2023 Edition

Occupational Therapist Practice Test

Take this free occupational therapist practice test to get an idea of what is on the NBCOT exam. 

The NBCOT certification exam tests the requisite knowledge, skills and abilities essential to occupational therapists and occupational therapy students. Certification in addition to any state licensure requirements are the key to career success in the occupational therapy field.

The actual exam tests your knowledge, skills and abilities in the areas of: Evaluation and Assessment; Analysis and Interpretation; Intervention Management; and Competency and Practice Management with a total of 3 clinical simulation test (CST) items and 170 multiple choice questions. The total time of the test is four hours.


1. A therapist is evaluating a twelve-month-old in a clinical setting. Which of the following milestones are unlikely to have emerged?
2. A complete T5 spinal cord injury client is referred for an occupational therapy evaluation. What is most important to assess in this client?
3. A young adult client in a psychiatric rehabilitation unit has declined participation in group and individual activities. Which assessment should the occupational therapist select to gain baseline data about the client's roles and use the results to create motivating goals?
4. An occupational therapist evaluates a five-month-old who was born at 34 weeks gestation and stayed 3 weeks in the NICU. The therapist holds the infant under his shoulders in a vertical plane. The infant positions his head upright when she tilts the baby to the front, side, and back. Which positive reflex is the infant demonstrating?
5. A supervisor asks her level II fieldwork student in a mental health placement to view a client case with the Ecology of Human Performance (EHP) Model as a frame of reference. Which intervention method best represents this model?
6. An occupational therapist who works in an outpatient clinic evaluates an individual who works in a call center. The patient reports tingling and numbness in her right forearm and hand after reaching for her desktop phone multiple times per day. Which test should the occupational therapist perform?
7. A home health occupational therapist is evaluating an 82-year-old man with dementia. Which of the following is MOST essential to assess so that the therapist can make appropriate recommendations for activity participation between therapy sessions?
8. Sam, a 30-year-old, is being evaluated following an exacerbation of multiple sclerosis symptoms. The occupational therapist plans to create a thorough occupational profile with an expanded focus on performance skills. Which of the following is an example of a performance skill?


9. Sara is a five-year-old in a preschool setting. She was recently evaluated for occupational therapy and scored two deviations below the mean on a standardized test measuring visual-motor skills. What would be an appropriate goal given this information?
10. While peer-reviewing a coworker's documentation, an OT reviews a goal about an older client s/p hip fracture who had a recent fall. It states: "Carla will transfer to and from her toilet, given a walker and grab bars, with minimum assistance in 4/4 trials within three days." Which SMART goal criteria is lacking in this goal?
11. An occupational therapist is planning treatment for an adolescent with an intellectual disability. The client shared that he would like to use public transportation to get groceries by himself. Which of the following interventions would NOT be appropriate for this client?
12. A school-based occupational therapist consults with a teacher about an eight-year-old recently diagnosed with autism spectrum disorder and is in the school's RTI (response to intervention) program. The teacher explains that she is concerned about his short-term attention span, lack of positive interaction with peers, and sensory-seeking behavior. Which Tier 2 setting would be most appropriate for the therapist to conduct intervention?
13. An occupational therapist creates goals for an adolescent softball pitcher who has a suspected overuse injury. Which goal is most appropriate?
14. An occupational therapist is providing recommendations to a school team following a sensory assessment of a 6-year-old student named Kevin. The student is overresponsive to auditory and tactile input and seeks proprioceptive input. Which accommodation would be appropriate to support Kevin's classroom participation?
15. An occupational therapist recently evaluated Mr. Garcia, an older gentleman who has experienced age-related musculoskeletal degeneration. He recently used a rolling walker but can no longer transfer from sit to stand without supervision. The occupational therapist has no concerns about Mr. Garcia's cognition. Given this information, which wheelchair would be most appropriate?

Intervention Management

16. A therapist is selecting a physical agent modality for a patient with Raynaud's disease ahead of preparing a meal. Which modality is contraindicated?
17. A preschooler is receiving push-in OT services in their early education classroom. When a fire alarm goes off, the child starts screaming and running in circles around the classroom. From a sensory perspective, which tool could the therapist use at that moment?
18. A 44-year-old woman recently fell on ice, resulting in a Colles fracture. The fracture is healed, but she now presents with complex regional pain syndrome in the affected wrist and hand. Which of the following interventions is NOT indicated?
19. An entry-level occupational therapist in a rehabilitation center is assessing a patient with an L1 spinal cord injury. While conducting the interview portion of the evaluation, the OT discovers that the patient is interested in resuming sexual activity. Which of the following interventions is appropriate for an entry-level OT to provide?
20. An occupational therapist is consulting with an architecture company about designing a new community building. They need to construct a ramp that raises the user 16 inches. In order to ensure this building is accessible, the occupational therapist should recommend which of the following wheelchair ramps?
21. An occupational therapist is providing fall prevention education to the staff at a long-term care facility. Which of the following client factors puts residents at risk for falls?
22. Melissa, an outpatient client, and transcriptionist with a history of carpal tunnel syndrome, has transferred to a job that involves working remotely. She is concerned about the ergonomics of her new workstation. Which of the following recommendations is the best?
23. An occupational therapist plans to fabricate a splint for an individual with wrist drop following a radial nerve injury. Which splint is most appropriate?
24. An occupational therapist in a long-term care facility meets with the medical team about Mrs. Stevens, a new intake who had a stroke three weeks ago. In her prior setting, she was on a level two dysphagia diet due to the risk of aspiration. Which of the following should the team identify as unsafe for Mrs. Stevens?
25. A 28-year-old male with a recent above-the-elbow amputation is eager to return to driving. He has full use of his non-dominant upper extremity and is not using a prosthetic on the impaired side. Which adaptive equipment is appropriate to recommend?
26. A level II fieldwork student is working on a cardiopulmonary rehabilitation unit. While reviewing a patient chart, the student notices that the patient can participate in MET level 2 activities. Which therapeutic intervention is appropriate for the student to select?

Competency and Practice Management

27. A patient in an acute care setting becomes unresponsive following a transfer to her hospital bed. What should the occupational therapist do first?
28. An occupational therapist in an emerging area decides to collect data in a level II empirical study. Which of the following is NOT required for the therapist to proceed?
29. A rehabilitation manager is reviewing her clinical documentation standards for the unit to ensure that they are compliant with all standards. Which of the following is not sufficient to adhere to standards for reimbursement?
30. An occupational therapist is assigned to a unit where two isolated individuals have C. diff. Which precaution is necessary for the OT when visiting the affected patient's room to limit spread to themselves and others?