NBCOT & OTKE Practice Exams | Verified Questions and
Correct Answers for 2025–2026
This document provides a large and detailed set of practice questions with verified answers for the 2025–
2026 NBCOT (National Board for Certification in Occupational Therapy) and OTKE (Occupational Therapy
Knowledge Exam
An OT is conducting an evaluation on a client post-CVA. The client present with
contralateral hemiplegia, grasp reflex, incontinence, confusion, and apathy.
What is the involved artery and the site of the infarct?
Select one:
a. Posterior cerebral artery (PCA)
b. Middle cerebral artery (MCA)
c. Internal carotid artery (ICA)
d. Anterior cerebral artery (ACA) - <<answer>>>..d. Anterior cerebral artery
(ACA)
A child has recently begun to build with blocks both horizontally and vertically
but cannot yet build a tower of nine cubes, what age is this child?
Select one:
a. 24-30 months
b. 6-9 months
c. 21-24 months
d. 12-15 months - <<answer>>>..a. 24-30 months
An OT working in a school setting is observing a new client in the classroom.
The OT notices that the child is reluctant to fully participate in the school
environment. In order to assess functional performance to promote increased
participation in the school environment, which assessment should the OT use?
Select one:
a. School Function Assessment
,b. Participation Scale
c. Test of Playfulness Revised Version 3.5
d. Coping Inventory - <<answer>>>..a. School Function Assessment Correct
The OT is observing a typical 3-year-old child playing house with her doll. The
child is using a teapot filled with cotton balls that symbolizes the "tea" she is
serving. She uses a variety of words that she did not use before, as well as
phrases. While there are other children in the clinic, the child is not playing with
them. What stage of play is the child experiencing?
Select one:
a. Creative Play
b. Exploratory Play
c. Games
d. Symbolic Play - <<answer>>>..d. Symbolic Play
An OT is evaluating a 10-month-old child who was referred to OT for
developmental delays. The infant exhibits extension of the extremities on the
face side and flexion of extremities on the skull side. Which reflex is not
integrated and will likely affect the child's ability to creep and crawl?
Select one:
a. ATNR
b. STNR
c. TLR
d. BOB - <<answer>>>..a. ATNR
An OT begins seeing a 2-year-old client for feeding. Upon initial observation, the
OT notices that the client pockets a large amount of food in his mouth. The
client's parents report that he typically holds food in his mouth for hours at a time
and refuses to swallow in between bites. What is the most appropriate
intervention strategy to apply during treatment sessions?
Select one:
a. Prevent tongue retraction to avoid choking
,b. Refer the parents for a VFSS
c. Facilitate swallow by placement and slight downward pressure of the spoon
on the middle aspect of the tongue
d. Facilitate chewing by placement of long, crunchy-textured food on lateral
molars - <<answer>>>..c. Facilitate swallow by placement and slight downward
pressure of the spoon on the middle aspect of the tongue
An OT is treating an 86-year-old male who has difficulty visually scanning
objects outside of his central vision. After providing a visual screen, the OT
notices that the client has tunnel vision and has difficulty seeing objects in the
outer borders of his visual field in both eyes. This leads the OT to believe that
the client has loss of peripheral vision. What is the most likely cause of this
vision loss?
Select one:
a. Macular degeneration
b. Glaucoma
c. Cataracts
d. Diabetic retinopathy - <<answer>>>..b. Glaucoma
An OT is working with an 88-year-old female client who was admitted to a SNF
s/p R THA. During the evaluation, you ask the client what her goals are for
therapy and she replies with: "I want to get stronger so I can go back home and
be able to take care of myself." Which of the following statements is TRUE that
the OT should keep in mind when designing her client-centered goals and
exercise program?
Select one:
a. The exercise program should consist of strength training at 70-80% of the
client's one-rep max in order to see improved strength with predictable results.
b. The exercise program should focus more on cardio rather than strength
training
c. Elders ages 80 and above should not participate in any kind of strength
training because they are frail and it is unsafe for their health.
, d. Improvements in strength does not correlate with improving ability to complete
functional tasks. - <<answer>>>..a. The exercise program should consist of
strength training at 70-80% of the client's one-rep max in order to see improved
strength with predictable results.
A 75-year-old male client is complaining of ringing in both of his ears during
treatment and cannot comprehend the OT's directions when engaging in
therapy. Which type of hearing loss is the client exhibiting?
Select one:
a. Tinnitus
b. Conductive
c. Presbycusis
d. Sensorineural - <<answer>>>..c. Presbycusis
An OT who is working in a pediatric clinic is completing an evaluation on a new
5-year-old client. The OT needs an assessment that will detect the client's
functional deficits, determine developmental level and assess capabilities.
Which overall development assessment is most appropriate for the OT to use?
Select one:
a. Hayley Scales of Infant Development (BSID-III)
b. Pediatric Evaluation of Disabilities Inventory (PEDI)
c. Miller Assessment for Preschoolers (MAP)
d. Denver Developmental Screening Test II - <<answer>>>..b. Pediatric
Evaluation of Disabilities Inventory (PEDI)
An OT receives a home health referral for a 78-year-old male client with general
weakness. During the evaluation, the OT notices that the client is dehydrated,
malnourished, has poor personal hygiene, and is living in unsafe conditions. The
OT suspects that this is a case of elderly abuse. Given these signs and
symptoms, what form of elderly abuse is suspected?
