Occupational Therapist Prometric exam questions

The Occupational Therapist exam in every GCC country

From each regulator's own exam pages; anything a regulator does not publish says so. Assessment mode also depends on your licence title, so confirm your route on your eligibility notice.

12 worked Occupational Therapist practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Occupational Therapy Evaluation & Assessment

   A therapist must select a norm-referenced motor assessment for a 3-year-old with suspected developmental delay in both gross and fine motor domains. Which choice is MOST appropriate and why?

   1. ABOT-2, because it is normed from birth through adolescence
   2. BSchool Function Assessment, because it yields standard scores for motor skills
   3. CPDMS-2, because it is norm-referenced from birth to 5 years and provides gross motor, fine motor and total motor quotients
   4. DSensory Profile 2, because motor delay is always secondary to sensory processing difficulty
   Show answer and explanation

   Correct answer: C. PDMS-2, because it is norm-referenced from birth to 5 years and provides gross motor, fine motor and total motor quotients

   The Peabody Developmental Motor Scales-2 is normed for children from birth to 5 years and generates gross motor, fine motor and total motor quotients, making it the appropriate norm-referenced choice at age 3. The BOT-2 is normed from 4 to 21 years and so does not cover this child, the School Function Assessment is criterion-referenced and school-based, and the Sensory Profile does not measure motor performance.

   Reference: Folio & Fewell, Peabody Developmental Motor Scales, 2nd ed. (2000); Bruininks & Bruininks, BOT-2 Manual (2005)

2. Question 2 · Occupation-Based Intervention: ADL, IADL, Work, Play, Leisure & Social Participation

   A man with expressive aphasia after stroke has withdrawn from his social circle because he is embarrassed by his speech. Which occupational therapy intervention best targets social participation?

   1. ADaily naming drills in individual sessions until speech normalises
   2. BAdvising his family to speak on his behalf in social settings
   3. CIntroducing communication supports such as a picture or writing aid and gesture use, and graded participation in a supportive conversation group with trained partners
   4. DPostponing social interventions until speech therapy is discharged
   Show answer and explanation

   Correct answer: C. Introducing communication supports such as a picture or writing aid and gesture use, and graded participation in a supportive conversation group with trained partners

   Supported conversation with trained partners and multimodal communication tools removes the participation barrier immediately rather than waiting for impairment-level recovery, which aligns with participation-focused practice. Naming drills alone target impairment and do not restore social roles. Family speaking for him reduces his autonomy and reinforces withdrawal, and deferring social intervention prolongs occupational deprivation.

   Reference: Kagan A. Supported Conversation for Adults with Aphasia (Aphasia Institute); national clinical guideline for stroke, communication and participation recommendations

3. Question 3 · Physical Rehabilitation, Musculoskeletal & Hand Therapy

   A client attending for lymphoedema therapy presents with a sudden increase in arm warmth, spreading redness, tenderness and a temperature of 38.6 degrees Celsius. The therapist should:

   1. AProceed with manual lymphatic drainage but reduce bandage pressure
   2. BApply a hot pack to increase circulation and then bandage as usual
   3. CWithhold manual lymphatic drainage and compression and refer urgently for medical assessment of suspected cellulitis
   4. DIncrease the intensity of decongestive exercise to disperse the inflammation
   Show answer and explanation

   Correct answer: C. Withhold manual lymphatic drainage and compression and refer urgently for medical assessment of suspected cellulitis

   Acute cellulitis is a recognised contraindication to manual lymphatic drainage and compression, and requires prompt antibiotic treatment before decongestive therapy resumes. Continuing drainage or bandaging risks spreading infection and causes significant pain. Heat and increased exercise both raise local metabolic demand and lymph load and would worsen an acute infection, so neither is appropriate.

   Reference: International Society of Lymphology Consensus Document (2020); British Lymphology Society and Lymphoedema Support Network cellulitis guidelines

4. Question 4 · Mental Health & Psychosocial Occupational Therapy

   A client on a first-generation antipsychotic reports persistent inner restlessness and cannot remain seated through a 45-minute craft group, constantly pacing. Which is the MOST appropriate interpretation and action?

   1. AProbable akathisia; report to the prescribing team and meanwhile adapt the session to allow movement
   2. BTardive dyskinesia; document the involuntary movements and continue the group unchanged
   3. CAnxiety-driven avoidance; increase the demand to build sitting tolerance
   4. DPositive symptom relapse; recommend immediate seclusion for safety
   Show answer and explanation

   Correct answer: A. Probable akathisia; report to the prescribing team and meanwhile adapt the session to allow movement

   Subjective inner restlessness with an irresistible urge to move is characteristic of akathisia, a distressing extrapyramidal side effect that must be reported for medication review while the therapist adapts activity demands to permit movement. Tardive dyskinesia involves involuntary choreoathetoid movements typically of the face and tongue rather than subjective restlessness, and neither an anxiety formulation with increased demand nor seclusion is appropriate or safe here.

