AOTA PRACTICE EXAM QUESTIONS
AND ANSWERS. VERIFIED 2026.
A client with bilateral transtibial amputation is being fitted for a wheelchair. Which of the
following adaptations is MOST important?
A. Swing-away elevating footrests
B. Rear antitipping devices
C. Padded swing-away arm rests
D. Wheel-lock extensions - ANS b (Because of the change in their center of gravity, clients
with bilateral amputations are more likely to tip over backward during weight shifts. Rear
antitipping devices are necessary for safety.)
Which of the following symptoms is a COTA® likely to observe in a client in a hospital setting
during the plateau phase of Guillain-Barré syndrome?
A. Unilateral pain in a lower extremity
B. Inability to communicate vocally
C. Confusion from short-term memory loss
D. Hyposensitivity to tactile input - ANS b (Because of paralysis of muscles in the head and
neck, spoken communication is often impaired in the plateau phase of Guillain-Barré
syndrome.)
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,A client with depression enjoyed exercising in the past because it helped the client experience
more positive feelings. The client now has difficulty finding the motivation to participate in
exercise. Which strategy would be BEST for the COTA® to use to encourage this client to resume
exercise?
A. Use motivational interviewing to encourage exploration of desirable leisure activities.
B. Provide opportunities for the client to explore new leisure pursuits.
C. Use the remotivation approach to determine the appropriate motivational stage for
intervention related to exercise.
D. Provide the client with useful feedback about performance in occupational therapy
interventions related to exercise and why the client should resume it. - ANS c (Remotivation
is an evidence-based intervention for motivation that helps clients reengage in desired positive
behaviors. Because the client has already self-identified exercise, remotivation will help the
COTA assist the client in a specific motivation strategy to resume exercise.)
A client with a unilateral transradial amputation is undergoing pre-positioning training for a
myoelectric arm. Which of the following is the MOST appropriate goal?
A. Within three sessions, the client will independently don the prosthesis and obtain good
electrical contacts with the electrode sites 100% of the time.
B. Within three sessions, the client will be able to open and close the myoelectric terminal
device 100% of the time.
C. Within 1 week, the client will be able to accurately identify how to arrange the wrist of the
myoelectric terminal device to be able to optimally grasp different objects.
D. Within 1 month, the client will be able to use the myoelectric terminal device as a functional
assist and stabilizer in 100% of daily activities. - ANS c (The pre-positioning phase focuses on
teaching the client with an amputation to position the terminal device for optimal grasp.)
What piece of adaptive equipment is MOST useful for a client with an incomplete T2 spinal cord
injury?
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,A. A weighted spoon
B. A long-handled sponge
C. A plate protector
D. A button hook - ANS b
A COTA® is working with a client who has decreased nerve function. The client has lost precision
pinch, thenar opposition, and the ability to bend the index and long fingers at the proximal and
distal interphalangeal joints. What deformity does the client MOST likely have?
A. Ulnar claw
B. Boutonniere deformity
C. Swan neck deformity
D. Ape hand deformity - ANS d (Ape hand deformity is the result of a high median nerve
injury at the elbow or proximal forearm.)
An 88-year-old client has given up driving as a result of decreased vision. The client has a history
of carpal tunnel syndrome, diabetes mellitus (poorly controlled), congestive heart failure, and
osteoarthritis in both knees and thumbs. The client has frequent medical appointments within a
20-mile radius of home. The client lives alone and is 10 blocks away from the closest bus station.
What is the BEST choice for community mobility for this client?
A. Fixed-route transportation
B. Paratransit transportation
C. Neighbors providing rides
D. Volunteer driver program - ANS b
A client with Alzheimer's disease (AD) reports getting lost when going to a daughter's
apartment. The client's daughter has been living in the same apartment building for more than
10 years, but she lives 3 hours away from the client. In what stage of dementia is this client?
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, A. End
B. Early
C. Middle
D. Late - ANS b (In the early stage of AD, higher level executive functions that affect IADL
performance are the first observed signs of the disease process.)
A client has fair (3/5) muscle strength of the shoulder flexors and is participating in a
strengthening program. Which position and movement pattern would be MOST EFFECTIVE for
initially increasing strength of the client's shoulder flexors?
A. Seated, moving the arm in a sagittal plane
B. Seated, moving the arm on a skateboard
C. Side lying, moving the arm in a horizontal plane
D. Supine, moving the arm in a non-resisted plane - ANS a (Moving the arm in the sagittal
plane will allow active movement against gravity, which in turn will facilitate the client's current
strength with full active motion against gravity.)
A COTA is teaching a client with stroke compensatory strategies to don a pullover shirt. The
client has hemiparesis that limits upper-extremity movement in the affected side. What is the
FIRST step the client should be taught?
A. Dress the affected arm by placing the sleeve over the affected arm
B. Put the head through the neck opening by bending the neck forward
C. Place the unaffected arm into the sleeve by placing the sleeve over the unaffected arm
D. Rub the affected arm on the leg to straighten the sleeve - ANS a
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
AND ANSWERS. VERIFIED 2026.
A client with bilateral transtibial amputation is being fitted for a wheelchair. Which of the
following adaptations is MOST important?
A. Swing-away elevating footrests
B. Rear antitipping devices
C. Padded swing-away arm rests
D. Wheel-lock extensions - ANS b (Because of the change in their center of gravity, clients
with bilateral amputations are more likely to tip over backward during weight shifts. Rear
antitipping devices are necessary for safety.)
Which of the following symptoms is a COTA® likely to observe in a client in a hospital setting
during the plateau phase of Guillain-Barré syndrome?
A. Unilateral pain in a lower extremity
B. Inability to communicate vocally
C. Confusion from short-term memory loss
D. Hyposensitivity to tactile input - ANS b (Because of paralysis of muscles in the head and
neck, spoken communication is often impaired in the plateau phase of Guillain-Barré
syndrome.)
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,A client with depression enjoyed exercising in the past because it helped the client experience
more positive feelings. The client now has difficulty finding the motivation to participate in
exercise. Which strategy would be BEST for the COTA® to use to encourage this client to resume
exercise?
A. Use motivational interviewing to encourage exploration of desirable leisure activities.
B. Provide opportunities for the client to explore new leisure pursuits.
C. Use the remotivation approach to determine the appropriate motivational stage for
intervention related to exercise.
D. Provide the client with useful feedback about performance in occupational therapy
interventions related to exercise and why the client should resume it. - ANS c (Remotivation
is an evidence-based intervention for motivation that helps clients reengage in desired positive
behaviors. Because the client has already self-identified exercise, remotivation will help the
COTA assist the client in a specific motivation strategy to resume exercise.)
A client with a unilateral transradial amputation is undergoing pre-positioning training for a
myoelectric arm. Which of the following is the MOST appropriate goal?
A. Within three sessions, the client will independently don the prosthesis and obtain good
electrical contacts with the electrode sites 100% of the time.
B. Within three sessions, the client will be able to open and close the myoelectric terminal
device 100% of the time.
C. Within 1 week, the client will be able to accurately identify how to arrange the wrist of the
myoelectric terminal device to be able to optimally grasp different objects.
D. Within 1 month, the client will be able to use the myoelectric terminal device as a functional
assist and stabilizer in 100% of daily activities. - ANS c (The pre-positioning phase focuses on
teaching the client with an amputation to position the terminal device for optimal grasp.)
What piece of adaptive equipment is MOST useful for a client with an incomplete T2 spinal cord
injury?
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,A. A weighted spoon
B. A long-handled sponge
C. A plate protector
D. A button hook - ANS b
A COTA® is working with a client who has decreased nerve function. The client has lost precision
pinch, thenar opposition, and the ability to bend the index and long fingers at the proximal and
distal interphalangeal joints. What deformity does the client MOST likely have?
A. Ulnar claw
B. Boutonniere deformity
C. Swan neck deformity
D. Ape hand deformity - ANS d (Ape hand deformity is the result of a high median nerve
injury at the elbow or proximal forearm.)
An 88-year-old client has given up driving as a result of decreased vision. The client has a history
of carpal tunnel syndrome, diabetes mellitus (poorly controlled), congestive heart failure, and
osteoarthritis in both knees and thumbs. The client has frequent medical appointments within a
20-mile radius of home. The client lives alone and is 10 blocks away from the closest bus station.
What is the BEST choice for community mobility for this client?
A. Fixed-route transportation
B. Paratransit transportation
C. Neighbors providing rides
D. Volunteer driver program - ANS b
A client with Alzheimer's disease (AD) reports getting lost when going to a daughter's
apartment. The client's daughter has been living in the same apartment building for more than
10 years, but she lives 3 hours away from the client. In what stage of dementia is this client?
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, A. End
B. Early
C. Middle
D. Late - ANS b (In the early stage of AD, higher level executive functions that affect IADL
performance are the first observed signs of the disease process.)
A client has fair (3/5) muscle strength of the shoulder flexors and is participating in a
strengthening program. Which position and movement pattern would be MOST EFFECTIVE for
initially increasing strength of the client's shoulder flexors?
A. Seated, moving the arm in a sagittal plane
B. Seated, moving the arm on a skateboard
C. Side lying, moving the arm in a horizontal plane
D. Supine, moving the arm in a non-resisted plane - ANS a (Moving the arm in the sagittal
plane will allow active movement against gravity, which in turn will facilitate the client's current
strength with full active motion against gravity.)
A COTA is teaching a client with stroke compensatory strategies to don a pullover shirt. The
client has hemiparesis that limits upper-extremity movement in the affected side. What is the
FIRST step the client should be taught?
A. Dress the affected arm by placing the sleeve over the affected arm
B. Put the head through the neck opening by bending the neck forward
C. Place the unaffected arm into the sleeve by placing the sleeve over the unaffected arm
D. Rub the affected arm on the leg to straighten the sleeve - ANS a
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
