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DOT CERTIFICATION EXAM 202 5 /ACTUAL EXAM WITH
100+ QUESTIONS AND CORRECT DTAILED AND VERIFIED
ANSWERS/ALREADY GRADED A +
When do patients require a Skilled Performance Exam? ANSWER:-> IF they have a FIXED motor deficit of an extremity who cannot physically qualify to drive that needs afull evaluation by a specialist (Not for patients with a progressive motor deficit) Rationale: These patients must provide proof of the exam by the specialist in order to obtain certification or be given a referral letter if you think they need an exam What two special populations of drivers are given exemptions by the DOT? ANSWER :-> 1.Patients with vision disorders
2. Diabetics Rationale: The exemption allows the grandfathering in of certain drivers who participated in vision and diabetes waiver study programs Drivers can be certified as long as they meet the provisions and have the certificate with them at the time of the DOT exam What are your duties as a DOT examiner? ANSWER :-> To detect the presence of any physical,mental, or organic conditions of such character and extent as to affect the ability of the driver to operate a CMV safely
What is the definition of Incapacitation? ANSWER:-> The onset of incapacitating symptoms so rapidly that they interfere with safe driving or that the driver may be unable tosafely stop the vehicle before beocming incapacitated If the patient has any side effects of medications, can they be certified? ANSWER :-> NO!! Any side effects such as drowsiness, dizziness, orthostasis, blurred vision or changes in mental status prohibit the driver from being certified What conditions lead to AUTOMATIC DISQUALIFICATION for DOT certificates? ANSWER:->DEFIBRILLATOR DIALYSIS What are the VISION requirements for DOT certification? ANSWER:-> 1. Distant visual acuityof at least 20/40 in EACH EYE with or w/o lenses
- Distant BINOCULAR vision of at least 20/40 in both eyes, with or w/o lenses
- Field of vision of AT LEAST 70 DEGREES in the horizontal meridian in each eye
- Ability to recognize/distinguish among colors of traffic signals (RED, AMBER,GREEN)
What are the BP regulations for a person with STAGE 1 HTN (BP of 140/90ANSWER:-> 159/99)? person is only certified for 1 year and if BP is
140/90 then they get 3 month cert at the 1 year recert What are the BP regulations for a perston with STAGE 2 HTN (BP of 160/ to 180/110? ANSWER:-> Person can only get a 3 month certificate and then at recertification ifthe BP is less than 140/90, they can get 1 year from the date of the original exam What are the DOT regulations for a driver with STAGE 3 HTN (BP>180/110)? ANSWER:->DRIVER IS DISQUALIFIED until the BP is <140/ When BP is <140/90, they can only get a 6 month certificate forever What does a urinalysis check for DOT certification? ANSWER:-> Specific gravity Proteinuri a Hematuri a Glycosuria What should the PE rule out in every driver? ANSWER:-> Presence of any current CV disease accompanied by and/or likely to cause symptoms of syncope, dyspnea, collapse orCHF
How long must a driver wait to be certified after having an AMI? ANSWER:-> There is a 2 months waiting period so driver is temporarily disqualified for 2 months and canonly be certified for a max of 1 year if they are Asx, tolerating meds, has a satisfactory Exercise Tolerance test has resting EF >40% and no ischemic changeson EKG For the initial certification exam following an MI, an in-hospital post-MI echo showing LV EF>40% is sufficient What LV EF is required after an MI for a patient to obtain DOT certificate? ANSWER:-> LVEF>40% What conditions disqualify a patient after an MI? ANSWER:-> ANSWER:->Rest angina or change inanginal patterns ANSWER:->ischemic changes on rest EKG ANSWER:->intolerance to cardio meds How long must a driver wait after having a CABG before they can be certified? ANSWER:-> 3 months How often is an Exercise Tolerance Test required for a patient after having an AMIvs a CABG? ANSWER:-> ETT every 2 years after an MI ETT every year after a CABG
What is the maximum time that an alcoholic patient can be certified? ANSWER:-
2 years
no recommended time frame for alcoholism waiting period, driver can be certified as long as they have no residual disqualifying physical impairment, completed counseling or no current disqualifying alcoholANSWER:->related d/o's What is required for a driver with a history of drug abuse to be certified? ANSWER:-> 1.Driver must be evaluated by a SAP (Substance Abuse Person)
- Comply with recommended rehab
- Have a negative return-toANSWER:->duty drug test What drugs prohibit you from giving a driver a DOT certificate? ANSWER:-> - Use of schedule 1 controlled substances (Amphetamines, Narcotics)
- :->Any habit forming drug
- :->Methadone (reason for Rx is irrelevant)
- :->Marijuana (even if it's legal in that state) Can a driver with DM who uses insulin be certified? ANSWER:-> NO!! INsulin use is an automatic disqualifier unless the pt has a DM exemption letter/paperwork froman Endocrinologist
ANSWER:->loss of pedal sensation ANSWER:->resting tachy ANSWER:->orthostasis ANSWER:->peripheral neuropathy Any driver on oral hypoglycemic meds for DM can only be certified for how long? ANSWER:-> 1 year You need a letter from endocrinologist stating pt's DM is under good control and pt is not on any meds that can cause hypoglycemia, dizziness, orthostasis For which population of drivers is a skilled performance exam appropriate? ANSWER:-> Onlyfor drivers with fixed deficits of the EXTREMITIES (not the neck or torso) SPE cannot be used as an alternative standard for deficits caused by progressive diseases such as MS What is the waiting period during which a driver with depression must be temporarily disqualified? ANSWER:-> 6 months symptom free following a nonANSWER:->psychoticmajor depression unaccompanied by suicidal behavior 1 year symptom free following a MAJOR/SEVERE depressive episode, suicide
