NBCOT Occupational Therapy Certification Study set exam
Questions and Answers 2024/2025
A client with oculomotor dysfunction and double vision is referred for occupational
therapy evaluation. What is the most appropriate way for the otr® to begin this
evaluation?
A. Determine possible limitations in daily occupations secondary to double vision
B. Determine the etiology of the oculomotor dysfunction that is causing double vision
C. Provide occlusion for the client to reduce the visual stress caused by double vision
D. Provide eye exercises for the client to reduce the visual stress caused by double
vision - correct answer a: the purpose of an occupational therapy evaluation is to
determine whether the client is experiencing limitations in daily occupations because of
dysfunction, in this case in the client's oculomotor system.
B: determining the etiology of the double vision is the role of the optometrist or
ophthalmologist.
C, d: occlusion and eye exercises are intervention approaches for double vision;
however, neither would be appropriate for an otr to prescribe without supervision by an
optometrist or ophthalmologist.
A client who had a total hip replacement 2 days ago with severe kyphosis as a result of
osteoporosis is referred to occupational therapy. The chart notes that the client has
been demonstrating signs of malnutrition for the past 4 months. What is the first
evaluation the otr® should complete?
A. Evaluation of eating
B. Evaluation of meal preparation
C. Evaluation of knowledge of nutrition
D. Evaluation of feeding - correct answer a: kyphosis often leads to deficits in eating
skills (e.g., the ability to keep and manipulate food or fluid in the mouth and swallow it).
,B: the hip fracture would have affected the client's ability to complete meal preparations,
but it is not an underlying cause of the malnutrition because the hip fracture is recent
and the malnutrition is longstanding.
C, d: the client was successfully preventing malnutrition until 4 months ago, suggesting
sufficient knowledge of nutrition and feeding skills.
An otr® is treating a client who sustained dorsal hand burns secondary to a work-
related injury. In the intensive care unit phase of treatment, which technique for
completing rom of the hand is safest?
A. Passively range all digits and joints at once
B. Passively range each digit and joint one at a time
C. Instruct the client to actively make a fist, then straighten the fingers completely
D. Instruct the client to wear a resting hand splint at all times - correct answer b:
ranging each joint separately decreases the chance of rupturing finger extensor tendons
with dorsal hand burns.
A, c: arom or prom of more than one joint at a time increases the chance of a tendon
rupture after a burn to the dorsal hand.
D: wearing a splint inhibits performing rom of the hand.
An otr® is working with a client who has visual field deficits. What implications do those
deficits have for driving performance?
A. Difficulty with lane positioning or timing of turns
B. Difficulty adapting to the dark or to the bright lights of oncoming vehicles
C. Difficulty recognizing road signs at a distance
D. Delayed responses to stimuli in the driving environment - correct answer a: visual
field deficits imply an obstruction or occlusion in the field of view; the driver will have
problems with maneuvers such as adequately positioning the car in the lane, taking
turns smoothly, and avoiding potential hazards in the roadway.
,B, c, d: these choices pertain to the performance implications of poor visual acuity for
driving.
An otr® is evaluating a child with level 1 autism spectrum disorder without intellectual
impairment (asperger syndrome). At 1:05 p.m., the child pulls out a smartphone and
says, "it's 1:05. I have to check the weather." what response to this behavior would be
most effective?
A. Redirect the behavior to a more appropriate one
B. Insist that the child put the cell phone away during the evaluation
C. Find out more about the child's insistence on checking the weather
D. Introduce the child to a new weather app for the smart phone - correct answer c:
an evaluation includes identification of factors that affect participation in occupation, and
this ritual is one such factor. It is good client-centered practice to obtain the client's
perspective on what the weather at 1:05 means to this person and to gather enough
information about it to determine whether this factor is a strength or a weakness.
A, c: interrupting a ritualistic behavior may provoke anxiety or a meltdown, which would
render the remaining data the otr® gathers unreliable. Keeping the client functioning at
his or her optimal level by reducing and minimizing anxiety is essential to the evaluation
process.
