Preparing for the NBCOT Exam

August 8, 2007 at 1:14 am 707 comments

Sorry for the delay in this post.

The NBCOT exam consists of 200 questions and you get 4 full hours to complete the test. Of those 200, 30 are not counted, as they are “experimental questions,” questions that may or may not be put into future tests.

I took the exam a little over a month ago, and it took me only 3 hours to complete, and that was with me taking my time. Thankfully, I passed. This post will be about what materials I used to study and how I studied.

I utilized the following four books:

I’ll say right away that I do NOT recommend getting the first book in the list, the one by Sladyk. The study questions in that book were not representative of the questions on the actual exam and were in fact much harder than the questions on the exam.

The second book in the list, the one by Johnson, was by far the best book (besides the official NBCOT study guide) in terms of questions that are representative of the NBCOT exam. There are multiple tests, and it comes with a CD-ROM that allows you to customize the questions that are presented to you, in case you need more guidance in one particular area. Additionally, if you take an entire 200-question exam on the computer, it will break down exactly what areas you need to work on. I HIGHLY recommend this book.

The third book on the list is the official NBCOT study guide. It only comes with one shortened test, but it gives you a pretty good picture of what the questions on the exam will look like. While I do recommend getting this book, it is probably not necessary for passing the exam.

Finally, the last book is another must have. Whereas all the other books just have study guides (sleep well the night before, arrive early, etc.) and practice questions/exams, this book has all the information that will appear on the test. It has all the information about all the diagnoses, from hands to kids to neuro, how we treat them, what to look for, and more. It is meant to be a primary study source, meaning that you can use this book without looking back at your notes. While ultimately I did look back at my notes and other textbooks while studying, I mainly used this book. The book also comes with a CD-ROM for you to take practice tests, but I found the study questions to be very difficult and not having enough information within the questions to answer the questions appropriately. While not as difficult as the Sladyk book, I still would not recommend taking these test questions.

Now that I’ve covered which textbooks I used, I’ll just say a little bit about the actual studying. First, do not study alone! Initially, I was going to study alone, but I got myself a study partner, and believe me, it helped! I would not have passed without her. With a study partner, you can set goals, test each other, cover material out loud, and review things that you may have problems with.

I recommend taking LOTS of practice quizzes. The Johnson book is great for this, as it has many questions, and if you use the CD, you can have about 800 study questions! You don’t have to do 200 questions in a row for the practice quizzes. I found it helpful to do about 50 at a time, so that I can review all the answers and see what areas I needed help in studying. The quizzes helped me realize what style all the actual test questions would be in, and really narrowed down the areas I needed to work on most.

Good luck!


Entry filed under: nbcot, studying.

Where I’ve been I made a splint!

707 Comments Add your own

  • 1. Angie  |  August 27, 2007 at 2:44 am

    Thanks for the advice, you never know what you’re getting from the internet. I’m a OT graduate (2000)from Canada who is thinking about writing the NBCOT exam. Since I’ve been out of school for some time now, I don’t know where to begin studying.

    • 2. Sara  |  July 20, 2009 at 9:36 am

      I took the OT Advantage Online Exam Prep Course and found it helpful. I had failed my exam before and the instructor taught me test strategy and how to organize my study plan. I highly recommend taking a look at it:

    • 3. Daphnee  |  July 20, 2011 at 12:47 pm

      Cool thinking about changing my major from nursing to ot. Angie I’m thinking about moving to Canada with my family once I’m done with school. Whats there pat rates for OT over at Canada?

  • 4. Lianne  |  August 30, 2007 at 1:33 pm

    Great blog Nathan, I am sure you have helped out many OT students getting ready for the NBCOT. I have linked your site on my blog, Feel free to visit it and post a comment!

  • 5. Jonathan  |  September 5, 2007 at 2:01 pm

    I, like Angie graduated from a Canadian university (Dalhousie) in 2006. I am just now getting around to write my US exam. I really find it overwhelming as to where I should start. Your recomendations for books is a good help. Want to sell any of them? If so contact me at
    I know that when I prepared for all of my exams I would make detailed notes with all of my consolidated material. If you have anything like that I would also be willing to pay. Haha… anything to make this process a little easier!
    Thanks very much and I look forward to hearing from you and raeding more of your blog!

