NBCOT- COTA Exam 2025/2026 Exam
Questions Marking Scheme New Update
| A+ Rated
A client with bilateral elbow contractures has 45° active extension and 90°
active flexion of both elbows and 5° supination/pronation. Upper extremity
muscle strength is Normal (5/5). Which activity would be MOST DIFFICULT
for the client to perform without using compensatory movements?
A.Putting a belt through pant belt loops
B.Tying shoelaces
C.Using a spoon to eat soup - 🧠 ANSWER ✔✔C
The results of a task analysis of each of these activities indicate that using
a spoon to eat soup requires supination and would be MOST DIFFICULT
for the client to perform without using compensatory movements.
A COTA is working with the Individualized Education Program (IEP) team
to determine a student's eligibility for school-based OT intervention. What
1
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,information does the team rely upon for making final eligibility
determinations?
A.Classroom performance and curriculum-based needs
B.Birth history and previous early intervention services
C.Physician's referral and diagnosis severity
D.Standardized test scores and documented disability - 🧠 ANSWER
✔✔Correct Answer: A
Rationale:
The Individuals with Disabilities Education Act (IDEA) mandates that
eligibility requirements for IEP services are based on a student's classroom
needs and performance in relation to curriculum-based objectives.
A 4-year-old child with pervasive developmental delay requires maximum
assistance for toileting. The COTA is teaching the child's parents strategies
for improving the child's independence with these tasks. During a session,
the parents indicate that over the past several months the child typically
does not have a bowel movement for several days at a time due to
constipation. Which recommendation should the COTA provide the parents
in response to this comment?
2
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STATEMENT. ALL RIGHTS RESERVED
,A.Consult with a dietitian to learn how to increase the amount of fiber in the
child's diet.
B.Schedule an appointment with the child's primary physician to rule out
gastrointestinal issues.
C.Ask a pharmacist to recommend a non-prescription children's stool
softener for the child. - 🧠 ANSWER ✔✔Correct Answer: B
Rationale:
A referral to the primary physician is warranted to determine if there is a
medical cause for the child's constipation.
A COTA is preparing to assess light touch sensation of a client who has an
acute radial nerve palsy. Based on the TYPICAL pattern of sensory
impairment for this condition, where on the dorsum of the affected hand
should the COTA expect to detect diminished light touch?
A.Entire length of the fifth digit
B.Fingertips of the index and middle fingers
C.Area over the first dorsal interossei - 🧠 ANSWER ✔✔Correct Answer: C
Rationale:
3
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
, The area over the first dorsal interossei falls within the sensory distribution
of the radial nerve.
A COTA working in a long term care facility is responsible for teaching the
residents strategies for supporting their independence with BADL. During
BADL sessions over the past week, several of the residents reported that
the assistive devices used during the sessions are not available to them
when completing routine BADL with the nursing aides. What action would
be MOST BENEFICIAL for the COTA to take in response to these reports?
A.Submit an incident report about the nursing aides to the appropriate
supervisor.
B.Present in-service training to nursing staff about the benefits and uses of
BADL devices.
C.Ensure the assistive devices are in a visible location and labeled with the
residents' name.
D.Advise the residents to ask for the assistive devices prior to starting
BADL. - 🧠 ANSWER ✔✔Correct Answer: B
Rationale:
4
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
Questions Marking Scheme New Update
| A+ Rated
A client with bilateral elbow contractures has 45° active extension and 90°
active flexion of both elbows and 5° supination/pronation. Upper extremity
muscle strength is Normal (5/5). Which activity would be MOST DIFFICULT
for the client to perform without using compensatory movements?
A.Putting a belt through pant belt loops
B.Tying shoelaces
C.Using a spoon to eat soup - 🧠 ANSWER ✔✔C
The results of a task analysis of each of these activities indicate that using
a spoon to eat soup requires supination and would be MOST DIFFICULT
for the client to perform without using compensatory movements.
A COTA is working with the Individualized Education Program (IEP) team
to determine a student's eligibility for school-based OT intervention. What
1
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
,information does the team rely upon for making final eligibility
determinations?
A.Classroom performance and curriculum-based needs
B.Birth history and previous early intervention services
C.Physician's referral and diagnosis severity
D.Standardized test scores and documented disability - 🧠 ANSWER
✔✔Correct Answer: A
Rationale:
The Individuals with Disabilities Education Act (IDEA) mandates that
eligibility requirements for IEP services are based on a student's classroom
needs and performance in relation to curriculum-based objectives.
A 4-year-old child with pervasive developmental delay requires maximum
assistance for toileting. The COTA is teaching the child's parents strategies
for improving the child's independence with these tasks. During a session,
the parents indicate that over the past several months the child typically
does not have a bowel movement for several days at a time due to
constipation. Which recommendation should the COTA provide the parents
in response to this comment?
2
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
,A.Consult with a dietitian to learn how to increase the amount of fiber in the
child's diet.
B.Schedule an appointment with the child's primary physician to rule out
gastrointestinal issues.
C.Ask a pharmacist to recommend a non-prescription children's stool
softener for the child. - 🧠 ANSWER ✔✔Correct Answer: B
Rationale:
A referral to the primary physician is warranted to determine if there is a
medical cause for the child's constipation.
A COTA is preparing to assess light touch sensation of a client who has an
acute radial nerve palsy. Based on the TYPICAL pattern of sensory
impairment for this condition, where on the dorsum of the affected hand
should the COTA expect to detect diminished light touch?
A.Entire length of the fifth digit
B.Fingertips of the index and middle fingers
C.Area over the first dorsal interossei - 🧠 ANSWER ✔✔Correct Answer: C
Rationale:
3
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
, The area over the first dorsal interossei falls within the sensory distribution
of the radial nerve.
A COTA working in a long term care facility is responsible for teaching the
residents strategies for supporting their independence with BADL. During
BADL sessions over the past week, several of the residents reported that
the assistive devices used during the sessions are not available to them
when completing routine BADL with the nursing aides. What action would
be MOST BENEFICIAL for the COTA to take in response to these reports?
A.Submit an incident report about the nursing aides to the appropriate
supervisor.
B.Present in-service training to nursing staff about the benefits and uses of
BADL devices.
C.Ensure the assistive devices are in a visible location and labeled with the
residents' name.
D.Advise the residents to ask for the assistive devices prior to starting
BADL. - 🧠 ANSWER ✔✔Correct Answer: B
Rationale:
4
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
