Vision — All Questions

Question 1 of 154

1. Question

Category: Vision: Acuity Standards

When conducting a vision examination, a driver must have at least what distant visual acuity in each eye with or without correction?

20/40

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20/20

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20/10

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20/60

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Question 2 of 154

2. Question

Category: Vision: Field of Vision

When conducting a vision examination, a driver must have at least what degree of peripheral in each eye in his or her horizontal meridian?

70 degrees

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90 degrees

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45 degrees

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120 degrees

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Question 3 of 154

3. Question

Category: Vision: General Vision

Which of the following colors is not necessary to be able to distinguish and recognize in traffic signals and devices?

Blue is not a required color for recognition

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Amber

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Red

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Green

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Question 4 of 154

4. Question

Category: Vision: Eye Conditions

Which of the following types of vision can still qualify for certification under the standard in 391.41(b)(10)?

Use of contact lenses

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Vision correctable only with bioptic telescopic lenses

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Use of telescopic lenses

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Failure to meet any part of the vision testing criteria with one eye or both eyes

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Question 5 of 154

5. Question

Category: Vision: General Vision

Which of the following is not a necessary vision skill of a driver?

Perceive the weight of other vehicles on the road

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Perceive the relative distance of objects

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Make lane changes

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Avoid other vehicles on the road

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Question 6 of 154

6. Question

Category: Vision: General Vision

Which of the following does not magnify the visual demands of driving?

Various colors of traffic signs and lights

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Vehicles with larger blind spots

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Longer turning radiuses

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Increased stopping times

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Question 7 of 154

7. Question

Category: Vision: General Vision

A driver indicates that he or she has an eye disorder. Which of the following represents the appropriate next action?

Ask for clarification of the disorder and document all the details

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Send the driver to a specialist

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Automatically disqualify the driver

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Proceed asking the other questions about vision

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Question 8 of 154

8. Question

Category: Vision: General Vision

A driver indicates that he or she has impaired vision, excluding the use of corrective lenses. Which of the following represents the appropriate next action?

Ask for clarification of the impairment and document all the details

Correct Incorrect Correct answer

Automatically disqualify the driver

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Send the driver to a specialist

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Proceed asking the other questions about vision

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Question 9 of 154

9. Question

Category: Vision: Eye Conditions

A medical examiner examines a driver’s eyes and suspects cataracts, but the driver has never been diagnosed with cataracts. What is the proper subsequent action for the medical examiner?

Send the driver to a specialist

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Diagnose the driver with growing cataracts

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Simply make note of the potential cataracts and proceed

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Do nothing about the cataracts; proceed with the rest of the vision testing

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Question 10 of 154

10. Question

Category: Vision: Eye Conditions

While asking about certain eye disorders and conditions, a driver describes the symptoms of macular degeneration. Which of the following is the proper subsequent action for the examiner?

Send the driver to a specialist

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Diagnose the driver with macular degeneration

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Simply make note of the driver's comments and proceed

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Do nothing about the comments; proceed with the rest of the vision testing

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Question 11 of 154

11. Question

Category: Vision: Acuity Standards

Which of the following does the Snellen chart or the Titmus Vision Tester measure?

Static distant visual acuity

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Peripheral vision

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Depth of eye trauma

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Intraocular pressure

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Question 12 of 154

12. Question

Category: Vision: Acuity Standards

A driver needs corrective lenses during the central visual acuity test. Which of the following is true about such a driver?

Given further certification, he or she must wear the corrective lenses while driving

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There is no need to wear the lenses while driving

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The driver is automatically disqualified

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The driver has the option to wear the lenses while driving

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Question 13 of 154

13. Question

Category: Vision: Acuity Standards

Which of the following does not represent Snellen eye test results that meet the minimum requirements?

20/50

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20/20

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20/40

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20/30

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Question 14 of 154

14. Question

Category: Vision: General Vision

If a peripheral vision test is inconclusive, what is the appropriate subsequent action for the medical examiner?

Send the driver to a specialist

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Disqualify the driver

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Perform the test one more time before passing the driver

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Do nothing about the results; it is not a required test

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Question 15 of 154

15. Question

Category: Vision: General Vision

During confrontation visual field testing, which of the following describes the correct technique?

The individual looks at the ME's eye or nose and counts fingers shown in the peripheral visual field

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The individual tracks a moving light across the visual field while both eyes remain open

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The individual reads letters from a peripheral chart positioned at 70 degrees

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The individual closes both eyes alternately while the ME shines a light from the side

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Question 16 of 154

16. Question

Category: Vision: Eye Conditions

Which of the following accurately describes monocular vision?

Vision requirements are met in only one eye

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Involuntary eye movement

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Vision that needs corrective lenses

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Near-sighted vision

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Question 17 of 154

17. Question

Category: Vision: Eye Conditions

Which of the following accurately describes cataracts?

Opacification of the crystalline lens of the eye

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Abnormal regulation of intraocular pressure

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Disease that impacts the macula function and interferes with detailed, central vision

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Noninflammatory damage to the retina of the eye

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Question 18 of 154

18. Question

Category: Vision: Acuity Standards

Which of the following describes the effects of glaucoma?

Deficits in peripheral vision, which cannot be restored

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Distorts the optical passage of light to the retina resulting in diminished visual acuity

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Drop in visual acuity, lengthened recovery from bright light, and eventually a partial or total scotoma develops

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Possible partial scotomas in central vision or gross hemorrhage in the eye, obscuring vision, which could lead to retinal detachment and blindness

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Question 19 of 154

19. Question

Category: Vision: Eye Conditions

Which of the following is most commonly caused by diabetes mellitus?

Retinopathy

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Macular degeneration

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Glaucoma

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Cataracts

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Question 20 of 154

20. Question

Category: Vision: Eye Conditions

An ophthalmologist diagnoses a driver with macular degeneration, but says that wearing telescopic lenses can assist the driver’s vision and slow the effects of the degeneration. Which of the following is the appropriate subsequent action by the medical examiner?

Disqualify the driver because drivers cannot use telescopic lenses while driving

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Certify the driver with an exemption

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Certify the driver and mark on the report form that the driver must wear telescopic lenses

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Send the driver to a different specialist for further observation

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Question 21 of 154

21. Question

Category: Vision: Eye Conditions

A driver has insulin-treated diabetes mellitus and is diagnosed with proliferative diabetic retinopathy. Which of the following is the appropriate subsequent action by the medical examiner?

Disqualify the driver

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Certify the driver under the alternative vision standard (49 CFR 391.44)

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Send the driver to a specialist

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Certify the driver and mark on the report which diagnoses were reported

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Question 22 of 154

22. Question

Category: Vision: General Vision

A driver wears contact lenses, passes the vision test only with contacts, has two years of documented good tolerance, and does not carry backup glasses. What should the ME do?

Certify the driver with the corrective lenses requirement noted on both forms

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Require the driver to obtain backup glasses before certification

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Refer the driver for evaluation under the alternative vision standard

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Defer certification until the driver can demonstrate tolerance for at least 3 years

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Question 23 of 154

23. Question

Category: Vision: General Vision

Vision testing for the DOT physical qualification examination may be performed by which of the following?

The Medical Examiner, an optometrist, or ophthalmologist

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Only an ophthalmologist

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Only the Medical Examiner

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Only an optometrist

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Question 24 of 154

24. Question

Category: Vision: Field of Vision

Which of the following is true regarding horizontal field of vision testing for CMV drivers?

Medical Examiners may use a variety of reasonably reliable methods to measure field of vision in the clinical setting

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The passing parameter requires 75 degrees or more in each eye's horizontal visual field

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Only automated perimetry (Humphrey or Goldmann) testing is accepted for field of vision measurement

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Field of vision testing is only required when the driver reports a history of visual field loss

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Question 25 of 154

25. Question

Category: Vision: General Vision

Under 49 CFR 391.44, what specialist evaluation is required for a driver seeking certification under the alternative vision standard?

