Practice Exams Questions and Answers-
NBCOT COTA.
An OTR® is writing treatment goals for a client receiving occupational therapy services
in a work conditioning program after a right shoulder sprain. The client is employed as a
surgical technician in an outpatient surgery center. Which option is the BEST example
of a long-term goal?
A. Client will return to full duty as a surgical technician in a full-time capacity within 4
weeks.
B. Client's employer will implement reasonable accommodations to promote the client's
ability to complete full-time physical demands as a surgical technician within 4 weeks.
C. Client will return to full duty as a surgical technician with the ability to carry over
proper body mechanics to reduce risk for reinjury.
D. Client will use proper body mechanics 100% of the time while completing the job of a
surgical technician within 4 weeks. -
\Client will return to full duty as a surgical technician in a full-time capacity within 4
weeks. The goal is client centered, objectively focused on the goal of full-duty and full-
time employment in the role of surgical technician within a specified timeline.
What is an effective strategy to facilitate maximal independence in self-feeding with a
client who has middle- to late-stage dementia?
A. Change the client's diet to foods that are palatable and easy to chew.
B. Change the consistency of foods to allow for easier chewing and swallowing.
C. Provide hand-over-hand guidance for food retrieval and utensil-to-mouth motions.
D. Provide constant verbal cues throughout feeding to improve attention to the self-
feeding task. -
\Provide hand-over-hand guidance for food retrieval and utensil-to-mouth motions.
Hand-over-hand guidance is an effective strategy to encourage maximal independence
through participation in daily living tasks, including self-feeding.
During the initial evaluation for a client with Parkinson's disease, the OTR® asks the
client to "pretend you are brushing your teeth," that is, show the movement of brushing
teeth without using the supplies needed for brushing teeth. The client is unable to
initiate movement of the dominant arm toward the mouth to demonstrate oral hygiene.
Which step should the OTR take NEXT in the evaluation of this client?
A. Try a wrist weight to stabilize the arm during teeth brushing
B. Ask whether the caregiver can provide arm support to bring the hand to the mouth
C. Observe as the client brushes teeth with toothbrush and toothpaste at the bathroom
sink
D. Provide a mobile arm support to compensate for arm movement when brushing teeth
-
,\Observe as the client brushes teeth with toothbrush and toothpaste at the bathroom
sink. The client may not have understood the verbal instructions, and performing the
task in the actual context may allow for more accurate demonstration of the client's
abilities.
An OTR® is adapting the environment to reduce the incidence of repetitive strain
injuries among office workers. To maximize the effectiveness of the ergonomic program,
what would the OTR® be MOST likely to include?
A. Visual reinforcement with signs posted around the office and workstations
B. Empowerment of the workers and creation of a positive group-safety culture
C. A series of lectures and videos showing bad versus good workstation ergonomics
D. Education of supervisors in how to identify noncompliant workers -
\Empowerment of the workers and creation of a positive group-safety culture. Motivation
is a big factor for change to occur. Creating a sense of teamwork allows for mutual
support to accomplish goals together.
An extremely agitated patient is admitted to an inpatient psychiatric hospital late on a
Friday afternoon. Because nursing is short staffed, the nurse on the unit requests that
the patient attend an occupational therapy group being led by a COTA® that evening.
The COTA® calls the OTR®, who is working at a location far from the unit, for guidance.
The OTR® is unable to return to the unit in time to evaluate the client before the
session. What is the BEST course of action the OTR® should direct the COTA® to
take?
A. Allow the patient to attend the group
B. Do not allow the patient to attend the group
C. Cancel the group and evaluate the client
D. Allow the patient to attend the group with the understanding that the OTR® will
complete the evaluation on returning to the unit -
\Do not allow the patient to attend the group. The COTA® is not permitted to initiate
treatment of a client; the OTR® must do the initial assessment of the client. Allowing the
patient to attend a group session would be an ethics violation and liability risk.
A client with a unilateral transradial amputation is undergoing pre-positioning training for
a myoelectric arm. Which of the following is the MOST appropriate goal?
A. Within three sessions, the client will independently don the prosthesis and obtain
good electrical contacts with the electrode sites 100% of the time.
B. Within three sessions, the client will be able to open and close the myoelectric
terminal device 100% of the time.
C. Within 1 week, the client will be able to accurately identify how to arrange the wrist of
the myoelectric terminal device to be able to optimally grasp different objects.
D. Within 1 month, the client will be able to use the myoelectric terminal device as a
functional assist and stabilizer in 100% of daily activities. -
\Within 1 week, the client will be able to accurately identify how to arrange the wrist of
the myoelectric terminal device to be able to optimally grasp different objects. The pre-
positioning phase focuses on teaching the client with an amputation to position the
terminal device for optimal grasp.
