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Quizzes > Health & Medicine > Human Anatomy & Medicine

NBCOT Practice Exam: Challenge Your Occupational Therapy Skills

Dive into free NBCOT practice questions and ace your occupational therapy practice test

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for NBCOT practice exam quiz on teal background

Ready to boost your confidence for the NBCOT? Our nbcot practice exam is packed with sample nbcot questions designed to sharpen your occupational therapy skills. Whether you're tackling your first free practice questions or diving into a quick OT quiz , this occupational therapy practice test helps you identify strengths, target areas for improvement, and simulate test-day conditions. Perfect for students and professionals, these free nbcot practice questions estimate your readiness and guide your study plan. Jump in now, challenge yourself, and ace the test with confidence!

Which of the following is considered an Activity of Daily Living in the Occupational Therapy Practice Framework?
Child rearing
Home management
Meal preparation
Toileting
Activities of Daily Living (ADLs) are basic self-care tasks necessary for fundamental functioning. Toileting is one of the six core ADLs defined in the OTPF. Other ADLs include feeding, dressing, bathing, and hygiene.
Instrumental Activities of Daily Living (IADLs) are best represented by which of the following?
Dressing
Eating
Bathing
Home management
IADLs are more complex activities that support daily life, such as meal preparation, shopping, and financial management. Home management falls under IADLs because it involves planning and execution of household tasks. ADLs, by contrast, involve basic self-care.
What is the primary purpose of a static splint in hand therapy?
Maintain joint alignment
Facilitate tendon gliding
Strengthen muscles
Provide dynamic movement
Static splints are designed to hold a joint in a specific position to prevent deformity and support healing. They do not allow active motion but maintain alignment and reduce contracture risk. Dynamic splints, by contrast, promote movement.
Under HIPAA regulations, which aspect of patient care is specifically protected?
Occupational therapy documentation
Billing procedures
Professional liability
Patient health information
The Health Insurance Portability and Accountability Act (HIPAA) protects the privacy and security of individually identifiable health information. This includes any demographic information that relates to health status or services. While occupational therapy documentation is covered, the core protection is of patient health information.
In manual muscle testing, a grade of 3 indicates which level of strength?
Slight resistance only
Full range with moderate resistance
Full range of motion against gravity
No detectable movement
A grade 3 muscle test indicates that the muscle can move the joint through a full range of motion against gravity but cannot handle any additional resistance. Grade 4 implies moderate resistance, while grade 5 is full resistance. Grades 0 - 2 reflect less than full anti-gravity performance.
The Canadian Occupational Performance Measure (COPM) primarily assesses:
Client's perceived occupational performance
Cognitive skills
Hand dexterity
Muscle tone
The COPM is a client-centered outcome measure that identifies occupational performance issues and tracks self-perceived changes over time. It does not directly measure physical constructs but rather the client's own rating of performance and satisfaction. It guides goal setting in therapy.
Which grasp pattern uses the thumb opposing the radial side of the index finger?
Power grasp
Tip pinch
Three-jaw chuck
Lateral pinch
A lateral pinch, also known as a key pinch, occurs when the thumb presses against the radial side of the index finger, similar to holding a key. This differs from tip pinch (pad-to-pad) and three-jaw chuck (thumb and two fingers). Power grasps involve the palm more than the fingertips.
Which of the following is an Instrumental Activity of Daily Living (IADL)?
Meal preparation
Feeding
Toileting
Washing oneself
IADLs are complex skills needed for independent community living, including meal preparation, shopping, medication management, and finances. Feeding, toileting, and bathing are basic ADLs. Recognizing the distinction guides appropriate intervention planning.
Which standardized assessment tool evaluates motor proficiency in children?
Six-Minute Walk Test
COPM
Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
Disabilities of Arm, Shoulder and Hand (DASH)
The BOT-2 is a norm-referenced assessment that measures fine and gross motor skills in children aged 4 - 21. It provides percentile ranks and standard scores. It is widely used in pediatric occupational therapy.
According to the Model of Human Occupation (MOHO), which component drives motivation for occupation?
Environment
Habituation
Performance
Volition
MOHO defines volition as the process by which individuals are motivated and choose what activities to engage in. Habituation refers to routines, while performance capacity relates to skills. The environment also influences occupational choices but is not the driver of motivation.
Which ethical principle focuses on fairness and justice in occupational therapy practice?
Justice
Autonomy
Nonmaleficence
Beneficence
Justice in ethics refers to impartiality and fairness in service delivery and resource allocation. Occupational therapists must ensure equitable access to services. Beneficence and nonmaleficence address doing good and avoiding harm, while autonomy supports client decision-making.
What is the main focus of sensory integration therapy?
Adaptive equipment prescription
Muscle strengthening
Cognitive remediation
Response to sensory stimuli
Sensory integration therapy addresses the way the central nervous system processes sensory inputs. The goal is to improve adaptive responses to sensory experiences. It is used with clients who have sensory processing difficulties, such as autism.
