Certified Occupational Therapy Assistant (COTA)
COTA – CERTIFIED OCCUPATIONAL THERAPY ASSISTANT (NBCOT) | EXAM
QUESTIONS AND CORRECT ANSWERS | VERIFIED OCCUPATIONAL THERAPY
ASSISTANT LATEST 2026/2027
CERTIFIED OCCUPATIONAL THERAPY ASSISTANT (COTA)
NBCOT
1. A COTA is treating a 4-year-old with developmental coordination
disorder. Which developmental milestone would typically be achieved
by this age?
A) Walking independently
B) Rolling from prone to supine
C) Hopping on one foot for a few seconds
D) Sitting without support
C) Hopping on one foot for a few seconds. Single-foot hopping for a
few seconds is a typical 4-year gross motor milestone.
2. Which of the following best reflects the concept of "occupational
identity"?
A) A therapist's clinical impression of a client's diagnosis
B) The number of occupations a client engages in weekly
C) A person's sense of who they are and want to become based on their
history of occupational participation
D) The list of ADLs a person can perform independently
C) A person's sense of who they are and want to become based on
their history of occupational participation. Occupational identity is a
composite sense of self built from one's occupational history.
Page 1 of 52
, Certified Occupational Therapy Assistant (COTA)
3. An 80-year-old client reports feeling "useless" since retiring from
farming 10 years ago. This reflects a disruption in which area?
A) Proprioception
B) Visual perception
C) Motor planning
D) Occupational identity/role competence
D) Occupational identity/role competence. Loss of a valued
occupational role commonly disrupts identity and role competence.
4. By what age should a child typically demonstrate a mature tripod
pencil grasp?
A) 8 years
B) 4-6 years
C) 12-18 months
D) 2 years
B) 4-6 years. A mature dynamic tripod grasp typically emerges
around 4-6 years of age.
5. Erikson's stage of "generativity vs. stagnation" is most associated
with which life stage?
A) Older adulthood
B) Early childhood
C) Middle adulthood
D) Adolescence
C) Middle adulthood. Generativity vs. stagnation describes the
psychosocial task of middle adulthood.
6. A COTA notes that a client's cultural background emphasizes family
caregiving over facility-based rehab. This is an example of which
performance context factor?
A) Physical context
B) Virtual context
C) Temporal context
D) Cultural context
D) Cultural context. Beliefs and customs shared by a group describe
the cultural context.
7. Which factor is considered part of a client's "values" in the
occupational profile per the OTPF?
Page 2 of 52
, Certified Occupational Therapy Assistant (COTA)
A) Range of motion measurements
B) Vital signs
C) Muscle tone grading
D) Personal convictions about what is good, right, and important to do
D) Personal convictions about what is good, right, and important to
do. Values are the client's beliefs about what is worthwhile and
meaningful.
8. A client who sustained a traumatic brain injury at age 22 is now 25.
Which developmental task is most likely disrupted?
A) Primitive reflex integration
B) Object permanence
C) Establishing independence and career identity
D) Parallel play skills
C) Establishing independence and career identity. Early adulthood
centers on establishing independence, career, and identity.
9. Body functions in the OTPF include which of the following?
A) The client's cultural beliefs
B) The client's occupational history
C) Mental, sensory, neuromusculoskeletal, and movement-related
functions
D) The physical layout of the home
C) Mental, sensory, neuromusculoskeletal, and movement-related
functions. Body functions are physiological and psychological
functions of body systems.
10. Which lived-experience factor is most likely to influence a client's
engagement in a home exercise program?
A) The brand of equipment used
B) The clinic's accreditation status
C) The client's prior experience with and beliefs about rehabilitation
D) The COTA's years of experience
C) The client's prior experience with and beliefs about
rehabilitation. Personal history and beliefs strongly shape
engagement and adherence.
Occupational Profile & Client-Centered Data Gathering
11. The primary purpose of the occupational profile is to:
Page 3 of 52
, Certified Occupational Therapy Assistant (COTA)
A) Assign a diagnosis code
B) Determine third-party payer reimbursement rates
C) Replace the need for a formal assessment
D) Understand the client's occupational history, needs, and priorities from
the client's perspective
D) Understand the client's occupational history, needs, and priorities
from the client's perspective. The occupational profile captures the
client's own story, needs, and priorities.
12. Under OTR supervision, a COTA gathering information about a
client's typical daily routine is contributing to which part of the OT
process?
A) Discharge planning
B) Equipment ordering
C) Reimbursement documentation
D) Occupational profile
D) Occupational profile. Daily routine information is a core
component of the occupational profile.
13. Which is the most appropriate method for a COTA to use when a
client has difficulty verbally expressing needs due to aphasia?
A) Skip the interview and rely solely on family report
B) Ask only yes/no questions in rapid succession
C) Use supplemented communication such as gestures, pictures, or
communication boards
D) Discontinue data gathering until speech returns
C) Use supplemented communication such as gestures, pictures, or
communication boards. Augmentative communication supports
client-centered data gathering despite aphasia.
14. A client's "prioritized needs and wants" are best identified through:
A) Standardized manual muscle testing alone
B) Chart review only
C) Physician's orders exclusively
D) Client interview and collaborative goal-setting
D) Client interview and collaborative goal-setting. Interview and
collaboration are the primary sources of the client's priorities.
