Occupational Therapist Prometric exam questions with answers

1. Question 1Foundations of Occupational Therapy: Theory, Models & Frames of Referenceeasy

   In the Model of Human Occupation (MOHO), which three interacting components make up the person?

   1. APerson, environment and occupation
   2. BVolition, habituation and performance capacity
   3. CSelf-care, productivity and leisure
   4. DBody functions, activities and participation
   Show answer and explanation▾

   Answer: B. Volition, habituation and performance capacity

   MOHO describes the person as volition (motivation, values and interests), habituation (habits and roles) and performance capacity (physical and mental abilities), interacting with the environment. Person, environment and occupation are the elements of the PEO model, which is the most commonly confused alternative.

2. Question 2Anatomy, Physiology, Kinesiology & Applied Neurosciencehard

   A client cannot hold a sheet of paper between the thumb and the side of the index finger without strongly flexing the thumb interphalangeal joint. He also has clawing of the ring and little fingers. Which nerve is most likely injured?

   1. AMedian nerve
   2. BRadial nerve
   3. CMusculocutaneous nerve
   4. DUlnar nerve
   Show answer and explanation▾

   Answer: D. Ulnar nerve

   A positive Froment sign reflects weakness of adductor pollicis (ulnar nerve), compensated by flexor pollicis longus (anterior interosseous branch of the median nerve), and clawing of the ring and little fingers results from loss of the ulnar-innervated lumbricals and interossei. Median nerve injury instead causes thenar weakness and loss of opposition, with clawing mainly of the index and middle fingers if the lesion is at the wrist.

3. Question 3Conditions & Pathology Affecting Occupational Performancemedium

   A woman with rheumatoid arthritis has early ulnar drift at the metacarpophalangeal joints. Which joint protection advice is most appropriate?

   1. ACarry bags over the forearm rather than in the fingers
   2. BTwist jar lids open with a strong grip of the fingers
   3. CSqueeze a firm ball repeatedly to build grip strength
   4. DLean on the knuckles when pushing up from a chair
   Show answer and explanation▾

   Answer: A. Carry bags over the forearm rather than in the fingers

   Joint protection aims to reduce load on vulnerable small joints by using larger, stronger joints and avoiding tight grip and deforming forces, so bags are carried over the forearm. Tight gripping, twisting and pressure on the knuckles all push the MCP joints into further ulnar deviation and volar subluxation.

4. Question 4Occupational Therapy Evaluation & Assessmentmedium

   An occupational therapist wants to identify the occupational performance problems a client considers most important, and have the client rate their own performance and satisfaction. Which assessment is designed for this?

   1. AFunctional Independence Measure
   2. BBarthel Index
   3. CCanadian Occupational Performance Measure
   4. DAssessment of Motor and Process Skills
   Show answer and explanation▾

   Answer: C. Canadian Occupational Performance Measure

   The COPM is a semi-structured, client-centred interview in which the client identifies problems and rates importance, performance and satisfaction on 1-10 scales, so change can be measured from the client's perspective. The AMPS is an observation-based assessment of task performance rated by the therapist, and the FIM and Barthel are clinician-rated measures of dependence in ADL.

5. Question 5Analysis, Clinical Reasoning, Interpretation & Intervention Planningmedium

   Which goal for a client recovering from a stroke is written in the most measurable, client-centred format?

   1. AThe client will improve upper limb function so that getting dressed becomes easier over the coming weeks
   2. BThe therapist will teach the client one-handed dressing techniques during sessions
   3. CWithin 3 weeks, the client will put on a front-opening shirt independently, seated, using a one-handed technique
   4. DThe client will be fully independent in all activities of daily living before discharge
   Show answer and explanation▾

   Answer: C. Within 3 weeks, the client will put on a front-opening shirt independently, seated, using a one-handed technique

   A good goal states who will do what, under which conditions, to what level of performance and by when, as in the SMART format. The goal describing what the therapist will teach is an intervention, not a client outcome, and the others are too vague or too broad to measure.

6. Question 6Occupation-Based Intervention: ADL, IADL, Work, Play, Leisure & Social Participationmedium

   A client is 3 days after a total hip replacement via a posterior approach and must follow hip precautions. Which approach to lower-body dressing should the therapist teach?