Which pinch uses only the pads of the thumb and index finger in a tip-to-tip fashion?
Hook grasp
Lateral pinch
Spherical grasp
Tip pinch
Tip pinch (or pincer grasp) involves opposition of the thumb pad to the index finger pad. It is crucial for precision tasks like picking up small objects. Lateral pinch and three-jaw chuck involve different finger alignments.
Occupational therapy assistants must work under the supervision of which professional?
Occupational therapist
Physical therapist
Registered nurse
Social worker
OT assistants deliver therapy services under the direct or indirect supervision of a licensed occupational therapist. This ensures client safety and adherence to professional standards. They cannot independently plan or interpret evaluative findings.
Which model emphasizes the interaction among person, environment, and occupation?
Model of Human Occupation (MOHO)
Biomechanical model
PEOP (Person-Environment-Occupation-Performance)
Sensory integration model
The PEOP model specifically highlights the dynamic interplay among person factors, environmental context, and occupational performance. MOHO also considers environment and occupation but focuses on volition, habituation, and performance capacity. PEOP is chosen when emphasizing environmental fit.
What is the primary purpose of the Functional Independence Measure (FIM)?
Assess cognitive deficits
Test manual dexterity
Evaluate functional independence in ADLs
Measure reflexes
The FIM is an 18-item tool that assesses physical and cognitive disability in terms of burden of care. It rates independence in self-care, sphincter control, mobility, locomotion, communication, and social cognition. It is widely used for service reimbursement and outcome measurement.
Which PNF diagonal pattern promotes shoulder flexion, abduction, and external rotation?
D2 extension
D1 flexion
D2 flexion
D1 extension
PNF D2 flexion involves shoulder flexion, abduction, and external rotation. It is used to improve reaching movements and scapular mobility. D1 patterns involve flexion/adduction or extension/abduction.
Constraint-induced movement therapy (CIMT) is most indicated for clients who have had which condition?
Rheumatoid arthritis
Stroke
Low back pain
Cerebral palsy
CIMT forces use of the affected upper limb by restraining the unaffected side, improving motor function after stroke. It is supported by research showing neuroplastic changes. It is less commonly used in other diagnoses.
The Six-Minute Walk Test is used primarily to assess which client characteristic?
Balance
Endurance
Dexterity
Vision
The Six-Minute Walk Test measures functional exercise capacity and endurance by recording distance walked in six minutes. It is used in pulmonary and cardiac rehabilitation. It does not directly assess balance or dexterity.
What is the term for the accuracy of a measurement tool in measuring what it intends to measure?
Validity
Reliability
Specificity
Sensitivity
Validity refers to the degree to which an instrument measures what it claims to measure. Reliability, in contrast, refers to consistency of results. Sensitivity and specificity relate to a test's ability to detect true positives or negatives.
In Allen's Cognitive Disabilities Model, what type of actions characterize Level 3?
Manual actions
Exploratory actions
Spontaneous actions
Goal-directed actions
Level 3 clients demonstrate manual actions, using their hands to manipulate objects but without a clear goal beyond sensory stimulation. They cannot sequence tasks for a purpose. Level 4 indicates goal-directed actions.
Which adaptive device is most appropriate for a client with decreased wrist extension during self-feeding?
Plate guard
Universal cuff
Long straw
Built-up handle utensil
A universal cuff holds utensils securely and does not require active wrist extension or grasp. Plate guards help with scooping but do not address wrist positioning. Built-up handles increase diameter, and long straws assist drinking.
Which action by a therapist best exemplifies the principle of nonmaleficence in the AOTA Code of Ethics?
Charging fees based on service complexity
Maintaining client confidentiality
Promoting client autonomy
Avoiding interventions that may cause harm
Nonmaleficence obligates practitioners to refrain from actions that cause harm. Avoiding high-risk interventions without appropriate precautions exemplifies this principle. Confidentiality is related to privacy, and autonomy focuses on self-determination.
The Beck Depression Inventory is designed to assess which area?
Anxiety
Motor function
Depression
Cognitive function
The Beck Depression Inventory (BDI) is a self-report questionnaire that measures the severity of depressive symptoms in adults and adolescents. It is widely used in mental health settings. It is not designed to assess anxiety or motor performance.
During a home safety evaluation, which intervention best reduces fall risk?
Providing nightlights
All of the above
Installing grab bars
Removing throw rugs
Reducing fall risk involves environmental modifications such as installing grab bars in the bathroom, providing adequate lighting, and removing trip hazards like throw rugs. An integrated approach addresses multiple risk factors simultaneously.
Which dressing is most appropriate to maintain a moist wound environment in burn care?
Gauze
Hydrocolloid
Transparent film
Dry dressings
Hydrocolloid dressings create a moist environment that promotes autolytic debridement and supports healing. Transparent films also maintain moisture but are less absorptive. Gauze and dry dressings can desiccate the wound and impede healing.
What is the primary goal of energy conservation techniques for clients with COPD?
Increase muscle strength
Improve balance
Enhance sensory processing
Reduce dyspnea during tasks
Energy conservation strategies, such as pacing and task simplification, help clients with COPD minimize exertion and reduce breathlessness. This promotes greater independence in ADLs. Strength improvements are secondary benefits of exercise programs.