D: introducing the client to a new weather app is more appropriate in evaluating the
ability to adapt to new learning.
A cota® in a short-term acute care psychiatric hospital is leading a psychodynamic
group. Which of the following activities would be the most appropriate for this group?
A. Paint by number
B. Crossword puzzles
C. Free-form clay building
D. Decorating gingerbread cookies - correct answer c: free-form clay building allows
for the least amount of structure. Clients are free to form the clay however they want, so
the piece takes on a symbolic meaning important to the client.
, A: painting by number is highly structured, with minimal opportunity for a participant to
express subconscious thoughts and feelings.
B: crossword puzzles provide minimal opportunity for self-expression or for conflicts in
the psyche to emerge.
D: decorating gingerbread cookies involves some choice in expression and the potential
to evoke body-related thoughts and feelings, but free-form clay building has less
structure and is a more effective activity for this group.
An otr® is working with a client in an inpatient psychiatric facility and decides to use the
allen cognitive level screen to assess cognitive functioning. Which goals would be
appropriate on the basis of the cognitive disabilities model?
A. The client will demonstrate appropriate coping skills in identified stressful situations
with 100% success.
B. The client will independently apply relaxation techniques and report relief from stress
at 0/10 after using the technique.
C. The client will apply grounding techniques with 100% accuracy as a preventative
measure to reduce over-stimulation.
D. The client will be discharged home from the inpatient psychiatric unit with daily
checks from caregiver to address novel safety needs in the home environment. -
correct answer d: the cognitive disabilities model assesses the client's current
cognitive functioning to maximize supports in the environment that will facilitate maximal
occupational performance. This goal suggests that after discharge, the client will be
placed in an environment that will successfully manage the client's current cognitive
ability through appropriate environmental supports.
A: this goal is based on a cognitive-behavioral approach, not the cognitive disabilities
model.
B: this goal is based on the behavioral approach, not the cognitive disabilities model.
C: this goal is based on a sensorimotor approach, not the cognitive disabilities model.
Questions and Answers 2024/2025
A client with oculomotor dysfunction and double vision is referred for occupational
therapy evaluation. What is the most appropriate way for the otr® to begin this
evaluation?
A. Determine possible limitations in daily occupations secondary to double vision
B. Determine the etiology of the oculomotor dysfunction that is causing double vision
C. Provide occlusion for the client to reduce the visual stress caused by double vision
D. Provide eye exercises for the client to reduce the visual stress caused by double
vision - correct answer a: the purpose of an occupational therapy evaluation is to
determine whether the client is experiencing limitations in daily occupations because of
dysfunction, in this case in the client's oculomotor system.
B: determining the etiology of the double vision is the role of the optometrist or
ophthalmologist.
C, d: occlusion and eye exercises are intervention approaches for double vision;
however, neither would be appropriate for an otr to prescribe without supervision by an
optometrist or ophthalmologist.
A client who had a total hip replacement 2 days ago with severe kyphosis as a result of
osteoporosis is referred to occupational therapy. The chart notes that the client has
been demonstrating signs of malnutrition for the past 4 months. What is the first
evaluation the otr® should complete?
A. Evaluation of eating
B. Evaluation of meal preparation
C. Evaluation of knowledge of nutrition
D. Evaluation of feeding - correct answer a: kyphosis often leads to deficits in eating
skills (e.g., the ability to keep and manipulate food or fluid in the mouth and swallow it).
,B: the hip fracture would have affected the client's ability to complete meal preparations,
but it is not an underlying cause of the malnutrition because the hip fracture is recent
and the malnutrition is longstanding.
C, d: the client was successfully preventing malnutrition until 4 months ago, suggesting
sufficient knowledge of nutrition and feeding skills.
An otr® is treating a client who sustained dorsal hand burns secondary to a work-
related injury. In the intensive care unit phase of treatment, which technique for
completing rom of the hand is safest?