An ophthalmologist or optometrist must complete the Vision Evaluation Report (MCSA-5871)

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Any healthcare provider may perform the vision evaluation

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The ME conducts all vision testing without specialist referral

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A neurologist must confirm that the vision impairment is not neurological in origin

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Question 26 of 154

26. Question

Category: Vision: Acuity Standards

To pass the interstate CMV driver vision exam, a visual acuity of corrected or uncorrected is required.

20/20 in each eye individually and both eyes combined

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20/40 in each eye individually and both eyes combined

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20/20 in at least 1 eye

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20/40 in at least 1 eye

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Question 27 of 154

27. Question

Category: Vision: Acuity Standards

Required vision testing does not include:

Distant visual acuity

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Near visual acuity

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Peripheral horizontal visual fields

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Color

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Question 28 of 154

28. Question

Category: Vision: Acuity Standards

What is the minimum distant visual acuity required for CMV driver certification per FMCSA?

20/20 in each eye

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20/40 in each eye with or without correction

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20/50 binocular

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20/30 in the better eye

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Question 29 of 154

29. Question

Category: Vision: Field of Vision

The FMCSA requires a horizontal field of vision of at least how many degrees in each eye?

90 degrees

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60 degrees

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70 degrees

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120 degrees

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Question 30 of 154

30. Question

Category: Vision: General Vision

What color recognition ability is required for CMV driver certification?

Ability to distinguish all colors on the visible spectrum

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Ability to recognize and distinguish traffic signal colors: red, green, and amber

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Ability to pass a full-spectrum Farnsworth-Munsell test

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No color vision requirement exists

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Question 31 of 154

31. Question

Category: Vision: Acuity Standards

Which chart is most commonly used for distance visual acuity testing during a DOT physical?

Jaeger chart

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Snellen chart

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Ishihara plates

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Amsler grid

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Question 32 of 154

32. Question

Category: Vision: General Vision

Which test is commonly used to evaluate color vision during a DOT physical?

Snellen chart

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Confrontation visual field test

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Ishihara pseudoisochromatic plates

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Amsler grid

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Question 33 of 154

33. Question

Category: Vision: Acuity Standards

A driver has 20/40 vision in the right eye and 20/60 vision in the left eye with best correction. What is the determination?

Certified, as one eye meets the standard

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Does not meet the standard vision requirements under 391.41(b)(10)(i) because each eye must individually meet 20/40

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Certified with monocular restrictions

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Certified if binocular acuity is 20/40

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Question 34 of 154

34. Question

Category: Vision: Acuity Standards

A driver wears contact lenses and achieves 20/30 in each eye. What is the certification determination?

Disqualified because corrective lenses are not permitted

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Certified with a notation that corrective lenses are required while driving

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Certified with no restrictions since vision exceeds 20/40

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Must wear glasses instead of contacts

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Question 35 of 154

35. Question

Category: Vision: General Vision

Which type of corrective lenses is NOT acceptable for meeting FMCSA vision standards?

Bifocal glasses

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Contact lenses

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Telescopic or bioptic lenses

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Progressive multifocal lenses

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Question 36 of 154

36. Question

Category: Vision: Eye Conditions

What is the primary safety concern with monocular vision in CMV drivers?

Color vision deficiency

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Reduced depth perception and peripheral vision on one side

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Inability to read road signs

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Night blindness

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Question 37 of 154

37. Question

Category: Vision: Acuity Standards

A driver had cataract surgery in the right eye 3 months ago and now has 20/25 in that eye. What is the determination?

Disqualified for 1 year after cataract surgery

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Certified if both eyes individually meet 20/40 and 70-degree field after stable recovery

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Certified only with FVE

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6-month temporary certification

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Question 38 of 154

38. Question

Category: Vision: Acuity Standards

A driver with glaucoma should have what aspects of vision evaluated during the DOT exam?

Only intraocular pressure

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Both visual acuity and visual fields, as glaucoma can reduce peripheral vision

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Only color vision

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Only central acuity

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Question 39 of 154

39. Question

Category: Vision: Acuity Standards

A driver with open-angle glaucoma controlled on eye drops meets 20/40 acuity and 70-degree fields in both eyes. What is appropriate?

Disqualified due to glaucoma diagnosis

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Certification with possible shortened certification period for monitoring

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Standard 2-year certification with no additional considerations

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FVE required regardless of current visual function

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Question 40 of 154

40. Question

Category: Vision: Acuity Standards

Macular degeneration primarily affects what aspect of vision that could impact CMV driver certification?

Peripheral vision only

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Color vision only

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Central visual acuity

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Night vision only

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Question 41 of 154

41. Question

Category: Vision: Acuity Standards

A driver with dry age-related macular degeneration has 20/40 in the right eye and 20/50 in the left eye. What is the determination?

Certified since one eye meets the standard

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Does not meet the vision standard because each eye must be 20/40 or better

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Certified with monocular restrictions

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Certified for intrastate only automatically

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Question 42 of 154

42. Question

Category: Vision: Field of Vision

A driver with retinitis pigmentosa should be carefully evaluated for loss of what?

Central acuity only

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Color vision only

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Peripheral vision (visual fields)

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Hearing

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Question 43 of 154

43. Question

Category: Vision: Acuity Standards

A driver had a retinal detachment repaired in the left eye 6 months ago. Vision is now 20/35 with 68-degree field. What is the determination?

Certified if the right eye meets all standards

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Does not meet the field of vision standard (requires 70 degrees in each eye)

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Standard certification since acuity meets 20/40

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Certified under the alternative vision standard automatically

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Question 44 of 154

44. Question

Category: Vision: Acuity Standards

LASIK surgery affects CMV driver certification in what way?

LASIK disqualifies a driver permanently

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The driver can be certified once vision has stabilized and meets standards post-surgery

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A 1-year waiting period is required after LASIK

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FVE is always required after LASIK

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Question 45 of 154

45. Question

Category: Vision: Acuity Standards

A driver had PRK surgery 2 months ago and now has 20/25 in both eyes with full visual fields. What is appropriate?

Cannot certify for 6 months after PRK

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Certify if vision is stable and meets all standards

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FVE required after any refractive surgery

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1-year certification maximum

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Question 46 of 154

46. Question

Category: Vision: Acuity Standards

Aphakia (absence of the natural lens) in a CMV driver can be corrected with what to meet vision standards?

Only intraocular lens implant

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Contact lens or intraocular lens implant, as long as acuity standards are met

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Telescopic lenses

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Aphakia cannot be corrected sufficiently for CMV driving

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Question 47 of 154

47. Question

Category: Vision: Acuity Standards

A driver reports floaters in their vision but has 20/30 acuity and full visual fields. What should the examiner do?

Disqualify due to floaters

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Certify if acuity and field standards are met; floaters alone are not disqualifying

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Require immediate retinal surgery

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Issue only a 3-month certificate

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Question 48 of 154

48. Question

Category: Vision: General Vision

A driver fails the Ishihara color test but can correctly identify traffic signal colors on a practical test. What is the determination?

Disqualified because they failed the Ishihara test

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May be certified if they can demonstrate ability to recognize traffic signal red, green, and amber

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Must pass the Ishihara test specifically

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Referral to ophthalmology is mandatory before any determination

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Question 49 of 154

49. Question

Category: Vision: General Vision

A driver with red-green color deficiency who cannot reliably distinguish traffic signal colors should receive what determination?

