Download DOT Exam/ 319 Questions with Certified Solutions/ 2024. and more Exams Nursing in PDF only on Docsity!
DOT Exam/ 319 Questions with Certified
Solutions/ 2024.
The driver presents with a SPE Certificate. The Medical Examiner's next step should be: - Answer: Proceed with the examination. A 21-year-old driver presents with a history of ADHD for 10 years, taking stable dosing of Adderall. He describes no side effects. Which of the following is true? a. A significant percentage of individuals with adult ADHD show a moderate to marked degree of improvement on central nervous system stimulant medication. b. ADHD is a disqualifying condition. c. Adderall is a Schedule 1 drug.
d. Medical Examiners should test for serum drug levels of Adderall. - Answer: A significant percentage of individuals with adult ADHD show a moderate to marked degree of improvement on central nervous system stimulant medication Which of the following is the most important examination finding that requires additional evaluation? a. Acrochordon. b. Hyperopia. c. Palpable calf cords. d. Verruca vulgaris. - Answer: Palpable calf cords The driver reports taking Digoxin. What findings would raise the most significant concerns regarding certification? a. Arrhythmias. b. Anorexia. c. Nausea and vomiting. d. Diarrhea. - Answer: Arrhythmias. The driver is taking theophylline. Which of the following is not true? a. Serum levels may be checked. b. The primary indication for theophylline is in the treatment of neurological conditions. c. Cardiac toxicity is a significant risk of theophylline use. d. Theophylline can be administered orally or intravenously (IV - Answer: The primary indication for theophylline is in the treatment of neurological conditions.
driver says that he doesn't need the hearing aid to drive and doesn't think it should be required. The next step for the Medical Examiner is: a. Test the driver's hearing without the hearing aid. b. Examine the driver's ears. c. Refer the driver for hearing assessment by a specialist with specialized audiometric testing capabilities for testing drivers while wearing a hearing aid. d. Certify the driver with the qualification "wearing hearing aid - Answer: Test the driver's hearing without the hearing aid. A driver has an indication for obtaining a cardiac stress test. If the driver is not taking a beta blocker, what is the percentage of maximum heart rate that the driver should meet to indicate a satisfactory stress test: a. 60%. b. 75%. c. 85%. d. 100%. - Answer: 85% The driver is missing the 4th finger of his right hand. The Medical Examiner should: a. Refer for orthopedic evaluation. b. Indicate the driver will need a SPE Certificate. c. Test the driver's grasp and prehension.
d. Disqualify the driver - Answer: Test the driver's grasp and prehension. The driver describes a history of dizzy spells. Which examination finding is not indicated? a. Test the driver for nystagmus. b. Romberg testing. c. Orthostatic blood pressure measurements. d. Liver and spleen palpation - Answer: Liver and spleen palpation Guidance (not regulatory) recommendations are that drivers with dizziness or vertigo should not be qualified until the driver has achieved a 2-month symptom free interval regardless of examination findings. Vision testing may be performed by: a. The Medical Examiner, an optometrist, or ophthalmologist. b. Only an ophthalmologist. c. Only the Medical Examiner. d. Only an optometrist - Answer: The Medical Examiner, an optometrist, or ophthalmologist The driver has 1,000 ng/ml of glucose on urinalysis. What is the next appropriate step for the Medical Examiner?
