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

A driver with an infected finger is experiencing pain during gripping. What should the medical examiner do next?

1. Obtain a hand X-ray

2. Assess capillary refill

3. Obtain a culture and sensitivity

4. Assess the driver's grip strength

The correct answer is: Assess the driver's grip strength

When a driver presents with an infected finger and exhibits pain during gripping, the medical examiner must first evaluate the functional impact of the infection. Assessing the driver's grip strength serves this purpose effectively as it provides direct insight into how the infection is affecting the driver's ability to perform key tasks. By determining grip strength, the examiner can gauge both the severity of the infection and its potential implications on driving safety. This assessment can help point to whether the infection may impair the driver's capabilities significantly. Ultimately, grip strength evaluation assists in making informed decisions about the driver's medical fitness for operating a commercial vehicle. Other actions, such as obtaining a hand X-ray or assessing capillary refill, may not immediately indicate the functional limitations imposed by the infection, and obtaining a culture and sensitivity might be a necessary follow-up but does not directly assess the driver's capacity to grip or handle a vehicle effectively in a practical sense. Therefore, evaluating grip strength is the most relevant and immediate next step in this scenario.