Page 4 of 52
COTA – CERTIFIED OCCUPATIONAL THERAPY ASSISTANT (NBCOT) | EXAM
QUESTIONS AND CORRECT ANSWERS | VERIFIED OCCUPATIONAL THERAPY
ASSISTANT LATEST 2026/2027
CERTIFIED OCCUPATIONAL THERAPY ASSISTANT (COTA)
NBCOT
1. A COTA is treating a 4-year-old with developmental coordination
disorder. Which developmental milestone would typically be achieved
by this age?
A) Walking independently
B) Rolling from prone to supine
C) Hopping on one foot for a few seconds
D) Sitting without support
C) Hopping on one foot for a few seconds. Single-foot hopping for a
few seconds is a typical 4-year gross motor milestone.
2. Which of the following best reflects the concept of "occupational
identity"?
A) A therapist's clinical impression of a client's diagnosis
B) The number of occupations a client engages in weekly
C) A person's sense of who they are and want to become based on their
history of occupational participation
D) The list of ADLs a person can perform independently
C) A person's sense of who they are and want to become based on
their history of occupational participation. Occupational identity is a
composite sense of self built from one's occupational history.
Page 1 of 52
, Certified Occupational Therapy Assistant (COTA)
3. An 80-year-old client reports feeling "useless" since retiring from
farming 10 years ago. This reflects a disruption in which area?
A) Proprioception
B) Visual perception
C) Motor planning
D) Occupational identity/role competence
D) Occupational identity/role competence. Loss of a valued
occupational role commonly disrupts identity and role competence.
4. By what age should a child typically demonstrate a mature tripod
pencil grasp?
A) 8 years
B) 4-6 years
C) 12-18 months
D) 2 years
B) 4-6 years. A mature dynamic tripod grasp typically emerges
around 4-6 years of age.
5. Erikson's stage of "generativity vs. stagnation" is most associated
with which life stage?
A) Older adulthood
B) Early childhood
C) Middle adulthood
D) Adolescence
C) Middle adulthood. Generativity vs. stagnation describes the
psychosocial task of middle adulthood.
6. A COTA notes that a client's cultural background emphasizes family
caregiving over facility-based rehab. This is an example of which
performance context factor?
A) Physical context
B) Virtual context
C) Temporal context
D) Cultural context
D) Cultural context. Beliefs and customs shared by a group describe
the cultural context.
7. Which factor is considered part of a client's "values" in the
occupational profile per the OTPF?
Page 2 of 52
, Certified Occupational Therapy Assistant (COTA)
A) Range of motion measurements
B) Vital signs
C) Muscle tone grading
D) Personal convictions about what is good, right, and important to do
D) Personal convictions about what is good, right, and important to
do. Values are the client's beliefs about what is worthwhile and
meaningful.
8. A client who sustained a traumatic brain injury at age 22 is now 25.
Which developmental task is most likely disrupted?
A) Primitive reflex integration
B) Object permanence
C) Establishing independence and career identity
D) Parallel play skills
C) Establishing independence and career identity. Early adulthood
centers on establishing independence, career, and identity.
9. Body functions in the OTPF include which of the following?
A) The client's cultural beliefs
B) The client's occupational history
C) Mental, sensory, neuromusculoskeletal, and movement-related
functions
D) The physical layout of the home
C) Mental, sensory, neuromusculoskeletal, and movement-related
functions. Body functions are physiological and psychological
functions of body systems.
10. Which lived-experience factor is most likely to influence a client's
engagement in a home exercise program?
A) The brand of equipment used
B) The clinic's accreditation status
C) The client's prior experience with and beliefs about rehabilitation
D) The COTA's years of experience
C) The client's prior experience with and beliefs about
rehabilitation. Personal history and beliefs strongly shape
engagement and adherence.
Occupational Profile & Client-Centered Data Gathering
11. The primary purpose of the occupational profile is to:
Page 3 of 52
, Certified Occupational Therapy Assistant (COTA)
A) Assign a diagnosis code
B) Determine third-party payer reimbursement rates
C) Replace the need for a formal assessment
D) Understand the client's occupational history, needs, and priorities from
the client's perspective
D) Understand the client's occupational history, needs, and priorities
from the client's perspective. The occupational profile captures the
client's own story, needs, and priorities.
12. Under OTR supervision, a COTA gathering information about a
client's typical daily routine is contributing to which part of the OT
process?
A) Discharge planning
B) Equipment ordering
C) Reimbursement documentation
D) Occupational profile
D) Occupational profile. Daily routine information is a core
component of the occupational profile.
13. Which is the most appropriate method for a COTA to use when a
client has difficulty verbally expressing needs due to aphasia?
A) Skip the interview and rely solely on family report
B) Ask only yes/no questions in rapid succession
C) Use supplemented communication such as gestures, pictures, or
communication boards
D) Discontinue data gathering until speech returns
C) Use supplemented communication such as gestures, pictures, or
communication boards. Augmentative communication supports
client-centered data gathering despite aphasia.
14. A client's "prioritized needs and wants" are best identified through:
A) Standardized manual muscle testing alone
B) Chart review only
C) Physician's orders exclusively
D) Client interview and collaborative goal-setting
D) Client interview and collaborative goal-setting. Interview and
collaboration are the primary sources of the client's priorities.
Page 4 of 52
