COTA EXAM PREP: PURPLE BOOK
QUESTIONS AND CORRECT
ANSWERS
The child being observed is preforming dressing activity which is age appropriate for a 5 y/o child. A
typical child at this age can dress unsupervised and is able to tie and untie knots, but generally does
not know how to tie a bow independently.
In administering an assessment of finger-tip pinch strength, the OT practitioner would instruct the
individual being tested to place his or her fingers in which position?
a. Thumb against the tip of the index finger
b. Thumb against the side of the index finger
c. Thumb against the tips of the index and middle fingers
d. Thumb against the tips of all the fingers at once ✅✅ANSW-a. Thumb against the tip of the
index finger
The correct position for tip pinch is the thumb against the tip of the index finger. The thumb against
the side of the index finger describes the position for lateral inch. The thumb against the tip of the
index and middle fingers describes the test position for three jaw chuck, or palmar pinch. The thumb
against the tips of all the fingers is not a standard test position.
The OT treatment approach that will MOST likely meet the overall needs experienced by individuals
with substance abuse problems is to:
a. Assist with skill development in the areas of leisure, self-expression and ADLs
b. Educate the family members about making safety modifications to the kitchen area
c. Encourage AA involvement, address personal appearance, and issues of loss
d. Make aftercare arrangements for vocational counseling and AA; provide time management
education for self-care activities ✅✅ANSW-a. . Assist with skill development in the areas of
leisure, self-expression and ADLs
In general, the areas of focus with OT intervention for individuals identified with substance abuse
problems are alternative leisure time use, improved expression of feeling, and the acquiring of social
and occupational roles. The approach described in answer B addresses the cognitive disability frame
of reference approach, Answers C and D my address specific needs of the patient, but the overall
needs of this population.
,In assessing the dressing skills of a 5 y/o child, the COTA observes that the child is able to put on a
jacket, zip the zipper, and tie a knot in the draw string, but needs verbal cueing to tie the bow. The
COTA would MOST likely determine that the child's dressing skills are:
a. Age appropriate
b. Delayed
c. Advanced
d. Limited ✅✅ANSW-a. Age appropriate
A COTA observes that a 10-month old child is able to sit alone by propping himself forward on his
arms, but consistently loses his balance when reaching for a toy. His behavior most likely indicates:
a. a developmental delay.
b. unintegrated primitive reflexes.
c. normal development.
d. advanced development. ✅✅ANSW-a. a developmental delay.
Typically developing children (answer c) should be able to sit unsupported for several minutes by the
age of 8 to 9 months; therefore, this child demonstrates delayed development (answer A) The ability
to sit while propped forward on his arms indicates primitive reflexes have been integrated (answer
b). Sitting unsupported earlier than 8 months could indicated advanced development (answer D).
An individual demonstrates the ability to pick up a penny from a flat surface. this represents which
of the following prehension patterns?
a. lateral
b. palmar
c. tip
d. three-jaw chuck ✅✅ANSW-c. Tip
Tip prehension is accomplished by flexing the IP joint of the thumb, and the PIP and DIP joints of the
finger, and bringing the tips of the thumb and finger together. This type of prehension is used to pick
up objects such as a pin, nail, or coin. Lateral prehension (answer A) is formed by positioning the pad
of the thumb against the radial side of the finger. This prehension pattern is used for holding a pen,
utensil or key. Palmar prehension (answer b), also known as three-jaw chuck (answer d), is formed
by positioning the thumb in opposition to the tips of the index and middle fingers, forming a pad-to-
pad opposition. This form of prehension is commonly used to lift objects from a flat surface and to
tie a shoelace.
When conducting a structured interview, it is MOST important for the OT practitioner to:
a. rephrase the interview questions in his or her own words.
b. ask questions that he or she thinks are pertinent to this patient.
,c. ask the question as they are stated on the interview sheet.
d. ask additional questions(other than those listed) to gain further insight into the patient.
✅✅ANSW-c. ask the questions as they are stated on the interview sheet.
A structured interview requires following the procedure, order, and wording of the questions to be
asked, Answers a, b, and d are appropriate for semistructured interviews .
A 3 y/o child demonstrates the ability to use the toilet independently except for wiping and
readjusting clothing afterward. This behavior indicates the child is performing at which of the
following levels?
a. significantly below age level
b. slightly below age level
c. at age level
d. above age level ✅✅ANSW-c. at age level
At 3 y/o age a child is expected to know when her or she has t use the toilet and be able to get on
and off the toilet. 3 y/o children may need assistance to cleanse themselves effectively and to
manage fasteners or difficult clothing. Complete independence in using the toilet (answer d) is
usually achieved by the age of 4 to 5 y/o. By the age of 2 (answer b), most children have daytime
control over elimination with occasional accidents, so thy still need to be reminded to go to the
toilet. One y/o infants (answer a) indicate discomfort when wet or soiled.
