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Latest 2025 Updated National Board for Certification of Occupational Therapists - 2025 Questions and Answers

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NBCOT Exam Format | NBCOT Course Contents | NBCOT Course Outline | NBCOT Exam Syllabus | NBCOT Exam Objectives

DOMAIN

EVALUATION AND ASSESSMENT 25%

Acquire information regarding factors that influence

occupational performance on an ongoing basis throughout

the occupational therapy process.



- Impact of typical development and aging on occupational performance, health, and wellness across the life span

- Expected patterns, progressions, and prognoses associated with conditions that limit occupational performance

- Impact of body functions, body structures, and values, beliefs, and spirituality on occupational performance

- Resources for acquiring information about the clients current condition and occupational performance

- Administration, purpose, indications, advantages, and limitations of standardized and non-standardized screening and exam tools

- Internal and external factors influencing a clients meaningful engagement in occupation related to typical habits, roles, routines, and rituals, and the level and type of assistance required

- Therapeutic application of theoretical approaches, models of practice, and frames of reference that guide intervention in a variety of practice contexts and environments

- Task analysis in relation to a clients performance skills, the occupational profile, practice setting, stage of occupational therapy process, areas of occupation, and activity demands



DOMAIN

ANALYSIS AND INTERPRETATION 23%

Formulate conclusions regarding client needs and priorities to develop and monitor an intervention plan throughout the occupational therapy process.



- Interpretation and analysis of quantitative exams designed to measure specific client factors and performance skills

- Integration of qualitative data collected from interviews, observation, and exam of the social and physical
environments, valued activities, necessary occupations, and priorities

- Integration of screening and exam results with the client occupational profile, client condition, expected outcomes, and level of service delivery to guide critical decision-making for determining eligibility for services, prioritizing needs, and identifying a targeted intervention plan

- Characteristics and functions of interprofessional teams for coordinating client care and providing efficient and effective programs and services consistent with specific core competencies, expertise, unique contributions, team roles, and context of the organization

- Management of collaborative client-centered intervention plans, Individualized Education Program plans, and transition plans based on client skills, abilities, and expected outcomes in relation to available resources, level of service delivery, and frequency and duration of intervention

- Prioritization of intervention goals and activities based on client needs, wants, developmental skills, abilities, progress, and expected outcomes in relation to level of service delivery as well as frequency and duration of intervention

- Strategies used for assessing and addressing health literacy to enhance non-verbal and verbal interactions with a client and relevant others in order to promote positive health behaviors, enable informed decisions, maximize safety of care delivery, and promote carry-over of the intervention to support positive intervention outcomes

- Factors used for determining and managing the context and type of individual and group activities for effectively supporting intervention goals and objectives


Methods for monitoring the effectiveness of individual and group intervention in order to make decisions about continuation of the intervention or modifications to the intervention approach, context, or goals
- Clinical decision-making for adapting or modifying the intervention plan and prioritizing goals in response to physiological changes, behavioral reaction, emotion regulation, and developmental needs of the client



DOMAIN

INTERVENTION MANAGEMENT 37%

Select interventions for managing a client-centered
plan throughout the occupational therapy process.



Methods and techniques for selecting and preparing the environment
to support optimal engagement in the intervention and promote goal
achievement


- Indications, contraindications, and precautions associated with wound
management, considering the characteristics of a wound, the stage
of wound healing, and the influence of the wound on engagement
in occupation as guided by evidence, best practice standards, scope
of practice, and state licensure practice acts in order to support
functional outcomes

- Indications, contraindications, precautions, and appropriate clinical
application of superficial thermal agents as guided by evidence, best
practice standards, scope of practice, and state licensure practice acts

- Indications, contraindications, precautions, and appropriate clinical
application of deep thermal, mechanical, and electrotherapeutic physical
agent modalities as guided by evidence, best practice standards, scope
of practice, and state licensure practice acts

- Interventions for supporting leisure and play-based exploration and
participation consistent with client interests, needs, goals, and context

- Methods for grading an activity, task, or technique based on level of
development, client status, response to intervention, and client needs


