National Registry of Certified Medical Examiners (NRCME) DOT Practice Exam

A driver after triple coronary artery bypass presents a note from his provider stating he can drive. What should the examiner do?

1. Disqualify the driver until the waiting period is completed

2. Disqualify due to low ejection fraction

3. Certify the driver for 1 year

4. Certify the driver for 2 years

The correct answer is: Disqualify the driver until the waiting period is completed

The situation involves a driver recovering from a triple coronary artery bypass and providing a note from their provider indicating that they can drive. The examiner's role requires consideration of safety regulations and guidelines established for commercial driving, particularly regarding cardiovascular health. The correct approach is to disqualify the driver until the waiting period, as mandated by Federal Motor Carrier Safety Administration (FMCSA) guidelines, has been completed. These guidelines recommend a waiting period following significant cardiac events such as coronary artery bypass surgery. This waiting period allows for sufficient recovery and assessment of the driver's cardiovascular stability. Certifying the driver for a specific period such as 1 or 2 years without confirmation of their overall cardiac health would not align with safety practices, ensuring that the driver has adequately healed and can handle the demands of driving. Furthermore, considerations like ejection fraction become relevant only after the appropriate assessment and waiting period have passed. Until those criteria are fully evaluated and satisfied, maintaining a conservative and cautious approach is essential for ensuring not only the driver's safety but also the safety of others on the road.