Free Occupational Therapist mock test

Occupational Therapist sample questions with answers

10 more original exam-style Occupational Therapist questions, worked in full. They are not real or recalled exam questions, and none of them is in the mock above or on the bank page, so sit the mock first if you have not.

1. Question 1 · Analysis, Clinical Reasoning, Interpretation & Intervention Planning

   A woman 3 weeks after a left middle cerebral artery infarct has emerging isolated shoulder flexion and gross grasp on the right, is medically stable, and wants to resume cooking. Which approach is best supported by current evidence?

   1. APassive range of motion and positioning only, until muscle grades reach 3/5
   2. BImmediate training in one-handed techniques with the unaffected left arm as the primary strategy
   3. CTask-oriented, repetitive task-specific practice of graded kitchen activities using the affected arm
   4. DNeuromuscular electrical stimulation as a stand-alone programme without functional practice
   Show answer and explanation

   Correct answer: C. Task-oriented, repetitive task-specific practice of graded kitchen activities using the affected arm

   With emerging isolated movement early after stroke, task-specific repetitive practice embedded in meaningful occupation has the strongest evidence for improving arm function and carryover. Restricting the client to passive movement withholds active practice during the period of greatest neuroplastic potential, defaulting to one-handed compensation risks learned non-use, and electrical stimulation is an adjunct rather than a substitute for functional training.

   Reference: National Clinical Guideline for Stroke for the UK and Ireland (2023); Winstein CJ et al., AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery, Stroke (2016)

2. Question 2 · Professional Practice, Patient Safety, Ethics, Infection Control & Scope of Practice

   A therapist with no training in lymphoedema management is referred a post-mastectomy patient for complete decongestive therapy. The next available trained therapist is three weeks away. What is the most defensible action?

   1. ABegin bandaging and manual lymphatic drainage using an online video tutorial as a guide
   2. BProvide safe within-competence care such as education, skin care and range of motion, and refer or arrange supervised training for the specialised components
   3. CDecline the referral entirely and provide no occupational therapy input
   4. DDelegate the complete decongestive therapy to an occupational therapy assistant who has observed the technique
   Show answer and explanation

   Correct answer: B. Provide safe within-competence care such as education, skin care and range of motion, and refer or arrange supervised training for the specialised components

   Practising within the boundaries of competence means delivering the elements the therapist is qualified to provide while arranging referral or supervised training for specialised components. Attempting manual lymphatic drainage and compression bandaging from a video without competence risks harm and constitutes negligent practice. Declining all input abandons the patient unnecessarily, and delegating a specialised technique to an assistant who merely observed it fails service competency requirements.

   Reference: AOTA Occupational Therapy Code of Ethics (2020); International Society of Lymphology Consensus Document on the Diagnosis and Treatment of Peripheral Lymphedema (2020)

3. Question 3 · Neurological Rehabilitation & Neuro-Occupational Therapy

   A patient has marked difficulty initiating movement of the upper limb. The therapist moves the limb passively through a diagonal pattern with rhythmic verbal cueing, then progresses to active-assisted, then active, then lightly resisted movement in the same pattern. Which PNF technique is being used?

   1. ARhythmic stabilisation
   2. BContract-relax
   3. CRhythmic initiation
   4. DSlow reversal-hold
   Show answer and explanation

   Correct answer: C. Rhythmic initiation

   Rhythmic initiation progresses from passive through active-assisted to active and resisted movement in one pattern, with rhythmic cueing, and is specifically indicated for difficulty initiating movement, rigidity and hypertonia. Rhythmic stabilisation uses alternating isometric contractions without motion to build stability. Contract-relax is a relaxation technique for restricted range, and slow reversal-hold uses alternating isotonic contractions of agonist and antagonist to build reversal of direction.

   Reference: Adler SS, Beckers D, Buck M. PNF in Practice: An Illustrated Guide, 4th ed. (2014)

4. Question 4 · Anatomy, Physiology, Kinesiology & Applied Neuroscience

   During the remodelling phase after tendon repair, the therapist applies controlled, progressive tensile stress to the healing tissue. What is the primary physiological rationale for this?