attempt or manic episode Depressed pts can only be certified for 1 yr What is the minimum waiting period for any driver with a history of stroke? ANSWER:-> Atleast 1 year for any pt that has no risk of seizures (vascular lesions in the cerebellum or brainstem) At least 5 years for a pt with stroke related to seizure risk (cortical or subcorticallesions) Driver must be cleared by neuro; Max certification for a pt that has had astroke is 1 yr What are the requirements for obtaining a Sleep Apnea referral for DOT drivers? ANSWER:->Hypertension BMI >35 % and Neck Circumference >17in in M and >16in in F How long is the waiting period for sleep apnea drivers? ANSWER:-> At least 1 month afterstarting CPAP (so pt must be temporarily disqualified for at least 1 mo after starting) At least 3 months symptom free after surgery tx Max certification for 1 year
At least 3 month temporary disqualification for a driver with an underlying dz suchas neurocardiogenic syncope or hypersensitive carotid sinus with syncope
How long can a pt with Diabetes be certified if the Diabetes is well controlled? ANSWER:-> Ingeneral 1 year certification is safest ANSWER:->Pt will need annual evaluation of vision, neuro fxn, cardio dz and HTN Who sets the qualification standards for the DOT exam? ANSWER:-> Federal Motor CarrierSafety Administration (FMCSA) What does CDL stand for? ANSWER:-> Commercial Driver's License (any motor vehicle usedfor commercial purposes that has a weight >10,000 lbs, is used to transport hazardous materials or can carry at least 16 passengers) What are the vision requirements of DOT testing? ANSWER:-> At least 20/ visual acuity ineach eye with or w/o correction At least 70 degrees peripheral vision in each eye Ability to distinguish between red/green/amber colors (Ishihara test) Must demonstrate BINOCULAR VISION *always note use of corrective lenses on the test What is the name of the test to assess for color blindness ANSWER:-> Ishihara Test
What is the definition of controlled Diabetes? ANSWER:-> Fasting plasma glucose < 1402 hour postANSWER:->prandial glucose < HgbA1C < *Ask all patients about hypoglycemic episodes What are the restrictions/guidelines for applicants with Cardiovascular dz? ANSWER:-> Current CV disease that is accompanied by or likely to cuase any symptoms ofSYNCOPE, DYSPNEA, COLLAPSE OR CHF SHOULD BE DISQUALIFIED *Always obtain eval by a Cardiologist ANSWER:->If pt has established CV disease, they must undergo a resting and stress EKG *CABG, pacemakers, Coumadin or NOT disqualifying so refer to Cardiologist forclearance What is the HTN Algorithm ANSWER:-> BP 161 ANSWER:-
180/91ANSWER:-> 100 can be qualified for 3 months. IF the BP is then less than or equal to 160/90 within the 3 months then qualify for 1 year from date of initial exam with documented Rx and BP control BP >180/104 is disqualified until reduced to <180/104 then driver can be qualifiedfor 3 months. If the BP is <160/90 in 3 months, the driver can be qualified for 6 months with documented Rx and BP control
What are the restrictions on applicants with history of epilepsy/seizures? ANSWER:-> Any ptwith a hx of epilepsy, current diagnosis of epilepsy or taking antiseizure meds is DISQUALIFIED ANSWER:->If a patient has a suddent LOC or seizure of unknown cause that did not requireantiANSWER:->seizure meds then there is a 6 month waiting period with neurologic clearance. If Neuro does not prescribe pt with antiANSWER:->seizure meds, pt can then becleared Vision ANSWER:-> Use of contact lenses in 1 eye for distance and 1 eye for near vision meansdriver must be disqualified ANSWER:->If visual acuity is normal only while wearing corrective lenses, then the patientmust wear them in order to qualify What medications are disqualifying according to the DOT? ANSWER:-> Schedule 1 meds suchas Heroine, Marijuana, Amphetamines, Narcotics or any other habitANSWER:->forming drugs (Exception is only if the driver was prescribed the med by a doctor familiar withthe patient's history, duties and has been told it will not interfere with safe driving) Hypertension Stage 1 ANSWER:-> BP between 140/90 and 159/
What is the maximum certification period that can be allowed for a patient on ananticoagulant? ANSWER:-> 1 year for Cardiac anticoagulant, disqualified for BRAIN What is the waiting period after starting CPAP? ANSWER:-> 1 month What is the maximum recertification for drivers with OSA? ANSWER:-> 1 year What is the minimum compliance with CPAP machines required by drivers? ANSWER:-> 4 hours a day on 70% of days How long must a driver stop driving after an MI? ANSWER:-> 2 months ANSWER:->Driver needs an Echo with EF>40% and ETT How long must a driver stop driving after a CABG? ANSWER:-> 3 months to allow for fullsternal healing Can a driver taking medical marijuana be given a DOT card? ANSWER:-> NO, per the FMCSA itis against the rules
What is the criteria for a patient to return to work after having a STENT placed? ANSWER:->Exam and approval letter from treating Cardiologist Asymptomatic ETT 3 ANSWER:-> 6 months post PCI (Stent placement)Annual medical exam Negative ETT at least every other year Is hematuria a disqualifying medical disorder? ANSWER:-> No, you can certify the patient,but you must document a referral to the patients PCP or specialist for further workup Proteinuria ANSWER:-> This is a sign of renal dysfunctionAlways document referral to Nephrologist Can a driver who needs a Diabetes or vision exemption be certified? ANSWER:-> No! Theyare disqualified until they obtain the exemption