Select one:
a. Physical abuse
Correct Answers for 2025–2026
This document provides a large and detailed set of practice questions with verified answers for the 2025–
2026 NBCOT (National Board for Certification in Occupational Therapy) and OTKE (Occupational Therapy
Knowledge Exam
An OT is conducting an evaluation on a client post-CVA. The client present with
contralateral hemiplegia, grasp reflex, incontinence, confusion, and apathy.
What is the involved artery and the site of the infarct?
Select one:
a. Posterior cerebral artery (PCA)
b. Middle cerebral artery (MCA)
c. Internal carotid artery (ICA)
d. Anterior cerebral artery (ACA) - <<answer>>>..d. Anterior cerebral artery
(ACA)
A child has recently begun to build with blocks both horizontally and vertically
but cannot yet build a tower of nine cubes, what age is this child?
Select one:
a. 24-30 months
b. 6-9 months
c. 21-24 months
d. 12-15 months - <<answer>>>..a. 24-30 months
An OT working in a school setting is observing a new client in the classroom.
The OT notices that the child is reluctant to fully participate in the school
environment. In order to assess functional performance to promote increased
participation in the school environment, which assessment should the OT use?
Select one:
a. School Function Assessment
,b. Participation Scale
c. Test of Playfulness Revised Version 3.5
d. Coping Inventory - <<answer>>>..a. School Function Assessment Correct
The OT is observing a typical 3-year-old child playing house with her doll. The
child is using a teapot filled with cotton balls that symbolizes the "tea" she is
serving. She uses a variety of words that she did not use before, as well as
phrases. While there are other children in the clinic, the child is not playing with
them. What stage of play is the child experiencing?
Select one:
a. Creative Play
b. Exploratory Play
c. Games
d. Symbolic Play - <<answer>>>..d. Symbolic Play
An OT is evaluating a 10-month-old child who was referred to OT for
developmental delays. The infant exhibits extension of the extremities on the
face side and flexion of extremities on the skull side. Which reflex is not
integrated and will likely affect the child's ability to creep and crawl?
Select one:
a. ATNR
b. STNR
c. TLR
d. BOB - <<answer>>>..a. ATNR
An OT begins seeing a 2-year-old client for feeding. Upon initial observation, the
OT notices that the client pockets a large amount of food in his mouth. The
client's parents report that he typically holds food in his mouth for hours at a time
and refuses to swallow in between bites. What is the most appropriate
intervention strategy to apply during treatment sessions?
Select one:
a. Prevent tongue retraction to avoid choking
,b. Refer the parents for a VFSS
c. Facilitate swallow by placement and slight downward pressure of the spoon
on the middle aspect of the tongue
d. Facilitate chewing by placement of long, crunchy-textured food on lateral
molars - <<answer>>>..c. Facilitate swallow by placement and slight downward
pressure of the spoon on the middle aspect of the tongue
An OT is treating an 86-year-old male who has difficulty visually scanning
objects outside of his central vision. After providing a visual screen, the OT
notices that the client has tunnel vision and has difficulty seeing objects in the
outer borders of his visual field in both eyes. This leads the OT to believe that
the client has loss of peripheral vision. What is the most likely cause of this
vision loss?
Select one:
a. Macular degeneration
b. Glaucoma
c. Cataracts
d. Diabetic retinopathy - <<answer>>>..b. Glaucoma
An OT is working with an 88-year-old female client who was admitted to a SNF
s/p R THA. During the evaluation, you ask the client what her goals are for
therapy and she replies with: "I want to get stronger so I can go back home and
be able to take care of myself." Which of the following statements is TRUE that
the OT should keep in mind when designing her client-centered goals and
exercise program?
Select one:
a. The exercise program should consist of strength training at 70-80% of the
client's one-rep max in order to see improved strength with predictable results.
b. The exercise program should focus more on cardio rather than strength
training
c. Elders ages 80 and above should not participate in any kind of strength
training because they are frail and it is unsafe for their health.
, d. Improvements in strength does not correlate with improving ability to complete
functional tasks. - <<answer>>>..a. The exercise program should consist of
strength training at 70-80% of the client's one-rep max in order to see improved
strength with predictable results.
A 75-year-old male client is complaining of ringing in both of his ears during
treatment and cannot comprehend the OT's directions when engaging in
therapy. Which type of hearing loss is the client exhibiting?
Select one:
a. Tinnitus
b. Conductive
c. Presbycusis
d. Sensorineural - <<answer>>>..c. Presbycusis
An OT who is working in a pediatric clinic is completing an evaluation on a new
5-year-old client. The OT needs an assessment that will detect the client's
functional deficits, determine developmental level and assess capabilities.
Which overall development assessment is most appropriate for the OT to use?
Select one:
a. Hayley Scales of Infant Development (BSID-III)
b. Pediatric Evaluation of Disabilities Inventory (PEDI)
c. Miller Assessment for Preschoolers (MAP)
d. Denver Developmental Screening Test II - <<answer>>>..b. Pediatric
Evaluation of Disabilities Inventory (PEDI)
An OT receives a home health referral for a 78-year-old male client with general
weakness. During the evaluation, the OT notices that the client is dehydrated,
malnourished, has poor personal hygiene, and is living in unsafe conditions. The
OT suspects that this is a case of elderly abuse. Given these signs and
symptoms, what form of elderly abuse is suspected?
Select one:
a. Physical abuse