Which seating intervention is most effective in reducing pressure ulcer risk for long-term wheelchair users?
Foam cushion
Wooden seat
Gel cushion
No cushion
Gel cushions conform to body contours and distribute pressure evenly, reducing risk of skin breakdown. Foam cushions offer some pressure relief but may compress over time. Hard surfaces like wooden seats offer no pressure distribution.
What is the main purpose of the three-jaw chuck grasp in hand function?
Power grip
Precision pinch
Gross grasp
Hook grasp
The three-jaw chuck or tripod pinch involves opposition of the thumb to the pads of the index and middle fingers. It is used for precision tasks like writing or manipulating small objects. It is categorized as a precision grip rather than power or gross grasp.
The Allen Cognitive Level Screen (ACLS) primarily assesses which client characteristic?
Sensation
Motor strength
Cognitive processing
Psychosocial status
The ACLS evaluates cognitive processing levels through leather-lacing tasks. It helps determine a client's ability to learn and perform familiar tasks. It does not directly measure sensory or psychosocial factors.
Which intervention emphasis uses meaningful occupations to remediate client deficits?
Task-oriented approach
Biomechanical approach
Sensory integration
Holistic approach
The task-oriented approach focuses on performance of meaningful occupations to improve underlying performance components. By engaging clients in real-world tasks, therapists promote functional carryover. It differs from purely biomechanical or sensory-based interventions.
After completing an occupational profile, what is the next step in the OT evaluation process?
Goal writing
Intervention plan
Initial assessment
Service implementation
The OTPF describes evaluation as consisting of the occupational profile followed by analysis of occupational performance and creating the intervention plan. Goal writing occurs within the intervention plan phase. Implementation follows planning.
Which of the following is an example of a compensatory strategy in OT practice?
Progressive resistive exercise
Home modifications
Task grading
Strengthening exercises
Compensatory strategies involve changing the task or environment to bypass client deficits, such as installing grab bars or rearranging kitchen items. Strengthening and resistive exercises are remedial approaches aiming to restore function. Task grading modifies task complexity but still seeks remediation.
Use of a universal cuff is best indicated for clients with which impairment?
Decreased sensory awareness
Visual deficits
Spasticity
Decreased fine motor coordination
A universal cuff secures utensils or tools to the hand without requiring a grasp, benefiting clients who have limited fine motor coordination but preserved wrist stability. It is less helpful for spasticity or sensory loss alone.
Which documentation format is characterized by the use of SOAP notes?
Flow sheet
Narrative notes
Problem-oriented medical record
Electronic health record only
SOAP notes (Subjective, Objective, Assessment, Plan) are part of the Problem-Oriented Medical Record format. They provide a structured way to document client encounters. Narrative notes are free-form, and flow sheets are used for repetitive data.
When converting raw scores to Z-scores on norm-referenced tests, a raw score two standard deviations above the mean corresponds to which Z-score?
-2
2
1
0
Z-scores represent how many standard deviations a score is from the mean. A raw score two standard deviations above the mean equals a Z-score of +2. A score two below would be - 2. A Z of 0 indicates the mean.
In Wilbarger deep pressure and proprioceptive technique, which component is essential?
Rotatory movements
Thermal stimulation
Brushing
Free play
The Wilbarger Protocol includes brushing the skin with a surgical brush followed by joint compressions to provide deep pressure. This sensory-based intervention aims to reduce defensiveness. Rotatory movements and thermal stimuli are not part of the standard protocol.
The PENS-Plus approach in spinal cord injury intervention emphasizes which modality?
Electrical stimulation
Passive exercises
Sensory integration
Constraint training
PENS stands for Patterned Electrical Neuromuscular Stimulation. The 'Plus' indicates integration with functional tasks. Electrical stimulation helps maintain muscle mass and promotes neural recovery in SCI.
In Neuro-Developmental Treatment (NDT), handling techniques are primarily intended to address:
Cognitive deficits
Sensory processing
Social interaction
Motor control
NDT handling provides sensory-motor input to facilitate normal movement patterns and inhibit abnormal tone. It focuses on improving motor control. Sensory processing may be indirectly affected, but the primary target is movement execution.
Which intervention is evidence-based for unilateral neglect after stroke?
Aquatic therapy
Splinting
Prism adaptation
Treadmill training
Prism adaptation shifts visual field to encourage scanning to the neglected side, reducing spatial neglect in stroke survivors. Multiple studies support its efficacy. Splinting and aquatic therapy are not primary neglect interventions.
Calculating sensitivity and specificity in test development primarily assesses which attribute of an instrument?
Bias
Standardization
Reliability
Validity
Sensitivity and specificity determine how accurately a test identifies true positives and true negatives, core aspects of validity. Reliability focuses on consistency. Standardization refers to uniform administration, and bias addresses systematic error.
Which seating assessment method measures pelvic obliquity through pressure distribution analysis?
Pressure mapping
Wheelchair Skills Test
Functional Independence Measure
Pelvic measurement
Pressure mapping systems provide visual feedback on pressure distribution and can identify pelvic obliquity or uneven seating surfaces. It is used for complex seating assessments. Wheelchair Skills Test evaluates user ability, not seating pressure.
