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NBCOT PRACTICE 2026 COMPREHENSIVE
ASSESSMENT
◉ An individual cannot independently get from a supine position to a sitting position to a sitting position. The person has good scapular, shoulder, and elbow muscle strength. What is the MOST APPROPRIATE recommendation for the OTR to make to improve bed mobility? A. Bed rail assist B. Log roll technique C. Roll ladder. Answer: C. Rope ladder Quiz # ◉ An individual who had a CVA one year ago continues to demonstrate unilateral neglect. The individual drives daily to therapy despite several suggestions from the OTR to discontinue this activity. The therapists has determined that the client is an unsafe driver. What is the BEST approach for the OTR to take in this situation? A. Report the individual to the department of motor vehicles B. Report the information to the physician C. Suggest that the individual attend a driver training program. Answer: B. Report the information to the physician
Quiz # ◉ A four-year-old preschooler is referred to OT. Upon evaluation, the occupational therapists determines that the child demonstrates age- appropriate cognitive and fine motor skills. What would the OTR observe in the child to help make this determination? A. Assemble a four-piece puzzle of a human body B. Build a tower of nine cubes C. Copy a five-cube gate block construction. Answer: A. Assemble a four-piece puzzle of a human body Quiz # ◉ The OTR works on increasing extensor tone in an individual's upper extremity. What is the MOST APPROPRIATE intervention according to the Rood approach? A. Tendinous pressure over the insertion of the triceps B. Maintained stretch to the triceps C. High frequency vibration on the triceps D. Low frequency vibration on the triceps. Answer: C. High frequency vibration on the triceps Quiz #
Quiz # ◉ After a motor vehicle accident, a 23 year-old college student was in a coma for 3 weeks. She regained consciousness and was severely confused. She frequently became agitated for no apparent reason. Her level of agitation has recently decreased but she is still distractible. Currently, she remains forgetful and confused, repeating the same questions throughout the day. Her family and friends visit consistently and have asked the OTR for an activity recommendation that they can do with the client during visiting hours. What is the MOST APPROPRIATE activity for the OTR to recommend the visitors complete with the individual? A. Play a simple board game that is familiar from her childhood B. Review the client's memory picture book of familiar people and activities C. Play a matching card game that includes pictures of her past interests.. Answer: B. Review the client's memory picture book of familiar people and activities Quiz # ◉ An individual with ALS swims three times a week to maximize strength and endurance. Initially able to swim for only 10 minutes, the individual is now able to swim 20 minutes without becoming fatigued. What would be the NEXT step with this individual?
A. Continue the program of swimming 20 minutes, three times a week B. Decrease swimming frequency to two times a week C. Increase swimming time to 25 minutes or to tolerance. Answer: C. Increase swimming time to 25 minutes or to tolerance Quiz # ◉ An OTR is working with a group of 3-year-old children in a preschool setting. The OTR has decided to initiate a group that facilitates symbolic play. Which of the following would be the MOST APPROPRIATE activity to introduce first? A. Scissors and cutting activities with construction paper B. Make-believe group with stuffed animals and imaginary friends C. Building towers with blocks that resemble pictures in books. Answer: B. Make-believe group with stuffed animals and imaginary friends Quiz # ◉ An individual who recently had a stroke seems to have difficulty with selecting utensils while he eats and the OTR would like to perform a screening for agnosia. Which of the following screening techniques would be MOST APPROPRIATE for this purpose?
