A driver reports being a smoker and out of breath often. What should the examiner do next?

In the scenario where a driver reports being a smoker and experiencing frequent breathlessness, ordering spirometry is a crucial next step. Spirometry is a common pulmonary function test that measures how much air the lungs can hold and how quickly air can be expelled. This information is vital in assessing lung function and identifying any obstructive or restrictive airway diseases, such as chronic obstructive pulmonary disease (COPD) or asthma, which are conditions commonly associated with smoking.

By conducting spirometry, the examiner can obtain objective data regarding the driver's respiratory health. The results of this test will help determine if the breathlessness the driver is experiencing is due to a respiratory condition that may affect their ability to operate a commercial vehicle safely.

Other options, such as ordering an EKG, referring the driver to the emergency department, or providing a one-year certification, may not address the immediate need to evaluate the patient's respiratory function. For instance, an EKG is more relevant for assessing cardiac issues rather than direct respiratory problems. A referral to the emergency department may be unnecessary unless the driver is showing signs of a serious medical emergency that requires immediate intervention. Lastly, providing a one-year certification without further assessing the respiratory condition could overlook a critical health issue that might impair the driver's ability to perform