,An OTR® is evaluating a patient who underwent an open reduction and internal fixation
(ORIF) of the hip and is non-weight bearing. The patient wants to return home but will
require a temporary wheelchair to do so. What would be the MOST important concern
for this patient in relation to chosing a wheelchair?
A. Overall cost-effectiveness
B. Durability of the product
C. Individualism of the parts
D. Adjustability of the wheelchair -
\Overall cost-effectiveness. Whether a medical condition is temporary, stable, or
progressive will influence a client's wheelchair selection. Someone with a temporary
condition will most likely be more concerned with the cost of a temporary wheelchair
than with individualism of the parts, the product's durability, or adjustability.
A client has central vision loss secondary to macular degeneration. The OTR® plans to
teach the client eccentric viewing techniques to compensate for the client's visual loss.
What should the OTR® teach the client as the FIRST step of this process?
A. Head positioning for optimal viewing
B. Methods for using a magnification device
C. Scanning exercises across the full field of vision
D. Strategies for increasing blind spot awareness -
\Strategies for increasing blind spot awareness. The first step in eccentric viewing
techniques is increasing the client's awareness of the central scotoma, or blind spot.
An OTR® is working with an infant who is recovering from a brachial plexus injury. What
type of sling should the OTR® fabricate?
A. A sling that fits proximally around the humerus
B. A sling that fits proximally around the radius
C. A sling that fits proximally around the ulna
D. A sling that fits proximally around the clavicle -
\A sling that fits proximally around the humerus. A sling that fits proximally around the
humerus will prevent the child from sustaining further injury to the brachial plexus during
ADLs.
The Safe, Accountable, Flexible, Efficient Transportation Equity Act (Pub. L. 109-59)
was signed into law in 2005. What is the basic premise of this law?
A. This law includes providing transportation benefits to optimize access to the
workplace and assumes that lack of transportation is a major barrier and challenge in
sustainable employment.
B. That people who can access fixed-route public transportation may travel more
successfully compared with those who do not have such access.
C. That state and local transportation decision makers play a role in bringing attention to
safety concerns related to individual users of different transportation modes
D. That people who can access public transportation in a sustainable fashion, are more
likely to be successful in welfare-to-work initiatives. -
, \That state and local transportation decision makers play a role in bringing attention to
safety concerns related to individual users of different transportation modes. This option
describes the premise of the Safe, Accountable, Flexible, Efficient Transportation Equity
Act.
An OTR® is using the Ayres Sensory Integration Intervention program for a 6-year-old
child with attention deficit hyperactivity disorder and sensory-seeking behaviors. Which
principle should the OTR® keep in mind when selecting activities for this intervention
program?
A. The sensory environment is completely structured to allow for optimum integration of
sensory information.
B. Sensory experiences are limited to one sensory factor at a time to ensure mastery.
C. Passive participation on the part of the child is encouraged.
D. Appropriate activities are done individually and not in a small group. -
\Appropriate activities are done individually and not in a small group.
The Ayres Sensory Integration Intervention program is applied individually rather than in
groups.
An OTR® is working with a client with Alzheimer's disease (AD) in a skilled nursing
facility. The client's adult child, who is the client's primary caregiver, appears to be
stressed and fatigued and has asked the OTR® for advice about how to best manage
the parent's progressive decline in function. What would be the BEST approach the
OTR® could use?
A. Refer the caregiver to a physician for treatment.
B. Refer the caregiver to the social worker for community resources.
C. Provide the caregiver with education about the progression of AD.
D. Suggest that the caregiver use the massage services at the facility. -
\Provide the caregiver with education about the progression of AD. The most
appropriate approach for an OTR® when dealing with caregivers of clients with AD is to
provide education about the progression of AD along with strategies to improve the
caregiver's self-efficacy in caring for the client.
An OTR® receives orders to evaluate and treat a client in the acute phase of spinal cord
injury. What is the OTR®'s INITIAL role during this phase?
A. Evaluation of the client's ADL ability
B. Evaluation of the client's strength
C. Evaluation of total body positioning
D. Evaluation of possible discharge location -
\Evaluation of total body positioning. During the acute, immobilized phase of spinal cord
injury, the OTR® initiates total body positioning to prevent problems associated with
body functions (ROM) or body structures (skin).
Which activity is an important part of the process of deciding whether a professional
dilemma might in fact involve a violation of the Occupational Therapy Code of Ethics
(2015)?
A. Taking quick action to reduce the potential for the dilemma to become greater
NBCOT COTA.
