NBCOT Occupational Therapy Certification Essential Test
Toolkit Exam Questions and Approved with Distinction
Marking Scheme Latest 2024/2025
The OTR completes testing for touch sensation using two-point discrimination for a
client following a nerve repair. Which rationale BEST describes why this assessment
was chosen for this client? - correct answer map nerve repair and test receptor
density
Prior to establishing an intervention plan, the OTR should - correct answer complete
an occupational profile and assessment, assess client pain and determine the amount
of caregiver support available after discharge.
To determine therapy goals, the OTR should - correct answer consider a guiding
theory and work with the client to determine goals.
Before discharge the OTR will - correct answer assess the ability of the caregiver to
safely assist in transfers and provide recommendations for home safety.
During a home care session, a client with Alzheimer disease describes to the OTR an
event where the client drove to the grocery store and had difficulty finding the way
home. What is the MOST APPROPRIATE way for the OTR to respond? - correct
answer perform an assessment to determine a client's driving safety
An OTR is preparing to evaluate a client with low vision. Before the client arrives to the
clinic, the OTR reviews the chart and prepares for the evaluation. Which definition
BEST describes low vision? - correct answer bilateral vision impairment that is unable
to be corrected medically, surgically, or by refraction (the use of glasses or contacts)
A client with an extensive history of alcohol abuse is referred for an occupational
therapy evaluation. What type of assessment is MOST APPROPRIATE for the OTR to
choose? - correct answer Occupational performance, self-efficacy, and role
competence are most appropriate to assess in order to construct the client's
occupational profile and collaborate to develop meaningful and realistic goals.
,An OTR is discussing home modifications to allow a 35-year-old client to return home
after sustaining a C8 spinal cord injury. The client lives at home with two children,
spouse, and elderly mother-in-law. Which of the following home modifications reflect the
principles of universal design? - correct answer Installing a toilet seat with a switch to
adjust it to a comfortable height
An OTR is fabricating a splint for a client with median nerve injury. What position should
be avoided to protect the client's wrist and hand? - correct answer
Metacarpophalangeal hyperextension
A splint for a median nerve injury should prevent - correct answer hyperextension due
to the unopposed pull of the extensor digitorum communis, which is innervated by the
radial nerve.
An OTR is conducting a feeding evaluation in a family's home. The OTR observes the
child stuffing solid food into the mouth during feeding. The parents seem worried that
the child will choke due to the overstuffing behavior. Which feeding issue is the child
most likely experiencing? - correct answer oral hyposensitivity, tends to lack sensory
awareness in the mouth
An OTR is working with a 2.5-year-old child in an early intervention program who was
premature at 25 weeks gestation. The child presents to occupational therapy with upper
extremity weakness and poor grasping. The child's mother would like for the child to
self-feed independently. Currently, the child does not use a spoon and relies on finger
feeding using a raking grasp. The meal process is slow and the mother continues to
feed the child in order to meet nutritional needs. Which is the MOST APPROPRIATE
intervention to promote self-feeding independence? - correct answer A light-weight,
built-up handle on the spoon or universal cuff
Diabetic retinopathy - correct answer occurs when the small blood vessels in the
retina develop swelling or bleeding, resulting in loss of vision. Impacts all aspects of
visual functioning, including loss of central vision, loss or peripheral vision, loss of color
vision, decreased night vision, and fluctuations in vision.
10-year-old child with cerebral palsy is working in the classroom on signing work. The
OTR has been facilitating written name production during direct intervention times;
however, the task is tedious and frustrating to the child. The OTR has consulted with the
teacher and decided to incorporate some adaptive equipment to provide positive
feedback to the child as well as identify the child's work. Which is the MOST appropriate
adaptive equipment to use with this child? - correct answer name stamp
,A client with left homonymous hemianopsia following a cerebrovascular accident is
experiencing difficulty with reading. Previously, the client enjoyed reading novels,
newspapers, and magazines. Which is the MOST EFFECTIVE intervention to promote
the client's return to reading? - correct answer A vertical line on the left side of the
page
An OTR is working with a 12-year-old child diagnosed with emotional disturbance. The
child has a history of being off task, poor social skills, and becoming overly upset about
things when something does not go as anticipated. The child attends middle school and
the teacher reports that the child has difficulty following directions, completing
schoolwork, and has frequent outbursts resulting in visits to the principal's office. What
intervention or strategy is MOST EFFECTIVE for improving school behavior and
performance? - correct answer A token economy or contingency method to reinforce
cooperation and task completion
The OTR is planning an INITIAL intervention session with a client who is in the acute
manic phase of bipolar disorder. Which intervention strategy is MOST IMPORTANT to
achieve maximum participation? - correct answer provide an environment with
minimal distractions
A client has been receiving OT in an outpatient rehabilitation center for six weeks and is
at the end of the plan of care. The client is preparing to return to work in a busy legal
firm with multiple demands. Which goal area would be MOST APPROPRIATE for the
OTR to implement in order to prepare the client for return to work? - correct answer
Work hardening
A client attends a group intervention program to address substance abuse. The client is
aware that the number of therapy sessions are limited. Which is the MOST
BENEFICIAL assessment for the OTR to conduct with this client based on the limited
number of sessions? - correct answer Use a tool that Allows the client to self-identify
occupational challenges
An OTR is fabricating a splint for a client who sustained radial nerve damage from a
motor vehicle crash. Based on the nerve injury, which is the BEST position for the splint
to place the wrist and hand during the healing phase? - correct answer To reduce
flexion and overstretching of the extensor tendons, the splint should support the wrist,
metacarpophalanges, and thumb in extension, placing the hand in functional position.