  • 6. Jamie F  |  February 11, 2008 at 9:45 am

    Another cool blog site puts up questions on what you should know for the NBCOT Exam. It’s worth checking out.. you need to use every resource you can get your hands on!

  • 7. Cully  |  April 28, 2008 at 1:32 am

    Big thanks for all the great information. I found the National Occupational Therapy Certification Exam Review book on Amazon for 200+ dollars and decided I could do without it. The site you provided, directly to the seller, has it at 80$–and from what you said it isn’t something to throw out or give away after the exam. I’ll but sure to use it for the test.

    Great advice . . . thanks again,


  • 8. Tom  |  May 9, 2008 at 6:17 pm

    By far the best book was the National Occupational Therapy Certification Exam Review & Study Guide by Rita Cottrell–now Castaldy. It’s the only book that has both content review and practice questions. I thought the practice exams were the most like the real exam and the content review was really valuable. I thought the book was bad–didn’t even seem like it was by OT’s. The 1000 questions were decent but I thought the questions in the Rita book were more like the real exam questions. Hope this helps and good luck!

  • 9. MC  |  September 7, 2008 at 1:16 am

    Wow I saw your blog about being out since 2000. I thought I was the only one who hasn’t taken the exam since that long ago.

  • 10. Laura H  |  September 7, 2008 at 8:33 pm

    HELP! I am a practicing OT in the US (took NBCOT in 2004) and am now sitting for the exam in Canada. What do i need to know about the differences in practice? I have searched everywhere!!

  • 11. AL  |  September 16, 2008 at 7:56 pm

    Hi Laura, not sure if this is what you were looking for but you can find info on the Canadian exam at the Canadian Association of Occupational Therapist (CAOT) site and there is a exam procedures & resource manual to download that gives you an idea of sample case studies questions.

  • 12. Mariam Z  |  November 23, 2008 at 2:46 pm

    Hi guys

    Quick questions, do we need to know assessments tools in detail (who its developed by, how its administered, etc) for the NBCOT?

  • 13. Sarah  |  January 29, 2009 at 3:58 pm

    What about the NBCOT one that they recommend on their website? Anything good come out of that?

  • 14. maria  |  March 2, 2009 at 8:31 pm

    here there any one out there who has taken the new test? As of Jan,9,2009 NBCOT as put a new test that now has clinical simulations.

  • 15. dude  |  April 16, 2009 at 1:21 pm

    I just found out i passed the new 2009 test. TIPS:
    3. National Occupational Therapy Certification Exam Review and Study Guide, by Rita Cottrell. THIS IS ANOTHER MUST HAVE, BUT MAKE SURE YOU BUY THE LATEST EDITION


    • 16. katie  |  June 15, 2009 at 4:40 pm

      Well….I have done everything you had stated. I have not passed yet. I have taken it three times. And the worst part is I PASS THE PRACTICE EXAMS but not the real exam.

      I have nothing more to study and have no idea why I am not passing. I have called nbcot and they were no help.

      So annoyed!

      • 17. Lisa  |  June 29, 2009 at 12:39 am

        Katie, I have unsuccessfully taken the exam twice already. A good friend who had to repeat the exam and finally passed, suggested making flash cards and doing more online exams. I am sure you already have a good grasp of the material, so try more practice tests. My friend also spaced out the amount of studying they did, so that it would not be too overwhelming. For example: they would do a full practice test from the Castaldy 2009 book one day and review the answers the next. They also mixed in some fun made sure they were getting a good nights rest. This is what I plan to do. Good luck!

      • 18. ND  |  July 1, 2009 at 1:44 pm

        is there any other practice exams other than the 3 books i have [ 1] NBCOT study guide, 2] National OT certification exam and study guide 5th ed,by Rita fleming and 3] Ot exam review guide by carolyn johnson. I have done all these and i know of the online exams which r available as well.

