258 practice questions for the NBCOT OTR exam, the certification exam every state uses to license occupational therapists, split the way the 2022 content outline splits the real test: evaluation and assessment 23%, analysis, interpretation and planning 23%, selecting and managing interventions 38%, competency and practice management 16%. Most are clinical cases: the findings, then the best tool, plan, intervention, precaution or next step. Twelve are scenario sets like the real exam's: an opening scene, then four questions where you pick the three best of six. 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: 180 questions in 4 hours at a Pearson VUE test center: single-answer multiple choice plus multi-select scenario sets (an opening scene, then four questions where you pick the three best of six). Scored 300 to 600; 450 passes, and every state requires the certification for an OT license. Our practice test is 90 questions split by the four outline domains, with whole scenario sets and a 70% practice mark.
Here: 258 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 four domains and 16 tasks of the NBCOT 2022 OTR content outline. Not the exam's questions. Free.
"On the test" is the rough share of a 90-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 grooms both sides slowly and then rereads the written steps taped to the mirror
B.She shaves and combs only the right side of her head and face
C.She uses the comb on her teeth, then tries to brush her hair with the toothbrush
D.She cannot name the razor or the comb when the therapist holds each one up
Show answer
B. She shaves and combs only the right side of her head and face
OT-1 · Evaluation and Assessment
A child earns a standard score of 70 on a motor test with a mean of 100 and a standard deviation of 15. How far below the mean is this score?
A.Two standard deviations below the mean
B.One standard deviation below the mean
C.Within the average range for the age group
D.Thirty percentile ranks below the mean
Show answer
A. Two standard deviations below the mean
OT-49 · Analysis, Interpretation, and Planning
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.Mild stiffness that eases after a few minutes
C.A history of osteoarthritis in the same fingers
D.A wedding ring she took off before treatment
Show answer
A. An open, draining cut on the back of the hand
OT-95 · Select and Manage Interventions
A therapist wants to know whether task-oriented training improves dressing more than strengthening exercise for adults after stroke. Which clinical question format organizes this search?
A. PICO: population, intervention, comparison, outcome
OT-175 · Competency and Practice Management
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.Left unilateral neglect of the near personal space and the body
C.Ideational apraxia, a loss of the idea of what each tool is for
D.Ideomotor apraxia
Show answer
D. Ideomotor apraxia
OT-2 · Evaluation and Assessment
A student's score sits one standard deviation below the mean on a normally distributed test. About which percentile is that?
A.The 50th percentile
B.The 16th percentile
C.The 34th percentile
D.The 2nd percentile
Show answer
B. The 16th percentile
OT-50 · Analysis, Interpretation, and Planning
A moist hot pack is applied to a client's upper back before a reaching task. What is the safest practice?
A.Have the client lie on top of the pack so it stays in full contact longer
B.Place it directly on bare skin so the heat reaches deeper muscle quickly
C.Wrap it in several layers of towel and check the skin after about 5 minutes
D.Leave it on for 45 minutes so the tissue warms all the way through first
Show answer
C. Wrap it in several layers of towel and check the skin after about 5 minutes
OT-96 · Select and Manage Interventions
Which type of study generally sits at the top of the hierarchy of evidence for an intervention question?
A.A single well-designed randomized controlled trial at one community hospital
B.Expert opinion published by a respected national professional group
C.A large case series describing outcomes from one clinic's clients
D.A systematic review and meta-analysis of randomized controlled trials
Show answer
D. A systematic review and meta-analysis of randomized controlled trials
OT-176 · Competency and Practice Management
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.Handwriting that starts normal and gets smaller and more cramped across the line
C.A sudden drop in blood pressure that comes on when he sits up at the desk
D.Intention tremor that grows larger as the pen nears the signature line
Show answer
B. Handwriting that starts normal and gets smaller and more cramped across the line
OT-3 · Evaluation and Assessment
A test manual reports a standard error of measurement of 4 points. How should the therapist use it when reporting a client's score of 82?
A.Report a range around 82, since the true score likely falls within it
B.Add 4 to the score to correct for the client's anxiety while testing
C.Subtract 4 from the score, since tests usually overestimate ability
D.Ignore it, since it only matters for research rather than clinic use
Show answer
A. Report a range around 82, since the true score likely falls within it