The driver describes alcohol use including 2 drinks a night during the week and a 6 pack on the weekends. The Medical Examiner's next step should be to: a. Refer the driver for evaluation by a substance abuse professional. b. Further assess the driver's history of and current use of alcohol. c. Disqualify the driver. d. Test the driver for drugs and alcohol - Answer: Further assess the driver's history of and current use of alcohol What is the driver required to sign for on MCSA-5875? a. Health history. b. Release of information. c. Acknowledgement of testing results. d. Acceptance of the Medical Examiner's certification determination - Answer: Health history. What is appropriate preparation for the physical examination? a. Dress and stockings. b. Examination gown and underwear. c. Shorts and tennis shoes. d. Loose fitting clothing. - Answer: Examination gown and underwear
The driver has a history of coronary artery bypass grafting (CABG) 3 years ago. He is now describing shortness of breath. The Medical Examiner's next step is: a. Refer the driver for cardiac stress testing. b. Refer the driver for cardiology evaluation. c. Disqualify the driver. d. Assess cardiac risk factors and further characterize the driver's symptoms - Answer: Assess cardiac risk factors and further characterize the driver's symptoms Which of the following should raise the greatest concern for the Medical Examiner's assessment? a. History of lumbar fusion 2 years ago. b. Grade 1 ankle sprain 1 month ago. c. Prepatellar bursitis 3 months ago. d. Rotator cuff injury 6 months ago. - Answer: Grade 1 ankle sprain 1 month ago. The driver smokes and describes long hours of prolonged driving. Which of the following is the most important condition or symptom that the Medical Examiner should discuss with the driver? a. Fatigue.
The driver gives a history of a seizure 14 years ago due to an adverse medication reaction. What is the next step for the Medical Examiner? a. Disqualify the driver. b. Indicate that the driver is only medically qualified with a seizure/epilepsy exemption/waiver. c. Check pharmacy records for anti-seizure medications. d. Confirm the driver's medical history with the driver's primary care provider. - Answer: Confirm the driver's medical history with the driver's primary care provider The driver has a BMI of 37 and 2+ edema in the lower extremities. The Medical Examiner's next step is to: a. Advise the driver to elevate legs above heart. b. Assess cardiac risk factors. c. Refer the driver for a cardiology evaluation. d. Recommend a diuretic medication - Answer: Assess cardiac risk factors The driver gives a history of a recent right shoulder injury. The following measurements are described in the shoulders. Abduction R 90 L 160 IR R 40 L 50 Flexion R 100 L 170 ER R 30 L 50. The Medical Examiner should note which of the following?
a. Instability. b. Normal ROM. c. Abnormal ROM. d. Weakness - Answer: Abnormal ROM. Which conditions are disqualifying by regulation? a. Hearing loss and seizures/epilepsy. b. Seizures/epilepsy and insulin-dependent diabetes. c. Insulin-dependent diabetes and monocular vision. d. Hearing loss and insulin-dependent diabetes. - Answer: Hearing loss and seizures/epilepsy. Which conditions would be appropriate for the Medical Examiner to consider for Determination Pending? a. Urinalysis with 500 mg/dL of glucose. b. Blood pressure of 175/80. c. Hearing whisper test with first detected results at 3 feet R, 4 feet L. d. Driver with history of myocardial infarction 3 weeks ago - Answer: Urinalysis with 500 mg/dL of glucose
b. Refer the driver for a cardiology evaluation. c. Require that the driver provide evidence of monthly INR checks. d. Place the driver in Determination Pending - Answer: Disqualify the driver
- FMCSA guidance (not regulatory) recommendations include disqualification of drivers with neurologic conditions who are on blood thinning medications. Since this is a guidance recommendation, the Medical Examiner could (and should) obtain a detailed medical history of both the driver's neurologic and cardiac conditions and could consider referral for neurologic and cardiac evaluations The driver reports a recent diagnosis of atrial fibrillation 6 weeks ago. He is taking warfarin (Coumadin). What is the most appropriate next step for the Medical Examiner? a. Disqualify pending receipt of INR testing results. b. Qualify for 1 year with monthly INR checks. c. Qualify 3 months to assess INR stability. d. Consider Determination Pending - Answer: Disqualify pending receipt of INR testing results
- Drivers who are on warfarin are required to have monthly INR checks. When warfarin treatment is started, measurements of INR function should be required
to assure that INR treatment is therapeutic and stable. After this is established, FMCSA guidance recommendations are for monthly INR testing The driver gives a recent history of a right wrist fusion. Grip strength is 10# on the right and 60# on the left. The most appropriate Medical Examiner next step is: a. Qualify the driver for 1 year. b. Disqualify the driver. c. Place the driver in Determination Pending and refer for an orthopedic evaluation. d. Qualify the driver with a requirement that the driver wear a wrist brace - Answer: Disqualify the driver The measured grip strength on the right is significant and likely to be functionally impairing with respect to the many driver duties that require firm grasping. The driver fails an Ishihara color test. The next step for the Medical Examiner should: a. Refer the driver for an ophthalmology evaluation. b. Disqualify the driver. c. Test the driver for the ability to recognize red, amber, and green.