A. Passively range all digits and joints at once
B. Passively range each digit and joint one at a time
C. Instruct the client to actively make a fist, then straighten the fingers completely
D. Instruct the client to wear a resting hand splint at all times - correct answer b:
ranging each joint separately decreases the chance of rupturing finger extensor tendons
with dorsal hand burns.
A, c: arom or prom of more than one joint at a time increases the chance of a tendon
rupture after a burn to the dorsal hand.
D: wearing a splint inhibits performing rom of the hand.
An otr® is working with a client who has visual field deficits. What implications do those
deficits have for driving performance?
A. Difficulty with lane positioning or timing of turns
B. Difficulty adapting to the dark or to the bright lights of oncoming vehicles
C. Difficulty recognizing road signs at a distance
D. Delayed responses to stimuli in the driving environment - correct answer a: visual
field deficits imply an obstruction or occlusion in the field of view; the driver will have
problems with maneuvers such as adequately positioning the car in the lane, taking
turns smoothly, and avoiding potential hazards in the roadway.
,B, c, d: these choices pertain to the performance implications of poor visual acuity for
driving.
An otr® is evaluating a child with level 1 autism spectrum disorder without intellectual
impairment (asperger syndrome). At 1:05 p.m., the child pulls out a smartphone and
says, "it's 1:05. I have to check the weather." what response to this behavior would be
most effective?
A. Redirect the behavior to a more appropriate one
B. Insist that the child put the cell phone away during the evaluation
C. Find out more about the child's insistence on checking the weather
D. Introduce the child to a new weather app for the smart phone - correct answer c:
an evaluation includes identification of factors that affect participation in occupation, and
this ritual is one such factor. It is good client-centered practice to obtain the client's
perspective on what the weather at 1:05 means to this person and to gather enough
information about it to determine whether this factor is a strength or a weakness.
A, c: interrupting a ritualistic behavior may provoke anxiety or a meltdown, which would
render the remaining data the otr® gathers unreliable. Keeping the client functioning at
his or her optimal level by reducing and minimizing anxiety is essential to the evaluation
process.
D: introducing the client to a new weather app is more appropriate in evaluating the
ability to adapt to new learning.
A cota® in a short-term acute care psychiatric hospital is leading a psychodynamic
group. Which of the following activities would be the most appropriate for this group?
A. Paint by number
B. Crossword puzzles
C. Free-form clay building
D. Decorating gingerbread cookies - correct answer c: free-form clay building allows
for the least amount of structure. Clients are free to form the clay however they want, so
the piece takes on a symbolic meaning important to the client.
, A: painting by number is highly structured, with minimal opportunity for a participant to
express subconscious thoughts and feelings.
B: crossword puzzles provide minimal opportunity for self-expression or for conflicts in
the psyche to emerge.
D: decorating gingerbread cookies involves some choice in expression and the potential
to evoke body-related thoughts and feelings, but free-form clay building has less
structure and is a more effective activity for this group.
An otr® is working with a client in an inpatient psychiatric facility and decides to use the
allen cognitive level screen to assess cognitive functioning. Which goals would be
appropriate on the basis of the cognitive disabilities model?
A. The client will demonstrate appropriate coping skills in identified stressful situations
with 100% success.
B. The client will independently apply relaxation techniques and report relief from stress
at 0/10 after using the technique.
C. The client will apply grounding techniques with 100% accuracy as a preventative
measure to reduce over-stimulation.
D. The client will be discharged home from the inpatient psychiatric unit with daily
checks from caregiver to address novel safety needs in the home environment. -
correct answer d: the cognitive disabilities model assesses the client's current
cognitive functioning to maximize supports in the environment that will facilitate maximal
occupational performance. This goal suggests that after discharge, the client will be
placed in an environment that will successfully manage the client's current cognitive
ability through appropriate environmental supports.
A: this goal is based on a cognitive-behavioral approach, not the cognitive disabilities
model.
B: this goal is based on the behavioral approach, not the cognitive disabilities model.
C: this goal is based on a sensorimotor approach, not the cognitive disabilities model.