   1. AUse a sock aid and long-handled reacher, dressing the operated leg first
   2. BSit on a low chair and bend forward to reach the feet slowly
   3. CCross the operated leg over the other knee to reach the foot
   4. DStand and dress the unoperated leg first while holding the bed rail
   Show answer and explanation▾

   Answer: A. Use a sock aid and long-handled reacher, dressing the operated leg first

   Adaptive equipment such as a reacher, sock aid and long-handled shoehorn lets the client dress without flexing the hip beyond 90 degrees, and the operated leg is dressed first and undressed last. Low chairs, bending forward and crossing the legs combine flexion and adduction, which risks posterior dislocation.

7. Question 7Physical Rehabilitation, Musculoskeletal & Hand Therapyhard

   After a zone II flexor tendon repair, the hand surgeon requests a protective orthosis for an early active motion programme. Which position is typically used?

   1. AVolar orthosis: wrist extended 30 degrees, MCPs extended, IPs flexed
   2. BDorsal orthosis: wrist fully flexed, all finger joints in full flexion
   3. CVolar wrist cock-up in 20 degrees extension, fingers left free
   4. DDorsal blocking: wrist neutral to slight flexion, MCPs flexed, IPs extended
   Show answer and explanation▾

   Answer: D. Dorsal blocking: wrist neutral to slight flexion, MCPs flexed, IPs extended

   A dorsal blocking orthosis keeps the wrist in neutral or slight flexion and the MCPs in flexion, which reduces tension on the repaired flexor tendons, while allowing the IP joints to rest in extension to prevent flexion contracture. A volar orthosis with wrist and MCP extension would place the repair under tension and risk rupture.

8. Question 8Physical Rehabilitation, Musculoskeletal & Hand Therapyeasy

   A data-entry clerk has night-time tingling in the thumb, index and middle fingers, relieved by shaking the hand. Which conservative orthotic intervention is most appropriate?

   1. AA thumb spica orthosis worn during the day only
   2. BA wrist orthosis in a neutral position worn at night
   3. CA wrist orthosis in 30 degrees of flexion worn at night
   4. DA dynamic finger flexion orthosis worn at night
   Show answer and explanation▾

   Answer: B. A wrist orthosis in a neutral position worn at night

   Carpal tunnel pressure is lowest with the wrist in a neutral position, so a neutral wrist orthosis worn at night is the standard conservative intervention for carpal tunnel syndrome. Wrist flexion increases carpal tunnel pressure and is the posture that provokes symptoms, as in Phalen's test.

9. Question 9Neurological Rehabilitation & Neuro-Occupational Therapymedium

   A client with a right parietal stroke ignores food on the left side of his plate and misses words on the left side of the page. Which remedial intervention is most appropriate?

   1. AVisual scanning training with a bright anchor on the left
   2. BPlacing all items permanently on the right side so he can find them
   3. CApproaching and speaking to him only from his right side
   4. DUsing written instructions placed in the centre of his field of view
   Show answer and explanation▾

   Answer: A. Visual scanning training with a bright anchor on the left

   Unilateral neglect is addressed with remedial strategies such as visual scanning training with a left-sided anchor, which teaches the client to search systematically toward the neglected side. Placing everything on the right and always approaching from the right are compensatory measures that may help in the short term but do not encourage attention to the left.

10. Question 10Neurological Rehabilitation & Neuro-Occupational Therapyhard

    A therapist is screening a client 6 months after stroke for constraint-induced movement therapy. Which minimum active movement criteria in the affected hand are commonly used?

    1. A10 degrees of wrist flexion and any flicker of finger movement
    2. B45 degrees of wrist extension and 30 degrees of finger abduction
    3. C20 degrees wrist extension and 10 degrees finger and thumb extension
    4. DFull composite grip with 5 kg of grip strength
    Show answer and explanation▾

    Answer: C. 20 degrees wrist extension and 10 degrees finger and thumb extension

    Standard CIMT protocols (from the EXCITE trial) require at least 20 degrees of active wrist extension and 10 degrees of active extension at the thumb and finger joints, because enough voluntary extension is needed to practise functional tasks while the less affected hand is restrained. A flicker of movement is insufficient for intensive task practice, and higher thresholds would exclude many clients who benefit.

