NBCOT & OTKE PRACTICE EXAM COMPLETE
QUESTIONS WITH 100% VERIFIED ANSWERS
1. A patient with C7 tetraplegia is 3 weeks post-injury and
demonstrates trace wrist extension but no finger movement. What is
the MOST appropriate splint to prevent contractures during the acute
phase?
A) Resting hand splint
B) Wrist cock-up splint
C) Dorsal forearm-based thumb spica
D) Tenodesis splint
[Correct Answer] A – Resting hand splint maintains functional
alignment of wrist (20-30° extension), MCP joints (70-90° flexion), and
IP joints (extension) to prevent contractures. Tenodesis splint (D) is for
C6 to enhance grasp, not acute prevention.
2. An OT is treating a client with left hemineglect after a right MCA
stroke. Which intervention is MOST supported by evidence for
functional improvement in activities of daily living?
A) Visual scanning training with a static anchor on the left side
B) Prism adaptation therapy to shift visual field to the right
C) Constraint-induced movement therapy of the left arm
D) Verbal cuing to attend to the left side during grooming
[Correct Answer] B – Prism adaptation therapy has Level I evidence for
reducing neglect and improving ADL performance by recalibrating
,visuomotor systems. Scanning training (A) helps awareness but
transfers less to daily function.
3. A child with autism spectrum disorder engages in repetitive hand-
flapping when transitions occur. Using an antecedent-based
intervention, what should the OT do FIRST?
A) Provide a weighted vest before transitions
B) Teach the child to request a break using a picture card
C) Use a visual timer to signal the end of an activity
D) Ignore the hand-flapping and redirect to a sensory bin
[Correct Answer] C – Visual timers reduce transition-related anxiety by
providing predictable warning, preventing the antecedent trigger.
Requesting a break (B) is a reactive strategy, not antecedent.
4. In a hand therapy clinic, a patient with a flexor tendon repair (zone
II) is 2 weeks post-op. The OT notes the patient removing the dorsal
blocking splint to “clean the hand.” What is the PRIORITY action?
A) Reinforce splint wear schedule and check incision site for infection
B) Immediately stop the patient and apply a new splint
C) Instruct the patient in gentle passive extension exercises
D) Document non-compliance and report to the surgeon
[Correct Answer] A – Patient education on 24/7 splint wear is critical to
prevent rupture; checking for infection also addresses safety. Zone II
repairs are high-risk; patient may not understand consequences.
5. An elderly patient with moderate Alzheimer’s disease is agitated
and pacing the halls. Which environmental modification is MOST likely
to reduce agitation?
A) Dim lighting and soft classical music
B) High-contrast signage for the bathroom
,C) A large digital clock showing date and time
D) Removing all personal items to reduce clutter
[Correct Answer] A – Dim lighting and calming music reduce
overstimulation in dementia. High-contrast signage (B) aids wayfinding
but not acute agitation. Pacing often reflects sensory overload.
6. A COTA reports that a client with Guillain-Barré syndrome is
progressing from flaccid paralysis to proximal muscle weakness. At
this stage, which intervention is MOST appropriate to prevent
secondary complications?
A) Passive range of motion 2x daily with positioning
B) Resistive strengthening for proximal muscles using bands
C) Functional electrical stimulation for ambulation training
D) Bed rest with splinting only
[Correct Answer] A – During early recovery (flaccid → weak), PROM
and positioning prevent contractures and DVT. Resistive exercise (B)
may fatigue recovering nerves; FES (C) is later.
7. An OT is evaluating a child with developmental coordination
disorder (DCD). Which standardized assessment is MOST specific to
DCD diagnosis?
A) Peabody Developmental Motor Scales – 2
B) Bruininks-Oseretsky Test of Motor Proficiency – 2 (BOT-2)
C) Movement Assessment Battery for Children – 2 (MABC-2)
D) Sensory Integration and Praxis Tests (SIPT)
[Correct Answer] C – MABC-2 is the gold standard for DCD, with norms
and cutoff scores matching DSM-5 criteria. BOT-2 (B) is broader; SIPT (D)
assesses sensory integration, not DCD.
, 8. A patient with a right total hip arthroplasty (posterior approach) is 4
days post-op. Which ADL instruction is CORRECT?
A) Use a long-handled sponge to reach feet while sitting on a shower
chair
B) Flex hip to 100° to put on socks using a sock aid
C) Cross legs at ankles while lying supine to don pants
D) Bend forward at waist to pick up a dropped washcloth
[Correct Answer] A – Long-handled sponge allows cleaning without
exceeding 90° hip flexion or crossing midline, avoiding dislocation. B
and D violate flexion precautions; C crosses legs.
9. An OT is working with a client who has hoarding disorder. What is
the FIRST step in intervention according to the Cognitive-Behavioral
model?
A) Sorting items into keep, donate, discard bins
B) Developing a harm reduction plan for safety hazards
C) Motivational interviewing to explore ambivalence about discarding
D) In-home exposure therapy with graded discarding
[Correct Answer] C – Motivational interviewing addresses resistance
and builds insight before any sorting or discarding (D). Hoarding
requires engagement first; forced sorting (A) increases anxiety.
10. A child with cerebral palsy (spastic diplegia) uses a posterior
walker but has crouch gait. Which orthosis is MOST indicated to
improve upright posture?
