PURPLE BOOK NBCOT COMPREHENSIVE
SCRIPT 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉ A 3-year-old child has been referred for early intervention. In the
discussion about intervention with the family, the team should be
sure to:
A. Use lay terminology to describe the early intervention process
B. Explain conditions in detailed technical and medical terms
C. Discourage parents asking questions
D. Ignore parents' feedback and ideas on intervention Answer: A.
The team dealing with the case should use lay terminology to
describe the early intervention process and repeat information to
make sure that the parents understand. They should also welcome
parental feedback and incorporate the parents' ideas into a
suggested activity. Professionals should encourage parents to ask
questions and repeat information when necessary. Because the
language used by health care professionals is often technical and
medically related, families can easily misunderstand its meaning.
OTs and other team members must make a concerted effort to use
lay terminology to describe function, rather than neurophysiologic
components. (Occupational Therapy for Children by Case-Smith)
,◉ A 6-year-old is interested in learning to roller skate. However,
after the initial few minutes of practice the child does not continue
with it and appears to lack the will to follow up what was started.
This behavior is typical of Erik Eriksson's psychosocial development
stage that deals with:
A. Basic trust versus mistrust stage
B. Autonomy versus doubt and shame stage
C. Self-identity versus role diffusion stage
D. Security versus instability Answer: B. This stage is characterized
by holding on and letting go and is exemplified by the crisis that
occurs through the toilet-training process. This stage brings
independent movement away from the parents, enabling the child to
explore the environment. Parents must provide opportunities for the
child to make choices and develop a sense of self-controlled will.
(Occupational Therapy for Children by Case-Smith)
◉ Which one of the four components of the adaptation process
pertains to reception of sensory stimuli from internal and external
environments?
A. Assimilation
B. Accommodation
C. Association
D. Differentiation Answer: A. Assimilation is the reception of sensory
stimuli from internal and external environments. Accommodation is
the motor response to these stimuli. Association is the organized
process of relating current sensory information with the current
,motor response and then relating this relationship to past
responses. Differentiation is the process of identifying the specific
elements in a situation that are useful and relevant to another
situation to refine the responsive pattern. (Occupational Therapy for
Children by Case-Smith)
◉ A 4-year-old has been diagnosed with mental retardation. A
characteristic that is likely to occur with impaired intellectual ability
is:
A. Acceptable social skills
B. Impairment of occupational performance areas
C. Development of bizarre attachment to unusual objects
D. Poor eye contact Answer: B. A child diagnosed with mental
retardation will show significantly impaired intellectual ability,
behavioral deficits, and impairmnet of the skills required for
independence in occupational performance areas (i.e., age-
appropriate play, dressing, and communication). (Occupational
Therapy for Children by Case-Smith)
◉ A 3-year-old has accidentally ingested lead while playing near
ceramic tiles that the family bought to renovate their house. A
system that an OT working in pediatric acute care would note to be
affected by lead poisoning would be:
A. Vocal
B. Circulatory
, C. Digestive
D. Cardiac Answer: B. In lead poisoning, lead affects the circulatory
system by severely limiting the body's ability to synthesize heme,
leading to the accumulation of alternate metabolites in the body and,
ultimately, anemia. The most significant and irreversible damage
occurs in the nervous system. Fluid builds up in the brain, and
intracranial pressure can reach life-threatening levels. Cortical
atrophy and lead encephalitis can lead to mental retardation,
paralysis, blindness, and deafness. (Occupational Therapy for
Children by Case-Smith)
◉ A child with cerebral palsy shows significant impairment in the
function of the lower extremities with mild involvement of the upper
extremities. The classification of cerebral palsy for this child would
be:
A. Hemiplegia
B. Tetraplegia
C. Choreoathetosis
D. Diplegia Answer: D. In diplegia, the lower extremities are
impaired significantly, with only mild involvement of the upper
extremities. Hemiplegia involves the impairment of upper and lower
limbs on one side of the body, and tetraplegia or quadriplegia means
that all four extremities are affected. Therefore, diplegia is the
possible classification of the child's condition. (Occupational
Therapy for Children by Case-Smith)
SCRIPT 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉ A 3-year-old child has been referred for early intervention. In the
discussion about intervention with the family, the team should be
sure to:
A. Use lay terminology to describe the early intervention process
B. Explain conditions in detailed technical and medical terms
C. Discourage parents asking questions
D. Ignore parents' feedback and ideas on intervention Answer: A.
The team dealing with the case should use lay terminology to
describe the early intervention process and repeat information to
make sure that the parents understand. They should also welcome
parental feedback and incorporate the parents' ideas into a
suggested activity. Professionals should encourage parents to ask
questions and repeat information when necessary. Because the
language used by health care professionals is often technical and
medically related, families can easily misunderstand its meaning.
OTs and other team members must make a concerted effort to use
lay terminology to describe function, rather than neurophysiologic
components. (Occupational Therapy for Children by Case-Smith)
,◉ A 6-year-old is interested in learning to roller skate. However,
after the initial few minutes of practice the child does not continue
with it and appears to lack the will to follow up what was started.
This behavior is typical of Erik Eriksson's psychosocial development
stage that deals with:
A. Basic trust versus mistrust stage
B. Autonomy versus doubt and shame stage
C. Self-identity versus role diffusion stage
D. Security versus instability Answer: B. This stage is characterized
by holding on and letting go and is exemplified by the crisis that
occurs through the toilet-training process. This stage brings
independent movement away from the parents, enabling the child to
explore the environment. Parents must provide opportunities for the
child to make choices and develop a sense of self-controlled will.
(Occupational Therapy for Children by Case-Smith)
◉ Which one of the four components of the adaptation process
pertains to reception of sensory stimuli from internal and external
environments?
A. Assimilation
B. Accommodation
C. Association
D. Differentiation Answer: A. Assimilation is the reception of sensory
stimuli from internal and external environments. Accommodation is
the motor response to these stimuli. Association is the organized
process of relating current sensory information with the current
,motor response and then relating this relationship to past
responses. Differentiation is the process of identifying the specific
elements in a situation that are useful and relevant to another
situation to refine the responsive pattern. (Occupational Therapy for
Children by Case-Smith)
◉ A 4-year-old has been diagnosed with mental retardation. A
characteristic that is likely to occur with impaired intellectual ability
is:
A. Acceptable social skills
B. Impairment of occupational performance areas
C. Development of bizarre attachment to unusual objects
D. Poor eye contact Answer: B. A child diagnosed with mental
retardation will show significantly impaired intellectual ability,
behavioral deficits, and impairmnet of the skills required for
independence in occupational performance areas (i.e., age-
appropriate play, dressing, and communication). (Occupational
Therapy for Children by Case-Smith)
◉ A 3-year-old has accidentally ingested lead while playing near
ceramic tiles that the family bought to renovate their house. A
system that an OT working in pediatric acute care would note to be
affected by lead poisoning would be:
A. Vocal
B. Circulatory
, C. Digestive
D. Cardiac Answer: B. In lead poisoning, lead affects the circulatory
system by severely limiting the body's ability to synthesize heme,
leading to the accumulation of alternate metabolites in the body and,
ultimately, anemia. The most significant and irreversible damage
occurs in the nervous system. Fluid builds up in the brain, and
intracranial pressure can reach life-threatening levels. Cortical
atrophy and lead encephalitis can lead to mental retardation,
paralysis, blindness, and deafness. (Occupational Therapy for
Children by Case-Smith)
◉ A child with cerebral palsy shows significant impairment in the
function of the lower extremities with mild involvement of the upper
extremities. The classification of cerebral palsy for this child would
be:
A. Hemiplegia
B. Tetraplegia
C. Choreoathetosis
D. Diplegia Answer: D. In diplegia, the lower extremities are
impaired significantly, with only mild involvement of the upper
extremities. Hemiplegia involves the impairment of upper and lower
limbs on one side of the body, and tetraplegia or quadriplegia means
that all four extremities are affected. Therefore, diplegia is the
possible classification of the child's condition. (Occupational
Therapy for Children by Case-Smith)