An OTR® is writing treatment goals for a client receiving occupational therapy services
in a work conditioning program after a right shoulder sprain. The client is employed as a
surgical technician in an outpatient surgery center. Which option is the BEST example
of a long-term goal?
A. Client will return to full duty as a surgical technician in a full-time capacity within 4
weeks.
B. Client's employer will implement reasonable accommodations to promote the client's
ability to complete full-time physical demands as a surgical technician within 4 weeks.
C. Client will return to full duty as a surgical technician with the ability to carry over
proper body mechanics to reduce risk for reinjury.
D. Client will use proper body mechanics 100% of the time while completing the job of a
surgical technician within 4 weeks. -
\Client will return to full duty as a surgical technician in a full-time capacity within 4
weeks. The goal is client centered, objectively focused on the goal of full-duty and full-
time employment in the role of surgical technician within a specified timeline.
What is an effective strategy to facilitate maximal independence in self-feeding with a
client who has middle- to late-stage dementia?
A. Change the client's diet to foods that are palatable and easy to chew.
B. Change the consistency of foods to allow for easier chewing and swallowing.
C. Provide hand-over-hand guidance for food retrieval and utensil-to-mouth motions.
D. Provide constant verbal cues throughout feeding to improve attention to the self-
feeding task. -
\Provide hand-over-hand guidance for food retrieval and utensil-to-mouth motions.
Hand-over-hand guidance is an effective strategy to encourage maximal independence
through participation in daily living tasks, including self-feeding.
During the initial evaluation for a client with Parkinson's disease, the OTR® asks the
client to "pretend you are brushing your teeth," that is, show the movement of brushing
teeth without using the supplies needed for brushing teeth. The client is unable to
initiate movement of the dominant arm toward the mouth to demonstrate oral hygiene.
Which step should the OTR take NEXT in the evaluation of this client?
A. Try a wrist weight to stabilize the arm during teeth brushing
B. Ask whether the caregiver can provide arm support to bring the hand to the mouth
C. Observe as the client brushes teeth with toothbrush and toothpaste at the bathroom
sink
D. Provide a mobile arm support to compensate for arm movement when brushing teeth
-
,\Observe as the client brushes teeth with toothbrush and toothpaste at the bathroom
sink. The client may not have understood the verbal instructions, and performing the
task in the actual context may allow for more accurate demonstration of the client's
abilities.
An OTR® is adapting the environment to reduce the incidence of repetitive strain
injuries among office workers. To maximize the effectiveness of the ergonomic program,
what would the OTR® be MOST likely to include?
A. Visual reinforcement with signs posted around the office and workstations
B. Empowerment of the workers and creation of a positive group-safety culture
C. A series of lectures and videos showing bad versus good workstation ergonomics
D. Education of supervisors in how to identify noncompliant workers -
\Empowerment of the workers and creation of a positive group-safety culture. Motivation
is a big factor for change to occur. Creating a sense of teamwork allows for mutual
support to accomplish goals together.
An extremely agitated patient is admitted to an inpatient psychiatric hospital late on a
Friday afternoon. Because nursing is short staffed, the nurse on the unit requests that
the patient attend an occupational therapy group being led by a COTA® that evening.
The COTA® calls the OTR®, who is working at a location far from the unit, for guidance.
The OTR® is unable to return to the unit in time to evaluate the client before the
session. What is the BEST course of action the OTR® should direct the COTA® to
take?
A. Allow the patient to attend the group
B. Do not allow the patient to attend the group
C. Cancel the group and evaluate the client
D. Allow the patient to attend the group with the understanding that the OTR® will
complete the evaluation on returning to the unit -
\Do not allow the patient to attend the group. The COTA® is not permitted to initiate
treatment of a client; the OTR® must do the initial assessment of the client. Allowing the
patient to attend a group session would be an ethics violation and liability risk.
A client with a unilateral transradial amputation is undergoing pre-positioning training for
a myoelectric arm. Which of the following is the MOST appropriate goal?
A. Within three sessions, the client will independently don the prosthesis and obtain
good electrical contacts with the electrode sites 100% of the time.
B. Within three sessions, the client will be able to open and close the myoelectric
terminal device 100% of the time.
C. Within 1 week, the client will be able to accurately identify how to arrange the wrist of
the myoelectric terminal device to be able to optimally grasp different objects.
D. Within 1 month, the client will be able to use the myoelectric terminal device as a
functional assist and stabilizer in 100% of daily activities. -
\Within 1 week, the client will be able to accurately identify how to arrange the wrist of
the myoelectric terminal device to be able to optimally grasp different objects. The pre-
positioning phase focuses on teaching the client with an amputation to position the
terminal device for optimal grasp.