, Which of the following approaches is MOST APPROPRIATE for a client with edema of
the upper extremity? - correct answer biomechanical approach (massage,
compression, and active range of motion)
Which of the following movements allows the OTR to evaluate the strength and control
of the client's trunk flexors? - correct answer The client leans backwards and holds
the position, then forward to sit up
A client diagnosed with depression and anorexia nervosa attends an evening support
group for 90 minutes each week. The client reports limited occupational engagement.
The OTR collaborates with the client to develop a plan to increase involvement in
avocational activities. The client expresses interest in exercise and volunteerism. In high
school, the client was captain of the swim team, played tennis, and worked in an after-
school program for young children. Which is the MOST APPROPRIATE activity for the
client to explore? - correct answer local elementary school for volunteer opportunities
An OTR is planning treatment sessions for adolescents diagnosed with eating disorders
in an outpatient, voluntary community mental health complex. Which goal is MOST
IMPORTANT to address INITIALLY? - correct answer Increasing self-awareness with
expressive activities
OTR is working with an adult with a substance abuse disorder in a community-based
setting. The client has maintained sobriety for 1 year; however, the evaluation results
indicate that the client has inadequate adaptive skills, poor hygiene, and low self-
esteem. What INITIAL goal is MOST BENEFICIAL to include in the intervention plan to
improve occupational performance and participation? - correct answer acquisition of
basic life skills for greater independence
A client is recovering from a recent exacerbation of congestive heart failure. The client
has a history of coronary artery disease and is diagnosed with class III cardiovascular
disability using the Specific Activity Scale. The client was referred to occupational
therapy to increase independence with instrumental activities of daily living. Which of
the following instrumental activities of daily living can the OTR INITIALLY include in the
plan of care? - correct answer Making the bed (2 METS)
The definition of low vision is bilateral vision impairment that is unable to be - correct
answer corrected medically, surgically, or by refraction (the use of glasses or
contacts).
Toolkit Exam Questions and Approved with Distinction
Marking Scheme Latest 2024/2025
The OTR completes testing for touch sensation using two-point discrimination for a
client following a nerve repair. Which rationale BEST describes why this assessment
was chosen for this client? - correct answer map nerve repair and test receptor
density
Prior to establishing an intervention plan, the OTR should - correct answer complete
an occupational profile and assessment, assess client pain and determine the amount
of caregiver support available after discharge.
To determine therapy goals, the OTR should - correct answer consider a guiding
theory and work with the client to determine goals.
Before discharge the OTR will - correct answer assess the ability of the caregiver to
safely assist in transfers and provide recommendations for home safety.
During a home care session, a client with Alzheimer disease describes to the OTR an
event where the client drove to the grocery store and had difficulty finding the way
home. What is the MOST APPROPRIATE way for the OTR to respond? - correct
answer perform an assessment to determine a client's driving safety
An OTR is preparing to evaluate a client with low vision. Before the client arrives to the
clinic, the OTR reviews the chart and prepares for the evaluation. Which definition
BEST describes low vision? - correct answer bilateral vision impairment that is unable
to be corrected medically, surgically, or by refraction (the use of glasses or contacts)
A client with an extensive history of alcohol abuse is referred for an occupational
therapy evaluation. What type of assessment is MOST APPROPRIATE for the OTR to
choose? - correct answer Occupational performance, self-efficacy, and role
competence are most appropriate to assess in order to construct the client's
occupational profile and collaborate to develop meaningful and realistic goals.
,An OTR is discussing home modifications to allow a 35-year-old client to return home
after sustaining a C8 spinal cord injury. The client lives at home with two children,
spouse, and elderly mother-in-law. Which of the following home modifications reflect the
principles of universal design? - correct answer Installing a toilet seat with a switch to
adjust it to a comfortable height
An OTR is fabricating a splint for a client with median nerve injury. What position should
be avoided to protect the client's wrist and hand? - correct answer
Metacarpophalangeal hyperextension
A splint for a median nerve injury should prevent - correct answer hyperextension due
to the unopposed pull of the extensor digitorum communis, which is innervated by the
radial nerve.
