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Georgia Occupational Therapy Assistant
Licensure Examination Questions And
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- A COTA is working with a client recovering from a CVA who has right hemiplegia. Which intervention is MOST appropriate to improve dressing independence? A. Encourage use of unaffected side only B. Practice hemi-dressing techniques with adaptive strategies C. Perform all dressing tasks for the client D. Restrict dressing practice until full motor recovery Correct Answer: B Rationale: Hemiplegic dressing techniques promote independence by teaching the client to dress the affected limb first and use adaptive strategies such as dressing aids or modified clothing. This supports neuroplasticity and functional recovery. Avoiding participation or performing tasks for the client reduces independence and delays rehabilitation progress.
- Which splint is MOST appropriate for maintaining functional position of a hand with flexor tone following stroke? A. Resting hand splint B. Volar cock-up splint
C. Thumb spica splint D. Ulnar gutter splint Correct Answer: A Rationale: A resting hand splint positions the wrist and fingers in neutral to slight extension, helping prevent contractures and manage flexor tone after stroke. Cock-up splints primarily support wrist extension but do not address full hand positioning. Other splints are designed for specific injuries rather than tone management.
- A child with sensory processing disorder seeks excessive movement and crashes into objects. This behavior is MOST consistent with: A. Sensory avoidance B. Low muscle tone C. Sensory seeking D. Fine motor delay Correct Answer: C Rationale: Sensory seeking behaviors involve craving intense proprioceptive or vestibular input, such as crashing or excessive movement. These behaviors help the child regulate sensory input. Avoidance would involve withdrawal from stimuli, not increased engagement.
- Which is the PRIMARY purpose of standardized occupational therapy assessments? A. Replace clinical observation B. Provide objective measurement of performance C. Eliminate need for documentation D. Diagnose medical conditions Correct Answer: B
- A COTA documenting treatment should ensure documentation is: A. Subjective and narrative only B. Delayed until discharge C. Objective, timely, and measurable D. Written only by supervising OT Correct Answer: C Rationale: Proper documentation must be objective, timely, accurate, and include measurable outcomes. It supports continuity of care, legal compliance, and reimbursement. Subjective-only notes or delayed documentation are not acceptable standards.
- Which cognitive level is MOST appropriate for a client who follows simple one-step commands but requires cueing? A. Level 1 B. Level 3 C. Level 5 D. Level 7 Correct Answer: B Rationale: At Level 3 (Confused-Post Confusional), clients can follow simple commands with assistance and cueing but have impaired safety awareness. Higher levels involve more independence and complex task performance.
- A child with ADHD benefits MOST from: A. Long written instructions B. Structured environment with visual cues C. Unstructured free play only D. Reduced sensory input entirely Correct Answer: C
Rationale: Structured environments with visual cues and consistent routines support attention and task completion in ADHD. Long verbal or written instructions overwhelm processing, while unstructured play alone does not support skill development. 10.The BEST positioning to prevent pressure ulcers in bed-bound clients is: A. Supine position only B. Prone positioning exclusively C. Regular repositioning every 2 hours D. Sitting upright at all times Correct Answer: C Rationale: Regular repositioning redistributes pressure, improves circulation, and reduces risk of skin breakdown. No single position prevents ulcers alone; alternating positions is essential for prevention. 11.When teaching energy conservation, the MOST appropriate instruction is: A. Complete tasks quickly without breaks B. Prioritize, pace, and plan activities C. Avoid all physical activity D. Increase workload gradually without rest Correct Answer: D Rationale: Energy conservation techniques focus on pacing, prioritization, and planning to reduce fatigue. Avoiding activity entirely leads to deconditioning, while rushing increases fatigue and risk of injury. 12.Which modality is contraindicated over areas of impaired sensation?
