NBCOT OTR Practice Questions (2026) — Free Sample Questions with Answers

Answer: A, C, F

Observe her nighttime route from bed to bathroom under usual lighting: Right — the most recent fall happened on this route; observing it in context identifies lighting, layout and performance hazards (activity analysis in the natural environment).

Assess her eligibility for state home modification grant funding: Funding may matter later, but it is not an evaluation priority for her fall risk at the first visit.

Administer a standardized balance and mobility test such as the Timed Up and Go: Right — a standardized performance measure quantifies fall risk and gives a baseline for reevaluation.

Perform manual muscle testing of every upper extremity muscle group: An impairment-level screen of every muscle is lower priority than functional mobility and home hazards for fall risk.

Schedule an on-road driving evaluation during the first visit: Premature and off-target: she is receiving home health services and the referral concern is falls at home.

Ask about her fear of falling and activities she now avoids: Right — fear of falling drives activity restriction and deconditioning and shapes client-centered priorities (occupational profile).

At evaluation, target the referral concern: observe performance where falls occur, use a standardized risk measure and capture the client's perspective. The real exam gives credit for each correct option selected.

Answer: B, C, E

Perform a resisted grip strength test with a dynamometer: Contraindicated: resisted gripping 5 days after repair risks tendon rupture.

Inspect the incision and measure finger edema circumferentially: Correct: wound status and edema are baseline measures that guide orthosis fit and edema care.

Test light-touch sensation in the digital nerve areas: Correct: zone II lacerations often involve the digital nerves, and sensation affects safety and prognosis.

Measure full passive composite extension of the wrist and fingers: Contraindicated: stretching the wrist and fingers into composite extension at once loads the fresh repair.

Ask about his cooking duties, child care and daily routines: Correct: the occupational profile shows the demands and risks that will shape the plan and his adherence.

Perform manual muscle testing of FDP and FDS strength: Contraindicated: resistance against the repaired flexors is unsafe at this stage.

Evaluate within the protection the repair needs: gather wound, edema, sensation and occupational profile data, and do no resisted or full-stretch testing early after a flexor tendon repair. The exam gives credit for each correct option selected.

Answer: B, E, F

Arrange a behind-the-wheel driving evaluation during the first week: Wrong: premature for this stage of recovery; driving is assessed later if indicated.

Observe grooming at the sink to see how he attends to his left side: Right: performance-based observation in a real ADL shows how left inattention affects function (Task 2).

Complete a timed pegboard test of left-hand dexterity: Wrong: with minimal active hand movement the test will floor out and give no useful information.

Assess his capacity for a return to work as a bus mechanic: Wrong: not client-centered, because he is retired.

Screen visual fields and visual attention to tell hemianopia from neglect: Right: the tray finding could reflect a field cut or neglect, and the two need different strategies.

Interview him and his wife about routines and his valued garage work: Right: the occupational profile identifies priorities, roles and supports.

At evaluation, combine the occupational profile with performance-based observation and screen the specific deficits the scene suggests. The real exam gives credit for each correct option selected.

Answer: B, C, E

Administer a standardized intelligence test to establish eligibility: Outside OT scope: intelligence testing is the school psychologist's role.

Observe the student during written work and at recess: Right: observing in natural school contexts shows how the student performs where the problems occur.

Interview the teacher about classroom routines and work demands: Right: the teacher identifies educationally relevant demands and priorities.

Start a classroom movement-break program before testing begins: Premature: intervening before the evaluation is complete skips the OT process.

Gather standardized sensory processing ratings from home and school: Right: rating forms from both settings show whether sensory processing differences affect participation across contexts.

Complete the standardized testing in a quiet, distraction-free room: Wrong context: quiet-room testing hides the classroom and recess demands where the difficulty occurs, so it cannot replace observation in context.

School-based evaluation combines standardized tools with observation and interviews in natural school contexts, within OT scope. The real exam gives credit for each correct option selected.

Answer: A

Administer a performance-based assessment of a complex IADL: Correct: brief screens often miss executive deficits; observing a complex real-world task shows how cognition affects performance.

Accept the screen results and record no cognitive deficit: Incomplete: it ignores the family report and the known limits of brief screens.

Repeat the same cognitive screen in 1 week: Low yield: retesting with the same insensitive tool will not reveal executive deficits.