   1. AIt accelerates the inflammatory response and increases exudate
   2. BIt orients collagen fibres along lines of stress and increases tensile strength
   3. CIt prevents fibroblast migration into the wound bed
   4. DIt converts type III collagen back into fibrin
   Show answer and explanation

   Correct answer: B. It orients collagen fibres along lines of stress and increases tensile strength

   Controlled mechanical loading during remodelling guides collagen fibre alignment along lines of stress and promotes the conversion of weaker type III collagen to stronger, better-organised type I collagen, improving tensile strength and reducing restrictive adhesions. Loading does not intentionally amplify inflammation, and fibroblast migration and fibrin formation are earlier events that are not reversed by stress.

   Reference: Skirven TM et al. (eds), Rehabilitation of the Hand and Upper Extremity, 7th ed., Elsevier, 2021

5. Question 5 · Paediatric Occupational Therapy & Developmental Practice

   A 7-year-old boy has normal strength and no neurological signs, yet he cannot copy unfamiliar body postures, is slow to learn new playground equipment, and produces disorganised, clumsy movement sequences he has not performed before. Familiar, well-rehearsed tasks are performed adequately. This profile is most consistent with a deficit in:

   1. APraxis, specifically ideation and motor planning of novel actions
   2. BSensory over-responsivity to tactile input
   3. CVestibular-bilateral integration only
   4. DVisual acuity and oculomotor control
   Show answer and explanation

   Correct answer: A. Praxis, specifically ideation and motor planning of novel actions

   Difficulty with novel motor sequences and posture imitation with intact performance of overlearned tasks is the classic signature of a praxis deficit (dyspraxia) involving ideation, motor planning and execution. Sensory over-responsivity produces avoidance and distress rather than selective breakdown on novel tasks, vestibular-bilateral deficits centre on balance, postural control and crossing midline, and no visual findings are described.

   Reference: Ayres, Sensory Integration and the Child (25th anniversary ed., 2005); Bundy & Lane, Sensory Integration: Theory and Practice, 3rd ed. (2020)

6. Question 6 · Foundations of Occupational Therapy: Theory, Models & Frames of Reference

   Migrant labourers in shared accommodation have no accessible space or time for rest, exercise or social contact outside work hours. Which occupational justice concept best names this situation?

   1. AOccupational imbalance only, since the issue is simply too much work
   2. BOccupational deprivation, because external factors outside the individuals' control restrict engagement in meaningful occupation over time
   3. COccupational alienation, because the workers report no subjective distress
   4. DOccupational apartheid is not applicable to employment settings
   Show answer and explanation

   Correct answer: B. Occupational deprivation, because external factors outside the individuals' control restrict engagement in meaningful occupation over time

   Occupational deprivation denotes prolonged exclusion from needed or meaningful occupation due to external circumstances beyond the person's control, which precisely describes structural restrictions imposed by housing and working conditions. Occupational imbalance describes a disproportionate distribution of occupations, occupational alienation refers to experiencing occupation as meaningless or disconnected from self (and is defined by subjective experience rather than its absence), and occupational apartheid does apply to segregation of occupational opportunity including in labour contexts.

   Reference: Whiteford G, Occupational Deprivation: Global Challenge in the New Millennium, British Journal of Occupational Therapy (2000); Wilcock AA & Hocking C, An Occupational Perspective of Health, 3rd ed. (2015)

7. Question 7 · Occupational Therapy Evaluation & Assessment

   A therapist reports that a client's score on an outcome measure changed by an amount larger than the minimal detectable change (MDC) but smaller than the minimal clinically important difference (MCID). What is the MOST accurate interpretation?