Certified with a color vision exemption

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Does not meet the color recognition requirement and cannot be certified

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Certified for daytime driving only

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Certified if they memorize signal position (top, middle, bottom)

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Question 50 of 154

50. Question

Category: Vision: Acuity Standards

During a DOT vision exam, each eye should be tested separately. Which eye should be covered first?

Always the right eye first

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Always the left eye first

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Either eye may be tested first; each must be tested individually

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Only the weaker eye needs testing

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Question 51 of 154

51. Question

Category: Vision: Acuity Standards

A driver uses reading glasses for near vision only. Distance acuity without correction is 20/30 in each eye. What is appropriate?

Must wear correction for driving because they use glasses

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Certified without a corrective lens restriction since distance acuity meets standards uncorrected

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Must bring reading glasses to the exam

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Cannot be certified with presbyopia

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Question 52 of 154

52. Question

Category: Vision: Acuity Standards

A driver’s vision test shows 20/40 in the right eye and 20/40 in the left eye with glasses. What is the certification?

Does not meet standard because 20/40 is the minimum

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Certified with corrective lens restriction , 20/40 in each eye meets the standard

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Requires FVE because both eyes are at the minimum

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Must have better than 20/40 in at least one eye

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Question 53 of 154

53. Question

Category: Vision: Field of Vision

What visual field testing method is acceptable during a DOT physical examination?

Only automated perimetry (Humphrey visual field)

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Confrontation visual field testing is acceptable as a screening method

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Only tangent screen testing

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Visual field testing is not required

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Question 54 of 154

54. Question

Category: Vision: Field of Vision

A driver has a visual field of 75 degrees in the right eye and 65 degrees in the left eye. What is the determination?

Certified since one eye meets 70 degrees

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Does not meet the standard because each eye must individually have at least 70-degree field

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Certified with restrictions

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Average of both eyes meets the standard

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Question 55 of 154

55. Question

Category: Vision: Field of Vision

A driver with progressive glaucoma whose visual fields are gradually narrowing should receive what certification consideration?

Standard 2-year certification

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Shortened certification period to monitor for field loss below the 70-degree requirement

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Permanent 2-year certification if fields currently meet standard

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Automatic FVE

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Question 56 of 154

56. Question

Category: Vision: Acuity Standards

A driver has had a corneal transplant in the right eye. When can they be considered for certification?

Immediately after surgery

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After vision stabilizes and meets standards, typically several months post-transplant

Correct Incorrect Correct answer

Never, corneal transplant is permanently disqualifying

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After exactly 1 year

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Question 57 of 154

57. Question

Category: Vision: Field of Vision

A 55-year-old driver presents with new-onset visual field defect in the left eye. The right eye is normal. What should the examiner do?

Certify with an FVE

Correct Incorrect Correct answer

Defer certification and refer for ophthalmologic evaluation to determine the cause

Correct Incorrect Correct answer

Certify if right eye meets all standards

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Issue a 6-month temporary certificate

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Question 58 of 154

58. Question

Category: Vision: Acuity Standards

Diabetic retinopathy in a CMV driver can affect certification by causing what visual changes?

Only color vision loss

Correct Incorrect Correct answer

Decreased central acuity and possible visual field loss from vitreous hemorrhage

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Only night vision problems

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No effect on vision standards

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Question 59 of 154

59. Question

Category: Vision: Acuity Standards

A driver with a history of amblyopia (lazy eye) has 20/30 in the right eye and 20/100 in the left amblyopic eye. What is the determination?

Certified since amblyopia is a childhood condition

Correct Incorrect Correct answer

Does not meet the 20/40 standard in each eye; may qualify under the alternative vision standard

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Certified with monocular driving restriction

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Disqualified permanently due to amblyopia

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Question 60 of 154

60. Question

Category: Vision: Acuity Standards

A driver has had intravitreal injections for wet macular degeneration. Can they be certified?

No, any eye injection disqualifies from driving

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Yes, if visual acuity and fields meet standards after treatment and the condition is stable

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Only with a 2-year waiting period after last injection

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Only if they stop treatment

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Question 61 of 154

61. Question

Category: Vision: Acuity Standards

A driver with keratoconus uses rigid gas permeable contact lenses and achieves 20/35 in both eyes. What is the determination?

Disqualified due to keratoconus

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Certified with corrective lens restriction

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FVE required for keratoconus

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Cannot certify with specialty contact lenses

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Question 62 of 154

62. Question

Category: Vision: Acuity Standards

What type of visual acuity is tested for CMV driver certification , near or distant?

Near acuity only

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Both near and distant acuity equally

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Distant visual acuity

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Only binocular near acuity

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Question 63 of 154

63. Question

Category: Vision: General Vision

A driver presents with a patch over one eye following recent eye surgery. Can they be tested today?

Yes, test only the uncovered eye

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No, both eyes must be testable; defer until the patch is removed and vision has stabilized

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Certify based on last known vision in the patched eye

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Issue a temporary certificate for 30 days

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Question 64 of 154

64. Question

Category: Vision: Acuity Standards

A 68-year-old driver with early cataracts has 20/40 in both eyes. What consideration should be given?

Disqualify until cataract surgery is performed

Correct Incorrect Correct answer

Certify but consider a shortened certification period as cataracts may progress

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Standard 2-year certification with no additional consideration

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FVE required for all cataract patients

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Question 65 of 154

65. Question

Category: Vision: General Vision

A driver who uses tinted lenses (sunglasses) for photophobia should be evaluated for what?

Nothing, sunglasses are a personal choice

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Whether the tinting impairs low-light or night vision and whether the underlying condition affects certification

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Whether the tint is FDA-approved

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Only the color of the tint

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Question 66 of 154

66. Question

Category: Vision: Acuity Standards

A driver had a vitreous hemorrhage in the left eye 3 months ago. Current vision is 20/50 in that eye. What is the determination?

Certified since the right eye compensates

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Does not meet the 20/40 standard in the left eye; defer or evaluate under the alternative vision standard

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Certified with 1-year restriction

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Certify since the hemorrhage is resolving

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Question 67 of 154

67. Question

Category: Vision: Field of Vision

What should the examiner do if a driver’s visual field cannot be adequately assessed by confrontation testing?

Skip the visual field assessment

Correct Incorrect Correct answer

Refer for formal perimetry testing

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Estimate the field based on the driver's medical history

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Certify if acuity meets standards

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Question 68 of 154

68. Question

Category: Vision: Acuity Standards

A driver with nystagmus should be evaluated for what impact on vision standards?

No impact on vision

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Possible reduction in visual acuity due to involuntary eye movements

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Only color vision effects

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Nystagmus is always disqualifying

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Question 69 of 154

69. Question

Category: Vision: Acuity Standards

During the DOT physical exam, the ME notes exophthalmos (bulging eyes) in a driver. What is the appropriate next step?

Certify the driver if vision testing meets all standards

Correct Incorrect Correct answer

Consider the finding under a different physical qualification standard and evaluate further

Correct Incorrect Correct answer

Automatically disqualify the driver

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Note the finding but take no additional action if vision is 20/40

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Question 70 of 154

70. Question

Category: Vision: Eye Conditions

A driver reports difficulty seeing at night. Does FMCSA have a night vision standard?

Yes, the driver must pass a formal dark adaptation test

Correct Incorrect Correct answer

No specific night vision standard exists, but the examiner should evaluate the underlying cause

Correct Incorrect Correct answer

Night vision testing is part of every DOT physical

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Night blindness automatically disqualifies

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Question 71 of 154

71. Question

Category: Vision: Acuity Standards

What is the examiner’s responsibility regarding a driver who previously wore glasses but now claims they can see without them?

Accept the driver's statement and certify without correction

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Test visual acuity without correction; if standards are met, remove the corrective lens restriction

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Require the driver to wear glasses regardless

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Disqualify for inconsistency

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Question 72 of 154

72. Question

Category: Vision: Acuity Standards

A driver with strabismus (misaligned eyes) can be certified if they meet what requirements?