11. Question 11Mental Health & Psychosocial Occupational Therapymedium

    A client with moderate depression has withdrawn from almost all activities and spends most of the day in bed. Which occupation-based intervention is most appropriate?

    1. AWaiting for her mood to improve before planning any activity
    2. BGraded activity scheduling of small, meaningful and achievable activities
    3. CScheduling a full day of activities immediately to break the cycle
    4. DEncouraging rest and avoidance of demanding tasks for several weeks
    Show answer and explanation▾

    Answer: B. Graded activity scheduling of small, meaningful and achievable activities

    Behavioural activation, using graded scheduling of meaningful and achievable activities, breaks the cycle of withdrawal and low mood, and success builds motivation and a sense of mastery. Waiting for mood to lift reinforces inactivity, while a full schedule at once is likely to fail and increase feelings of hopelessness.

12. Question 12Paediatric Occupational Therapy & Developmental Practiceeasy

    At about what age do typically developing children copy a triangle?

    1. AAbout 2 years
    2. BAbout 3 years
    3. CAbout 7 years
    4. DAbout 5 years
    Show answer and explanation▾

    Answer: D. About 5 years

    Pre-writing shape copying follows a developmental sequence: vertical line around 2 years, circle around 3 years, cross around 4 years, square around 4-5 years, triangle around 5 years and diamond around 6-7 years. Expecting a 3-year-old to copy a triangle would wrongly suggest delay.

13. Question 13Orthotics, Prosthetics, Assistive Technology, Seating & Environmental Modificationeasy

    A wheelchair user needs a permanent ramp to her front door. What is the commonly recommended maximum gradient for an independently used ramp?

    1. A1:6
    2. B1:8
    3. C1:20
    4. D1:12
    Show answer and explanation▾

    Answer: D. 1:12

    Accessibility standards such as the ADA standards commonly specify a maximum running slope of 1:12 (one unit of rise to 12 units of length) for ramps, with level landings at set intervals. Steeper ramps such as 1:6 or 1:8 are hard to propel up and dangerous to descend independently, while 1:20 is the gradient at which a walkway is generally not considered a ramp.

14. Question 14Geriatrics, Community Practice, Health Promotion & Population Healthmedium

    A man with moderate dementia living at home with his wife is often incontinent because he cannot find or recognise the toilet. Which environmental modification is most appropriate?

    1. AFit a contrasting toilet seat and a picture sign on the bathroom door
    2. BFit a highly patterned rug in the hallway leading to the bathroom
    3. CLock the bathroom door at night so he does not wander
    4. DInstall a large mirror opposite the toilet to help orientation
    Show answer and explanation▾

    Answer: A. Fit a contrasting toilet seat and a picture sign on the bathroom door

    People with dementia have difficulty with visual perception and recognition, so strong colour contrast and clear pictorial signage help them locate and identify the toilet. Patterned floors can be misperceived as obstacles or holes, and mirrors can cause distress when the reflection is not recognised.

15. Question 15Professional Practice, Patient Safety, Ethics, Infection Control & Scope of Practicehard

    A 78-year-old woman with full decision-making capacity wants to return home after a fall, against the team's advice that she should move to residential care. What is the most appropriate response by the occupational therapist?

    1. ADelay discharge until she agrees to residential care
    2. BRespect her decision, explain the risks, offer risk reduction and document
    3. CAsk her family to persuade her to accept residential care without her consent
    4. DDischarge her home but withdraw all further therapy input
    Show answer and explanation▾

    Answer: B. Respect her decision, explain the risks, offer risk reduction and document

    An adult with capacity has the right to make decisions that others consider unwise, so the therapist explains the risks, offers risk-reduction such as equipment, a pendant alarm and home support, and documents the discussion. Delaying discharge or involving family to pressure her without consent breaches her autonomy and confidentiality.

Last reviewed September 2026. Questions are original and written to the published exam blueprint; they are not taken from any real paper.