A) Supramalleolar orthosis (SMO)
B) Solid ankle-foot orthosis (AFO) with plantarflexion stop
C) Articulated AFO with dorsiflexion assist
D) Knee-ankle-foot orthosis (KAFO)
[Correct Answer] B – Solid AFO with plantarflexion stop controls
QUESTIONS WITH 100% VERIFIED ANSWERS
1. A patient with C7 tetraplegia is 3 weeks post-injury and
demonstrates trace wrist extension but no finger movement. What is
the MOST appropriate splint to prevent contractures during the acute
phase?
A) Resting hand splint
B) Wrist cock-up splint
C) Dorsal forearm-based thumb spica
D) Tenodesis splint
[Correct Answer] A – Resting hand splint maintains functional
alignment of wrist (20-30° extension), MCP joints (70-90° flexion), and
IP joints (extension) to prevent contractures. Tenodesis splint (D) is for
C6 to enhance grasp, not acute prevention.
2. An OT is treating a client with left hemineglect after a right MCA
stroke. Which intervention is MOST supported by evidence for
functional improvement in activities of daily living?
A) Visual scanning training with a static anchor on the left side
B) Prism adaptation therapy to shift visual field to the right
C) Constraint-induced movement therapy of the left arm
D) Verbal cuing to attend to the left side during grooming
[Correct Answer] B – Prism adaptation therapy has Level I evidence for
reducing neglect and improving ADL performance by recalibrating
,visuomotor systems. Scanning training (A) helps awareness but
transfers less to daily function.
3. A child with autism spectrum disorder engages in repetitive hand-
flapping when transitions occur. Using an antecedent-based
intervention, what should the OT do FIRST?
A) Provide a weighted vest before transitions
B) Teach the child to request a break using a picture card
C) Use a visual timer to signal the end of an activity
D) Ignore the hand-flapping and redirect to a sensory bin
[Correct Answer] C – Visual timers reduce transition-related anxiety by
providing predictable warning, preventing the antecedent trigger.
Requesting a break (B) is a reactive strategy, not antecedent.
4. In a hand therapy clinic, a patient with a flexor tendon repair (zone
II) is 2 weeks post-op. The OT notes the patient removing the dorsal
blocking splint to “clean the hand.” What is the PRIORITY action?
A) Reinforce splint wear schedule and check incision site for infection
B) Immediately stop the patient and apply a new splint
C) Instruct the patient in gentle passive extension exercises
D) Document non-compliance and report to the surgeon
[Correct Answer] A – Patient education on 24/7 splint wear is critical to
prevent rupture; checking for infection also addresses safety. Zone II
repairs are high-risk; patient may not understand consequences.
5. An elderly patient with moderate Alzheimer’s disease is agitated
and pacing the halls. Which environmental modification is MOST likely
to reduce agitation?
A) Dim lighting and soft classical music
B) High-contrast signage for the bathroom
,C) A large digital clock showing date and time
D) Removing all personal items to reduce clutter
[Correct Answer] A – Dim lighting and calming music reduce
overstimulation in dementia. High-contrast signage (B) aids wayfinding
but not acute agitation. Pacing often reflects sensory overload.
6. A COTA reports that a client with Guillain-Barré syndrome is
progressing from flaccid paralysis to proximal muscle weakness. At
this stage, which intervention is MOST appropriate to prevent
secondary complications?
A) Passive range of motion 2x daily with positioning
B) Resistive strengthening for proximal muscles using bands
C) Functional electrical stimulation for ambulation training
D) Bed rest with splinting only
[Correct Answer] A – During early recovery (flaccid → weak), PROM
and positioning prevent contractures and DVT. Resistive exercise (B)
may fatigue recovering nerves; FES (C) is later.
7. An OT is evaluating a child with developmental coordination
disorder (DCD). Which standardized assessment is MOST specific to
DCD diagnosis?
A) Peabody Developmental Motor Scales – 2
B) Bruininks-Oseretsky Test of Motor Proficiency – 2 (BOT-2)
C) Movement Assessment Battery for Children – 2 (MABC-2)
D) Sensory Integration and Praxis Tests (SIPT)
[Correct Answer] C – MABC-2 is the gold standard for DCD, with norms
and cutoff scores matching DSM-5 criteria. BOT-2 (B) is broader; SIPT (D)
assesses sensory integration, not DCD.
, 8. A patient with a right total hip arthroplasty (posterior approach) is 4
days post-op. Which ADL instruction is CORRECT?
A) Use a long-handled sponge to reach feet while sitting on a shower
chair
B) Flex hip to 100° to put on socks using a sock aid
C) Cross legs at ankles while lying supine to don pants
D) Bend forward at waist to pick up a dropped washcloth
[Correct Answer] A – Long-handled sponge allows cleaning without
exceeding 90° hip flexion or crossing midline, avoiding dislocation. B
and D violate flexion precautions; C crosses legs.
9. An OT is working with a client who has hoarding disorder. What is
the FIRST step in intervention according to the Cognitive-Behavioral
model?
A) Sorting items into keep, donate, discard bins
B) Developing a harm reduction plan for safety hazards
C) Motivational interviewing to explore ambivalence about discarding
D) In-home exposure therapy with graded discarding
[Correct Answer] C – Motivational interviewing addresses resistance
and builds insight before any sorting or discarding (D). Hoarding
requires engagement first; forced sorting (A) increases anxiety.
10. A child with cerebral palsy (spastic diplegia) uses a posterior
walker but has crouch gait. Which orthosis is MOST indicated to
improve upright posture?
A) Supramalleolar orthosis (SMO)
B) Solid ankle-foot orthosis (AFO) with plantarflexion stop
C) Articulated AFO with dorsiflexion assist
D) Knee-ankle-foot orthosis (KAFO)
[Correct Answer] B – Solid AFO with plantarflexion stop controls