The COTA is observing dressing skills in an individual with COPD. While putting on his shirt, the
individual becomes short of breath and stops to rest before finishing with that shirt and going on to
his trousers. This behavior MOST likely indicates a deficit in:
a. postural control
b. muscle tone
c. strength
d. endurance ✅✅ANSW-d. endurance
A deficit in endurance is demonstrated by the individual's inability to sustain cardiac pulmonary, and
musculoskeletal exertion for the duration of the activity. Answer a a deficit in postural control,
would be correct if the client had been unable to maintain his balance while putting on the shirt. A
deficit in muscle tone (answer b) would have been evident if the client had demonstrated spasticity
while putting on the shirt. Inability to push his arm through the resistance of the shirt sleeve would
demonstrate a deficit in strength (answer c).
An individual with the goal of increasing attention span is frequently observed watching the person
next to her instead of performing her assigned task, This behavior MOST likely indicates a problem
with:
, a. memory.
b. spatial operations.
c. generalization of learning.
d. distractibility. ✅✅ANSW-d. distractibility
Distractibility involves losing ones focus because of other stimuli. Memory (answer a) is the ability to
recall knowledge and past events. Problems with spatial operations (answer b) are generally
observed when individuals attempt to fit objects into specific spaces. Generalization of learning
(answer c) may be observed by asking the client to use existing knowledge in a new situation.
In screening a child who has been referred to OT, the PRIMARY goal of the OT practitioner is to:
a. obtain necessary information for an occupational therapy consultation with teachers or parents.
b. test a wide variety of developmental behaviors
c. establish and information base for the occupational therapy treatment plan.
d. determine the need for further evaluation. ✅✅ANSW-d. determine the need for further
evaluation.
The purpose of screening is to determine whether further assessments are needed and if so which
tests would be appropriate for the child a screening test is not designed for planning programs
(answer c) or consultation (answer a) and they do not test any skills (answer b) in a comprehensive
way.
A COTA is working with and individual who is unable to name or demonstrate the use of common
household objects. This behavior MOST likely indicates:
a. apraxia
b. stereognosis
c. visual agnosia
d. alexia ✅✅ANSW-c. visual agnosia
Visual agnosia is the inability to recognize common objects and demonstrate their use in an activity.
Apraxia (answer a) is the inability to perform purposeful movement on command. A person with
alexia (answer d) is unable to understand written language. Stereognosis (answer b) is the ability to
identify an object by manipulating it with the fingers without seeing it.
When reporting data collected to the OTR, it is MOST important for the COTA to:
a. observe everything the patient said and did during the interview and provide extensive notes for
the OTR to read.
b. provide the OTR with a comprehensive treatment plan based on the results of the evaluation.
QUESTIONS AND CORRECT
ANSWERS
The child being observed is preforming dressing activity which is age appropriate for a 5 y/o child. A
typical child at this age can dress unsupervised and is able to tie and untie knots, but generally does
not know how to tie a bow independently.
In administering an assessment of finger-tip pinch strength, the OT practitioner would instruct the
individual being tested to place his or her fingers in which position?
a. Thumb against the tip of the index finger
b. Thumb against the side of the index finger
c. Thumb against the tips of the index and middle fingers
d. Thumb against the tips of all the fingers at once ✅✅ANSW-a. Thumb against the tip of the
index finger
The correct position for tip pinch is the thumb against the tip of the index finger. The thumb against
the side of the index finger describes the position for lateral inch. The thumb against the tip of the
index and middle fingers describes the test position for three jaw chuck, or palmar pinch. The thumb
against the tips of all the fingers is not a standard test position.
The OT treatment approach that will MOST likely meet the overall needs experienced by individuals
with substance abuse problems is to:
a. Assist with skill development in the areas of leisure, self-expression and ADLs
b. Educate the family members about making safety modifications to the kitchen area
c. Encourage AA involvement, address personal appearance, and issues of loss
d. Make aftercare arrangements for vocational counseling and AA; provide time management
education for self-care activities ✅✅ANSW-a. . Assist with skill development in the areas of
leisure, self-expression and ADLs
In general, the areas of focus with OT intervention for individuals identified with substance abuse
problems are alternative leisure time use, improved expression of feeling, and the acquiring of social
and occupational roles. The approach described in answer B addresses the cognitive disability frame
of reference approach, Answers C and D my address specific needs of the patient, but the overall
needs of this population.
,In assessing the dressing skills of a 5 y/o child, the COTA observes that the child is able to put on a
jacket, zip the zipper, and tie a knot in the draw string, but needs verbal cueing to tie the bow. The
COTA would MOST likely determine that the child's dressing skills are:
a. Age appropriate
b. Delayed
c. Advanced
d. Limited ✅✅ANSW-a. Age appropriate
A COTA observes that a 10-month old child is able to sit alone by propping himself forward on his
arms, but consistently loses his balance when reaching for a toy. His behavior most likely indicates:
a. a developmental delay.
b. unintegrated primitive reflexes.
c. normal development.
d. advanced development. ✅✅ANSW-a. a developmental delay.