Quiz # ◉ A client attends a work hardening program. He arrives on time for his scheduled session but complains of sub sternal pain, discomfort in his epigastric areas, indigestion, and nausea. What is the OTR's MOST APPROPRIATE action? A. Initiate the session and provide support, breaks, and modifications as needed B. Cancel the session and call emergency medical services C. Cancel the session and tell the client to call his primary care physician. Answer: B. Cancel the session and call emergency medical services Quiz # ◉ A resident of a skilled nursing facility is recovering from a gastrointestinal virus that left him severely dehydrated. He is agitated and confused. The doctor prescribes IV fluid infusions, but the nursing staff is concerned that the individual will pull out the infusion line. They request that the occupational therapist provide a restraint for this resident. What is the BEST action for the OTR to take in this case? A. Provide soft fleeced mittens for the person's hands B. Decline the referral and explain that restraints are no longer allowed to be used in SNFs
C. Provide a lap board for when the resident is up in the wheelchair. Answer: A. Provide soft fleeced mittens for the person's hands Quiz # ◉ A rheumatologist has prescribed bilateral nighttime resting hand splints for a child who has early stage juvenile rheumatoid arthritis. The parents ask the OTR who works at the child's school to fabricate the splints. Despite having the disease, the child is functioning at grade-level and is not on the OT caseload. What action should the OTR take in response to the parents' request? A. Schedule a time after school hours to fabricate the splints for the child B. Initiate an IEP indicating the child's needs for school-based OT C. Inform the parents to schedule an appointment at an outpatient OT clinic. Answer: C. Inform the parents to schedule an appointment at an outpatient OT Clinic Quiz # ◉ An OTR who works in a skilled nursing facility frequently provides residents with adaptive devices to improve functional performance. Which of the following methods is MOST EFFECTIVE for evaluating the impact of an adaptive device for supporting the residents' participation in occupation?
extension of both upper extremities and flexion of both lower extremities following a stimulus of neck extension. How would the OTR interpret and document this reaction? A. +STNR, which is "abnormal" and has reappeared after the TBI B. +ATNR, which is "abnormal" and has reappeared after the TBI C. +STNR, which is "normal" in a child this age, the reflex has not yet been integrated.. Answer: A. +STNR, which is "abnormal" and has reappeared after the TBI Quiz # ◉ A client who has had a CVA is preparing for discharge from an inpatient rehabilitation facility to home. The client is independent with BADL, and the OTR has completed a visit to the client's home. Which of the following constructs represents the ecology of human performance approach and should be reflected in the client's discharge summary? A. Recommendations for home modifications to maximize accessibility and task performance B. Exercise protocols for maintaining physical strength and cardiovascular endurance C. Current functional status and anticipated occupational performance upon return home. Answer: A. Recommendations for home modifications to maximize accessibility and task performance
Quiz # ◉ An OTR is developing a program for clients who are scheduled to have bariatric surgery. Which of the following topics represents the effective use of an occupational science perspective for this program? A. Self-Actualization B. Stress management C. Lifestyle redesign D. Coping with change. Answer: C. Lifestyle redesign Quiz # ◉ Which of the following environmental adaptations will improve safety during meal preparation for a client who has low vision? A. Installing a microwave that has reprogrammed cooking options B. Placing tactile markings on the operating knobs of all appliances C. Use large sized bowls and pots for mixing and stove top cooking. Answer: B. Placing tactile markings on the operating knobs of all appliances Quiz #
C. Develop goals to improve sitting balance. Answer: A. Complete a sensorimotor evaluation Quiz # ◉ A second grade student is being evaluated by an OTR due to difficulty completing assigned art and writing activities. Standardized assessment results indicate the student has age- appropriate comprehension, visual object gnosia, and visual acuity, but sores on figure-ground subtests are well below the norm. Problems associated with this perceptual skill would be MOST EVIDENT during which of the following activities? A. Selecting a round bead from a bag of multi-shaped beads to complete a necklace B. Using plastic templates to trace basic geometric shapes on colored paper C. Placing tiles of the same color and shape in a straight line when making a trivet. Answer: A. Selecting a round bead from a bag of multi-shaped beads to complete a necklace Quiz # ◉ An OTR working in an acute rehabilitation center is asked to plan follow-up home-based services for a young adult with a complete lesion of the spinal cord at the C6 level In the transition plan, what