- Methods for facilitating individual and group participation in shared
tasks or activities consistent with the type, function, format, context,
goals, and stage of the group


- Interventions to support optimal sensory arousal, and visual motor,
cognitive, or perceptual processing for supporting engagement
in meaningful occupations consistent with developmental level,
neuromotor status, mental health, cognitive level, psychosocial skills
and abilities, task characteristics, context, and environmental demands
030205 Compensatory and remedial strategies for managing cognitive
and perceptual deficits or intellectual disabilities


- Adaptive and preventive strategies for optimal engagement in
occupation consistent with developmental level, neuromotor status,
and condition


- Intervention strategies and techniques used to facilitate oral motor
skills for drinking, eating, and swallowing consistent with developmental
level, client condition, caregiver interaction, and mealtime environment
and context


- Prevocational, vocational, and transitional services, options,
and resources for supporting strengths, interests, employment, and
lifestyle goals of the adolescent, middle-aged, and older adult client


- Methods for grading various types of therapeutic exercise and
conditioning programs consistent with indications and precautions
for strengthening muscles, increasing endurance, improving range
of motion and coordination, and increasing joint flexibility in relation
to task demands


- Methods and strategies used to develop, implement, and manage
sensory and motor reeducation, pain management, desensitization,
edema reduction, and scar management programs


- Techniques and activities for promoting or improving postural stability,
facilitating dynamic balance, and teaching proper body mechanics
and efficient breathing patterns during functional tasks to support
engagement in occupation

- Types and functions of immobilization, mobilization, restriction,
and non-articular orthoses for managing specific conditions

- Influence of anatomical, physiological, biomechanical, and healing
principles on orthotic selection, design, fabrication, and modification


- Methods and techniques for training in the safe and effective use
of orthotic and prosthetic devices consistent with prioritized needs,
goals, and task demands in order to optimize or enhance function


- Factors related to measuring, selecting, monitoring fit of, and
recommending modifications to seating systems, positioning devices,
and mobility aids

- Characteristics and features of high- and low-tech assistive technology
for supporting engagement in meaningful occupation

- Mobility options, vehicle adaptations, and alternative devices
for supporting participation in community mobility


- Training methods and other factors influencing successful use and
maintenance of commonly used assistive technology options, adaptive
devices, and durable medical equipment


- Principles of ergonomics and universal design for identifying,
recommending, and implementing reasonable accommodations and
features in the workplace, home, and public spaces in order to optimize
accessibility and usability


- Processes and procedures for identifying, recommending, and
implementing modifications in the workplace, home, and public spaces,
considering the interaction among client factors, contexts, roles, task
demands, and resources



DOMAIN COMPETENCY AND PRACTICE MANAGEMENT 15%

Manage professional activities of self and relevant others
as guided by evidence, regulatory compliance, and standards
of practice to promote quality care.



- Methods for defining a clinical question and performing a critical
appraisal to support evidence-based practice

- Methods for applying continuous quality improvement processes
and procedures to occupational therapy service delivery


- Methods for evaluating, monitoring, and documenting service
competency and professional development needs of self and assigned
personnel based on scope of practice and certification standards for
occupational therapy


- Methods for developing, analyzing, and applying evidence that supports
occupation-based programming to advance positive health outcomes
for individuals, groups, and specific populations

- Application of ethical decision-making and professional behaviors
guided by the NBCOT standards of practice and Code of Conduct

- Precautions or contraindications associated with a client condition
or stage of recovery

- Infection control procedures and universal precautions for reducing
transmission of contaminants

- Basic first aid in response to minor injuries and adverse reactions

- Safety procedures to implement during interventions

- Preventive measures for minimizing risk in the intervention environment


- Methods for identifying, locating, and integrating federal regulations,
facility policies, and accreditation guidelines related to service delivery
across occupational therapy practice settings

- Influence of reimbursement policies and guidelines on occupational
therapy service delivery


- Accountability processes and procedures using relevant practice
terminology, abbreviations, information technology, and reporting
mechanisms for justifying, tracking, and monitoring sentinel events
and outcomes related to occupational therapy service delivery

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