Which task is an occupational therapy assistant allowed to perform without direct supervision per AOTA guidelines?
Discharge planning
Initial evaluation
Documenting client progress
Modifying intervention plan
OT assistants may document client progress and responses to intervention under the supervision and direction of an OT. They cannot perform evaluations, discharge planning, or modify plans independently. These tasks require the OT's professional judgment.
What is the primary purpose of the Jebsen-Taylor Hand Function Test?
Balance testing
Strength measurement
Assessment of fine and gross hand function in standardized tasks
Sensory evaluation
The Jebsen-Taylor Hand Function Test assesses hand function through a series of timed tasks such as writing, card turning, and lifting small objects. It evaluates functional dexterity rather than strength or sensation alone.
In evidence-based practice hierarchies, which study design provides the highest level of evidence among these options?
Expert opinion
Case report
Cohort study
Randomized controlled trial
Randomized controlled trials (RCTs) minimize bias through randomization and control groups, offering high internal validity. Systematic reviews and meta-analyses rank above RCTs, but among the options, RCTs are highest. Cohort studies and case reports are lower-level evidence.
Which assessment tool is most appropriate for evaluating visual-motor integration skills in children?
Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI)
Snellen chart
Preschool Visual Motor Integration Assessment
Motor-Free Visual Perception Test (MVPT)
The Beery VMI assesses how well a child integrates visual and motor abilities by copying geometric shapes. It is widely used in OT to evaluate developmental coordination. MVPT measures only visual perception, and the Snellen chart evaluates visual acuity.
Which documentation standard is mandated by Medicare for home health occupational therapy services?
SOAP notes
Barthel Index
OASIS
FIM
Medicare requires Outcome and Assessment Information Set (OASIS) documentation for home health services, including OT. OASIS data is used for reimbursement, quality monitoring, and outcome measurement. SOAP notes are internal clinical documentation but not the mandated data set.
During the acute phase of burn recovery, which intervention is contraindicated?
Positioning to prevent contractures
Splinting in functional positions
Massage on open burn wounds
Gentle range of motion exercises
Massaging open burn wounds can disrupt fragile granulation tissue and increase infection risk. Gentle ROM, splinting, and positioning to prevent contractures are standard acute-phase interventions. Massage is introduced only after wounds have healed.
The Boehm Test of Basic Concepts for preschoolers measures which skill area?
Social skills
Motor skills
Sensory processing
Academic language concepts
The Boehm Test assesses a child's understanding of basic concepts (e.g., spatial, quantitative, temporal) that underpin academic learning. It is used by school-based therapists to identify concept deficits. It does not measure motor or sensory abilities.
In sensory modulation interventions, what is the primary goal of using a weighted blanket?
Improve fine motor skills
Provide deep pressure input
Increase arousal
Enhance cognitive processing
Weighted blankets deliver deep pressure stimulation that can have a calming, organizing effect on the nervous system. This helps clients with sensory modulation difficulties reduce anxiety and improve focus. It is not intended to increase arousal or target motor skills directly.
In Rasch analysis for test development, which statistic is used to evaluate item difficulty and fit?
Mean square fit statistic
Cronbach's alpha
Kappa statistic
Pearson correlation coefficient
Rasch analysis uses infit and outfit mean square statistics to examine how well items conform to a unidimensional measurement model. These fit statistics indicate if items are too predictable or erratic. Cronbach's alpha measures internal consistency, not item fit.
The Model of Human Occupation Screening Tool (MOHOST) primarily examines which domain?
Cognitive deficits
Occupational participation
Biological factors
Emotional status
MOHOST assesses volition, habituation, communication/interaction skills, process skills, and environment to determine occupational participation. It is a screening tool to guide further evaluation and intervention. It does not isolate only cognitive or emotional status.
What is the primary purpose of an advanced directive in occupational therapy practice?
Guide treatment decisions when a client loses decision-making capacity
Plan the discharge process
Record client functional goals
Document progress toward goals
An advanced directive specifies a client's wishes for medical treatment if they become unable to communicate or make decisions. OT practitioners must respect these directives when planning care. It is not a tool for goal documentation or discharge planning.
Which evidence-based practice model integrates clinical expertise, patient values, and the best research evidence?
PICO model
Stetler Model
Johns Hopkins Evidence-Based Practice Model
Sackett's model of evidence-based practice
Sackett's EBP model describes the integration of the best available research evidence, clinical expertise, and patient values/preferences. It is the foundational triad of evidence-based practice in healthcare. PICO is a question-formulation tool rather than a practice model.
The NIH Stroke Scale score is primarily used to:
Evaluate sensory function
Predict stroke outcome and severity
Measure ADL performance
Assess cognitive deficits
The NIH Stroke Scale is a standardized tool used in acute care to quantify stroke severity and predict outcomes. Higher scores indicate more severe impairment. It does not directly measure ADLs or detailed cognitive functions.
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Study Outcomes