15.A client with dementia benefits MOST from: A. Frequent environmental changes B. Consistent routines and familiar cues C. High stimulus environments D. Complex instructions Correct Answer: B Rationale: Consistent routines and familiar environments reduce confusion and anxiety in clients with dementia. High stimulation and complex instructions increase cognitive overload. 16.Which muscle is MOST important for shoulder stabilization in hemiplegia? A. Biceps brachii B. Deltoid C. Rotator cuff D. Trapezius only Correct Answer: C Rationale: The rotator cuff stabilizes the glenohumeral joint, preventing subluxation in hemiplegic patients. While other muscles assist movement, the rotator cuff is essential for joint integrity. 17.A COTA should document using: A. Personal opinions B. Objective performance data C. Patient assumptions D. Informal observations only Correct Answer: A
Rationale: Documentation must be objective, factual, and measurable. Personal opinions or assumptions are not acceptable in professional records. 18.Which condition is MOST associated with spasticity? A. Cerebral palsy B. Osteoarthritis C. Carpal tunnel syndrome D. Tendonitis Correct Answer: B Rationale: Cerebral palsy involves upper motor neuron lesions leading to spasticity. Other conditions listed are primarily musculoskeletal or peripheral nerve disorders. 19.A client with visual neglect benefits MOST from: A. Encouraging scanning to affected side B. Restricting head movement C. Ignoring affected side stimulation D. Using only auditory cues Correct Answer: C Rationale: Visual scanning training helps clients with neglect attend to the affected side, improving spatial awareness and safety. Ignoring the affected side worsens deficits. 20.A COTA assisting with transfer training should FIRST: A. Lift client manually B. Assess safety and setup environment
A. Repetition of meaningful play tasks B. Passive movement only C. Restricting hand use D. Avoiding manipulation tasks Correct Answer: A Rationale: Repetition through meaningful play promotes motor learning and skill development. Passive movement does not develop functional fine motor control. 24.A client with PTSD may benefit MOST from: A. High-stimulation environments B. Trauma-informed care approach C. Forced exposure to triggers D. Isolation from therapy Correct Answer: B Rationale: Trauma-informed care emphasizes safety, trust, and empowerment, which are essential for clients with PTSD. Forced exposure or overstimulation may worsen symptoms. 25.A COTA should prioritize client safety during: A. Documentation only B. Treatment sessions C. Administrative meetings D. Equipment storage only Correct Answer: B Rationale: Safety is most critical during treatment sessions where physical interaction and risk of injury are highest.
27.A client with spinal cord injury at C6 level is MOST likely to achieve independence in: A. Total body dressing without assistance B. Feeding and grooming with adaptive equipment C. Independent walking without devices D. Driving without modifications Correct Answer: B Rationale: A C6 spinal cord injury typically allows wrist extension and some tenodesis grasp, enabling independence in feeding and grooming with adaptive devices. Ambulation and unmodified driving are not realistic outcomes at this level. 28.The PRIMARY goal of task analysis is to: A. Simplify documentation B. Break activities into component steps C. Replace client participation D. Diagnose functional limitations Correct Answer: C Rationale: Task analysis involves breaking activities into smaller steps to identify performance demands and guide intervention. It does not replace participation or serve as a diagnostic tool. 29.Which intervention BEST supports handwriting development in children? A. Repetitive tracing worksheets only B. Strengthening fine motor and visual-motor integration C. Avoiding pencil use D. Increasing screen time activities
A. Avoid communication attempts B. Use alternative communication methods C. Speak only in medical jargon D. Increase verbal complexity Correct Answer: B Rationale: Aphasia interventions include alternative communication strategies such as gestures, boards, and simplified language to support functional communication. 33.The PRIMARY focus of occupational therapy is: A. Medical diagnosis B. Restoring occupational performance C. Surgical intervention D. Medication management Correct Answer: C Rationale: Occupational therapy focuses on improving occupational performance and participation in daily activities, not medical diagnosis or medication management. 34.Which is MOST appropriate for preventing shoulder subluxation? A. Arm sling at all times B. Proper positioning and weight bearing activities C. Ignoring affected arm D. Passive stretching only Correct Answer: D Rationale: Proper positioning and weight-bearing activities help maintain joint alignment and reduce subluxation risk. Prolonged sling use may contribute to contractures.
