COTA EXAMINATION REVIEW GUIDE QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026
Through the school-based evaluation process, the COTA may consider many possibilities for
intervention; however, the determination that occupational therapy will be included in the student's
IEP will MOST LIKELY be made at which point in the IEP process?
A. After the test data are reviewed and interpreted
B. During the interview with the classroom teacher
C. At the meeting once the test results are reviewed by team
D. After the goals and objectives are determined by the team - Answers D. After the goals and
objectives are determined by the team
After evaluation, a STG for an individual who had a THR was to dress with min assistance, using AE
and verbal cues to follow hip precautions. After 1 week of tx, the individual is able to dress with SBA,
using AE and verbal cues to follow hip precautions. What skills does this person need to demonstrate
before changing the goal?
A. Less time needed to perform dressing
B. Ability to consistently follow hip precautions
C. Ability to use AD appropriately - Answers B. Ability to consistently follow hip precautions
Overall health and wellness in individuals with schizophrenia negatively impacts occupational
performance. Which of the following is MOST descriptive of the impact on health and wellness on
occupational performance?
A. Medication may result in side effects such as tardive dyskinesia and dystonia
B. Individuals do not respond to interventions focusing in lifestyle behaviors
C. Oral medicines can increase development of type II diabetes and weight gain - Answers A.
Medication may result in side effects such as tardive dyskinesia and dystonia
The COTA will be working with a client who sustained an explosive-related extremity injury. Which of
the following issues would the patient MOST likely present with after sustaining this type of injury?
A. Tympanic membrane rupture, dizziness, and tinnitus
B. Amputations, fractures, crush injuries, and/or burns
C. Hypotension, renal contusion, and failure
D. Hemothorax, pneumothorax, and/or sepsis - Answers B. Amputations, fractures, crush injuries,
and/or burns
While evaluating an individual with arthritis, the COTA observes PIP joint hyperextension and DIP joint
flexion in the digits. How would the COTA MOST LIKELY document this deformity?
A. Boutonniere
B. Mallet finger
C. Congenital
D. Swan neck - Answers D. Swan neck
What is the NEXT step for a COTA team to follow after initial evaluation of a 1-year-old child requiring
early intervention services?
A. independently develop an IEP
B. collaboratively develop an IEP
C. independently develop an IFSP
D. collaboratively develop an IFSP - Answers D. Collaboratively develop an IFSP
During an OT session, a COTA observes that an individual is able to place dentures in their mouth, but
has difficulty apply denture cream to the appropriate place on the dentures and attempts to place the
cap on the tube backward. What is MOST LIKELY responsible for this observation?
A. Constructional apraxia
B. Ideomotor apraxia
C. Ideational apraxia
D. Developmental apraxia - Answers A. Constructional apraxia
When assessing for the presence of visual agnosia in a patient who had a CVA, what is the BEST
activity for the COTA to ask the patient to perform?
A. demonstrate common gestures such as waving
B. Name objects by only using the sense of touch
C. Identify the use of common household objects - Answers C. Identify the use of common household
objects
, An OT/COTA team receives a referral for an infant in the NICU whose parents have a history of drug
use during pregnancy. What is the FIRST action the team should take?
A. Determine the parent's current drug use, medical status, & support systems
B. Recommend a social work referral and provide community program information
C. Modify the environment to minimize excessive sensory stimulation prior to assessing the baby
D. Assess the baby's behavior and use gentle handling to promote positive sensory experiences -
Answers C. Modify the environment to minimize excessive sensory stimulation prior to assessing the
baby
A person who had a stroke tries unsuccessfully to put on a shirt using a one-handed technique. They
state, "I can do it, I'm just not trying hard enough." What would the COTA MOST likely recognize this
response to be?
A. Denial
B. Depression
C. Shock
D. Regression - Answers A. Denial
An OT practictioner is assessing a client who has schizophrenia and appears to be experiencing acute
symptoms of the disease. Which of the following is considered to be an acute or positive symptom of
schizophrenia that the OT might document in the assessment? Choose all that apply
A. Incoherency
B. Delusions
C. Low energy
D. Anhedonia
E. Inattention
F. Echolalia - Answers A. incoherency
B. delusions
C. echolalia
The parent of an 18-month-old child with hypertonia reports that dressing is extremely difficult. When
teaching the parent how to put on the child's shoes and socks, what should the COTA suggest they do
FIRST?
A. flex the child's hips
B. flex the child's knees
C. flex the child's neck - Answers A. flex the child's hips
The teacher notes that a student with quadriplegia frequently slumps to the side when sitting in a
w/c. What would the COTA MOST likely recommend to enable the child to maintain optimal w/c
positioning for seat work?
A. A reclining w/c
B. lateral trunk supports
C. lateral pelvic supports - Answers B. lateral trunk supports
An OT practitioner working in an acute care hospital is writing a progress note in the chart for a
treatment session held earlier that day. What types of information should ALWAYS be included in
medical documentation?
A. Succinct and objective
B. subjective and judgmental
C. concise and speculative
D. Subjective and opinionated - Answers A. succinct and objective
A COTA is treating an individual who demonstrates progressive weakness and atrophy of the thenar
muscles and numbness and tingling in the thumb and the index and middle fingers. The client also
complains of difficulty while grasping a coffee cup. The individual is not experiencing proximal upper
extremity limitations; therefore, the COTA will MOST likely suspect problems with which of the
following nerves?
A. Ulnar
B. Median
C. Radial
D. Brachial - Answers B. Median
A hospital-based COTA is working on discharge plans for a child with paraplegic spina bifida who has
just started using a power wheelchair. Which community resource recommendation is the MOST
critical for this child?
Through the school-based evaluation process, the COTA may consider many possibilities for
intervention; however, the determination that occupational therapy will be included in the student's
IEP will MOST LIKELY be made at which point in the IEP process?
A. After the test data are reviewed and interpreted
B. During the interview with the classroom teacher
C. At the meeting once the test results are reviewed by team
D. After the goals and objectives are determined by the team - Answers D. After the goals and
objectives are determined by the team
After evaluation, a STG for an individual who had a THR was to dress with min assistance, using AE
and verbal cues to follow hip precautions. After 1 week of tx, the individual is able to dress with SBA,
using AE and verbal cues to follow hip precautions. What skills does this person need to demonstrate
before changing the goal?
A. Less time needed to perform dressing
B. Ability to consistently follow hip precautions
C. Ability to use AD appropriately - Answers B. Ability to consistently follow hip precautions
Overall health and wellness in individuals with schizophrenia negatively impacts occupational
performance. Which of the following is MOST descriptive of the impact on health and wellness on
occupational performance?
A. Medication may result in side effects such as tardive dyskinesia and dystonia
B. Individuals do not respond to interventions focusing in lifestyle behaviors
C. Oral medicines can increase development of type II diabetes and weight gain - Answers A.
Medication may result in side effects such as tardive dyskinesia and dystonia
The COTA will be working with a client who sustained an explosive-related extremity injury. Which of
the following issues would the patient MOST likely present with after sustaining this type of injury?
A. Tympanic membrane rupture, dizziness, and tinnitus
B. Amputations, fractures, crush injuries, and/or burns
C. Hypotension, renal contusion, and failure
D. Hemothorax, pneumothorax, and/or sepsis - Answers B. Amputations, fractures, crush injuries,
and/or burns
While evaluating an individual with arthritis, the COTA observes PIP joint hyperextension and DIP joint
flexion in the digits. How would the COTA MOST LIKELY document this deformity?
A. Boutonniere
B. Mallet finger
C. Congenital
D. Swan neck - Answers D. Swan neck
What is the NEXT step for a COTA team to follow after initial evaluation of a 1-year-old child requiring
early intervention services?
A. independently develop an IEP
B. collaboratively develop an IEP
C. independently develop an IFSP
D. collaboratively develop an IFSP - Answers D. Collaboratively develop an IFSP
During an OT session, a COTA observes that an individual is able to place dentures in their mouth, but
has difficulty apply denture cream to the appropriate place on the dentures and attempts to place the
cap on the tube backward. What is MOST LIKELY responsible for this observation?
A. Constructional apraxia
B. Ideomotor apraxia
C. Ideational apraxia
D. Developmental apraxia - Answers A. Constructional apraxia
When assessing for the presence of visual agnosia in a patient who had a CVA, what is the BEST
activity for the COTA to ask the patient to perform?
A. demonstrate common gestures such as waving
B. Name objects by only using the sense of touch
C. Identify the use of common household objects - Answers C. Identify the use of common household
objects
, An OT/COTA team receives a referral for an infant in the NICU whose parents have a history of drug
use during pregnancy. What is the FIRST action the team should take?
A. Determine the parent's current drug use, medical status, & support systems
B. Recommend a social work referral and provide community program information
C. Modify the environment to minimize excessive sensory stimulation prior to assessing the baby
D. Assess the baby's behavior and use gentle handling to promote positive sensory experiences -
Answers C. Modify the environment to minimize excessive sensory stimulation prior to assessing the
baby
A person who had a stroke tries unsuccessfully to put on a shirt using a one-handed technique. They
state, "I can do it, I'm just not trying hard enough." What would the COTA MOST likely recognize this
response to be?
A. Denial
B. Depression
C. Shock
D. Regression - Answers A. Denial
An OT practictioner is assessing a client who has schizophrenia and appears to be experiencing acute
symptoms of the disease. Which of the following is considered to be an acute or positive symptom of
schizophrenia that the OT might document in the assessment? Choose all that apply
A. Incoherency
B. Delusions
C. Low energy
D. Anhedonia
E. Inattention
F. Echolalia - Answers A. incoherency
B. delusions
C. echolalia
The parent of an 18-month-old child with hypertonia reports that dressing is extremely difficult. When
teaching the parent how to put on the child's shoes and socks, what should the COTA suggest they do
FIRST?
A. flex the child's hips
B. flex the child's knees
C. flex the child's neck - Answers A. flex the child's hips
The teacher notes that a student with quadriplegia frequently slumps to the side when sitting in a
w/c. What would the COTA MOST likely recommend to enable the child to maintain optimal w/c
positioning for seat work?
A. A reclining w/c
B. lateral trunk supports
C. lateral pelvic supports - Answers B. lateral trunk supports
An OT practitioner working in an acute care hospital is writing a progress note in the chart for a
treatment session held earlier that day. What types of information should ALWAYS be included in
medical documentation?
A. Succinct and objective
B. subjective and judgmental
C. concise and speculative
D. Subjective and opinionated - Answers A. succinct and objective
A COTA is treating an individual who demonstrates progressive weakness and atrophy of the thenar
muscles and numbness and tingling in the thumb and the index and middle fingers. The client also
complains of difficulty while grasping a coffee cup. The individual is not experiencing proximal upper
extremity limitations; therefore, the COTA will MOST likely suspect problems with which of the
following nerves?
A. Ulnar
B. Median
C. Radial
D. Brachial - Answers B. Median
A hospital-based COTA is working on discharge plans for a child with paraplegic spina bifida who has
just started using a power wheelchair. Which community resource recommendation is the MOST
critical for this child?
