NBCOT Comprehensive Practice
Examination: Questions,
Answers, and Clinical Rationales
Domain 1: Evaluation, Assessment, and Data Collection (Questions 1-25)
1. A patient with a C6 spinal cord injury is being evaluated. Which muscle would the OT
expect to be INNERVATED and functional?
A) Flexor digitorum profundus
B) Extensor carpi radialis longus
C) Triceps
D) Latissimus dorsi
Correct Answer: B
, Rationale: A C6 injury typically allows for wrist extension (innervated by the radial nerve,
C6 root). Triceps (C7) and finger flexors (C8-T1) are not intact. Latissimus dorsi is innervated by
C6-8 but requires a lower level to be effectively functional.
2. A 70-year-old patient with right CVA (stroke) presents with left hemiparesis. During the
Manual Muscle Test (MMT), the patient’s left shoulder is able to abduct against gravity but
cannot hold against resistance. What MMT grade would you assign?
A) 2/5 (Poor)
B) 3/5 (Fair)
C) 4/5 (Good)
D) 5/5 (Normal)
Correct Answer: B
Rationale: A grade of 3/5 (Fair) is defined as the ability to complete the full range of
motion against gravity, but not against resistance. Grade 2 is against gravity eliminated, Grade 4
is against moderate resistance, and Grade 5 is against maximal resistance.
3. During a pediatric evaluation, a 4-year-old child is asked to stand on one foot. The child is
able to do this for 2 seconds before losing balance. This is MOST indicative of:
A) Developmental delay
B) Typical development for age
C) Vestibular dysfunction
D) Tactile defensiveness
Correct Answer: B
Rationale: A typically developing 4-year-old can usually stand on one foot for 1-3
seconds. A 5-year-old can typically do it for 4-6 seconds.
, 4. An OT is evaluating a patient with carpal tunnel syndrome. Which special test would be
MOST appropriate to confirm the diagnosis?
A) Apley’s Compression Test
B) Phalen’s Test
C) Lachman’s Test
D) Spurling’s Test
Correct Answer: B
Rationale: Phalen’s test (holding wrists in full flexion for 60 seconds) reproduces
symptoms of carpal tunnel syndrome. Apley's is for the knee, Lachman's is for the ACL, and
Spurling's is for cervical nerve root compression.
5. What is the PRIMARY purpose of the "Canadian Occupational Performance Measure"
(COPM)?
A) To assess fine motor dexterity.
B) To measure cognitive processing speed.
C) To identify client-perceived problems in occupational performance and track change over
time.
D) To evaluate visual-perceptual skills.
Correct Answer: C
Rationale: The COPM is a client-centered outcome measure that identifies a client's self-
perception of performance and satisfaction in areas of self-care, productivity, and leisure.
6. An OT is using the "Box and Block Test." What construct is being assessed?
A) Gross manual dexterity
B) Fine motor precision
C) Stereognosis
, D) Grip strength
Correct Answer: A
Rationale: The Box and Block Test measures unilateral gross manual dexterity by counting
the number of blocks moved from one compartment to another in 60 seconds.
7. A patient with dementia is having difficulty finding their way to the bathroom in their new
assisted living facility. This is a deficit in:
A) Topographical orientation
B) Figure-ground perception
C) Depth perception
D) Form constancy
Correct Answer: A
Rationale: Topographical orientation is the ability to find one's way in the environment.
Figure-ground is distinguishing a figure from the background; depth perception is judging
distances; form constancy is recognizing shapes regardless of size or orientation.
8. A child with autism spectrum disorder (ASD) is observed repeatedly flapping their hands
when excited. This is best described as:
A) Dystonia
B) Athetosis
C) Self-stimulatory behavior (Stimming)
D) Chorea
Correct Answer: C
Examination: Questions,
Answers, and Clinical Rationales
Domain 1: Evaluation, Assessment, and Data Collection (Questions 1-25)
1. A patient with a C6 spinal cord injury is being evaluated. Which muscle would the OT
expect to be INNERVATED and functional?
A) Flexor digitorum profundus
B) Extensor carpi radialis longus
C) Triceps
D) Latissimus dorsi
Correct Answer: B
, Rationale: A C6 injury typically allows for wrist extension (innervated by the radial nerve,
C6 root). Triceps (C7) and finger flexors (C8-T1) are not intact. Latissimus dorsi is innervated by
C6-8 but requires a lower level to be effectively functional.
2. A 70-year-old patient with right CVA (stroke) presents with left hemiparesis. During the
Manual Muscle Test (MMT), the patient’s left shoulder is able to abduct against gravity but
cannot hold against resistance. What MMT grade would you assign?
A) 2/5 (Poor)
B) 3/5 (Fair)
C) 4/5 (Good)
D) 5/5 (Normal)
Correct Answer: B
Rationale: A grade of 3/5 (Fair) is defined as the ability to complete the full range of
motion against gravity, but not against resistance. Grade 2 is against gravity eliminated, Grade 4
is against moderate resistance, and Grade 5 is against maximal resistance.
3. During a pediatric evaluation, a 4-year-old child is asked to stand on one foot. The child is
able to do this for 2 seconds before losing balance. This is MOST indicative of:
A) Developmental delay
B) Typical development for age
C) Vestibular dysfunction
D) Tactile defensiveness
Correct Answer: B
Rationale: A typically developing 4-year-old can usually stand on one foot for 1-3
seconds. A 5-year-old can typically do it for 4-6 seconds.
, 4. An OT is evaluating a patient with carpal tunnel syndrome. Which special test would be
MOST appropriate to confirm the diagnosis?
A) Apley’s Compression Test
B) Phalen’s Test
C) Lachman’s Test
D) Spurling’s Test
Correct Answer: B
Rationale: Phalen’s test (holding wrists in full flexion for 60 seconds) reproduces
symptoms of carpal tunnel syndrome. Apley's is for the knee, Lachman's is for the ACL, and
Spurling's is for cervical nerve root compression.
5. What is the PRIMARY purpose of the "Canadian Occupational Performance Measure"
(COPM)?
A) To assess fine motor dexterity.
B) To measure cognitive processing speed.
C) To identify client-perceived problems in occupational performance and track change over
time.
D) To evaluate visual-perceptual skills.
Correct Answer: C
Rationale: The COPM is a client-centered outcome measure that identifies a client's self-
perception of performance and satisfaction in areas of self-care, productivity, and leisure.
6. An OT is using the "Box and Block Test." What construct is being assessed?
A) Gross manual dexterity
B) Fine motor precision
C) Stereognosis
, D) Grip strength
Correct Answer: A
Rationale: The Box and Block Test measures unilateral gross manual dexterity by counting
the number of blocks moved from one compartment to another in 60 seconds.
7. A patient with dementia is having difficulty finding their way to the bathroom in their new
assisted living facility. This is a deficit in:
A) Topographical orientation
B) Figure-ground perception
C) Depth perception
D) Form constancy
Correct Answer: A
Rationale: Topographical orientation is the ability to find one's way in the environment.
Figure-ground is distinguishing a figure from the background; depth perception is judging
distances; form constancy is recognizing shapes regardless of size or orientation.
8. A child with autism spectrum disorder (ASD) is observed repeatedly flapping their hands
when excited. This is best described as:
A) Dystonia
B) Athetosis
C) Self-stimulatory behavior (Stimming)
D) Chorea
Correct Answer: C