a. Document a probable aortic aneurysm and disqualify the driver. b. Place the driver in Determination Pending. c. Certify the driver for 1 year. d. Recommend that the driver have an abdominal ultrasound - Answer: Document a probable aortic aneurysm and disqualify the driver When audiometric testing is performed, what is the standard that should be used? a. ISO - International Organization for Standards. b. ANSI - American National Standards Institute. c. OSHA - Occupational Safety and Health Administration. d. SDHE - Standard Diagnostic Hearing Evaluation. - Answer: ANSI - American National Standards Institute. The driver has a history of a lumbar laminectomy. What finding would raise concern? a. Hip ROM. b. Mild lumbar tenderness. c. Positive Lasegue's sign. d. Quadriceps stretch sign. - Answer: Positive Lasegue's sign
Lasegue's sign or straight leg raising test (SLRT) is a neurodynamic exam to assess nerve root irritation in the lumbosacral area and it used to help identify the likelihood of lumbar radiculopathy The driver has a lipoma that is not impairing. The Medical Examiner should: a. Refer the driver for surgical evaluation. b. Place the driver in Determination Pending. c. Assess driving risk related to the lipoma. d. Document the examination finding. - Answer: Document the examination finding. The driver resides in Canada and does not have a US driver's license. What is the Medical Examiner required to confirm? a. Where the driver is domiciled. b. The driver's identity. c. The driver's application for a US driver's license. d. The driver's international driver's license number. - Answer: The driver's identity The driver has swollen tonsils. What is the Medical Examiner's best next action?
a. Knee flexion. b. Ankle dorsiflexion. c. Hip ROM. d. Lumbar subluxations. - Answer: Knee flexion Knee flexion weakness could limit driver use of the lower extremity and can occur with compression of the L5 nerve which is associated with L4-5- disc herniation. The driver reports a recent concussion. Which of the following is most important for the Medical Examiner to assess: a. Nystagmus. b. Hearing loss. c. Patellar and ankle reflexes. d. Muscle weakness. - Answer: Nystagmus The driver describes shortness of breath. What findings would be potentially disqualifying? a. Respiratory rate of 14/minute. b. PaO2 less than 65 at elevations less than 5,000 feet. c. Oxygen saturation of 93% on room air.
d. PaCO2 of 35 mmHg. - Answer: PaO2 less than 65 at elevations less than 5, feet PaO2 less than 65 at elevations less than 5,000 feet or less than 60 at elevations above 5,000 feet are potentially disqualifying as is PaCO2 of > 45 mmHg. Which of the following is not required by 49 CFR Part 391.46 which describes requirements for the evaluation of a driver with Insulin-Treated Diabetes Mellitus (ITDM)? a. Evaluation by the treating clinician (TC), the provider responsible for managing the driver's diabetes and prescribing insulin. b. A requirement for drivers to carry a rapidly absorbable form of glucose. c. Completion by the treating clinician (TC) of form MCSA-5870, the InsulinTreated Diabetes Mellitus Assessment Form. d. Examination by the Medical Examiner no more than 45 days after completion of form MCSA-5870, the Insulin-Treated Diabetes Mellitus Assessment Form - Answer: A requirement for drivers to carry a rapidly absorbable form of glucose Required urinalysis tests required for driver physical examination include __________.