Typically developing children (answer c) should be able to sit unsupported for several minutes by the
age of 8 to 9 months; therefore, this child demonstrates delayed development (answer A) The ability
to sit while propped forward on his arms indicates primitive reflexes have been integrated (answer
b). Sitting unsupported earlier than 8 months could indicated advanced development (answer D).
An individual demonstrates the ability to pick up a penny from a flat surface. this represents which
of the following prehension patterns?
a. lateral
b. palmar
c. tip
d. three-jaw chuck ✅✅ANSW-c. Tip
Tip prehension is accomplished by flexing the IP joint of the thumb, and the PIP and DIP joints of the
finger, and bringing the tips of the thumb and finger together. This type of prehension is used to pick
up objects such as a pin, nail, or coin. Lateral prehension (answer A) is formed by positioning the pad
of the thumb against the radial side of the finger. This prehension pattern is used for holding a pen,
utensil or key. Palmar prehension (answer b), also known as three-jaw chuck (answer d), is formed
by positioning the thumb in opposition to the tips of the index and middle fingers, forming a pad-to-
pad opposition. This form of prehension is commonly used to lift objects from a flat surface and to
tie a shoelace.
When conducting a structured interview, it is MOST important for the OT practitioner to:
a. rephrase the interview questions in his or her own words.
b. ask questions that he or she thinks are pertinent to this patient.
,c. ask the question as they are stated on the interview sheet.
d. ask additional questions(other than those listed) to gain further insight into the patient.
✅✅ANSW-c. ask the questions as they are stated on the interview sheet.
A structured interview requires following the procedure, order, and wording of the questions to be
asked, Answers a, b, and d are appropriate for semistructured interviews .
A 3 y/o child demonstrates the ability to use the toilet independently except for wiping and
readjusting clothing afterward. This behavior indicates the child is performing at which of the
following levels?
a. significantly below age level
b. slightly below age level
c. at age level
d. above age level ✅✅ANSW-c. at age level
At 3 y/o age a child is expected to know when her or she has t use the toilet and be able to get on
and off the toilet. 3 y/o children may need assistance to cleanse themselves effectively and to
manage fasteners or difficult clothing. Complete independence in using the toilet (answer d) is
usually achieved by the age of 4 to 5 y/o. By the age of 2 (answer b), most children have daytime
control over elimination with occasional accidents, so thy still need to be reminded to go to the
toilet. One y/o infants (answer a) indicate discomfort when wet or soiled.
The COTA is observing dressing skills in an individual with COPD. While putting on his shirt, the
individual becomes short of breath and stops to rest before finishing with that shirt and going on to
his trousers. This behavior MOST likely indicates a deficit in:
a. postural control
b. muscle tone
c. strength
d. endurance ✅✅ANSW-d. endurance
A deficit in endurance is demonstrated by the individual's inability to sustain cardiac pulmonary, and
musculoskeletal exertion for the duration of the activity. Answer a a deficit in postural control,
would be correct if the client had been unable to maintain his balance while putting on the shirt. A
deficit in muscle tone (answer b) would have been evident if the client had demonstrated spasticity
while putting on the shirt. Inability to push his arm through the resistance of the shirt sleeve would
demonstrate a deficit in strength (answer c).
An individual with the goal of increasing attention span is frequently observed watching the person
next to her instead of performing her assigned task, This behavior MOST likely indicates a problem
with:
, a. memory.
b. spatial operations.
c. generalization of learning.
d. distractibility. ✅✅ANSW-d. distractibility
Distractibility involves losing ones focus because of other stimuli. Memory (answer a) is the ability to
recall knowledge and past events. Problems with spatial operations (answer b) are generally
observed when individuals attempt to fit objects into specific spaces. Generalization of learning
(answer c) may be observed by asking the client to use existing knowledge in a new situation.
In screening a child who has been referred to OT, the PRIMARY goal of the OT practitioner is to:
a. obtain necessary information for an occupational therapy consultation with teachers or parents.
b. test a wide variety of developmental behaviors
c. establish and information base for the occupational therapy treatment plan.
d. determine the need for further evaluation. ✅✅ANSW-d. determine the need for further
evaluation.
The purpose of screening is to determine whether further assessments are needed and if so which
tests would be appropriate for the child a screening test is not designed for planning programs
(answer c) or consultation (answer a) and they do not test any skills (answer b) in a comprehensive
way.
A COTA is working with and individual who is unable to name or demonstrate the use of common
household objects. This behavior MOST likely indicates:
a. apraxia
b. stereognosis
c. visual agnosia
d. alexia ✅✅ANSW-c. visual agnosia
Visual agnosia is the inability to recognize common objects and demonstrate their use in an activity.
Apraxia (answer a) is the inability to perform purposeful movement on command. A person with
alexia (answer d) is unable to understand written language. Stereognosis (answer b) is the ability to
identify an object by manipulating it with the fingers without seeing it.
When reporting data collected to the OTR, it is MOST important for the COTA to:
a. observe everything the patient said and did during the interview and provide extensive notes for
the OTR to read.
b. provide the OTR with a comprehensive treatment plan based on the results of the evaluation.
