Occupational Therapy Assistant Test Review

The National Board for Certification in Occupational Therapy (NBCOT) has created exams to assess the knowledge and skills of people who wish to pursue employment in this rapidly growing field. Individuals who receive NBCOT certification are considered to have all the essential qualities possessed by the most excellent practitioners. The Certified Occupational Therapy Assistant exam (NBCOT-COTA) is designed for individuals who wish to help registered occupational therapists fulfill their professional responsibilities. An Occupational Therapy Assistant will typically work in conjunction with a registered occupational therapist.

Free NBCOT-COTA Practice Test Questions

The COTA exam material covers four general tasks: obtaining information and developing a client-centered intervention plan (28% of the exam); choosing and implementing evidence-based interventions (47%); and maintaining high professional standards (20%). Exams are scored on a scale from 300 to 600. One's score is based on the number of questions answered correctly and the relative difficulty of the exam version. There is no distinction between unanswered questions and questions answered incorrectly. To pass the examination, candidates must achieve a score of at least 450. The official score report contains information about performance in each domain of the examination. The pass/fail determination, however, is based solely on the total score. The NBCOT recommends the COTA exam for individuals with between zero and three years of experience.

Occupational Therapist Exam

NBCOT-COTA Exam Questions

Free Occupational Therapy Assistant Practice Test Questions

1. A client with COPD complains that he has difficulty doing routine self-care because he gets so tired. Which of the following patient statements MOST indicates a need for education?

  1. "I use my walker when I stand at the sink so that I have support if I need it."
  2. "I keep the temperature at 70° because I feel cold a lot."
  3. "I have ordered meals from Meals on Wheels."
  4. "I try to rush and bathe, dress, cook, and clean first thing in the morning and rest afterward."

2. A 20-year-old woman with cerebral palsy has flexion contractions of the hips and knees with moderate spasticity and very limited abduction as well as occasional stress incontinence, but she plans to marry and asks advice about positioning for sexual activity. Which of the following positions is MOST likely to allow successful intercourse?

  1. Prone position flat in bed
  2. Supine position flat in bed
  3. Sitting or wheelchair position
  4. Side-lying with bolster between knees

3. The caregiver for an 80-year-old woman with advanced Alzheimer's disease states that the patient frequently chokes on food. Which of the following foods that the caregiver served the patient is LEAST likely to cause choking?

  1. A cup of coffee
  2. Moderately thick split-pea soup
  3. Soft white bread
  4. Finger foods, such as hot dogs

4. Which of the following is NOT an ergonomic risk factor?

  1. Frequency of rest periods
  2. Awkward or uncomfortable posture/position
  3. Vibrations
  4. Extremes of temperature

5. Which of the following laws requires that communities provide transportation services for the disabled, including accommodations for wheelchairs?

  1. Health Insurance Portability and Accountability Act (HIPAA)
  2. Older Americans Act (OAA)
  3. Omnibus Budget Reconciliation Act (OBRA)
  4. Americans with Disabilities Act (ADA)


  1. D: Trying to rush to do too many things upon arising is a poor strategy, because secretions pool during the night, increasing shortness of breath and intolerance to activity first thing in the morning, so delaying activities for an hour or so after arising and taking medications may increase tolerance. The patient should be taught to pace activities with periods of rest in between rather than exhausting himself by doing them in sequence without rest. Using assistive devices such as a walker, keeping room temperature at a comfortable level, and utilizing Meals On Wheels are all good strategies.
  2. D: The side-lying position with rear entry is usually the most successful to allow intercourse for a woman with flexion contractures from cerebral palsy (or arthritis). Placing a bolster between the legs may help to reduce spasticity and scissoring of the legs. To reduce the chance of stress incontinence during coitus, the patient should be advised to reduce fluid intake for about three hours prior to intercourse and to urinate immediately before to ensure that the bladder is empty. If her partner also has disabilities, then further accommodations may be needed.
  3. B: Moderately thickened liquids, such as split-pea soup, are less likely to cause choking with Alzheimer patients than thin liquids, such as coffee. Products such as Thick-It are available to add to thin liquids, but infant rice cereal and yogurt may also be used. Foods that are sticky, such as white bread and thick oatmeal, may cause an obstructive plug to form. Finger foods, such as carrot sticks and hot dogs, may choke the person if not chewed properly. The patient should be seated in the upright position while eating, and using a straw or sippy cup for liquids may help reduce choking.
  4. A: The duration of rest periods may be a factor in adapting to the work environment, but it is not an ergonomic risk factor, which includes vibrations, extremes of temperature, pronounced exertions, awkward or uncomfortable positions, repetitive activities, prolonged activities, and stressors related to contact. Faulty ergonomics frequently leads to or exacerbates neck and leg pain. The first adjustment is often to the height of the work surface and chair. Chairs should have adjustable arms and neck support, and the chair should be adjusted so that the client is in the triple-90 position: Feet are flat on the floor or a footrest with the knees flexed at 90 degrees and the hips flexed at 90 degrees.
  5. D: ADA provides the disabled, including those with mental impairment, access to employment and the community. Communities must provide transportation services for the disabled, including accommodation for wheelchairs. Public facilities (schools, museums, physician's offices, post offices, and restaurants) must be accessible, with ramps and elevators as needed. HIPAA addresses the rights of the individual related to privacy of health information. OAA provides improved access to services for older adults and Native Americans, including community services (meals, transportation, home health care, adult day care, legal assistance, and home repair). OBRA provides guidelines for nursing facilities, such as long-term care facilities.

Occupational Therapy Assistant test blueprint and breakdown

Occupational Therapy Assistant Review

Occupational Therapy Assistant Exam Study Guide with Practice Questions

NBCOT® is a registered trademark of the National Board for Certification in Occupational Therapy, Inc., which administers the NBCOT® exam. NBCOT does not endorse and is not affiliated in any way with Mometrix or its products and services.

Last Updated: 07/05/2018

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