An OTR is conducting a feeding evaluation in a family's home. The OTR observes the
child stuffing solid food into the mouth during feeding. The parents seem worried that
the child will choke due to the overstuffing behavior. Which feeding issue is the child
most likely experiencing? - correct answer oral hyposensitivity, tends to lack sensory
awareness in the mouth
An OTR is working with a 2.5-year-old child in an early intervention program who was
premature at 25 weeks gestation. The child presents to occupational therapy with upper
extremity weakness and poor grasping. The child's mother would like for the child to
self-feed independently. Currently, the child does not use a spoon and relies on finger
feeding using a raking grasp. The meal process is slow and the mother continues to
feed the child in order to meet nutritional needs. Which is the MOST APPROPRIATE
intervention to promote self-feeding independence? - correct answer A light-weight,
built-up handle on the spoon or universal cuff
Diabetic retinopathy - correct answer occurs when the small blood vessels in the
retina develop swelling or bleeding, resulting in loss of vision. Impacts all aspects of
visual functioning, including loss of central vision, loss or peripheral vision, loss of color
vision, decreased night vision, and fluctuations in vision.
10-year-old child with cerebral palsy is working in the classroom on signing work. The
OTR has been facilitating written name production during direct intervention times;
however, the task is tedious and frustrating to the child. The OTR has consulted with the
teacher and decided to incorporate some adaptive equipment to provide positive
feedback to the child as well as identify the child's work. Which is the MOST appropriate
adaptive equipment to use with this child? - correct answer name stamp
,A client with left homonymous hemianopsia following a cerebrovascular accident is
experiencing difficulty with reading. Previously, the client enjoyed reading novels,
newspapers, and magazines. Which is the MOST EFFECTIVE intervention to promote
the client's return to reading? - correct answer A vertical line on the left side of the
page
An OTR is working with a 12-year-old child diagnosed with emotional disturbance. The
child has a history of being off task, poor social skills, and becoming overly upset about
things when something does not go as anticipated. The child attends middle school and
the teacher reports that the child has difficulty following directions, completing
schoolwork, and has frequent outbursts resulting in visits to the principal's office. What
intervention or strategy is MOST EFFECTIVE for improving school behavior and
performance? - correct answer A token economy or contingency method to reinforce
cooperation and task completion
The OTR is planning an INITIAL intervention session with a client who is in the acute
manic phase of bipolar disorder. Which intervention strategy is MOST IMPORTANT to
achieve maximum participation? - correct answer provide an environment with
minimal distractions
A client has been receiving OT in an outpatient rehabilitation center for six weeks and is
at the end of the plan of care. The client is preparing to return to work in a busy legal
firm with multiple demands. Which goal area would be MOST APPROPRIATE for the
OTR to implement in order to prepare the client for return to work? - correct answer
Work hardening
A client attends a group intervention program to address substance abuse. The client is
aware that the number of therapy sessions are limited. Which is the MOST
BENEFICIAL assessment for the OTR to conduct with this client based on the limited
number of sessions? - correct answer Use a tool that Allows the client to self-identify
occupational challenges
An OTR is fabricating a splint for a client who sustained radial nerve damage from a
motor vehicle crash. Based on the nerve injury, which is the BEST position for the splint
to place the wrist and hand during the healing phase? - correct answer To reduce
flexion and overstretching of the extensor tendons, the splint should support the wrist,
metacarpophalanges, and thumb in extension, placing the hand in functional position.
, Which of the following approaches is MOST APPROPRIATE for a client with edema of
the upper extremity? - correct answer biomechanical approach (massage,
compression, and active range of motion)
Which of the following movements allows the OTR to evaluate the strength and control
of the client's trunk flexors? - correct answer The client leans backwards and holds
the position, then forward to sit up
A client diagnosed with depression and anorexia nervosa attends an evening support
group for 90 minutes each week. The client reports limited occupational engagement.
The OTR collaborates with the client to develop a plan to increase involvement in
avocational activities. The client expresses interest in exercise and volunteerism. In high
school, the client was captain of the swim team, played tennis, and worked in an after-
school program for young children. Which is the MOST APPROPRIATE activity for the
client to explore? - correct answer local elementary school for volunteer opportunities
An OTR is planning treatment sessions for adolescents diagnosed with eating disorders
in an outpatient, voluntary community mental health complex. Which goal is MOST
IMPORTANT to address INITIALLY? - correct answer Increasing self-awareness with
expressive activities
OTR is working with an adult with a substance abuse disorder in a community-based
setting. The client has maintained sobriety for 1 year; however, the evaluation results
indicate that the client has inadequate adaptive skills, poor hygiene, and low self-
esteem. What INITIAL goal is MOST BENEFICIAL to include in the intervention plan to
improve occupational performance and participation? - correct answer acquisition of
basic life skills for greater independence
A client is recovering from a recent exacerbation of congestive heart failure. The client
has a history of coronary artery disease and is diagnosed with class III cardiovascular
disability using the Specific Activity Scale. The client was referred to occupational
therapy to increase independence with instrumental activities of daily living. Which of
the following instrumental activities of daily living can the OTR INITIALLY include in the
plan of care? - correct answer Making the bed (2 METS)
The definition of low vision is bilateral vision impairment that is unable to be - correct
answer corrected medically, surgically, or by refraction (the use of glasses or
contacts).
