National Board for Certification in Occupational
Therapy (NBCOT) – Occupational Therapist (OTR)
Certification Exam Practice Test Questions And
Correct Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. An occupational therapist is working with a client who has had a right
hemisphere stroke. Which of the following deficits is MOST likely?
A. Aphasia
B. Left visual neglect
C. Difficulty with motor planning
D. Decreased language comprehension
Rationale: The right hemisphere controls attention and spatial processing;
left neglect is a common result of right hemisphere stroke.
2. When conducting a home safety evaluation for a client with low vision,
the therapist should FIRST:
A. Recommend contrast-colored flooring
B. Assess lighting and glare in each room
,C. Provide tactile cues on appliance dials
D. Suggest large-print labels for medications
Rationale: Lighting assessment is the foundational step in evaluating
environmental safety for low-vision clients.
3. A child with sensory processing disorder seeks constant movement. The
best therapeutic activity to meet this need is:
A. Painting
B. Listening to music
C. Swinging in a hammock
D. Sorting beads
Rationale: Swinging provides vestibular input that helps regulate sensory-
seeking behavior.
4. When teaching joint protection techniques to a client with rheumatoid
arthritis, the therapist should emphasize:
A. Applying heat before activity
B. Using larger joints to carry loads
C. Exercising to the point of fatigue
D. Using small repetitive movements
Rationale: Using larger joints reduces strain on smaller, inflamed joints
and preserves function.
,5. In the biomechanical approach, the focus of intervention is on:
A. Habits and routines
B. Range of motion, strength, and endurance
C. Task grading and adaptation
D. Role identification
Rationale: The biomechanical approach targets physical capacities to
improve occupational performance.
6. A client with spinal cord injury C6 requires assistance with self-feeding.
Which adaptive device is MOST appropriate?
A. Long straw
B. Universal cuff
C. Plate guard
D. Built-up handle
Rationale: A universal cuff allows individuals with limited hand function to
hold utensils for independent feeding.
7. The primary goal of energy conservation for clients with multiple sclerosis
is to:
A. Increase endurance through aerobic exercise
B. Prevent joint contractures
, C. Reduce fatigue during daily tasks
D. Strengthen weak muscles
Rationale: Energy conservation focuses on balancing activity and rest to
minimize fatigue.
8. During group therapy, an OT notices a client dominating discussion. The
best action is to:
A. Ignore the behavior
B. Redirect conversation to other members
C. End the session early
D. Confront the client publicly
Rationale: Redirecting maintains group cohesion and encourages equal
participation.
9. When documenting occupational performance, the most appropriate
term is:
A. Patient compliance
B. Therapy outcomes
C. Client participation in ADLs
D. Therapist intervention plan
Rationale: Occupational therapy documentation should emphasize the
client’s engagement in meaningful activities.
Therapy (NBCOT) – Occupational Therapist (OTR)
Certification Exam Practice Test Questions And
Correct Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. An occupational therapist is working with a client who has had a right
hemisphere stroke. Which of the following deficits is MOST likely?
A. Aphasia
B. Left visual neglect
C. Difficulty with motor planning
D. Decreased language comprehension
Rationale: The right hemisphere controls attention and spatial processing;
left neglect is a common result of right hemisphere stroke.
2. When conducting a home safety evaluation for a client with low vision,
the therapist should FIRST:
A. Recommend contrast-colored flooring
B. Assess lighting and glare in each room
,C. Provide tactile cues on appliance dials
D. Suggest large-print labels for medications
Rationale: Lighting assessment is the foundational step in evaluating
environmental safety for low-vision clients.
3. A child with sensory processing disorder seeks constant movement. The
best therapeutic activity to meet this need is:
A. Painting
B. Listening to music
C. Swinging in a hammock
D. Sorting beads
Rationale: Swinging provides vestibular input that helps regulate sensory-
seeking behavior.
4. When teaching joint protection techniques to a client with rheumatoid
arthritis, the therapist should emphasize:
A. Applying heat before activity
B. Using larger joints to carry loads
C. Exercising to the point of fatigue
D. Using small repetitive movements
Rationale: Using larger joints reduces strain on smaller, inflamed joints
and preserves function.
,5. In the biomechanical approach, the focus of intervention is on:
A. Habits and routines
B. Range of motion, strength, and endurance
C. Task grading and adaptation
D. Role identification
Rationale: The biomechanical approach targets physical capacities to
improve occupational performance.
6. A client with spinal cord injury C6 requires assistance with self-feeding.
Which adaptive device is MOST appropriate?
A. Long straw
B. Universal cuff
C. Plate guard
D. Built-up handle
Rationale: A universal cuff allows individuals with limited hand function to
hold utensils for independent feeding.
7. The primary goal of energy conservation for clients with multiple sclerosis
is to:
A. Increase endurance through aerobic exercise
B. Prevent joint contractures
, C. Reduce fatigue during daily tasks
D. Strengthen weak muscles
Rationale: Energy conservation focuses on balancing activity and rest to
minimize fatigue.
8. During group therapy, an OT notices a client dominating discussion. The
best action is to:
A. Ignore the behavior
B. Redirect conversation to other members
C. End the session early
D. Confront the client publicly
Rationale: Redirecting maintains group cohesion and encourages equal
participation.
9. When documenting occupational performance, the most appropriate
term is:
A. Patient compliance
B. Therapy outcomes
C. Client participation in ADLs
D. Therapist intervention plan
Rationale: Occupational therapy documentation should emphasize the
client’s engagement in meaningful activities.
