KEY INSIGHTS INTO THE NRCME TEST
Answer each question as though you are the driver’s PCP who is also their medical examiner.
- When to order a specific lab test such as a pulmonary function test (PFT), basic metabolic panel (BMP), complete metabolic panel (CMP), or a complete blood count (CBC). For example, a CMP contains the information needed monitor liver function, but a BMP does not. If you’re only interested in kidney function, you would order a BMP or solely a creatinine level.
Here are some additional points to remember as you prepare for the test:
– Alternate vision standard for monocular vision and MCSA-5871
– Note: The Jaeger vision chart measures near vision and is NOT a part of the physical exam
– Know how conditions such as cataracts, glaucoma, and retinopathy affect vision
– Xanthopsia is a dominantly yellow bias in vision due to a yellowing of the optical media of the eye predominantly caused by digoxin
– Xanthelasma Palpebrarum is a benign condition of soft yellow plaques on the inner aspect of the eyes. It is linked to conditions such as hyperlipidemia, diabetes, and thyroid dysfunction
– Strabismus is also known as cross-eyed
– Amblyopia is also known as lazy eye
– Nystagmus is an involuntary, rapid and repetitive movement of the eyes
– What does ANSI and ISO stand for
— To pass the audiometric test, you must have less than or equal to 40dB of hearing loss
— Hearing aides: must carry spare battery or spare hearing aide; Audiomentric test must be open field
– (click here for audiogram information)
– Otic diseases: Meniere’s, Vertigo
– Hearing Exemption
– What is a severe hypoglycemic episode and what are the guidelines?
– Deep Tendon Reflexes: decreased vs spastic and conditions that affect DTRs
– Jobe’s test is to diagnose anterior shoulder instability
– Hawkins–Kennedy Test is used to evaluate for muscular impingement of the shoulder due to injury
– Lasègue test (straight leg raise) is used to determine whether a patient with low back pain has an underlying nerve root sensitivity, often located at L5
– Phalen’s maneuver is a diagnostic test for carpal tunnel syndrome
– Anterior Drawer and Lachman tests are used to assess for possible rupture of the ACL of the knee
– What labs test for which organs?
– The most common diseases and symptoms affecting these organs
– Nerve roots and myotomes
– Seizures (nondiscretionary standard): provoked vs unprovoked, waiting periods, seizure exemption, medication = Depakote
– Parkinson’s: Sinemet, certify with mild symptoms
– Rhomberg’s test is used to check balance by having them stand with the feet together and the eyes closed and evaluating for any sway in their stance
– Anticoagulants are not disqualifying
– The only absolutely disqualifying medication is marijauna
– Know medications created to treat a certian condition but are commonly prescribed for other conditions (Lamotrigine is an anticonvolsant commonly prescribed for Bipolar or other mental health conditions. Same as for Topamax, commonly used for headaches. The anti-depressant Wellbutrin (Bupropion) is commonly prescribed for smoking cessation.)
– Focus on opioids and mental health medications (Zyprexa is for schizophrenia)
– Guidelines/recommendations surrounding smoking
– Sleep Apnea
a. Risk factors/When to order sleep study
b. Sleep study results (AHI)
– For which conditions would an ECHO be ordered vs an ETT
– Coumadin: INR 2-3
– Xarelto/Pradaxa/Eliquis affect kidneys, consider checking creatinine
– Digoxin is derived from Digitalis. It is used for arrhythmias; It can cause xanthopsia which is a dominantly yellow bias in vision due to a yellowing of the optical media of the eye
– Hypertension guidelines
While taking the test, if you are unable to immediately identify the correct answer, go back and re- read the question very closely. If a second reading does not seem to help, make your best choice for the answer, and save the question into the review list and come back to it after you have worked through the complete test. Do not spend too much time on any one question. It’s important to move deliberately through the test.
At the end of two hours, or when you exit the test, you will get a score. The passing score for that test will be displayed along with your score. If you do not pass, you will be able to reschedule online the following day. There is no waiting period before you can retake the test.
Remember to Pace Yourself!
After taking the National Registry certification test, if you notice questions that you found were particularly challenging or that you feel should be better covered in the training or practice test, please feel free to contact us at contact@TeamCME.com.