PURPLE BOOK NBCOT EXAMINATION SCRIPT
2026 QUESTIONS WITH FULL ANSWERS
GRADED A+
◉ A client attends a work hardening program. He arrives on time for
his scheduled session but complains of sub sternal pain, discomfort
in his epigastric areas, indigestion, and nausea. What is the OTR's
MOST APPROPRIATE action?
A. Initiate the session and provide support, breaks, and
modifications as needed
B. Cancel the session and call emergency medical services
C. Cancel the session and tell the client to call his primary care
physician. Answer: B. Cancel the session and call emergency medical
services
Quiz #9
◉ A resident of a skilled nursing facility is recovering from a
gastrointestinal virus that left him severely dehydrated. He is
agitated and confused. The doctor prescribes IV fluid infusions, but
the nursing staff is concerned that the individual will pull out the
infusion line. They request that the occupational therapist provide a
restraint for this resident. What is the BEST action for the OTR to
take in this case?
,A. Provide soft fleeced mittens for the person's hands
B. Decline the referral and explain that restraints are no longer
allowed to be used in SNFs
C. Provide a lap board for when the resident is up in the wheelchair.
Answer: A. Provide soft fleeced mittens for the person's hands
Quiz #9
◉ A rheumatologist has prescribed bilateral nighttime resting hand
splints for a child who has early stage juvenile rheumatoid arthritis.
The parents ask the OTR who works at the child's school to fabricate
the splints. Despite having the disease, the child is functioning at
grade-level and is not on the OT caseload. What action should the
OTR take in response to the parents' request?
A. Schedule a time after school hours to fabricate the splints for the
child
B. Initiate an IEP indicating the child's needs for school-based OT
C. Inform the parents to schedule an appointment at an outpatient
OT clinic. Answer: C. Inform the parents to schedule an appointment
at an outpatient OT Clinic
Quiz #9
◉ An OTR who works in a skilled nursing facility frequently
provides residents with adaptive devices to improve functional
, performance. Which of the following methods is MOST EFFECTIVE
for evaluating the impact of an adaptive device for supporting the
residents' participation in occupation?
A. Tracking the number of times the client brings the device to OT
sessions
B. Having the client verbalize understanding of the functional of the
device
C. Observing the client spontaneously using the device for a variety
of activities. Answer: C. Observing the client spontaneously using the
device for a variety of activities
Quiz #9
◉ An OTR uses a neurodevelopmental (NDT) approach to reduce
spasticity in a client's upper extremities. What is the MOST
APPROPRIATE intervention technique for the OTR to incorporate
into the treatment session?
A. Wrapping the upper extremities
B. Applying tendinous pressure
C. Tendon tapping
D. Upper extremity weight bearing. Answer: D. Upper extremity
weight bearing
Quiz #9
2026 QUESTIONS WITH FULL ANSWERS
GRADED A+
◉ A client attends a work hardening program. He arrives on time for
his scheduled session but complains of sub sternal pain, discomfort
in his epigastric areas, indigestion, and nausea. What is the OTR's
MOST APPROPRIATE action?
A. Initiate the session and provide support, breaks, and
modifications as needed
B. Cancel the session and call emergency medical services
C. Cancel the session and tell the client to call his primary care
physician. Answer: B. Cancel the session and call emergency medical
services
Quiz #9
◉ A resident of a skilled nursing facility is recovering from a
gastrointestinal virus that left him severely dehydrated. He is
agitated and confused. The doctor prescribes IV fluid infusions, but
the nursing staff is concerned that the individual will pull out the
infusion line. They request that the occupational therapist provide a
restraint for this resident. What is the BEST action for the OTR to
take in this case?
,A. Provide soft fleeced mittens for the person's hands
B. Decline the referral and explain that restraints are no longer
allowed to be used in SNFs
C. Provide a lap board for when the resident is up in the wheelchair.
Answer: A. Provide soft fleeced mittens for the person's hands
Quiz #9
◉ A rheumatologist has prescribed bilateral nighttime resting hand
splints for a child who has early stage juvenile rheumatoid arthritis.
The parents ask the OTR who works at the child's school to fabricate
the splints. Despite having the disease, the child is functioning at
grade-level and is not on the OT caseload. What action should the
OTR take in response to the parents' request?
A. Schedule a time after school hours to fabricate the splints for the
child
B. Initiate an IEP indicating the child's needs for school-based OT
C. Inform the parents to schedule an appointment at an outpatient
OT clinic. Answer: C. Inform the parents to schedule an appointment
at an outpatient OT Clinic
Quiz #9
◉ An OTR who works in a skilled nursing facility frequently
provides residents with adaptive devices to improve functional
, performance. Which of the following methods is MOST EFFECTIVE
for evaluating the impact of an adaptive device for supporting the
residents' participation in occupation?
A. Tracking the number of times the client brings the device to OT
sessions
B. Having the client verbalize understanding of the functional of the
device
C. Observing the client spontaneously using the device for a variety
of activities. Answer: C. Observing the client spontaneously using the
device for a variety of activities
Quiz #9
◉ An OTR uses a neurodevelopmental (NDT) approach to reduce
spasticity in a client's upper extremities. What is the MOST
APPROPRIATE intervention technique for the OTR to incorporate
into the treatment session?
A. Wrapping the upper extremities
B. Applying tendinous pressure
C. Tendon tapping
D. Upper extremity weight bearing. Answer: D. Upper extremity
weight bearing
Quiz #9
