Your ability to drive safely can be impaired by:
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Lack of sleep.
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Drugs, even if they are over-the-counter.
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Alcohol.
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All of the above.
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Explanation
Alcohol, drugs, and lack of sleep all impair your driving ability. Alcohol and drugs can cause physical effects that reduce your reflexes, physical control over the vehicle, and your ability to recognize and react to dangerous situations. Sleep deprivation can cause fatigue which dulls the mind and reduces your ability to act quickly and correctly.
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This question appears in the following DMV practice tests: