NBCOT OTR Certification Exam Prep
Test Bank Questions and Correct Answers
Question 1
A 4-year-old has been diagnosed with intellectual disability. A characteristic that is
likely to occur with impaired intellectual ability is:
A. Acceptable social skills
B. Impairment of occupational performance areas
C. Development of bizarre attachment to unusual objects
D. Poor eye contact
Correct Answer: B. Impairment of occupational performance areas is a
characteristic that commonly occurs with intellectual disability, affecting daily
living skills, social participation, and academic performance. (Occupational
Therapy for Children by Case-Smith)
Question 2
A 5-year-old child with Down syndrome shows significant loss of weight, high
fever, and paleness, and is diagnosed with acute lymphoid leukemia. In which of
the following phases of leukemia will he be administered chemotherapy to treat
small deposits of cells that remain after remission?
A. Phase I - Induction therapy
B. Phase II - Central nervous system prophylaxis
C. Phase III - Intensification and consolidation
D. Phase IV - Maintenance or continuation therapy
Correct Answer: C. Chemotherapy is administered in Phase III - the
intensification and consolidation phase - to remove small deposits of cells that
remain after remission. (Occupational Therapy for Children by Case-Smith)
Question 3
A 5-year-old child presents with difficulty climbing stairs, lying on a sitting or
,lying position, and demonstrates progressive fatigue caused by muscle weakness.
The OT might suspect a problem with:
A. Duchenne's muscular dystrophy
B. Limb-girdle muscular dystrophy
C. Facioscapulohumeral muscular dystrophy
D. A congenital muscular dystrophy
Correct Answer: A. Duchenne's muscular dystrophy is an X-linked recessive
disorder caused by the deficiency in the production of dystrophin. Dystrophin is a
component of the plasma membrane of the muscle fibers, the deficiency of which
causes the muscle to degenerate and malfunction. (Occupational Therapy for
Children by Case-Smith)
Question 4
The behavioral characteristics of autism, a pervasive developmental disorder
(PDD), can be classified into four subclusters of disturbances. Of these
disturbances, which is MOST closely related to prognosis?
A. Disturbances in communication
B. Disturbances in behaviors
C. Disturbances in social interactions
D. Disturbances of sensory and perceptual processing
Correct Answer: A. Disturbances in communication can range from mild (slight
articulation impairment) to severe (muteness); thus, the more mild the
communication deficit, the more likely the child will develop sufficient
communication to function as an adult. (Occupational Therapy for Children by
Case-Smith)
Question 5
A 3-year-old child is diagnosed with cerebral palsy and failure to thrive, and
reportedly has difficulty with drooling, chewing, and swallowing. The OT should
address:
A. Oral motor deficits
B. Motor sensory deficits
,C. Self-feeding
D. Vestibular input
Correct Answer: A. Oral motor deficits relate to issues with the oral motor
musculature around the mouth. OTs are qualified to address deficits related to
swallowing or dysphagia, chewing, and drooling. (Occupational Therapy for
Children by Case-Smith)
Question 6
A kindergarten teacher observed that a 5-year-old child does not participate in play
with other children and avoids movement activities on the playground. A screening
test you would recommend for this child to determine if there is a need for a more
comprehensive examination is:
A. Ages & Stages Questionnaires
B. The First STEP
C. Short Sensory Profile
D. Denver Developmental Screening Test-II (Denver-II)
Correct Answer: C. The teacher has already identified the child as being at risk
for developmental or functional deficits. Therefore, it is appropriate to use a type II
assessment, which is the Short Sensory Profile. This caregiver questionnaire
measures the frequency of behaviors related to sensory processing, modulation,
and emotional responsivity to sensory input in children 3 to 12 years of age.
(Occupational Therapy for Children by Case-Smith)
Question 7
A scenario in which an OT would use the School Function Assessment
examination is:
A. To screen a typically developing child for kindergarten readiness
B. To evaluate a student's participation and performance in school-related
functional tasks
C. To diagnose a learning disability
D. To assess sensory processing disorders in infants
Correct Answer: B. The School Function Assessment (SFA) is designed to
evaluate a student's ability to perform functional tasks that support participation in
, the school environment, including both physical and cognitive tasks. (Occupational
Therapy for Children by Case-Smith)
Question 8
A 7-year-old child with spastic quadriplegic cerebral palsy is unable to maintain an
upright sitting position independently. Which adaptive equipment would be MOST
appropriate to promote participation in classroom activities?
A. Standing frame
B. Customized wheelchair with pelvic positioning belt and lateral trunk supports
C. Prone positioner
D. Dynamic standing board
Correct Answer: B. A customized wheelchair with appropriate positioning
supports (pelvic belt and lateral trunk supports) provides the necessary stability for
upright sitting, allowing the child to use upper extremities for classroom
participation. (Occupational Therapy for Children by Case-Smith)
Question 9
An OT is working with a 6-year-old child with attention deficit hyperactivity
disorder (ADHD) who has difficulty completing multi-step tasks. Which
intervention strategy is MOST appropriate?