They must have surgery to correct the alignment

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Each eye individually meets acuity and field standards, and there is no disqualifying diplopia

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They cannot be certified with strabismus

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Only if the strabismus is less than 10 degrees

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Question 73 of 154

73. Question

Category: Vision: General Vision

What documentation should the medical examiner include when certifying a driver who requires corrective lenses?

No special documentation needed

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A notation on the medical certificate that corrective lenses are required while driving

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A copy of the driver's glasses prescription

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An ophthalmologist's letter

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Question 74 of 154

74. Question

Category: Vision: Acuity Standards

A driver had a central retinal artery occlusion (CRAO) in the left eye resulting in vision of 20/200. What is the certification path?

Standard certification

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May qualify under the alternative vision standard (49 CFR 391.44) if the right eye meets all requirements

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Permanent disqualification

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1-year certification with monitoring

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Question 75 of 154

75. Question

Category: Vision: Acuity Standards

How should the examiner handle a driver who presents wearing decorative (non-corrective) contact lenses?

Disqualify for wearing non-medical contacts

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Test vision with and without the contacts; certify based on results that meet standards

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Require the driver to remove them immediately

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Report the driver to FMCSA

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Question 76 of 154

76. Question

Category: Vision: Acuity Standards

A driver with bilateral cataracts has 20/70 vision in both eyes despite best correction. Can they operate a CMV?

Yes, with standard certification

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No, they do not meet the 20/40 standard and should be referred for cataract surgery

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Yes, with an FVE

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Yes, for intrastate only automatically

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Question 77 of 154

77. Question

Category: Vision: Acuity Standards

A driver who has had successful bilateral cataract surgery with intraocular lens implants achieves 20/25 in both eyes. What is the determination?

FVE required after cataract surgery

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Standard certification, as the driver meets vision standards with the implants

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1-year certification maximum

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Certification only with external glasses over the implants

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Question 78 of 154

78. Question

Category: Vision: Acuity Standards

What is the minimum visual acuity standard for CMV driver certification?

20/40 in each eye separately, with or without correction

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20/20 in each eye without correction

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20/40 binocular only

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20/50 in the better eye

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Question 79 of 154

79. Question

Category: Vision: Field of Vision

What is the minimum horizontal field of vision required for CMV driver certification?

90 degrees in each eye

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70 degrees in each eye

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120 degrees binocular

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60 degrees in each eye

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Question 80 of 154

80. Question

Category: Vision: Eye Conditions

Why should the ME ask a CMV driver about glaucoma during the health history portion of the exam?

Glaucoma can progressively reduce peripheral vision, potentially affecting the 70-degree field requirement

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Glaucoma is an automatic disqualification for CMV operation

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Glaucoma only affects near vision and reading ability

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Glaucoma diagnosis requires a permanent driving restriction

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Question 81 of 154

81. Question

Category: Vision: Field of Vision

A CMV driver with chronic open-angle glaucoma on maximum medical therapy has visual fields of 72 degrees in each eye. What is the most appropriate certification period?

Standard 2-year certification since fields meet the 70-degree minimum

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6-month temporary certification

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1-year certification to monitor for progressive field loss given the narrow margin above the 70-degree threshold

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Denial of certification because glaucoma on maximum therapy indicates poor prognosis

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Question 82 of 154

82. Question

Category: Vision: Acuity Standards

A driver with newly diagnosed acute angle-closure glaucoma had a laser peripheral iridotomy performed 2 weeks ago. When can certification be considered?

Immediately, since the procedure is minimally invasive

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A mandatory 6-month waiting period is required after any laser eye procedure

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Only after a Federal Vision Exemption is obtained

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After the acute episode has fully resolved, vision has stabilized, and acuity and field standards are met

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Question 83 of 154

83. Question

Category: Vision: Acuity Standards

A CMV driver has mild nonproliferative diabetic retinopathy with microaneurysms only. Visual acuity is 20/25 in both eyes with full fields. What is the appropriate certification approach?

Deny certification because any diabetic retinopathy is disqualifying

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Issue a standard 2-year certification since the condition is mild

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Certify with a shortened certification period to monitor for disease progression

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Require a Federal Vision Exemption

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Question 84 of 154

84. Question

Category: Vision: Eye Conditions

Which stage of diabetic retinopathy poses the greatest risk for sudden vision loss due to vitreous hemorrhage in a CMV driver?

Mild nonproliferative diabetic retinopathy

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Moderate nonproliferative diabetic retinopathy

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Diabetic retinopathy is never associated with vitreous hemorrhage

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Proliferative diabetic retinopathy

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Question 85 of 154

85. Question

Category: Vision: Acuity Standards

A driver with diabetes presents with clinically significant macular edema in the right eye. Visual acuity is 20/50 OD and 20/25 OS. What is the determination?

Does not meet the vision standard in the right eye; defer certification pending treatment and improvement

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Certified because the left eye compensates

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Issue a Federal Vision Exemption

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Certified with a monocular restriction

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Question 86 of 154

86. Question

Category: Vision: Acuity Standards

A CMV driver had successful anti-VEGF injection treatment for diabetic macular edema and now sees 20/30 in both eyes. How should ongoing treatment affect the certification decision?

The driver cannot be certified while receiving ongoing injections

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Certify with a shortened period, since anti-VEGF treatment requires ongoing monitoring and macular edema may recur between injections

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Standard 2-year certification since current vision meets standards

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Federal Vision Exemption is required during active treatment

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Question 87 of 154

87. Question

Category: Vision: Acuity Standards

A CMV driver with type 2 diabetes and background diabetic retinopathy reports stable vision with annual ophthalmology visits. What should the examiner request?

No additional documentation if the driver states vision is stable

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Only an HbA1c level

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A Federal Vision Exemption application

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A current ophthalmology report within the past 12 months documenting retinopathy stage, acuity, and any treatment

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Question 88 of 154

88. Question

Category: Vision: Eye Conditions

What is the key difference between dry and wet age-related macular degeneration regarding the timeline of vision loss relevant to CMV certification?

Wet AMD can cause rapid, sudden central vision loss from subretinal hemorrhage, whereas dry AMD typically progresses gradually

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Dry AMD causes sudden vision loss while wet AMD progresses slowly

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Both types progress at exactly the same rate

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Neither type affects central vision significantly

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Question 89 of 154

89. Question

Category: Vision: Eye Conditions

A CMV driver with dry age-related macular degeneration reports new onset of straight lines appearing wavy (metamorphopsia). What should the examiner do?

Certify with a notation about metamorphopsia

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Certify if Snellen acuity still meets 20/40

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Defer certification and refer urgently for ophthalmologic evaluation, as metamorphopsia suggests possible conversion to wet AMD

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Issue a Federal Vision Exemption

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Question 90 of 154

90. Question

Category: Vision: Acuity Standards

A 72-year-old CMV driver with intermediate AMD in both eyes (large drusen, pigmentary changes) currently has 20/30 vision bilaterally. What certification approach is most appropriate?

Standard 2-year certification since acuity meets the standard

Correct Incorrect Correct answer

Shortened certification period with ophthalmology follow-up, as intermediate AMD has significant risk of progressing to advanced disease

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Denial of certification due to the AMD diagnosis

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Federal Vision Exemption required for any AMD diagnosis

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Question 91 of 154

91. Question

Category: Vision: Acuity Standards

A CMV driver with wet AMD in only the left eye has received anti-VEGF injections and achieved stable 20/60 OS and 20/20 OD. What is the best course of action?

