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

An obese driver's urinalysis shows 500mg/dL of glucose. What should be the next step?

1. Obtain a finger stick glucose

2. Certify for 1 year and recheck at that time

3. Use determination pending and have the patient return for a repeat glucose dipstick within 45 days

4. Disqualify

The correct answer is: Obtain a finger stick glucose

When a urinalysis reveals a glucose level of 500mg/dL, it signifies that there is a significant presence of glucose in the urine, which is often indicative of potential underlying conditions such as diabetes. The next appropriate step is to obtain a finger stick glucose test to assess the driver's current blood glucose level. This test provides immediate results and helps determine whether the high glucose level in the urine corresponds with elevated blood glucose levels. If the finger stick reveals high blood glucose, further evaluation and management of the individual's condition would be necessary, while a normal result could indicate transient factors or a false positive in the urine test. This step is critical because it helps address the potential risk and safety concerns associated with driving while possibly undiagnosed or poorly managed diabetes. The other options do not sufficiently address the need for immediate assessment through blood glucose testing, which is crucial before making further decisions regarding the driver’s medical certification status.