ability is the MOST IMPORTANT for the OTR to recommend developing? A. Type independently after attendant set-up B. Groom with minimal assistance C. Dress lower extremities. Answer: C. Dress lower extremities Quiz # ◉ An OTR uses a motor learning intervention approach to develop prehension patterns with a 10-year-old recovering from a brain tumor. The OTR places small toys on a table and asks the child to pick up the toys and put them into a storage box that is also on the table. The OTR uses random practice during this activity. What are the MOST APPROPRIATE types and arrangement of toys for the OTR to provide according to the motor learning approach? A. Toys of different shapes, sizes, and weights in a mixed arrangement on the table B. Toys that are exactly the same shape, size, and weight in a mixed arrangement of the table C. Toys that are exactly the same shape, size, and weight placed in a straight line on the table. Answer: A. Toys of different shapes, sizes, and weights in a mixed arrangement on the table Quiz #
◉ An individual with chronic undifferentiated schizophrenia is referred to a day hospital. The referring psychiatrist notes the the individual's positive symptoms have responded well to a new medication, but negative symptoms remain. What would the OT MOST LIKELY observe during the evaluation based on this record? A. Limited engagement in tasks B. Inappropriate verbalizations due to delusions C. Immobility due to akathisia. Answer: A. Limited engagement in tasks Quiz # ◉ A 15-year-ol with a complete myelomenigocele at the T9 level is diagnosed with diabetes. What is the MOST LIKELY home exercise program the OTR will focus on? A. Consumer-initiated pressure relief B. Regular skin inspection performed by parent C. Upper extremity strengthening D. Bowl and bladder care. Answer: C. Upper extremity strengthening Quiz # ◉ An inpatient that has had a TBI is functioning at level V (confused- inappropriate) on the Rancho Los Amigos scale. Which of the
following approaches would an OTR use to facilitate the patient's success during a grooming task? A. Provide repeated verbal instructions until the patient completes the task B. Use forward chaining techniques if the patient is distracted from the task C. Demonstrate a portion of the activity then ask the patient to return the demonstration D. Give one-step instructions and hand-over-hand cueing throughout the task. Answer: D. Give one-step instructions and hand-over-hand cueing throughout the task Quiz # ◉ A person is diagnosed with COPD. The OTR instructs the individual on breathing exercises to use to control his respiration rate during activities. The OTR instructs the individual to inhale as if smelling roses. What is the BEST example the OTR should give when instructing the individual on how to exhale? A. As if flickering a lit candle B. As if blowing out 20 lit candles on a birthday cake C. As if blowing forcibly to relight a dying campfire D. In quick short, multiple breaths. Answer: A. As if flickering a lit candle
D. Splint construction methods and care instructions. Answer: B. Goniometric measurements of the affected hand Quiz # ◉ An OTR is asked, "What is the primary emphasis of occupational therapy services?" by another health professional. What is the MOST accurate response for the OTR to give? A. An emphasis on skill acquisition B. An emphasis on compensation for deficits C. An emphasis on environmental adaptation D. An emphasis on reinforcement and enhancement of performance. Answer: D. An emphasis on reinforcement and enhancement of performance Quiz # ◉ A young adolescent with right hemiplegic cereal palsy demonstrates a strong flexor synergy of the hand. The child does not use the hand for grasp, pinch, or release and often maintains the thumb flexed in the palm. The orthopedic hand surgeon recommends a flexor tendon release followed by several weeks of hand therapy and splinting. The family is very anxious about surgery and they ask the OTR what to do. What is the BEST response for the therapist to make?
A. Advise the family to review all the information to make an educated decision B. Recommend that the child follow the surgery presented by the doctor. C. Suggest a pre-operative course of intensive and static and dynamic splinting. D. Encourage the family to get a second opinion.. Answer: A. Advise the family to review all the information to make an educated decision. Quiz # 2 ◉ A 17 year old client with a diagnosis of borderline personality disorder and a history of self-abusive behaviors attends a transitional school-to-work program conducted a COTA and an OTR. During a vocational skills group, she expresses feelings of hopelessness about her future and questions the point of participating in this program. She states she has trouble sleeping, is too tired to concentrate, and asks if she can leave the group. What is the MOST APPROPRIATE intervention for the group leaders in this case? A. Allow the client to leave the group, reminding her to relay her concerns to her psychiatrist. B. Support the validity of the client's feelings and encourage her to remain in the group.