The left eye does not meet 20/40; the driver may be evaluated under the alternative vision standard (49 CFR 391.44)

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Standard certification since the right eye exceeds the standard

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Certification with a monocular driving restriction

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Deny certification permanently

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Question 92 of 154

92. Question

Category: Vision: Acuity Standards

After uncomplicated cataract surgery with posterior chamber intraocular lens implantation, what is the minimum waiting period before a CMV driver can be certified per FMCSA guidance?

30 days mandatory waiting period

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90 days mandatory waiting period

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There is no mandatory waiting period; certification depends on stable vision meeting standards

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6 months mandatory waiting period

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Question 93 of 154

93. Question

Category: Vision: Acuity Standards

A driver had complicated cataract surgery resulting in posterior capsule rupture and vitreous loss. Vision is currently 20/45 at 8 weeks post-op. What is the appropriate action?

Certify since the vision is close to 20/40

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Issue a Federal Vision Exemption immediately

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Certify with a corrective lens restriction

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Defer certification; the complicated surgery means vision may still be improving, and current acuity of 20/45 does not meet the 20/40 standard

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Question 94 of 154

94. Question

Category: Vision: Acuity Standards

What is posterior capsule opacification, and how does it relate to CMV driver certification after cataract surgery?

It is a clouding of the lens capsule after cataract surgery that can reduce acuity below 20/40, treatable with a YAG laser capsulotomy

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It is a type of glaucoma unrelated to cataract surgery

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It is a permanent complication that always disqualifies from CMV driving

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It only affects peripheral vision

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Question 95 of 154

95. Question

Category: Vision: Acuity Standards

A CMV driver had cataract surgery in the right eye and now has an intraocular lens implant. The left eye has a dense cataract with 20/60 acuity. What is the determination?

Certified because the right eye with the IOL meets the standard

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Certify with a restriction to wear glasses over the left eye

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Standard certification with no restrictions

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The left eye at 20/60 does not meet the 20/40 standard; defer for left cataract treatment or evaluate under 391.44

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Question 96 of 154

96. Question

Category: Vision: Acuity Standards

A CMV driver had bilateral cataract surgery and wears reading glasses for near vision but has 20/20 distance acuity uncorrected. Should the medical certificate include a corrective lens restriction?

Yes, because the driver uses reading glasses

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No, because the FMCSA vision standard tests distance acuity, and the driver meets it without correction

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Yes, because any lens use after cataract surgery requires a restriction

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Only if the IOLs are considered corrective devices

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Question 97 of 154

97. Question

Category: Vision: Eye Conditions

A CMV driver had cataract surgery 10 days ago. The ophthalmologist reports uncorrected vision of 20/25 but notes the refraction is not yet stable. Should the examiner certify?

Yes, since vision currently meets the standard

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Yes, with a 2-year certification

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No, the examiner should wait until the ophthalmologist confirms the refraction is stable before certifying

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Yes, but issue a temporary 30-day certificate

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Question 98 of 154

98. Question

Category: Vision: General Vision

A CMV driver recently had refractive eye surgery. What must be true before the ME can certify the driver?

The driver must present documentation from the surgeon confirming a specific waiting period has passed

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The driver's vision must be stable and meet all FMCSA vision standards at the time of examination

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The driver must wait a minimum of 6 months regardless of visual outcomes

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The driver must have a specialist letter stating there are no surgical complications

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Question 99 of 154

99. Question

Category: Vision: Field of Vision

How does retinitis pigmentosa characteristically affect visual function relevant to CMV driver certification standards?

It causes rapid central vision loss only

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It only affects color vision

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It causes progressive peripheral field constriction (tunnel vision) and impaired night vision, threatening the 70-degree field requirement

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It has no effect on the FMCSA visual standards

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Question 100 of 154

100. Question

Category: Vision: Acuity Standards

A CMV driver had a rhegmatogenous retinal detachment repaired with scleral buckle surgery in the right eye 4 months ago. Vision is 20/35 OD with 70-degree fields. What is appropriate?

Deny certification because retinal detachment is permanently disqualifying

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Federal Vision Exemption required after any retinal surgery

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Certify with a shortened certification period due to the risk of re-detachment and the need to monitor visual stability

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Standard 2-year certification

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Question 101 of 154

101. Question

Category: Vision: Acuity Standards

A CMV driver with a history of retinal detachment in both eyes (repaired at different times) has 20/30 acuity and 72-degree fields bilaterally. What should the examiner prioritize?

Shortened certification period with ophthalmology follow-up, as bilateral history increases re-detachment risk and fields are near the 70-degree minimum

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Deny certification because bilateral retinal detachment history is disqualifying

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Standard 2-year certification since all standards are met

Correct Incorrect Correct answer

Issue a Federal Vision Exemption

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Question 102 of 154

102. Question

Category: Vision: General Vision

A driver uses one contact lens for distance vision in one eye and a different lens for near vision in the other eye. Is this acceptable?

Yes, as long as the individual still meets the distant visual acuity standard

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No, both lenses must be the same type and prescription

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No, monovision contact lens correction is never acceptable for CMV drivers

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Yes, but only with a written waiver from an ophthalmologist

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Question 103 of 154

103. Question

Category: Vision: General Vision

Why are individuals with ITDM and severe non-proliferative or proliferative diabetic retinopathy permanently disqualified despite available treatment?

Because treatment for advanced diabetic retinopathy adversely impacts night and peripheral vision, which are important for operating a CMV

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Because treatment requires hospitalization that prevents regular driving schedules

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Because the medications used for treatment are automatically disqualifying under Schedule I

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Because advanced retinopathy always progresses to complete blindness within 6 months

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Question 104 of 154

104. Question

Category: Vision: General Vision

A driver with both corrective lenses for distance vision and hearing aids presents for certification. The ME must consider the risk of device failure during operation. Which counseling points are most appropriate?

Advise carrying a spare power source for the hearing aid and ensure good tolerance and adaptation to corrective lenses, recognizing that neither spare requirement is enforceable by the ME

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Require the driver to carry backup glasses and spare hearing aid batteries, documenting both on the certificate

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Disqualify the driver since reliance on two corrective devices simultaneously creates excessive risk

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Certify for only 6 months so the ME can verify device compliance at the next visit

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Question 105 of 154

105. Question

Category: Vision: General Vision

Which of the following is an accepted method for evaluating color perception during a CMV driver physical qualification examination?

The Snellen acuity chart only, with no additional color testing required

Correct Incorrect Correct answer

Standard tests such as the Ishihara or Farnsworth, or a controlled test using standard red, green, and amber colors

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A computerized color spectrum analysis that tests the full visible light range

Correct Incorrect Correct answer

Self-reported ability to distinguish traffic signal colors documented on the health history form

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Question 106 of 154

106. Question

Category: Vision: General Vision

What does the color recognition standard for CMV drivers specifically require an individual to demonstrate?

The ability to distinguish all colors in the visible spectrum without deficiency

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The ability to recognize the colors of traffic signals and devices showing standard red, green, and amber

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The ability to pass a full Ishihara plate test with no errors

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The ability to distinguish between blue and yellow in addition to red and green

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Question 107 of 154

107. Question

Category: Vision: Field of Vision

When performing confrontation visual field testing during a CMV driver physical qualification examination, which technique should the ME use?

Have the individual read letters at the edge of a wall-mounted Snellen chart while covering one eye

Correct Incorrect Correct answer

Have the individual look directly at the ME's eye or nose, close one eye at a time, and count the number of fingers the ME shows along the horizontal field of view

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Have the individual track a moving pen light from the center of vision outward until it disappears

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Have the individual identify colored targets projected onto a perimetry screen at various angles

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Question 108 of 154

108. Question

Category: Vision: Field of Vision

A driver undergoes peripheral vision testing during a physical qualification examination. What minimum field of vision in the horizontal meridian must each eye demonstrate to meet the standard under 49 CFR 391.41(b)(10)(i)?

At least 90 degrees in each eye

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At least 70 degrees in each eye

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At least 120 degrees combined for both eyes

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At least 50 degrees in each eye

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Question 109 of 154

109. Question

Category: Vision: Acuity Standards

A 52-year-old CDL driver has lost vision in his left eye due to a retinal detachment 2 years ago. His right eye has distant visual acuity of 20/25 with corrective lenses and a field of vision of 85 degrees in the horizontal meridian. He presents with a completed Vision Evaluation Report (MCSA-5871) signed by an ophthalmologist 40 days ago. The ophthalmologist indicates the vision deficiency is stable and the driver has had sufficient time to adapt. What is the maximum certification period?

24 months

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12 months

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6 months for the initial certification, then 12 months

Correct Incorrect Correct answer

3 months pending further evaluation

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Question 110 of 154

110. Question

Category: Vision: Acuity Standards

A 45-year-old driver presents for a DOT physical. Vision testing shows distant visual acuity of 20/60 in the right eye (correctable to 20/30 with glasses) and 20/20 in the left eye. Peripheral vision is 75 degrees in both eyes. The driver is not wearing corrective lenses. What should the medical examiner do?

Refer the driver for a vision evaluation under the alternative vision standard (49 CFR 391.44)

Correct Incorrect Correct answer

Certify the driver with the requirement to wear corrective lenses while driving

Correct Incorrect Correct answer

Disqualify the driver because uncorrected acuity in one eye is below 20/40

Correct Incorrect Correct answer

Place the driver in determination pending status until an ophthalmologist evaluation is obtained

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Question 111 of 154

111. Question

Category: Vision: General Vision

A 38-year-old CDL driver has a prosthetic left eye following enucleation for ocular melanoma 3 years ago. His right eye has distant visual acuity of 20/20, field of vision of 90 degrees in the horizontal meridian, and normal color perception. He presents with a completed MCSA-5871 from his ophthalmologist signed 20 days ago. The ophthalmologist states the vision deficiency is stable and the driver has adapted to monocular vision. The driver was previously certified under the old vision exemption program. What determination should the ME make regarding the vision exemption?

The driver still needs to maintain a vision exemption for certification

Correct Incorrect Correct answer

The driver should be evaluated under the alternative vision standard (49 CFR 391.44) and does not need a vision exemption

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The driver cannot be certified because the vision exemption program no longer exists

Correct Incorrect Correct answer

The driver should apply for a new medical exemption from FMCSA

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Question 112 of 154

112. Question

Category: Vision: Acuity Standards

What is the minimum required distant visual acuity for each eye under the standard vision qualification in 49 CFR 391.41(b)(10)?

20/40 (Snellen) in each eye, with or without corrective lenses

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20/20 (Snellen) in each eye, without corrective lenses

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20/30 (Snellen) in each eye, with or without corrective lenses

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20/50 (Snellen) in each eye, corrected to 20/40 with lenses

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Question 113 of 154

113. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which of the following insulin types has the longest duration of action?

Insulin degludec (Tresiba)

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Insulin lispro (Humalog)

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Regular insulin (Humulin R)

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Insulin NPH (Humulin N)

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Question 114 of 154

114. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Concentrated potassium chloride injection is classified as a high-alert medication primarily because of the risk of which adverse outcome?

Fatal cardiac arrhythmia if administered undiluted or too rapidly

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Severe allergic reaction requiring epinephrine administration

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Irreversible hepatotoxicity requiring liver transplantation

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Permanent renal failure requiring lifelong dialysis treatment

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Question 115 of 154

115. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which class of medications requires auxiliary warning labels indicating the product is a paralytic agent and can cause respiratory arrest?

Neuromuscular blocking agents

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Benzodiazepine sedatives

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Opioid analgesic agents

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Inhaled corticosteroids

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Question 116 of 154

116. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which anticoagulant requires regular INR monitoring to ensure therapeutic dosing and prevent bleeding complications?

Warfarin (Coumadin)

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Apixaban (Eliquis)

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Rivaroxaban (Xarelto)

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Dabigatran (Pradaxa)

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Question 117 of 154

117. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Hydromorphone is frequently confused with morphine due to similar names. How does hydromorphone compare to morphine in potency?

Hydromorphone is approximately 4 to 7 times more potent than morphine

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Hydromorphone is approximately equal in potency to morphine

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Hydromorphone is approximately half as potent as morphine

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Hydromorphone is approximately 100 times more potent than morphine

Correct Incorrect Correct answer

Question 118 of 154

118. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

Which of the following is a correct safety practice for storing neuromuscular blocking agents in a hospital pharmacy?

Store them in a separate, clearly labeled location away from other medications

Correct Incorrect Correct answer

Store them alphabetically alongside other injectable medications

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Store them in the same bin as sedative medications for convenience

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Store them on open shelving to allow quick identification by staff

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Question 119 of 154

119. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

On the ISMP high-alert medication list for community/ambulatory settings, which category of oral medications is included due to the risk of hypoglycemia?

Oral hypoglycemic agents (sulfonylureas)

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Proton pump inhibitor agents

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Statin cholesterol-lowering agents

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Angiotensin-converting enzyme inhibitor agents

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Question 120 of 154

120. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is filling a prescription for insulin glargine (Lantus) but notices the shelf also contains insulin lispro (Humalog). Both vials have similar packaging. What is the most important action to prevent a dispensing error?

Verify the product by checking the NDC number against the prescription label before dispensing

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Dispense whichever insulin vial is closest to its expiration date first

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Ask the patient which type of insulin they normally use at home

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Place both insulin products in the same bag for the pharmacist to sort

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Question 121 of 154

121. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A physician orders heparin 25,000 units in 500 mL of D5W to infuse at 1,000 units per hour. A pharmacy technician notices the order was handwritten as ‘heparin 25,000 u.’ What safety concern should the technician report to the pharmacist?

The abbreviation 'u' for units can be misread as a zero, leading to a tenfold overdose

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The heparin concentration ordered is not commercially available in premixed bags

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The infusion rate of 1,000 units per hour exceeds the maximum recommended dose

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Heparin should only be ordered in prefilled syringes rather than intravenous bags

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Question 122 of 154

122. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is preparing a chemotherapy order in the pharmacy. Which of the following represents the correct safety precaution for handling this medication?

Prepare the medication in a biological safety cabinet using closed-system transfer devices

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Prepare the medication on the regular pharmacy counter using standard nitrile gloves

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Prepare the medication in a laminar airflow workbench used for sterile compounding

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Prepare the medication in the anteroom while wearing a standard surgical face mask

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Question 123 of 154

123. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A hospital pharmacy receives an order for a fentanyl transdermal patch 75 mcg/hr for a patient who has never taken opioids before. What should the pharmacy technician do?

Alert the pharmacist because fentanyl patches are contraindicated in opioid-naive patients

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Fill the order as written since the prescriber has approved the dose

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Substitute the patch with an equivalent dose of oral fentanyl citrate

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Dispense the patch with instructions to cut it in half for a lower dose

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Question 124 of 154

124. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician is filling a prescription for warfarin 5 mg tablets. The patient also has a new prescription for fluconazole. What action should the technician take?

Flag the interaction for the pharmacist to review before dispensing both medications

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Dispense both prescriptions since they are prescribed by the same physician

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Hold the warfarin prescription and dispense only the fluconazole to the patient

Correct Incorrect Correct answer

Substitute the fluconazole with a topical antifungal cream without consulting the pharmacist

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Question 125 of 154

125. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician discovers that concentrated sodium chloride 23.4% injection vials are stored next to normal saline (0.9%) flush syringes on a nursing unit. What is the appropriate response?

Remove the concentrated sodium chloride from the nursing unit and notify the pharmacist immediately

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Relabel the concentrated sodium chloride vials with a brighter colored auxiliary label

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Move the concentrated sodium chloride to a different shelf on the same nursing unit

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Leave the vials in place and remind nurses to check the label before administration

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Question 126 of 154

126. Question

Category: Patient Safety and Quality Assurance: High Alert Medications

A pharmacy technician receives a prescription for U-500 regular insulin for a patient with severe insulin resistance. Which safety measure is most critical when dispensing this product?

Ensure the prescription label clearly states the concentration is U-500 (500 units/mL)

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Dispense the U-500 insulin with a standard U-100 insulin syringe for convenience

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Convert the dose to U-100 equivalent volume without notifying the patient

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Store the U-500 insulin on the shelf next to U-100 insulin for easy access

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Question 127 of 154

127. Question

Category: Vision: General Vision

A CMV driver fails the vision screening during a physical qualification examination. The driver does not have a completed Vision Evaluation Report, Form MCSA-5871, but asks to be placed in determination pending status while obtaining one. What should the ME do?

Decline the request; the driver must not be placed in determination pending status without a completed Vision Evaluation Report

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Place the driver in determination pending status and allow 45 days to obtain the Vision Evaluation Report

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Issue a temporary 30-day certificate while the driver obtains the report

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Refer the driver to an ophthalmologist and automatically place the exam on hold

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Question 128 of 154

128. Question

Category: Vision: General Vision

Under what circumstance may an ME place a driver in determination pending status for a vision issue?

When the driver has a completed Vision Evaluation Report, Form MCSA-5871, but the ME needs additional clarification from the ophthalmologist or optometrist

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When the driver fails the in-office vision screening and needs time to see a specialist

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When the driver's corrective lens prescription has recently changed and a new prescription is being prepared

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When the driver's vision has recently worsened and the ME wants to allow time for stabilization

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Question 129 of 154

129. Question

Category: Vision: General Vision

A driver is placed in determination pending status for a vision issue while the ME awaits additional information from the ophthalmologist. The driver’s current Medical Examiner’s Certificate expired last week. Can the driver continue to operate a CMV in interstate commerce during this period?

No, because determination pending does not extend the expiration date of a current certificate, and the driver's certificate has already expired

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Yes, because determination pending status automatically extends the certificate for up to 45 days

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Yes, but only for intrastate commerce until the new certificate is issued

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Yes, as long as the driver carries documentation showing they are in determination pending status

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Question 130 of 154

130. Question

Category: Vision: General Vision

A driver with a prosthetic left eye and 20/30 acuity with 75-degree horizontal field in the right eye presents for certification under the alternative vision standard (49 CFR 391.44). The ophthalmologist has completed Form MCSA-5871. What is the maximum certification period the ME may issue?

12 months

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24 months

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6 months

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3 months

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Question 131 of 154

131. Question

Category: Vision: General Vision

A monocular driver certified under the alternative vision standard (49 CFR 391.44) presents for recertification. What must the driver provide to the ME before the physical qualification examination can proceed?

A new Vision Evaluation Report, Form MCSA-5871, completed and signed by an ophthalmologist or optometrist

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A letter from the driver's primary care physician confirming stable vision since the last exam

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A copy of their previous Federal Vision Exemption certificate

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An updated prescription from their optician showing current corrective lens specifications

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Question 132 of 154

132. Question

Category: Vision: Acuity Standards

A driver has 20/40 distant visual acuity in the right eye with corrective lenses, but the left eye cannot be corrected beyond 20/200. The ophthalmologist reports the left eye condition is stable and the driver has had sufficient time to adapt. Which pathway applies to this driver’s certification?

The alternative vision standard under 49 CFR 391.44, because the worse eye cannot meet the acuity standard with corrective lenses

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The standard vision qualification under 49 CFR 391.41(b)(10)(i), since corrective lenses are being used

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The driver must apply for a Federal Vision Exemption before certification can proceed

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The driver is permanently disqualified because both eyes must individually meet 20/40 acuity

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Question 133 of 154

133. Question

Category: Vision: Field of Vision

During a physical qualification examination, a driver fails the confrontation visual field test in the left eye. The driver does not have a Vision Evaluation Report. What is the ME’s most appropriate action?

Instruct the driver to see an ophthalmologist or optometrist for a vision evaluation, and have the specialist complete Form MCSA-5871 if the ME believes the driver may qualify under the alternative standard

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Place the driver in determination pending status for up to 45 days while the vision evaluation is obtained

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Disqualify the driver permanently, as peripheral vision loss cannot be corrected

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Issue a 3-month certificate and require the driver to return with specialist documentation

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Question 134 of 154

134. Question

Category: Vision: Field of Vision

When performing confrontation visual field testing, the ME instructs the driver to look directly at the ME’s eye or nose. What is the correct next step in the testing procedure?

Have the driver close one eye at a time and count the number of fingers the ME displays along the horizontal field of view

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Have the driver cover both eyes alternately while the ME moves a penlight from peripheral to central vision

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Ask the driver to track a moving object from the center to the periphery of their visual field in each eye

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Instruct the driver to keep both eyes open and report when they first see the ME's hand entering their field of view from the side

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Question 135 of 154

135. Question

Category: Vision: Field of Vision

A 60-year-old CMV driver with progressive open-angle glaucoma has been certified under the alternative vision standard for the past two years. At the current annual exam, the ophthalmologist’s Vision Evaluation Report shows that the better eye now has a horizontal field of vision of 65 degrees. What should the ME determine?

The driver does not meet the alternative vision standard, because the better eye must have at least 70 degrees of horizontal field of vision

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The driver can be recertified because they have successfully adapted to their vision deficit over two years

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The driver should be placed in determination pending status to allow time for glaucoma treatment to restore the visual field

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The driver can be certified for 6 months with closer monitoring of the progressive condition

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Question 136 of 154

136. Question

Category: Vision: Eye Conditions

A CMV driver’s vision deficiency recently developed after an acute retinal event. The ophthalmologist’s Vision Evaluation Report for certification under the alternative vision standard states that the condition is stable but occurred only 3 weeks ago. The driver has 20/30 in the better eye with 72-degree field. What should the ME consider when making the certification decision?

Whether sufficient time has passed since the vision deficiency became stable for the driver to adapt to and compensate for the change in vision

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Whether the driver has completed a driving skills test demonstrating competency with the new vision deficit

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Whether the driver has been fitted with specialized corrective lenses to compensate for the vision loss

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Whether the driver's employer has provided a letter accepting responsibility for the driver's safety

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Question 137 of 154

137. Question

Category: Vision: Eye Conditions

A 58-year-old CMV driver has progressive macular degeneration. At the current exam, the better eye has 20/40 acuity and 70-degree field, qualifying under the alternative standard. However, the ophthalmologist notes the condition is progressing and significant acuity decline is expected within 6 to 8 months. What certification considerations apply?

The ME should consider the progressive nature of the condition when determining the certification period, using independent medical judgment, and may certify for less than the 12-month maximum

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The ME must certify for the full 12 months because the driver currently meets all measurable standards

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The ME should disqualify the driver because progressive conditions are incompatible with CMV operation

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The ME must defer the certification decision to the ophthalmologist since the specialist has more information about the prognosis

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Question 138 of 154

138. Question

Category: Vision: Acuity Standards

Under 49 CFR 391.44, what is the maximum certification period for a CMV driver who is certified under the alternative vision standard?

12 months

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24 months

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6 months

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18 months

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Question 139 of 154

139. Question

Category: Vision: General Vision

A CMV driver presents for a physical qualification examination and fails the vision screening in the right eye, with acuity of 20/100 corrected. The left eye measures 20/30 corrected. The driver does not have a completed Vision Evaluation Report (Form MCSA-5871). What should the ME do?

Instruct the driver to see an ophthalmologist or optometrist for a vision evaluation and have them complete Form MCSA-5871 before returning for a new examination

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Place the driver in determination pending status while the vision evaluation is obtained

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Certify the driver for 12 months under the alternative vision standard based on the left eye meeting the acuity requirement

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Disqualify the driver permanently because the right eye cannot be corrected to 20/40

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Question 140 of 154

140. Question

Category: Vision: Field of Vision

Under the alternative vision standard in 49 CFR 391.44, which testing requirement applies to field of vision evaluation performed by an ophthalmologist or optometrist?

Formal perimetry is required, utilizing a testing modality that tests to at least 120 degrees in the horizontal

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Confrontational visual field testing by the ME is sufficient for qualification under the alternative standard

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The Titmus Vision Tester must be used to confirm at least 70 degrees in each eye

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A standard peripheral vision screening with results documented on the Medical Examination Report Form is adequate

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Question 141 of 154

141. Question

Category: Vision: Acuity Standards

A driver presents for a physical qualification examination. Visual acuity testing shows: Right eye 20/40 with corrective lenses, Left eye 20/200 with corrective lenses. The driver provides a completed Vision Evaluation Report (MCSA-5871) signed by an ophthalmologist 30 days ago. The ophthalmologist reports the left eye vision deficiency is stable and the driver has had time to adapt. The right eye has 80 degrees of horizontal field of vision. What is the maximum certification period?

12 months, because the driver qualifies under the alternative vision standard in 49 CFR 391.44, which has a maximum certification period of 12 months

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24 months, because the driver meets the vision standard in the better eye and corrective lenses are used

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6 months, because the worse eye cannot be corrected to 20/40

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The driver cannot be certified because the left eye does not meet the 20/40 standard

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Question 142 of 154

142. Question

Category: Vision: Eye Conditions

A driver fails the vision screening during the physical qualification examination with 20/70 in the right eye (best corrected) and 20/30 in the left eye. The left eye has 75 degrees of horizontal field of vision. The driver does not have a Vision Evaluation Report (MCSA-5871). The driver’s current Medical Examiner’s Certificate expires in 2 weeks. What should the ME do?

Do not qualify or place the driver in determination pending status; instruct the driver to have an ophthalmologist or optometrist complete the Vision Evaluation Report (MCSA-5871) and return for a new examination

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Place the driver in determination pending status for 45 days while the Vision Evaluation Report is obtained

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Certify the driver for 12 months because the left (better) eye meets the 20/40 and 70-degree standards

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Disqualify the driver permanently because the right eye cannot meet the 20/40 standard

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Question 143 of 154

143. Question

Category: Vision: General Vision

A driver who was previously certified under a Federal Vision Exemption presents for renewal. The driver has monocular vision with 20/30 acuity and 75 degrees horizontal field of vision in the better eye, and no functional vision in the worse eye. The driver’s exemption-based Medical Examiner’s Certificate expired on March 22, 2023. The driver has no Vision Evaluation Report (MCSA-5871). What should the ME explain to this driver?

Federal Vision Exemptions are no longer part of the program; the driver must obtain a Vision Evaluation Report from an ophthalmologist or optometrist and may qualify under the alternative vision standard in 49 CFR 391.44

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The driver can renew the Federal Vision Exemption by submitting a new application to FMCSA

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The driver cannot be certified under any standard because the Federal Vision Exemption program has ended with no replacement

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The ME should certify the driver under the standard vision requirements since the better eye exceeds 20/40

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Question 144 of 154

144. Question

Category: Vision: Acuity Standards

What is the minimum distant visual acuity standard for each eye under 49 CFR 391.41(b)(10)?

20/40 (Snellen) in each eye, with or without corrective lenses

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20/20 (Snellen) in each eye, without corrective lenses

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20/40 (Snellen) in the better eye only

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20/30 (Snellen) in each eye, with or without corrective lenses

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Question 145 of 154

145. Question

Category: Vision: Field of Vision

What is the minimum peripheral vision requirement under the standard vision qualification?

At least 70 degrees in the horizontal meridian in each eye

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At least 90 degrees in the horizontal meridian in each eye

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At least 70 degrees in the horizontal meridian in the better eye only

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At least 120 degrees in the horizontal meridian in each eye

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Question 146 of 154

146. Question

Category: Vision: Acuity Standards

A driver’s worse eye cannot be corrected to 20/40 with corrective lenses, but the better eye has 20/20 acuity and 70-degree field of vision. What standard applies?

The alternative vision standard under 49 CFR 391.44

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The driver is automatically disqualified with no alternative pathway

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The standard vision requirement under 49 CFR 391.41(b)(10)

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The Federal Vision Exemption Program

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Question 147 of 154

147. Question

Category: Vision: Acuity Standards

What is the maximum certification period for a driver certified under the alternative vision standard (49 CFR 391.44)?

12 months

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24 months

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6 months

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3 months

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Question 148 of 154

148. Question

Category: Vision: Acuity Standards

A driver who needs the alternative vision standard presents without a completed Vision Evaluation Report (MCSA-5871). What should the ME do?

The driver does not meet the alternative vision standard and must not be qualified or placed in determination pending status

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The ME may proceed with the examination and place the driver in determination pending status

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The ME may certify the driver for 3 months while the report is obtained

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The ME should perform the vision evaluation in place of the specialist

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Question 149 of 154

149. Question

Category: Vision: Eye Conditions

Are bioptic telescopic lenses permissible for driving a commercial motor vehicle?

No, bioptic telescopic lenses are not permissible for the driving of CMVs

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Yes, if they correct visual acuity to 20/40 or better

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Yes, with a Federal Vision Exemption

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Only for intrastate commerce

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Question 150 of 154

150. Question

Category: Vision: Acuity Standards

A driver meets the vision standard using contact lenses. What must be documented on the MCSA-5875 and MCSA-5876?

The box for "Wearing corrective lenses" must be selected on both forms

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The type and brand of contact lenses must be recorded

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The uncorrected visual acuity must also be documented

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A separate notation that the driver uses contact lenses rather than glasses

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Question 151 of 154

151. Question

Category: Vision: Eye Conditions

During the eye examination, the ME notices abnormal pupils and nystagmus. Beyond the vision standard, what should the ME consider?

These findings may require evaluation under a different physical qualification standard

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These findings are only relevant to the vision standard

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The driver should be immediately disqualified

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These findings are normal variants that do not require further evaluation

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Question 152 of 154

152. Question

Category: Vision: Field of Vision

Under the alternative vision standard (391.44), what type of visual field testing is required?

Formal perimetry testing to at least 120 degrees in the horizontal by an ophthalmologist or optometrist

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Confrontational visual field testing by the ME

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Titmus Vision Tester screening

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Any testing method that documents 70 degrees in the better eye

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Question 153 of 154

153. Question

Category: Vision: Acuity Standards

How is the phrase “ability to recognize the colors of” interpreted regarding the vision standard?

If the driver can recognize standard red, green, and amber, the minimum standard is met even with some color perception deficiency

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The driver must have perfect color vision with no deficiency of any kind

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The driver must pass the Ishihara test with a perfect score

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The driver must distinguish all colors on the visible spectrum

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Question 154 of 154

154. Question

Category: Vision: Eye Conditions

A driver uses a contact lens in one eye for distance and another in the other eye for near vision. Does this arrangement meet the vision standard?

Yes, as long as the driver still meets the distant visual acuity and field of vision standards

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No, mixed contact lens prescriptions are not permitted for CMV drivers

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Only if approved by an ophthalmologist on the MCSA-5871

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Only under the alternative vision standard

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