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

If a medical examiner finds signs suggestive of early hepatic failure in a driver, what should be the first action taken?

1. Order an abdominal ultrasound

2. Order an abdominal CT scan

3. Order a set of Liver Function Tests

4. Refer the driver to his Primary Care Provider

The correct answer is: Refer the driver to his Primary Care Provider

In cases where a medical examiner identifies signs indicative of early hepatic failure in a driver, the immediate priority is to ensure proper evaluation and management of the potential condition. Referring the driver to their Primary Care Provider is the most appropriate first action. This is essential as the Primary Care Provider has the full medical history and can conduct a detailed assessment, which may include further diagnostic testing and evaluation tailored to the individual’s health status. Involving the Primary Care Provider early in the process ensures that the driver receives comprehensive care that may include additional diagnostics, treatment options, and further monitoring that a medical examiner may not be equipped to provide at that moment. This collaborative approach can help prevent escalation of the condition and safeguard the driver's health and safety. While ordering tests such as liver function tests or imaging studies could certainly provide valuable information, initiating a referral to the Primary Care Provider ensures that the driver is managed holistically and receives timely medical advice and intervention based on their complete health profile.