   1. AThe change is entirely attributable to measurement error and should be ignored
   2. BThe change is both real and clinically important, so intervention should be discontinued as successful
   3. CMDC and MCID are interchangeable terms, so the statement is contradictory
   4. DThe change is likely real rather than measurement error, but has not yet reached the magnitude patients typically perceive as worthwhile
   Show answer and explanation

   Correct answer: D. The change is likely real rather than measurement error, but has not yet reached the magnitude patients typically perceive as worthwhile

   MDC is the smallest change that exceeds measurement error, while MCID is the smallest change that clients perceive as beneficial; exceeding MDC but not MCID means the change is statistically real but not yet clinically meaningful. It is therefore neither pure error nor evidence of goal attainment, and the two indices are distinct concepts derived by different methods.

   Reference: Portney & Watkins, Foundations of Clinical Research, 4th ed. (2020); Copay et al., Understanding the minimum clinically important difference, The Spine Journal (2007)

8. Question 8 · Occupation-Based Intervention: ADL, IADL, Work, Play, Leisure & Social Participation

   A client with stable chronic heart failure has been given a home exercise and activity programme but reports she stops because she is 'not sure how hard is safe'. Which strategy best supports safe adherence?

   1. ATeach her to use a rating of perceived exertion scale with a target of moderate intensity and to record symptoms such as weight gain, oedema and increasing breathlessness
   2. BInstruct her to exercise until she is too breathless to speak, then rest
   3. CAdvise complete rest on any day she feels tired at all
   4. DSet a fixed daily step count identical for every client in the programme
   Show answer and explanation

   Correct answer: A. Teach her to use a rating of perceived exertion scale with a target of moderate intensity and to record symptoms such as weight gain, oedema and increasing breathlessness

   Self-monitoring with perceived exertion plus a daily symptom and weight log gives the client an internal, individualised safety gauge and an early-warning system for decompensation, which is what she is missing. Exercising to the point of being unable to speak exceeds recommended moderate intensity. Blanket rest promotes deconditioning, and an identical step target for all clients ignores individual capacity and clinical status.

   Reference: ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure, 2021; AACVPR/AHA cardiac rehabilitation guidance

9. Question 9 · Physical Rehabilitation, Musculoskeletal & Hand Therapy

   A therapist designs a progressive resistive exercise programme for a client after rotator cuff rehabilitation using the DeLorme approach. The client's 10-repetition maximum for shoulder external rotation is 4 kg. The correct first set of the DeLorme sequence is:

   1. A10 repetitions at 4 kg
   2. B10 repetitions at 3 kg
   3. C10 repetitions at 2 kg
   4. D10 repetitions at 5 kg
   Show answer and explanation

   Correct answer: C. 10 repetitions at 2 kg

   The DeLorme protocol progresses within a session from 50% of the 10RM, to 75%, then to 100%, so the first set here is 2 kg, followed by 3 kg and 4 kg. Starting at the full 10RM removes the built-in warm-up and increases injury risk in healing tendon. The reverse (Oxford) technique starts at 100% and decreases, which is a different protocol.

   Reference: Kisner C, Colby LA, Borstad J. Therapeutic Exercise: Foundations and Techniques, 7th ed. (2017)

10. Question 10 · Mental Health & Psychosocial Occupational Therapy

    An occupational therapist notices that she consistently feels irritated and impatient with a particular client who reminds her of a difficult family member, and she has begun shortening his sessions. Which term BEST describes this phenomenon, and what is the MOST appropriate first action?

    1. ATransference; the therapist should confront the client about his behaviour
    2. BTherapeutic alliance rupture; the therapist should transfer the case without discussion
    3. CCompassion fatigue; the therapist should take immediate extended leave
    4. DCountertransference; the therapist should seek supervision and reflect on her reactions
    Show answer and explanation

    Correct answer: D. Countertransference; the therapist should seek supervision and reflect on her reactions

    Countertransference is the therapist's own emotional reaction to a client, often shaped by the therapist's history, and the recognised first step is reflective practice and clinical supervision. Transference describes the client's projection onto the therapist, compassion fatigue is a broader cumulative depletion state rather than a reaction to one client, and abrupt case transfer without reflection or discussion abandons the client and misses the learning opportunity.

    Reference: Taylor, The Intentional Relationship: Occupational Therapy and Use of Self, 2nd ed. (2020); Cara & MacRae, Psychosocial Occupational Therapy, 4th ed. (2019)