   Reference: NICE Guideline CG178, Psychosis and Schizophrenia in Adults (2014); Maudsley Prescribing Guidelines in Psychiatry, 14th ed. (2021)

5. Question 5 · Conditions & Pathology Affecting Occupational Performance

   A 24-year-old man has a complete C6 tetraplegia (ASIA A) six months post-injury. Which functional outcome is realistically expected at this level with appropriate equipment and training?

   1. AIndependent manual wheelchair mobility over all outdoor terrain including kerbs and stairs
   2. BIndependent eating and grooming using a tenodesis grasp with adaptive equipment such as a universal cuff
   3. CIndependent lower body dressing and shoe tying without any adaptive equipment
   4. DFull-time ventilator dependence with no independent upper limb function
   Show answer and explanation

   Correct answer: B. Independent eating and grooming using a tenodesis grasp with adaptive equipment such as a universal cuff

   C6 preserves wrist extension (extensor carpi radialis), which allows a functional tenodesis grasp, so independent eating, grooming and light upper body tasks with adaptive equipment are expected outcomes. Independent stair-negotiating wheelchair skills and equipment-free lower body dressing are not expected at C6, and ventilator dependence with no arm function corresponds to high cervical (C1-C3) injury.

   Reference: Consortium for Spinal Cord Medicine, Outcomes Following Traumatic Spinal Cord Injury: Clinical Practice Guideline (1999/updated); ASIA-ISCoS International Standards for Neurological Classification of SCI (rev. 2019)

6. Question 6 · Orthotics, Prosthetics, Assistive Technology, Seating & Environmental Modification

   A client with C5 tetraplegia has a healed stage 3 ischial pressure injury, cannot perform independent weight shifts, and requires a cushion that maximises immersion and envelopment. Which cushion type and follow-up requirement is most appropriate?

   1. AFlat generic foam cushion, replaced annually
   2. BRigid gel-over-plywood insert, with no maintenance required
   3. CAir-cell cushion, with the client or carer checking and adjusting inflation regularly and inspecting for leaks
   4. DSheepskin overlay placed on the existing sling seat, laundered weekly
   Show answer and explanation

   Correct answer: C. Air-cell cushion, with the client or carer checking and adjusting inflation regularly and inspecting for leaks

   Air-cell (air-flotation) cushions provide high immersion and envelopment and are indicated for clients at highest risk who cannot offload independently, but they are pressure-sensitive devices that require regular inflation checks and leak inspection to remain effective. Flat generic foam gives poor pressure redistribution and bottoms out over time. A rigid gel-over-plywood construction concentrates loading, and sheepskin overlays manage moisture and friction but do not redistribute interface pressure.

   Reference: EPUAP/NPIAP/PPPIA. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline, 3rd ed., 2019

7. Question 7 · Geriatrics, Community Practice, Health Promotion & Population Health

   A 70-year-old woman with mild cognitive impairment and arthritis misses doses of her seven medications. Her vision is 6/18 corrected and grip strength is reduced. Which intervention is the highest OT priority?

   1. AAssess the medication-taking task, then trial a pre-filled organiser with large high-contrast labels, easy-open packaging and an alarm cue
   2. BRecommend the physician reduce her regimen to a single daily tablet
   3. CRefer to a memory clinic and defer any intervention until diagnosis is confirmed
   4. DInstruct her daughter to administer every dose from now on
   Show answer and explanation

   Correct answer: A. Assess the medication-taking task, then trial a pre-filled organiser with large high-contrast labels, easy-open packaging and an alarm cue

   Medication management is an IADL within OT scope; the therapist should analyse the actual task performance and address the identified barriers - visual, cognitive and hand function - with organisers, contrast labelling, easy-open containers and external cueing. Simplifying the regimen is a prescriber decision, deferring intervention leaves her unsafe, and full family administration removes independence unnecessarily.

   Reference: AOTA, Occupational Therapy Practice Framework: Domain and Process, 4th ed., 2020; Elliott RA, Drugs & Aging, 2014

8. Question 8 · Analysis, Clinical Reasoning, Interpretation & Intervention Planning

   A 58-year-old man 4 weeks after a right frontal haemorrhage scores 27/30 on the Montreal Cognitive Assessment. During an observed multi-step meal preparation task he omits steps, does not notice a boiling pot overflowing, and cannot self-correct without cueing. Which conclusion is best supported?

   1. ACognitive screening scores in the normal range do not rule out executive dysfunction, so performance-based functional assessment should guide the plan
   2. BThe MoCA result should be considered a false negative caused by poor test administration
   3. CThe observed errors most likely reflect low motivation rather than cognitive impairment
   4. DCognition is intact, so intervention should target upper limb motor control only
   Show answer and explanation

   Correct answer: A. Cognitive screening scores in the normal range do not rule out executive dysfunction, so performance-based functional assessment should guide the plan

   Brief cognitive screens are insensitive to executive dysfunction because they are structured, cued and short, whereas open-ended real-world tasks expose initiation, monitoring and error-correction deficits. The discrepancy is therefore a recognised measurement limitation rather than an administration error or a motivation problem, and dismissing the functional findings would miss a clinically important safety risk.