  1. Understand NBCOT Exam Format -

    Gain clarity on the structure and question types found in the nbcot practice exam to navigate the real test with confidence.

  2. Apply Clinical Reasoning -

    Use occupational therapy principles to analyze patient scenarios and select the most appropriate interventions, reflecting common exam content.

  3. Interpret Sample NBCOT Questions -

    Develop strategies for breaking down sample nbcot questions, improving accuracy when tackling similar items on the practice nbcot exam.

  4. Evaluate Performance and Track Progress -

    Assess your strengths and identify areas for improvement through free nbcot practice questions and detailed feedback.

  5. Manage Test-Taking Time -

    Practice pacing techniques in our occupational therapy practice test to complete questions efficiently under timed conditions.

Cheat Sheet

  1. Understand the OTPF Process -

    The AOTA's Occupational Therapy Practice Framework (OTPF) divides practice into evaluation, intervention, and outcomes, so review each step thoroughly. Remember the three-stage process: "Assess, Plan, Act" to mirror common sample NBCOT questions. This structure ensures you know where tasks like client factors, performance skills, and activity demands fit in the nbcot practice exam.

  2. Master Standardized Assessment Properties -

    Familiarize yourself with psychometric properties such as reliability (ICC ≥ 0.80) and validity types (content, construct, criterion) from sources like the Journal of Allied Health. For example, the COPM is highly client-centered and shows strong test-retest reliability over two weeks. Use the mnemonic "RVC" (Reliability, Validity, Ceiling) to recall key features when answering practice nbcot exam items.

  3. Apply Biomechanical Principles -

    Review formulas such as torque (T = F × d) and leverage classes when evaluating joint mechanics in rehabilitation, as detailed in standard textbooks (e.g., Salvendy's Handbook). Knowing how moment arms change under different grip positions can help you solve biomechanics questions swiftly. When tackling sample nbcot questions on seating or splint design, recall "T = Force × Distance" to calculate joint loading accurately.

  4. Use Clear Documentation Standards -

    Brush up on SOAP note structure (Subjective, Objective, Assessment, Plan) and ICD-10/CPT coding guidelines provided by the Centers for Medicare & Medicaid Services. Practice converting a brief client interaction into a concise SOAP note, as this skill often appears in occupational therapy practice tests. Remember: "SOAP = Story Of Actual Progress" to keep your notes consistent and exam-ready.

  5. Review AOTA's Code of Ethics -

    Study the six core principles - autonomy, beneficence, nonmaleficence, justice, veracity, fidelity - from the official AOTA Code of Ethics (2020). Create a memory phrase like "All Beneficial Nurses Judge Very Fairly" to recall each principle under pressure. This foundational knowledge frequently underpins scenarios in free NBCOT practice questions about professional conduct.

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