N AT I O N A L B O A R D F O R C E R T I F I C AT I O N I N O C C U PAT I O N A L T H E R A P Y
NBCOT Exam Study Guide
Comprehensive Review
Practice Questions with Detailed Clinical Rationales
Topic Focus: Orthopedics, Neurology, Pediatrics, Mental Health, & Professional
Practice
Edition 1 · August 2026 · 269 Questions
Table of Contents
1. Instructions for Use 2
2. Brachial Plexus & Shoulder Injuries (Questions 1–11) 2
3. Splinting & Orthotics (Questions 12–38) 4
4. Physical Agent Modalities (Questions 39–53) 7
,5. Ethics & Professional Practice (Questions 54–59) 8
6. Exercise & Rehabilitation (Questions 60–66) 9
7. Pediatric Reflexes & Milestones (Questions 67–96) 9
8. Neurological Conditions & CVA (Questions 97–116) 12
9. Spinal Cord Injury (Questions 117–126) 13
10. TBI & Neurodegenerative Disorders (Questions 127–141) 14
11. ALS, MS, GBS & Amputations (Questions 142–157) 15
12. Dysphagia & Feeding (Questions 158–167) 16
13. Pediatric Conditions & Interventions (Questions 168–200) 17
14. School-Based OT & Early Intervention (Questions 201–219) 19
15. NICU & Feeding Interventions (Questions 220–235) 20
16. Sensory Processing (Questions 236–249) 21
17. Autism & Handwriting (Questions 250–269) 22
NBCOT Exam Study Guide Page 1
,NBCOT EXAM STUDY GUIDE BRACHIAL PLEXUS & SHOULDER — Q1–11
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. All 269 questions are derived directly from the source material and verified for
accuracy.
Category: Brachial Plexus & Shoulder Injuries — Questions 1–11
1 What is Brachial Plexopathy?
A Compression of the brachial plexus
B Injury to the radial nerve at the wrist
C Inflammation of the median nerve
D Fracture of the humerus
Why A is correct: Brachial plexopathy occurs when the brachial plexus gets too
compressed, leading to pain, weakness, and sensory changes in the upper extremity.
B — Radial nerve injury at the wrist is a different condition (e.g., wrist drop).
C — Median nerve inflammation describes conditions like carpal tunnel syndrome.
D — Humeral fracture is a bony injury, not a nerve compression.
, 2 What is Thoracic Outlet Syndrome and what are contraindications for this condition?
A Compression on brachial plexus and vascular structures from trauma; avoid
overhead movements, poor posture, and sleeping on affected side
B Inflammation of the rotator cuff; avoid heavy lifting
C Fracture of the clavicle; avoid shoulder movement
D Nerve entrapment at the elbow; avoid repetitive elbow flexion
Why A is correct: Thoracic Outlet Syndrome involves compression on the brachial plexus
and vascular structures from trauma. Contraindications include avoiding overhead
movements, poor posture, and sleeping on the affected side (avoid protracted shoulder).
B — Rotator cuff inflammation is a separate condition.
C — Clavicle fracture is a bone injury, not TOS.
D — Cubital tunnel syndrome involves ulnar nerve entrapment at the elbow.
3 What are OT treatment strategies for brachial plexus injuries? (MEND vs. MOVE)
A MEND: manage pain, edema, nerve glides; MOVE: improve posture, strengthen
scapular elevators, encourage diaphragmatic breathing
B MEND: medication only; MOVE: surgery only
C MEND: immobilize completely; MOVE: no movement allowed
D MEND: focus on strengthening; MOVE: focus on stretching
Why A is correct: MEND focuses on managing pain, edema, and nerve glides (avoid
scapular depression with stretch). MOVE focuses on improving posture, strengthening
scapular elevators to prevent stooped posture, and encouraging diaphragmatic breathing.
B — OT interventions are not limited to medication or surgery.
C — Complete immobilization is not recommended for brachial plexus injuries.
