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

A urinalysis is a required part of the driver evaluations. If the UA indicates glycosuria, what should the medical examiner do?

1. Must disqualify the driver

2. Must not certify until a repeat urinalysis shows resolution

3. Must obtain a consultation with an endocrinologist

4. May elect to perform a finger stick to obtain random blood glucose

The correct answer is: May elect to perform a finger stick to obtain random blood glucose

In the context of driver evaluations, glycosuria—referring to the presence of glucose in the urine—can be indicative of an underlying condition such as diabetes. When a urinalysis reveals glycosuria, the medical examiner should prioritize assessing the driver's current health status and potential risk related to their driving ability. Performing a finger stick to obtain a random blood glucose level provides immediate and relevant information regarding the driver’s blood sugar status. This step is crucial for determining whether the glycosuria is a result of a transient condition or a more serious issue requiring further management. If the blood glucose level is normal, it may mitigate concerns associated with glycosuria and allow for possible certification, depending on other health factors. While it is important to ensure that drivers are healthy and fit to operate a vehicle, conducting additional tests like a blood glucose measurement is a practical approach to assess the situation accurately before reaching a conclusion about disqualification or needing specialist consultation. This method effectively enables the medical examiner to make informed decisions based on current evidence rather than solely relying on the urinalysis results.