Deck 3: Documentation of Ancillary Information

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.

Answer 1

Nothing; person is disqualified.

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 B)A clearance by the treating cardiologist, post-MI echocardiogram with LVEF C)A clearance by the treating cardiologist, post-MI echocardiogram with LVEF >?40%, tolerance to medication, and asymptomatic status with no angina
D)Post-CABG echocardiogram with LVEF >?40% and tolerance to medication

Answer 2

A clearance by the treating cardiologist, post-MI echocardiogram with LVEF >?40%, tolerance to medication, and asymptomatic status 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.

Answer 3

A Skill Performance Evaluation (SPE) Certificate by FMCSA.

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

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

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

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)

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.

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

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

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.

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

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

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

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

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

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

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

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

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

Question 21

Ancillary tests and/or consultation with a psychiatrist or psychologist, who understands the functions and demands of commercial driving, must be obtained:

A)For every person undergoing medical examination for CMV driving.
B)On a case-by-case basis depending on the medical examiner's own assessment of psychological well-being.
C)For persons diagnosed with obstructive sleep apnea (OSA).
D)For female CMV drivers.