214 practice questions for the NBCOT COTA exam, the certification exam for occupational therapy assistants, split the way the 2022 COTA content outline splits the real test: collaborate and gather information 27%, select and implement interventions 55%, uphold professional standards and responsibilities 18%. They are written the way a COTA works: gather data and contribute to the evaluation within service competency, carry out the OTR's intervention plan, grade the activity in the session, and know when to stop and tell the supervising OTR. Some are six-option multi-select questions where you pick the three best, like the real exam's. Every question carries its outline task, so your score report shows the tasks you miss. We wrote every question ourselves and each answer names its public source. A study aid, not clinical guidance.
The real test: 190 questions in 4 hours at a Pearson VUE test center: single-answer multiple choice plus stand-alone multi-select questions where you pick the three best of six (no scenario sets). Scored 300 to 600; 450 passes. Our practice test is 95 questions in 120 minutes split by the three COTA outline domains (27/55/18), with a 70% practice mark.
Here: 214 questions. Our own practice questions, with every fact cited to a public source (CDC, NIH, HHS, CMS, SAMHSA, OSHA, the ADA Standards, IDEA, FDA labeling, published clinical guidelines and studies; anatomy checked against OpenStax Anatomy and Physiology 2e, CC BY 4.0). Topics are the three domains and 15 tasks of the NBCOT 2022 COTA content outline. Not the exam's questions. Free.
Uphold Professional Standards and Responsibilities
~17
40
"On the test" is the rough share of a 95-question test for each topic, following the exam's published weights.
10 sample questions
Two weeks after a right-hemisphere stroke, a client grooms at the sink. Which observation is MOST consistent with the expected perceptual deficit?
A.She shaves and combs only the right side of her head and face
B.She grooms both sides slowly and then rereads the written steps taped to the mirror
C.She cannot name the razor or the comb when the therapist holds each one up
D.She uses the comb on her teeth, then tries to brush her hair with the toothbrush
Show answer
A. She shaves and combs only the right side of her head and face
COTA-1 · Collaborate and Gather Information
A client with stiff, healed hand fractures is scheduled for paraffin before range of motion. Which finding means paraffin should NOT be used today?
A.An open, draining cut on the back of the hand
B.A history of osteoarthritis in the same fingers
C.A wedding ring she took off before treatment
D.Mild stiffness that eases after a few minutes
Show answer
A. An open, draining cut on the back of the hand
COTA-41 · Select and Implement Interventions
A clinic finds that clients often miss home exercise programs. Staff try a text reminder for one month, measure adherence, then adjust and test again. Which quality method is this?
A.A root cause analysis after a sentinel event
B.A randomized controlled trial
C.A Plan-Do-Study-Act cycle
D.A retrospective chart audit only
Show answer
C. A Plan-Do-Study-Act cycle
COTA-91 · Uphold Professional Standards and Responsibilities
After a left-hemisphere stroke, a client brushes his teeth without trouble every morning but cannot show the therapist how he would brush his teeth when asked to pretend. This pattern is BEST described as:
A.Expressive aphasia
B.Ideomotor apraxia
C.Left unilateral neglect of the near personal space and the body
D.Ideational apraxia, a loss of the idea of what each tool is for
Show answer
B. Ideomotor apraxia
COTA-2 · Collaborate and Gather Information
A moist hot pack is applied to a client's upper back before a reaching task. What is the safest practice?
A.Leave it on for 45 minutes so the tissue warms all the way through first
B.Place it directly on bare skin so the heat reaches deeper muscle quickly
C.Have the client lie on top of the pack so it stays in full contact longer
D.Wrap it in several layers of towel and check the skin after about 5 minutes
Show answer
D. Wrap it in several layers of towel and check the skin after about 5 minutes
COTA-42 · Select and Implement Interventions
A senior center asks an OT to start an evidence-based program to reduce fear of falling among members. Which program fits this request?
A.A walking club with no balance or education content
B.A Matter of Balance, a structured small-group program
C.A brochure about falls placed at the front entrance
D.A one-time lecture about the danger of falls at home
Show answer
B. A Matter of Balance, a structured small-group program
COTA-92 · Uphold Professional Standards and Responsibilities
A client with Parkinson's disease says his checks are being returned by the bank. Which feature of the disease BEST explains this?
A.Loss of the ability to recognize printed letters while the motor output stays intact
B.Intention tremor that grows larger as the pen nears the signature line
C.Handwriting that starts normal and gets smaller and more cramped across the line
D.A sudden drop in blood pressure that comes on when he sits up at the desk
Show answer
C. Handwriting that starts normal and gets smaller and more cramped across the line
COTA-3 · Collaborate and Gather Information
Which client condition is a contraindication to applying an ice pack?
A.Pain after a therapy session for a stiff elbow
B.Raynaud's phenomenon in the treated hand
C.Acute swelling after a wrist sprain yesterday
D.Muscle spasm in the upper back after lifting
Show answer
B. Raynaud's phenomenon in the treated hand
COTA-43 · Select and Implement Interventions
A therapist leaves the room of a client with Clostridioides difficile infection. How should she clean her hands?
A.Alcohol hand rub, since it works better than soap and water here
B.Soap and water, since alcohol rub doesn't kill the spores
C.A quick rinse with water, since soap irritates skin
D.Gloves alone, since glove use replaces hand hygiene
Show answer
B. Soap and water, since alcohol rub doesn't kill the spores
COTA-93 · Uphold Professional Standards and Responsibilities
A client with multiple sclerosis reports that her vision blurs and her legs feel heavier after a hot shower, then improves an hour later. What should the therapist understand about this?
A.It signals a new relapse that needs emergency imaging before any further therapy
B.Raised body temperature can temporarily worsen MS symptoms without new damage
C.It is a side effect of dehydration and is unrelated to the disease process itself
D.It shows her disease has turned primary progressive and will no longer remit
Show answer
B. Raised body temperature can temporarily worsen MS symptoms without new damage