Perform manual muscle testing of both upper extremities: Wrong focus: the reported problems are cognitive, not motor.

Executive dysfunction after TBI is best shown in complex, performance-based tasks; screens have limited sensitivity.

Answer: A

Taking a hot shower after returning home from work: Correct: symptoms of MS typically worsen with heat exposure and accumulated daily fatigue, so a hot shower late in the day combines both triggers.

Eating breakfast while seated at the table: Less likely: a seated, low-demand task early in the day puts little stress on endurance.

Reading email at a desk in an air-conditioned office: Less likely: a cool environment and seated posture reduce symptom provocation.

Brushing teeth after waking in the morning: Less likely: fatigue in MS is usually lowest early in the day, and the task has low demand.

Heat sensitivity and fatigue that builds through the day are hallmark MS influences on performance; consider timing and temperature when evaluating.

Answer: D

Document the comment in his session note at the end of the day: Delays action on a possible safety risk.

Encourage him to choose a new hobby to replace the guitar he gave away: Misreads the statement as a leisure issue.

Redirect him to the group’s leisure-planning activity: Ignores warning signs.

Ask him privately and directly whether he is thinking about suicide: Correct: giving away possessions and statements about the future are warning signs; asking directly and then following the safety protocol is the priority (Task 3, suicidal ideation).

Warning signs of suicide take priority: ask directly, stay with the client and follow the facility’s safety protocol.

Answer: A

Have her demonstrate the transfer and explain the cues in her own words: Correct: teach-back with return demonstration shows real understanding and safe performance (Task 2, health literacy and caregiver training).

Ask her whether she has any questions about the technique: A yes/no question does not show whether she can do the skill.

Give her a detailed handout written at a college reading level: Written material at a high reading level is not accessible and does not confirm learning.

Have her sign a form stating that training was completed: Documents attendance, not competence.

Confirm caregiver learning with teach-back and return demonstration, not with yes/no questions or signatures.

Answer: A

1. Find the distance from the mean: 100 − 70 = 30 points.
2. Divide by the SD: 30 ÷ 15 = 2 SD below the mean.
3. On the normal curve, about 2% of scores fall 2 SD or more below the mean, so the score is near the 2nd percentile.

Performance is 2 SD below the mean, near the 2nd percentile: Correct: (100 − 70) ÷ 15 = 2 SD below the mean, which corresponds to roughly the 2nd percentile; this is quantitative interpretation for planning (Task 1).

Performance falls in the low-average range for the child’s age: Wrong range: low average is about 80–89; a score 2 SD below the mean is well below average.

The child completed about 70% of the test items correctly: Confuses a standard score with a percent-correct raw score.

Performance is 1 SD below the mean, near the 16th percentile: Miscalculates the distance: 1 SD below the mean would be a standard score of 85, not 70.

Convert a standard score by its distance from the mean in SD units: 1 SD below ≈ 16th percentile, 2 SD below ≈ 2nd percentile.

Answer: C

1. Maximum slope 1:12 means 12 in of run for each 1 in of rise.
2. Run = 24 in × 12 = 288 in.
3. 288 in ÷ 12 = 24 ft.
4. The rise (24 in) is under the 30-in maximum rise per run, so one run is enough.

2 ft: Treats the rise itself as the run length; this would be a near-vertical slope.

12 ft: Uses a 1:6 slope, twice as steep as the ADA maximum.

24 ft: Correct. At a 1:12 maximum slope, every 1 in of rise needs 12 in of run: 24 × 12 = 288 in = 24 ft (one run, since the rise is under 30 in).

30 ft: Confuses the 30-in maximum rise per run with the needed length.

ADA 2010: ramp slope at most 1:12, so run (in) = 12 × rise (in); add level landings at least 60 in long at top and bottom.

Answer: D

Providing a handheld magnifier for reading the newspaper: Wrong condition: magnification helps reduced acuity (e.g. macular degeneration), not a lost hemifield.

Switching to large-print books in place of the newspaper: Not client-centered and does not address the field loss; larger print still falls in the blind hemifield.

Covering the right half of each eyeglass lens: Wrong side: occluding the intact right field removes the vision the client depends on.

Adding a bright left-margin line and scanning to it: Correct. A left-margin anchor plus trained scanning toward the blind field is the compensatory strategy for a permanent field cut.