,An OTR® is evaluating a patient who underwent an open reduction and internal fixation
(ORIF) of the hip and is non-weight bearing. The patient wants to return home but will
require a temporary wheelchair to do so. What would be the MOST important concern
for this patient in relation to chosing a wheelchair?
A. Overall cost-effectiveness
B. Durability of the product
C. Individualism of the parts
D. Adjustability of the wheelchair -
\Overall cost-effectiveness. Whether a medical condition is temporary, stable, or
progressive will influence a client's wheelchair selection. Someone with a temporary
condition will most likely be more concerned with the cost of a temporary wheelchair
than with individualism of the parts, the product's durability, or adjustability.
A client has central vision loss secondary to macular degeneration. The OTR® plans to
teach the client eccentric viewing techniques to compensate for the client's visual loss.
What should the OTR® teach the client as the FIRST step of this process?
A. Head positioning for optimal viewing
B. Methods for using a magnification device
C. Scanning exercises across the full field of vision
D. Strategies for increasing blind spot awareness -
\Strategies for increasing blind spot awareness. The first step in eccentric viewing
techniques is increasing the client's awareness of the central scotoma, or blind spot.
An OTR® is working with an infant who is recovering from a brachial plexus injury. What
type of sling should the OTR® fabricate?
A. A sling that fits proximally around the humerus
B. A sling that fits proximally around the radius
C. A sling that fits proximally around the ulna
D. A sling that fits proximally around the clavicle -
\A sling that fits proximally around the humerus. A sling that fits proximally around the
humerus will prevent the child from sustaining further injury to the brachial plexus during
ADLs.
The Safe, Accountable, Flexible, Efficient Transportation Equity Act (Pub. L. 109-59)
was signed into law in 2005. What is the basic premise of this law?
A. This law includes providing transportation benefits to optimize access to the
workplace and assumes that lack of transportation is a major barrier and challenge in
sustainable employment.
B. That people who can access fixed-route public transportation may travel more
successfully compared with those who do not have such access.
C. That state and local transportation decision makers play a role in bringing attention to
safety concerns related to individual users of different transportation modes
D. That people who can access public transportation in a sustainable fashion, are more
likely to be successful in welfare-to-work initiatives. -
, \That state and local transportation decision makers play a role in bringing attention to
safety concerns related to individual users of different transportation modes. This option
describes the premise of the Safe, Accountable, Flexible, Efficient Transportation Equity
Act.
An OTR® is using the Ayres Sensory Integration Intervention program for a 6-year-old
child with attention deficit hyperactivity disorder and sensory-seeking behaviors. Which
principle should the OTR® keep in mind when selecting activities for this intervention
program?
A. The sensory environment is completely structured to allow for optimum integration of
sensory information.
B. Sensory experiences are limited to one sensory factor at a time to ensure mastery.
C. Passive participation on the part of the child is encouraged.
D. Appropriate activities are done individually and not in a small group. -
\Appropriate activities are done individually and not in a small group.
The Ayres Sensory Integration Intervention program is applied individually rather than in
groups.
An OTR® is working with a client with Alzheimer's disease (AD) in a skilled nursing
facility. The client's adult child, who is the client's primary caregiver, appears to be
stressed and fatigued and has asked the OTR® for advice about how to best manage
the parent's progressive decline in function. What would be the BEST approach the
OTR® could use?
A. Refer the caregiver to a physician for treatment.
B. Refer the caregiver to the social worker for community resources.
C. Provide the caregiver with education about the progression of AD.
D. Suggest that the caregiver use the massage services at the facility. -
\Provide the caregiver with education about the progression of AD. The most
appropriate approach for an OTR® when dealing with caregivers of clients with AD is to
provide education about the progression of AD along with strategies to improve the
caregiver's self-efficacy in caring for the client.
An OTR® receives orders to evaluate and treat a client in the acute phase of spinal cord
injury. What is the OTR®'s INITIAL role during this phase?
A. Evaluation of the client's ADL ability
B. Evaluation of the client's strength
C. Evaluation of total body positioning
D. Evaluation of possible discharge location -
\Evaluation of total body positioning. During the acute, immobilized phase of spinal cord
injury, the OTR® initiates total body positioning to prevent problems associated with
body functions (ROM) or body structures (skin).
Which activity is an important part of the process of deciding whether a professional
dilemma might in fact involve a violation of the Occupational Therapy Code of Ethics
(2015)?
A. Taking quick action to reduce the potential for the dilemma to become greater