D — Both MEND and MOVE include multiple intervention components.
NBCOT Exam Study Guide
Comprehensive Review
Practice Questions with Detailed Clinical Rationales
Topic Focus: Orthopedics, Neurology, Pediatrics, Mental Health, & Professional
Practice
Edition 1 · August 2026 · 269 Questions
Table of Contents
1. Instructions for Use 2
2. Brachial Plexus & Shoulder Injuries (Questions 1–11) 2
3. Splinting & Orthotics (Questions 12–38) 4
4. Physical Agent Modalities (Questions 39–53) 7
,5. Ethics & Professional Practice (Questions 54–59) 8
6. Exercise & Rehabilitation (Questions 60–66) 9
7. Pediatric Reflexes & Milestones (Questions 67–96) 9
8. Neurological Conditions & CVA (Questions 97–116) 12
9. Spinal Cord Injury (Questions 117–126) 13
10. TBI & Neurodegenerative Disorders (Questions 127–141) 14
11. ALS, MS, GBS & Amputations (Questions 142–157) 15
12. Dysphagia & Feeding (Questions 158–167) 16
13. Pediatric Conditions & Interventions (Questions 168–200) 17
14. School-Based OT & Early Intervention (Questions 201–219) 19
15. NICU & Feeding Interventions (Questions 220–235) 20
16. Sensory Processing (Questions 236–249) 21
17. Autism & Handwriting (Questions 250–269) 22
NBCOT Exam Study Guide Page 1
,NBCOT EXAM STUDY GUIDE BRACHIAL PLEXUS & SHOULDER — Q1–11
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. All 269 questions are derived directly from the source material and verified for
accuracy.
Category: Brachial Plexus & Shoulder Injuries — Questions 1–11
1 What is Brachial Plexopathy?
A Compression of the brachial plexus
B Injury to the radial nerve at the wrist
C Inflammation of the median nerve
D Fracture of the humerus
Why A is correct: Brachial plexopathy occurs when the brachial plexus gets too
compressed, leading to pain, weakness, and sensory changes in the upper extremity.
B — Radial nerve injury at the wrist is a different condition (e.g., wrist drop).
C — Median nerve inflammation describes conditions like carpal tunnel syndrome.
D — Humeral fracture is a bony injury, not a nerve compression.
, 2 What is Thoracic Outlet Syndrome and what are contraindications for this condition?
A Compression on brachial plexus and vascular structures from trauma; avoid
overhead movements, poor posture, and sleeping on affected side
B Inflammation of the rotator cuff; avoid heavy lifting
C Fracture of the clavicle; avoid shoulder movement
D Nerve entrapment at the elbow; avoid repetitive elbow flexion
Why A is correct: Thoracic Outlet Syndrome involves compression on the brachial plexus
and vascular structures from trauma. Contraindications include avoiding overhead
movements, poor posture, and sleeping on the affected side (avoid protracted shoulder).
B — Rotator cuff inflammation is a separate condition.
C — Clavicle fracture is a bone injury, not TOS.
D — Cubital tunnel syndrome involves ulnar nerve entrapment at the elbow.
3 What are OT treatment strategies for brachial plexus injuries? (MEND vs. MOVE)
A MEND: manage pain, edema, nerve glides; MOVE: improve posture, strengthen
scapular elevators, encourage diaphragmatic breathing
B MEND: medication only; MOVE: surgery only
C MEND: immobilize completely; MOVE: no movement allowed
D MEND: focus on strengthening; MOVE: focus on stretching
Why A is correct: MEND focuses on managing pain, edema, and nerve glides (avoid
scapular depression with stretch). MOVE focuses on improving posture, strengthening
scapular elevators to prevent stooped posture, and encouraging diaphragmatic breathing.
B — OT interventions are not limited to medication or surgery.
C — Complete immobilization is not recommended for brachial plexus injuries.
D — Both MEND and MOVE include multiple intervention components.