A. Provide verbal instructions only once at the beginning of the task
B. Break tasks into smaller steps and use visual schedules
C. Increase environmental noise to improve focus
D. Require the child to complete all steps without assistance
Correct Answer: B. Breaking tasks into smaller, manageable steps and using
visual schedules helps children with ADHD process information sequentially and
complete multi-step activities successfully. (Occupational Therapy for Children by
Case-Smith)
Question 10
A 2-year-old child with developmental delay exhibits difficulty grasping small
objects and cannot hold a crayon. The OT should FIRST assess:
Test Bank Questions and Correct Answers
Question 1
A 4-year-old has been diagnosed with intellectual disability. A characteristic that is
likely to occur with impaired intellectual ability is:
A. Acceptable social skills
B. Impairment of occupational performance areas
C. Development of bizarre attachment to unusual objects
D. Poor eye contact
Correct Answer: B. Impairment of occupational performance areas is a
characteristic that commonly occurs with intellectual disability, affecting daily
living skills, social participation, and academic performance. (Occupational
Therapy for Children by Case-Smith)
Question 2
A 5-year-old child with Down syndrome shows significant loss of weight, high
fever, and paleness, and is diagnosed with acute lymphoid leukemia. In which of
the following phases of leukemia will he be administered chemotherapy to treat
small deposits of cells that remain after remission?
A. Phase I - Induction therapy
B. Phase II - Central nervous system prophylaxis
C. Phase III - Intensification and consolidation
D. Phase IV - Maintenance or continuation therapy
Correct Answer: C. Chemotherapy is administered in Phase III - the
intensification and consolidation phase - to remove small deposits of cells that
remain after remission. (Occupational Therapy for Children by Case-Smith)
Question 3
A 5-year-old child presents with difficulty climbing stairs, lying on a sitting or
,lying position, and demonstrates progressive fatigue caused by muscle weakness.
The OT might suspect a problem with:
A. Duchenne's muscular dystrophy
B. Limb-girdle muscular dystrophy
C. Facioscapulohumeral muscular dystrophy
D. A congenital muscular dystrophy
Correct Answer: A. Duchenne's muscular dystrophy is an X-linked recessive
disorder caused by the deficiency in the production of dystrophin. Dystrophin is a
component of the plasma membrane of the muscle fibers, the deficiency of which
causes the muscle to degenerate and malfunction. (Occupational Therapy for
Children by Case-Smith)
Question 4
The behavioral characteristics of autism, a pervasive developmental disorder
(PDD), can be classified into four subclusters of disturbances. Of these
disturbances, which is MOST closely related to prognosis?
A. Disturbances in communication
B. Disturbances in behaviors
C. Disturbances in social interactions
D. Disturbances of sensory and perceptual processing
Correct Answer: A. Disturbances in communication can range from mild (slight
articulation impairment) to severe (muteness); thus, the more mild the
communication deficit, the more likely the child will develop sufficient
communication to function as an adult. (Occupational Therapy for Children by
Case-Smith)
Question 5
A 3-year-old child is diagnosed with cerebral palsy and failure to thrive, and
reportedly has difficulty with drooling, chewing, and swallowing. The OT should
address:
A. Oral motor deficits
B. Motor sensory deficits
,C. Self-feeding
D. Vestibular input
Correct Answer: A. Oral motor deficits relate to issues with the oral motor
musculature around the mouth. OTs are qualified to address deficits related to
swallowing or dysphagia, chewing, and drooling. (Occupational Therapy for
Children by Case-Smith)
Question 6
A kindergarten teacher observed that a 5-year-old child does not participate in play
with other children and avoids movement activities on the playground. A screening
test you would recommend for this child to determine if there is a need for a more
comprehensive examination is:
A. Ages & Stages Questionnaires
B. The First STEP
C. Short Sensory Profile
D. Denver Developmental Screening Test-II (Denver-II)
Correct Answer: C. The teacher has already identified the child as being at risk
for developmental or functional deficits. Therefore, it is appropriate to use a type II
assessment, which is the Short Sensory Profile. This caregiver questionnaire
measures the frequency of behaviors related to sensory processing, modulation,
and emotional responsivity to sensory input in children 3 to 12 years of age.
(Occupational Therapy for Children by Case-Smith)
Question 7
A scenario in which an OT would use the School Function Assessment
examination is:
A. To screen a typically developing child for kindergarten readiness
B. To evaluate a student's participation and performance in school-related
functional tasks
C. To diagnose a learning disability
D. To assess sensory processing disorders in infants
Correct Answer: B. The School Function Assessment (SFA) is designed to
evaluate a student's ability to perform functional tasks that support participation in
, the school environment, including both physical and cognitive tasks. (Occupational
Therapy for Children by Case-Smith)
Question 8
A 7-year-old child with spastic quadriplegic cerebral palsy is unable to maintain an
upright sitting position independently. Which adaptive equipment would be MOST
appropriate to promote participation in classroom activities?
A. Standing frame
B. Customized wheelchair with pelvic positioning belt and lateral trunk supports
C. Prone positioner
D. Dynamic standing board
Correct Answer: B. A customized wheelchair with appropriate positioning
supports (pelvic belt and lateral trunk supports) provides the necessary stability for
upright sitting, allowing the child to use upper extremities for classroom
participation. (Occupational Therapy for Children by Case-Smith)
Question 9
An OT is working with a 6-year-old child with attention deficit hyperactivity
disorder (ADHD) who has difficulty completing multi-step tasks. Which
intervention strategy is MOST appropriate?
A. Provide verbal instructions only once at the beginning of the task
B. Break tasks into smaller steps and use visual schedules
C. Increase environmental noise to improve focus
D. Require the child to complete all steps without assistance
Correct Answer: B. Breaking tasks into smaller, manageable steps and using
visual schedules helps children with ADHD process information sequentially and
complete multi-step activities successfully. (Occupational Therapy for Children by
Case-Smith)
Question 10
A 2-year-old child with developmental delay exhibits difficulty grasping small
objects and cannot hold a crayon. The OT should FIRST assess:
