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NBCOT and OTKE Practice Exam -Questions with Correct Answers and Explanations

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This practice exam is designed to help you prepare for the NBCOT OTR and COTA certification exams as well as the NBCOT Occupational Therapy Knowledge Exam (OTKE). The actual NBCOT OTR exam consists of 170 multiple-choice questions plus 3 Clinical Simulation Test (CST) items, with a 4-hour time limit . OTKE exams are available in multiple formats: OTR Pre-Level II OTKE (100 items), OTR Post-Fieldwork OTKE (180 items), OTR End-of-Program OTKE (180 items), COTA Pre-Level II OTKE (100 items), and COTA Post-Fieldwork OTKE (100 items)

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NBCOT and OTKE Practice Exam -Questions
with Correct Answers and Explanations

Question 1: An OT is evaluating a client with a traumatic brain injury (TBI). Which
assessment tool is most appropriate for measuring the client's level of consciousness
and cognitive functioning following a TBI?

 A) Mini-Mental State Examination (MMSE)
 B) Ranchos Los Amigos Scale (Levels of Cognitive Functioning)
 C) Kohlman Evaluation of Living Skills (KELS)
 D) Canadian Occupational Performance Measure (COPM)

Correct Answer: B) Ranchos Los Amigos Scale

*




.*




Question 2: An OT is evaluating a child with sensory processing difficulties. Which
standardized assessment is specifically designed to evaluate sensory modulation,
discrimination, and postural-ocular motor control?

 A) Sensory Integration and Praxis Tests (SIPT)
 B) Sensory Profile 2 (Caregiver questionnaire)
 C) Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
 D) Peabody Developmental Motor Scales (PDMS-3)

Correct Answer: A) Sensory Integration and Praxis Tests (SIPT)

*Explanation: The SIPT is a comprehensive standardized assessment of sensory
integration and praxis for children ages 4-8 years, specifically designed to evaluate
sensory modulation, discrimination, and postural-ocular motor control. The Sensory

, Profile 2 is a caregiver questionnaire. BOT-2 assesses motor proficiency. PDMS-3 is for
younger children (birth-5 years) .*




Question 3: A client with a cerebrovascular accident (CVA) presents with left
hemineglect (unilateral neglect). Which assessment is most appropriate to quantify the
severity of neglect?

 A) Mini-Mental State Examination (MMSE)
 B) Line bisection test and clock drawing test
 C) Montreal Cognitive Assessment (MoCA)
 D) Fugl-Meyer Assessment (FMA)

Correct Answer: B) Line bisection test and clock drawing test

Explanation: The line bisection test and clock drawing test are quick, standardized
assessments for unilateral neglect. Clients with left neglect will fail to mark the left side of
the line or place numbers only on the right side of the clock. The MMSE and MoCA screen
global cognition but are not specific for neglect. The FMA assesses motor recovery post-
stroke .




Question 4: An OT is evaluating a client with hand osteoarthritis. Which assessment is
most appropriate for measuring grip strength?

 A) Semmes-Weinstein Monofilament Test
 B) Jamar Dynamometer
 C) Pinch Gauge
 D) Purdue Pegboard Test

Correct Answer: B) Jamar Dynamometer

Explanation: The Jamar Dynamometer is the gold standard for measuring grip strength in
pounds or kilograms. It has established normative data and is used in hand therapy. The
Pinch Gauge measures tip, lateral, and palmar pinch. The Purdue Pegboard measures
finger dexterity. The Semmes-Weinstein measures light touch sensation .

, Question 5: An OT is evaluating a client with Alzheimer's disease in a memory care unit.
Which assessment is most appropriate for measuring cognitive-ADL performance
related to medication management?

 A) Executive Function Performance Test (EFPT)
 B) Allen Cognitive Level Screen (ACLS)
 C) Loewenstein Occupational Therapy Cognitive Assessment (LOTCA)
 D) Kohlman Evaluation of Living Skills (KELS)

Correct Answer: A) Executive Function Performance Test (EFPT)

Explanation: The EFPT includes a medication management task that assesses executive
functions (initiation, organization, sequencing, problem-solving, safety) required for
independent living. The ACLS provides a cognitive level but does not include a medication
task. The LOTCA assesses cognitive components but not specific ADLs. KELS includes some
ADLs but is less specific to executive function .




Question 6: A 20-year-old male patient had recently been involved in a car crash and
suffered a TBI. After reviewing his chart, you read that he has cortical blindness and
cannot see. What part of the brain is this most likely an injury from?

 A) Frontal lobe
 B) Occipital lobe
 C) Temporal lobe
 D) Parietal lobe

Correct Answer: B) Occipital lobe

Explanation: The occipital lobe is the primary visual cortex responsible for processing
visual information. Injury to this area results in cortical blindness. The frontal lobe controls
executive functions and motor planning. The temporal lobe processes auditory information
and memory. The parietal lobe processes somatosensory information and spatial
awareness .

, Question 7: An OT is evaluating a client with suspected carpal tunnel syndrome (CTS).
Which provocative test is most commonly used to assess for CTS?

 A) Phalen's test
 B) Finkelstein's test
 C) Tinel's sign
 D) Allen's test

Correct Answer: A) Phalen's test

Explanation: Phalen's test (flexing wrists for 60 seconds) reproduces paresthesia in the
median nerve distribution. Tinel's sign is tapping over the carpal tunnel. Finkelstein's test is
for De Quervain's tenosynovitis. Allen's test assesses patency of the radial and ulnar
arteries .




Question 8: A client is admitted to the hospital exhibiting the following symptoms:
symmetric muscular weakness, distal sensory loss, stocking-glove distribution (tingling
from the feet and legs to the upper body), and deep tendon reflex loss. What
neurological system disorder might this client have?

 A) Post-polio Syndrome
 B) Amyotrophic Lateral Sclerosis (ALS)
 C) Guillain-Barré Syndrome
 D) Muscular Dystrophy

Correct Answer: C) Guillain-Barré Syndrome

Explanation: Guillain-Barré Syndrome is an acute inflammatory demyelinating
polyneuropathy characterized by symmetric ascending weakness, distal sensory loss in a
stocking-glove distribution, and areflexia. Post-polio syndrome occurs years after polio.
ALS involves both upper and lower motor neurons. Muscular dystrophy is a progressive
muscle disease .

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