   Reference: Nasreddine ZS et al., Journal of the American Geriatrics Society (2005); Gillen G, Cognitive and Perceptual Rehabilitation: Optimizing Function (2009)

9. Question 9 · Professional Practice, Patient Safety, Ethics, Infection Control & Scope of Practice

   A therapist is offered a commission by an equipment supplier for every wheelchair she prescribes from that company's range. What is the most appropriate response?

   1. AAccept the commission but only prescribe equipment she believes is clinically suitable
   2. BAccept and disclose the arrangement to patients so they can decide for themselves
   3. CDecline the arrangement because it creates a conflict of interest that could bias clinical recommendations
   4. DAccept and donate the commission to the department's equipment fund
   Show answer and explanation

   Correct answer: C. Decline the arrangement because it creates a conflict of interest that could bias clinical recommendations

   Financial inducements tied to prescribing create a conflict of interest that compromises objectivity and the fiduciary duty owed to clients, so the arrangement should be declined outright. Disclosure or charitable redirection of the payment does not neutralise the incentive to favour one supplier over the clinically best option. Self-assessment of one's own impartiality is unreliable and is not an accepted safeguard.

   Reference: AOTA Occupational Therapy Code of Ethics (2020); WFOT Code of Ethics (2016)

10. Question 10 · Neurological Rehabilitation & Neuro-Occupational Therapy

    A patient with focal elbow and wrist flexor spasticity after stroke receives botulinum toxin type A injections today. What is the most appropriate occupational therapy plan?

    1. ASuspend all therapy for six weeks so that the toxin can take effect undisturbed
    2. BIntensify stretching, orthotic wear or serial casting and task-specific practice beginning within the first one to two weeks and continuing through the period of peak effect
    3. CDelay serial casting until the toxin effect has fully worn off at four to six months
    4. DBegin maximal resistive strengthening of the injected muscles immediately to counteract the induced weakness
    Show answer and explanation

    Correct answer: B. Intensify stretching, orthotic wear or serial casting and task-specific practice beginning within the first one to two weeks and continuing through the period of peak effect

    Botulinum toxin produces a window of reduced tone that begins within days, peaks at roughly two to six weeks and wanes by three to four months; adjuvant stretching, casting or splinting and goal-directed functional practice during that window is what converts tone reduction into functional gain. Withholding therapy or waiting until the effect has resolved wastes the therapeutic window, and immediate maximal resistive loading of the chemically denervated muscles does not address the underlying goal of length and function.

    Reference: Royal College of Physicians. Spasticity in Adults: Management Using Botulinum Toxin, National Guidelines (2018); National Clinical Guideline for Stroke for the UK and Ireland (2023)

11. Question 11 · Anatomy, Physiology, Kinesiology & Applied Neuroscience

    A therapist designs an upper limb strengthening programme and considers the force-velocity relationship of skeletal muscle. Under which condition does a muscle generate the greatest tension?

    1. ARapid concentric shortening
    2. BSlow concentric shortening
    3. CIsometric contraction at optimal length
    4. DEccentric (lengthening) contraction
    Show answer and explanation

    Correct answer: D. Eccentric (lengthening) contraction

    The force-velocity curve shows that maximal tension is produced during eccentric (lengthening) contraction, exceeding isometric force, which in turn exceeds concentric force; concentric force falls further as shortening velocity rises. Therefore rapid concentric contraction produces the least force, and isometric contraction is intermediate.

    Reference: Hall JE, Hall ME, Guyton and Hall Textbook of Medical Physiology, 14th ed., Elsevier, 2020

12. Question 12 · Conditions & Pathology Affecting Occupational Performance

    A client is two weeks post transradial amputation and the wound is healing well, but the prosthesis has not yet been fitted. Which set of goals is the priority for this pre-prosthetic phase?

    1. ATraining myoelectric signal control and terminal device grasp patterns
    2. BEstablishing a graded prosthetic wear schedule and skin tolerance checks under the socket
    3. CResidual limb shaping with figure-of-eight compression wrapping or shrinker, oedema control, desensitisation and scar management, and maintaining elbow and shoulder range to prevent flexion contracture
    4. DVocational placement and driving assessment before any limb management is undertaken
    Show answer and explanation

    Correct answer: C. Residual limb shaping with figure-of-eight compression wrapping or shrinker, oedema control, desensitisation and scar management, and maintaining elbow and shoulder range to prevent flexion contracture

    The pre-prosthetic phase focuses on preparing the residual limb, meaning oedema control and conical shaping with figure-of-eight wrapping, desensitisation and scar management, range of motion to prevent the elbow flexion contracture common after transradial amputation, and one-handed skills. Myoelectric control training and wear schedules belong to the prosthetic training phase once a device exists, and vocational and driving work follows rather than precedes limb readiness.

    Reference: Pedretti's Occupational Therapy: Practice Skills for Physical Dysfunction, 8th ed. (2018); VA/DoD Clinical Practice Guideline for the Management of Upper Limb Amputation Rehabilitation (2022)

Occupational Therapist reference books and guidelines

Every question in this bank names the textbook or guideline its answer rests on. These are the sources our Occupational Therapist questions cite most often - the reading list to revise from alongside the bank.

Where your regulator publishes a reading list, use the editions it names. Exam questions are not taken from any one book.