monthly INR monitoring to be within rangein order to be able to certify the driver according to FMCSA guidelines for persons with acute deep vein thrombosis (DVT).

Question 19

When requesting a cardiovascular specialistevaluationfor a driver who is at risk of developing a cardiovascular disease, which of the following information and notes do you need to include in your request?
A)Copy of the driver'sjob descriptionfound in the Medical Examination Report
B)Copy of the applicable standard and guidelines 49 CFR 391.41 found in the Medical Examination Report
C)None of the above
D)All of the above

Accepted Answer

All of the above
This is the correct answer because the specialist must understand the role and function of an interstate CMV driver including work hours, duties, lifestyles, physical emotional demands, stress factors and other factors that may affect their health. The applicable medical standards and physical qualifications will assist the specialist in understanding the acceptable criteria and benchmarks for a CMV driver.

Question 20

What ancillary information documentation must you obtain, and include in your medical examiner report, for a CMV driver who is diagnosed with Meniere's disease and who is currently on medication treatment?
A)Audiometric test
B)Clearance from a neurologist
C)None of the above
D)All of the above

Accepted Answer

None of the above
This is the correct answer because according to the recommendations of the Conference of Neurological Disorders and Commercial Drivers, persons with Meniere's disease must be disqualified from being CMV drivers. Meniere's disease is characterized by sensory-neural hearing loss, tinnitus,
pressure sensations within the ear, and severe attacks of vertigo. The conference concludes that the condition is of sufficient severity and unpredictability that would render a person unqualified to drive.

Quiz 3: Documentation of Ancillary Information

A45-year-old male driver informs you that he previously had three (3) incidents of unprovoked seizures in 2009, 2012, and 2013. He is currently taking anti-seizure medication. He has no other health issues.What additional ancillary information is required to include in your examiner's report?

A 50-year-old male driverpresents for examination with a history of myocardial infarction (MI) 6 months before. He is asymptomatic with no angina. What additional reports or information do you need to include/record in your examiner's report that would support the certification decision?

A34-year-old male driverwith a missingleft-hand index finger presents for examination. The driver is lefthanded. He has no other health issues disqualifying him.What ancillary documents are required to complete the examination of this person?

According to FMCSA's requirements, how many types of Endocrinologist Evaluation Checklistsexist for a CMV driver who is already qualified under the Federal Diabetes Exemption Program?

According to 49 CFR 391.64(a) (1) regulations, who is the only individual authorized to conduct the assessment, complete and sign the Endocrinologist Evaluation Checklist?

Which of the following ancillary document(s) is/are required to be reviewed and recorded as part of the medical examination of a person who has a history of atypical tuberculosis?

For which one of the following health conditions is a sleep study needed as ancillary information to be included in the medical examination for CMV drivers?

Drug/controlled substance level tests are not required as ancillary information during the medical examination process of CMV drivers because:

For which one of the following vision disordersis an ophthalmologist evaluationreport NOT required as ancillary information?

According to FMCSA guidelines, in relation to documentation of urinalysis, whose responsibility is it to record the test results on the Medical Examiner'sReport?

When a medical examiner, or a trained assistant, documents the audiometric test results on the Medical Examiner's Report, they must convertISO units to ANSI units by:

When documenting the hearing test results, if a CMV driver must use a hearing aid to meet the standard, you must indicate the same on the Medical Examiner's Report Form by checking which one of the following boxes?

What ancillary information documentationmust the medical examiner obtain before certifyinga driver with a history of alcoholism?

According to FMCSA guidelines, what ancillary information document(s) is/are required for a driver who is certified under the Federal Diabetes Exemption Program and who is applying for re-certification?

What ancillary information documentation is/are required to be included in the medical examination of a driver who has an implantable cardiac defibrillator (ICD) ?

What ancillary information documentation must you obtain,and include in your medical examiner report, for a driver with a history ofcongestive heart failure (CHF) ?

For which one of the following health conditions must spirometry test results be obtained by the medical examiner and included in the report?

What ancillary information documentation must you obtain, and include in your medical examiner report, for a CMV driver who has acute deep vein thrombosis (DVT) ?

When requesting a cardiovascular specialistevaluationfor a driver who is at risk of developing a cardiovascular disease, which of the following information and notes do you need to include in your request?

What ancillary information documentation must you obtain, and include in your medical examiner report, for a CMV driver who is diagnosed with Meniere's disease and who is currently on medication treatment?