35.A client with autism spectrum disorder benefits MOST from: A. Unstructured unpredictable environment B. Visual schedules and routine C. Frequent environmental changes D. Minimal sensory input always Correct Answer: C Rationale: Visual schedules and structured routines support predictability and reduce anxiety in autism. Unpredictability increases distress. 36.The BEST way to promote ADL independence is: A. Doing tasks for the client B. Grading activities appropriately C. Avoiding practice sessions D. Increasing dependency on caregiver Correct Answer: B Rationale: Grading activities ensures tasks are appropriately challenging and promotes skill development and independence. 37.Which is a sign of pressure ulcer development? A. Increased mobility B. Blanchable redness C. Persistent non-blanchable redness D. Improved circulation Correct Answer: B Rationale: Non-blanchable redness indicates early pressure injury. Blanchable redness is not yet tissue damage.
41.The BEST intervention for improving attention in ADHD is: A. Multitasking activities B. Structured single-step tasks C. High-distraction environments D. No routine structure Correct Answer: C Rationale: Structured tasks with minimal distractions help improve focus and task completion in ADHD. 42.A client post-stroke should begin occupational therapy: A. Only after full recovery B. As early as medically stable C. After 6 months D. Only at home Correct Answer: D Rationale: Early intervention promotes neuroplasticity and functional recovery once medically stable. 43.The MOST appropriate cognitive strategy for memory loss is: A. Repetition and external cues B. Ignoring deficits C. Increasing task complexity D. Removing all reminders Correct Answer: A Rationale: External cues, repetition, and memory aids support cognitive compensation strategies.
44.A COTA must always work under: A. Physician supervision B. Occupational therapist supervision C. Nurse supervision D. Physical therapist supervision Correct Answer: B Rationale: Certified Occupational Therapy Assistants work under the supervision of a licensed Occupational Therapist. 45.Which is MOST important in home safety assessment? A. Furniture color B. Fall hazards identification C. TV placement D. Wall decorations Correct Answer: D Rationale: Fall hazards such as loose rugs and clutter significantly increase injury risk and must be prioritized. 46.A client with burn injuries requires: A. No movement B. Scar management and ROM exercises C. Immobilization permanently D. Avoidance of therapy Correct Answer: B Rationale: Early range of motion and scar management prevent contractures and maintain function.
50.The PRIMARY purpose of splinting is: A. Restrict all movement permanently B. Maintain alignment and function C. Increase pain D. Replace therapy Correct Answer: C Rationale: Splints maintain alignment, prevent deformity, and support healing while allowing functional positioning. 51.A client with hemiplegia should be instructed to dress: A. Strong side first B. Weak side first C. Both sides simultaneously D. Therapist-determined order Correct Answer: B Rationale: Dressing the weak side first promotes independence by allowing the stronger limb to assist with clothing manipulation afterward. This is a standard hemiplegic dressing strategy used in occupational therapy. 52.Which BEST describes proprioception? A. Awareness of sound B. Awareness of body position in space C. Awareness of taste D. Awareness of smell Correct Answer: A
Rationale: Proprioception refers to body position and movement awareness, which is essential for coordination and motor planning. 53.A client with spinal cord injury at T12 is MOST likely to: A. Require full ventilatory support B. Have full upper body function with possible ambulation C. Be completely quadriplegic D. Lose all hand function Correct Answer: B Rationale: T12 injuries typically preserve full upper body function and may allow limited ambulation with orthotics depending on strength and balance. 54.The BEST intervention for improving standing balance is: A. Static seated exercises only B. Progressive weight-shifting activities C. Immobilization training D. Bed rest Correct Answer: C Rationale: Weight-shifting activities improve postural control and balance reactions necessary for functional standing. 55.A child with developmental coordination disorder struggles MOST with: A. Academic knowledge B. Motor coordination tasks C. Hearing deficits D. Vision loss Correct Answer: B
