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NBCOT COTAFree Certified Occupational Therapy Assistant practice test
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10 real NBCOT COTA practice questions with instant answers and explanations — no account, no credit card, no email. Score yourself, then unlock the full bank of 800 questions whenever you’re ready. The NBCOT COTA passing score is Scaled score of 450 (on a 300-600 scale).
A COTA is teaching a client with a total hip replacement to don pants using a reacher. Which precaution should the COTA reinforce?
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All 10 NBCOT COTA questions & answers
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Q1. A COTA is teaching a client with a total hip replacement to don pants using a reacher. Which precaution should the COTA reinforce?
Correct answer: A. Avoid hip flexion beyond 90 degrees
Standard posterior total hip precautions include avoiding hip flexion beyond 90 degrees, adduction past midline, and internal rotation to prevent dislocation.
Q2. Which adaptive equipment is most appropriate for a client with limited grip strength who has difficulty opening jars in the kitchen?
Correct answer: B. Jar opener with rubber grip
A jar opener with a rubber grip provides increased leverage and friction, compensating for reduced grip strength.
Q3. During a therapeutic activity to improve fine motor coordination in a client recovering from a stroke, the COTA notices the client fatiguing quickly. What is the best immediate action?
Correct answer: C. Grade the activity down by reducing repetitions or resistance
Grading down the activity (fewer reps, less resistance) allows the COTA to adjust treatment in real time within the established plan while maintaining client safety and engagement.
Q4. A COTA is implementing a sensory approach for a child who is tactile defensive. Which activity is most appropriate to begin with?
Correct answer: D. Deep pressure input through joint compressions
Deep pressure input is generally better tolerated by tactile defensive clients than light, unpredictable touch, which can be perceived as noxious.
Q5. When implementing a joint protection program for a client with rheumatoid arthritis, which instruction is correct?
Correct answer: A. Push open heavy doors with the palm rather than the fingers
Joint protection principles favor using larger, stronger joints and open palms to distribute force away from smaller, more vulnerable joints.
Q6. A COTA is working with a client on functional transfers from wheelchair to bed. The client begins to lose balance mid-transfer. What should the COTA do first?
Correct answer: B. Guide the client back to a seated, stable position
The immediate priority is to safely return the client to a stable seated position to prevent a fall; the gait belt should be used to assist, not released.
Q7. A COTA is treating a client with a C6 spinal cord injury who is learning to use a tenodesis grasp for feeding. Which statement best reflects appropriate handling by the COTA?
Correct answer: C. Encourage active wrist extension to passively close the fingers into a grasp
Tenodesis grasp relies on active wrist extension to passively flex the fingers, creating a functional grasp pattern for clients with limited hand innervation after a C6 injury.
Q8. Which of the following is an example of a compensatory approach to intervention?
Correct answer: D. Teaching one-handed shoe tying techniques after a stroke
Compensatory approaches teach alternative methods to complete tasks despite an impairment, such as one-handed techniques, rather than attempting to restore the underlying deficit.
Q9. A COTA is preparing a cooking activity for a client with low vision as part of an IADL intervention. Which environmental modification is most appropriate?
Correct answer: A. Use high-contrast colored cutting boards and containers
High-contrast colors improve visibility of objects against backgrounds for clients with low vision; consistent organization, not frequent rearranging, supports independence.
Q10. A COTA is using a hand-over-hand technique with a client with severe dementia during a dressing task. This is an example of which type of cueing?
Correct answer: B. Tactile or physical cueing
Hand-over-hand assistance provides direct physical guidance, often the most effective cueing level for clients with severe cognitive impairment.
Exam facts and objectives sourced from the official NBCOT certification page. Last reviewed June 2026.
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