A permanent field cut is managed with compensatory scanning toward the blind side, often with an anchor line.

Answer: D

Has a flaccid upper extremity with no active movement: Not a candidate: without any active wrist and finger extension there is no movement to shape.

Has good hand return but frequent falls and poor judgment: Unsafe: wearing a mitt on the stronger hand raises fall risk in a client who already falls.

Has near-normal coordination and uses both hands in all tasks: No indication: there is no learned nonuse to overcome.

Has 20° active wrist and 10° finger extension, safe balance: Correct: CIMT needs some active wrist and finger extension, enough cognition to follow the program and safe balance while the stronger hand is constrained (CIMT, D3 Task 3).

CIMT targets learned nonuse in clients with some active wrist and finger extension, adequate cognition and safe balance.

Answer: C

Apply NMES at a lower intensity and monitor heart rate: Contraindicated: lowering the intensity does not remove the risk of interfering with the pacemaker.

Switch to sensory-level TENS over the same shoulder muscles: Contraindicated: TENS is also electrical current applied near the chest.

Defer stimulation; use positioning and arm support: Correct: a demand pacemaker is a contraindication to electrical stimulation, especially near the thorax. Positioning, arm support during sitting and transfers, and caregiver handling training protect the shoulder safely (PAM contraindications, D3 Task 1).

Apply NMES to the opposite shoulder to avoid the device: Wrong side and still unsafe: it treats the unaffected shoulder and still passes current across the thorax region.

Screen for contraindications before any PAM: a pacemaker rules out electrical stimulation, so use non-electrical options such as positioning and support.

Answer: D

Have the client sit and rest, then recheck symptoms in 10 minutes before resuming: Delays treatment: rest does not raise blood glucose, and symptoms can progress to loss of consciousness.

Have the client finish the meal being prepared and eat it right away: Too slow: finishing and eating a mixed meal continues exertion and delays fast-acting carbohydrate.

Offer a peanut butter sandwich to provide longer-lasting energy for the task: Protein and fat slow absorption; fast-acting carbohydrate is needed first.

Stop the task, give 15 g of fast-acting carbohydrate and notify nursing: Correct — these are signs of hypoglycemia; a conscious client who can swallow receives fast-acting carbohydrate (e.g., 4 oz of regular juice) right away, and nursing is notified per facility protocol.

Suspected hypoglycemia in a conscious client: stop, give fast-acting carbohydrate, notify the team per protocol.

Answer: A

The change may be too small to matter to clients; weigh it with other evidence and preferences.: Correct — statistical significance shows the difference is unlikely to be chance, but a change below the minimal clinically important difference may not matter in daily life; the clinical bottom line integrates this with other evidence, expertise and client values.

The program is effective and should be adopted, because a significant p value confirms a meaningful benefit.: Overstates one trial: statistical significance shows the difference is unlikely to be chance, not that it is large enough to matter.

The difference is likely due to chance, since only p values below .01 count as significant.: Misreads the p value: .03 is below the usual .05 alpha, so chance is an unlikely explanation.

The group should replace current care, because an RCT is the highest level of evidence available.: Overstates the design: a single RCT ranks below systematic reviews, and a strong design does not make a clinically small effect meaningful.

Appraise both statistical significance (is it real?) and clinical significance (does it matter?) before forming a clinical bottom line.

Answer: A, C, E

Stay with him and notify the psychiatrist right away per protocol: Correct. Stockpiling medication together with a hopeless statement is a warning sign with access to means, so it requires immediate escalation to the treatment team while he stays under supervision.

Promise to keep his statements confidential to protect rapport: Lower priority than safety: risk of self-harm overrides confidentiality, and promising secrecy breaks fidelity.

Ask him directly whether he is thinking about killing himself: Correct. Asking directly about suicidal thoughts does not raise risk and clarifies how urgent the situation is.

Wait to raise the concern at the weekly team meeting: Lower priority than safety: delay is unsafe when warning signs are present.

Document his exact words, the actions taken and who was notified: Correct. Clear, objective documentation supports continuity of care and risk management.

Have him sign a no-harm contract and end the session: No-harm contracts do not prevent suicide and do not replace assessment and escalation.

With suicide warning signs, safety comes first: ask directly, do not leave the client alone, escalate per protocol and document objectively.