NBCOT PraCTiCe eXaM WiTH COrreCT aCTUaL QUeSTiONS aND
COrreCTLY WeLL DeFiNeD aNSWerS LaTeST aLreaDY GraDeD a+
(2025/2026)
B - aNSWer-In reading a client's medical chart, the COTA® notes that the client has a
history of postprandial orthostatic hypotension. What activity precautions should the
COTA give the client?
A. Limit standing to 30 minutes while completing an occupation such as cooking.
B. Avoid a positional change from lying down to standing within 30 minutes of eating a
meal.
C. Take several minutes to move from lying down to sitting and then to standing after
being in bed all night.
D. Avoid leaning the head too far forward, for example, bending over to tie shoes while
sitting.
C, D, F - aNSWer-A newly certified COTA® is working a first job on an inpatient
rehabilitation unit. The OTR® instructs the COTA to teach a bath bench transfer to a
patient while the OTR goes to another room to evaluate a new patient. The COTA never
completed a bath bench transfer before. What ethical principles should guide the student
in this situation? Select the 3 BEST choices.
A. Autonomy
B. Veracity
C. Beneficence
D. Nonmaleficence
E. Fidelity
F. Justice
B - aNSWer-A client with advanced amyotrophic lateral sclerosis (ALS) presents with a
stiff forward-flexed neck that is at risk for developing a contracture and impairing social
participation. Which intervention would the COTA® use to BEST prevent a contracture?
,A. A physical agent modality, such as diathermy or ultrasound, to minimize contractures
B. Caregiver training on gentle neck stretching and how to help the client don a soft
cervical collar
C. A home exercise program of isometric neck exercises in all planes
D. Patient and caregiver education on proper positioning at rest and during functional
tasks
C - aNSWer-A COTA® is working with a client who has sustained a low ulnar nerve injury
to the hand. The client has been instructed in visual protection of the hand. Over the
weekend, the client experiences burns to the injured hand. What area of the hand would
have been burned?
A. Thenar side of the hand
B. Thumb and index fingers
C. Hypothenar side of the hand
D. Index and middle fingers
A - aNSWer-A COTA® is working with a 2½-year-old child on age-appropriate fine motor
skills. Which activity would be most appropriate to support development?
A. Unbuttoning large buttons
B. Lacing a shoe
C. Cutting out shapes with scissors
D. Drawing shapes
C - aNSWer-The COTA®'s next client has macular degeneration in both eyes. To prepare
the treatment environment for this client, which course of action should the COTA®
take?
A. Close the blinds and the curtains
B. Sit directly in front of the client
C. Increase lighting and avoid glare
,D. Place dark objects on a black table
A - aNSWer-A 4-year-old child with arthrogryposis is being evaluated for ADLs. The child
needs to use utensils that are angled to be able to put food into the mouth. Which
characteristic of clients with this condition provides the rationale behind the use of these
adapted utensils?
A. Joint contractures in the arms and hands
B. Spasticity in the arms and hands
C. Hypotonia in the arms and hands
D. Decreased sensation in the arms and hands
D - aNSWer-A client with a learning disability is interested in exploring work
opportunities after high school graduation. The client has difficulty sequencing more
than three-step directions and lacks attention to detail. Which option would be
considered a component of the student's transitional program plan?
A. Completion of a transition-related evaluation by a vocational rehabilitation counselor
to identify the student's strengths, weaknesses, and interests
B. Completion of a job site analysis with physical demands to determine the feasibility of
the client's performing specific tasks
C. Provision of written directions to complete a three-step task and use of samples to
promote problem solving
D. Situational observation, interview, and activity analysis to determine a match between
the client's abilities and expected performance
B - aNSWer-A COTA® is working on postoperative discharge plan for a school-age child
with neurofibromatosis. The COTA® recommends that the parents move the child's
clothes from the top drawer so that the child can access them independently. Why might
the COTA® make this recommendation?
A. Children with neurofibromatosis have weakened shoulder girdles and reduced upper-
extremity strength.
B. Children with neurofibromatosis are of short stature and have skeletal anomalies.
C. Children with neurofibromatosis have decreased sensation and often drop things.
, D. Children with neurofibromatosis have difficulty initiating routines.
C - aNSWer-To facilitate participation in familiar daily living tasks by clients with
dementia, what would be an appropriate INITIAL stage of intervention?
A. Recommend home modifications.
B. Provide caregiver education.
C. Develop strategies to simplify familiar tasks.
D. Establish appropriate daily routines.
C - aNSWer-Because information-processing speed may affect a driver's on-road
performance, which is the BEST compensatory approach the COTA® can use?
A. Discuss with the supervising OTR® the client's driving cessation.
B. Instruct the client in proper visual search patterns and efficient scanning techniques.
C. Limit driving to familiar areas, simple traffic scenes, and roads with reduced speed
limits.
D. Educate the client in rules of the road and signs of the road.
D, E, F - aNSWer-A COTA® is working with a client with traumatic brain injury who is
displaying decorticate rigidity. What clinical characteristics can the COTA expect to find?
Select the 3 BEST choices.
A. Upper extremities are flaccid, with internal rotation.
B. Upper extremities are spastic, with external rotation.
C. Upper extremities are flaccid, with external rotation.
D. Upper extremities are spastic, with shoulder internal rotation and elbow flexion.
E. Lower extremities are spastic, with hip internal rotation.
F. Lower extremities are spastic, with ankle plantar flexion.
D - aNSWer-A client who uses an ultra lightweight wheelchair asks whether the chair can
accommodate a wraparound lapboard. The COTA® is not familiar with this type of
COrreCTLY WeLL DeFiNeD aNSWerS LaTeST aLreaDY GraDeD a+
(2025/2026)
B - aNSWer-In reading a client's medical chart, the COTA® notes that the client has a
history of postprandial orthostatic hypotension. What activity precautions should the
COTA give the client?
A. Limit standing to 30 minutes while completing an occupation such as cooking.
B. Avoid a positional change from lying down to standing within 30 minutes of eating a
meal.
C. Take several minutes to move from lying down to sitting and then to standing after
being in bed all night.
D. Avoid leaning the head too far forward, for example, bending over to tie shoes while
sitting.
C, D, F - aNSWer-A newly certified COTA® is working a first job on an inpatient
rehabilitation unit. The OTR® instructs the COTA to teach a bath bench transfer to a
patient while the OTR goes to another room to evaluate a new patient. The COTA never
completed a bath bench transfer before. What ethical principles should guide the student
in this situation? Select the 3 BEST choices.
A. Autonomy
B. Veracity
C. Beneficence
D. Nonmaleficence
E. Fidelity
F. Justice
B - aNSWer-A client with advanced amyotrophic lateral sclerosis (ALS) presents with a
stiff forward-flexed neck that is at risk for developing a contracture and impairing social
participation. Which intervention would the COTA® use to BEST prevent a contracture?
,A. A physical agent modality, such as diathermy or ultrasound, to minimize contractures
B. Caregiver training on gentle neck stretching and how to help the client don a soft
cervical collar
C. A home exercise program of isometric neck exercises in all planes
D. Patient and caregiver education on proper positioning at rest and during functional
tasks
C - aNSWer-A COTA® is working with a client who has sustained a low ulnar nerve injury
to the hand. The client has been instructed in visual protection of the hand. Over the
weekend, the client experiences burns to the injured hand. What area of the hand would
have been burned?
A. Thenar side of the hand
B. Thumb and index fingers
C. Hypothenar side of the hand
D. Index and middle fingers
A - aNSWer-A COTA® is working with a 2½-year-old child on age-appropriate fine motor
skills. Which activity would be most appropriate to support development?
A. Unbuttoning large buttons
B. Lacing a shoe
C. Cutting out shapes with scissors
D. Drawing shapes
C - aNSWer-The COTA®'s next client has macular degeneration in both eyes. To prepare
the treatment environment for this client, which course of action should the COTA®
take?
A. Close the blinds and the curtains
B. Sit directly in front of the client
C. Increase lighting and avoid glare
,D. Place dark objects on a black table
A - aNSWer-A 4-year-old child with arthrogryposis is being evaluated for ADLs. The child
needs to use utensils that are angled to be able to put food into the mouth. Which
characteristic of clients with this condition provides the rationale behind the use of these
adapted utensils?
A. Joint contractures in the arms and hands
B. Spasticity in the arms and hands
C. Hypotonia in the arms and hands
D. Decreased sensation in the arms and hands
D - aNSWer-A client with a learning disability is interested in exploring work
opportunities after high school graduation. The client has difficulty sequencing more
than three-step directions and lacks attention to detail. Which option would be
considered a component of the student's transitional program plan?
A. Completion of a transition-related evaluation by a vocational rehabilitation counselor
to identify the student's strengths, weaknesses, and interests
B. Completion of a job site analysis with physical demands to determine the feasibility of
the client's performing specific tasks
C. Provision of written directions to complete a three-step task and use of samples to
promote problem solving
D. Situational observation, interview, and activity analysis to determine a match between
the client's abilities and expected performance
B - aNSWer-A COTA® is working on postoperative discharge plan for a school-age child
with neurofibromatosis. The COTA® recommends that the parents move the child's
clothes from the top drawer so that the child can access them independently. Why might
the COTA® make this recommendation?
A. Children with neurofibromatosis have weakened shoulder girdles and reduced upper-
extremity strength.
B. Children with neurofibromatosis are of short stature and have skeletal anomalies.
C. Children with neurofibromatosis have decreased sensation and often drop things.
, D. Children with neurofibromatosis have difficulty initiating routines.
C - aNSWer-To facilitate participation in familiar daily living tasks by clients with
dementia, what would be an appropriate INITIAL stage of intervention?
A. Recommend home modifications.
B. Provide caregiver education.
C. Develop strategies to simplify familiar tasks.
D. Establish appropriate daily routines.
C - aNSWer-Because information-processing speed may affect a driver's on-road
performance, which is the BEST compensatory approach the COTA® can use?
A. Discuss with the supervising OTR® the client's driving cessation.
B. Instruct the client in proper visual search patterns and efficient scanning techniques.
C. Limit driving to familiar areas, simple traffic scenes, and roads with reduced speed
limits.
D. Educate the client in rules of the road and signs of the road.
D, E, F - aNSWer-A COTA® is working with a client with traumatic brain injury who is
displaying decorticate rigidity. What clinical characteristics can the COTA expect to find?
Select the 3 BEST choices.
A. Upper extremities are flaccid, with internal rotation.
B. Upper extremities are spastic, with external rotation.
C. Upper extremities are flaccid, with external rotation.
D. Upper extremities are spastic, with shoulder internal rotation and elbow flexion.
E. Lower extremities are spastic, with hip internal rotation.
F. Lower extremities are spastic, with ankle plantar flexion.
D - aNSWer-A client who uses an ultra lightweight wheelchair asks whether the chair can
accommodate a wraparound lapboard. The COTA® is not familiar with this type of
