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NBCOT Midterm Problem Solving Exam Questions and certified for accuracy solutions; updated 2025/2026

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NBCOT Midterm Problem Solving Exam Questions and certified for accuracy solutions; updated 2025/2026 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 - correct 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 - correct 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 - correct 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 - correct 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)

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NBCOT Midterm Problem Solving Exam Questions
and certified for accuracy solutions; updated
2025/2026

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 - correct 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 - correct 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 - correct 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 - correct 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)


A 7-year-old child is diagnosed with attention deficit hyperactivity disorder
(ADHD). An etiology for ADHD would be:

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