      • 19. Caroline  |  July 31, 2009 at 5:21 pm

        I understand where you are coming from. I have failed 3 times, however I’m passing all the numerous exam prep questions. I even passed the prep exam (80 grade) that NBCOT requests to take online. Have you taken the exam again? I’m just trying to find a job as a rehab tech in the meantime because I feel like I’m about to go CooCoo. These exams are getting expensive and like yourself I’m running out of resources. Do you know of maybe a study group? I

  • 20. Sarah  |  April 17, 2009 at 8:05 pm

    I took the therapy ed review course and recieved the Rita Cottrell exam prep book back in the summer and anticipated taking the exam in 2008 before the new test came out. Unfortunatly that was not the case and had to wait until after the first of the year to take the exam. Needless to say I only had the 2008 exam prep book by Rita Cottrell. Now I have been emailing and trying to get in touch with the company that offered the course b/c i think I should be entitled to the updated book without having to pay the new fee, especially since I gave them all that money for the course and the old book and still failed the exam in January. However, no one is emailing me back!!! Now I want to take the exam again soon, but only have the old book and it doesen’t have any info on the new section of the exam. What am I to do? Keep studying from the old book?????

  • 21. Rita  |  April 20, 2009 at 2:59 pm

    I have taken the old and new exam and did not pass either of them! I do have the old Rita book and always studied from that. As for the CST questions, I bought a test online for $40. It helped to get you prepared for that section of the test but it was way easier than the actual exam of course. I took the NBCOT recommended course also and spent all that money for nothing. The course was not helpful at all in my opinion.

    In response to Dude, didn’t you think the new test was harder? A lot of psychosocial info. Do you have any tips on answering the questions correctly? I always miss the exam by few points and am getting frustrated.

    Could anyone else give me any info? Needing to pass this exam!

  • 22. Tay  |  April 30, 2009 at 3:27 pm

    I have also taken the NBCOT exam in 2008 as well as twice in 2009 and have still failed. I do agree that 2009 is way more difficult than 2008. I am still barely missing it but i have no idea what to do? Does anyone know what else is helpful besides the NBCOT study guide?

    • 23. anisha  |  June 1, 2009 at 1:19 pm

      hey Tay, same here with me. i took the test once in 2008 and twice in 2009 but i failed all 3 times. when do u plan to take it again? i really hope we can try and form a study group and help each other. u can email me at

      • 24. Jiri  |  July 28, 2009 at 12:23 pm

        Hey Tay and anisha. I have taken it twice in 2009 and have failed twice only by 3 and 2 points . I am so frustrustrated because i have to do all of this studying over again and i have already went through like evey book possible. I wish we could form a study group. My email at

      • 25. Tin  |  August 22, 2009 at 7:36 pm

        Hi guys, I TOTALLY know how you are all feeling..I just found out yesterday that I didn’t pass again. It was the second time I took it..I too, am very frustrated because I am running out of testing material. I have the Johnson and Rita books, which are both the newest editions. I’m not even sure what I’m doing wrong because I felt like the way I was approaching the questions on the NBCOT exam the second time was much more like how Johnson wants us to approach her questions. And from experience, her book is by far the closest in comparison to the actual exam. I know I know my stuff. I just don’t understand why this keeps happening. What other online exams are available? I NEED to pass…

  • 26. Angela Rosales  |  May 2, 2009 at 5:19 pm

    Has anyone used the NBCOT Exam Secrets study guide by Morrison Media LLC? I just took the exam and failed and can not afford to do so again. I feel I need to improve my speed in clinical reasoning, I know the content well I just take too long to apply it (I ran out of time during the exam). What study material is best for improving clinical reasoning? Thanks!!

  • 27. Rita  |  May 4, 2009 at 10:58 pm

    At this point, no study guides can help you pass. I found out that a lot of people failed this 2009 exam. I would recommend calling NBCOT to see if they plan on changing or doing an update to the exam before taking it again. It was suggested to me to do so, but I have yet to have time to call. I need to improve in clinical reasoning too but they only way to do so is to read the practice questions to understand y you get it wrong and right. I can’t pass it either so…if anyone have any helpful suggestions, please post it up here.

  • 28. Eureka  |  May 6, 2009 at 12:26 pm

    I have so taken both old and new exam, and have not passed. I have spent over two grand. I have both old and new study guide as well as the above text suggested. I really agree that getting together with others and discussing questions and answers will really help. Is there anyone in the Metropolitian area (MD, DC, VA) wanting to meet and get a study group going?

    • 29. anisha  |  June 1, 2009 at 1:21 pm

      hey, same here…i spent enough on this exam and wish to start studying again…currently i am in india, but since i was based in US for all this time, we can fix up a time and try and study online together….contact me at

  • 30. Mandy  |  May 6, 2009 at 1:10 pm

    I also have spent over $2000 taking this test not including texts to study. Obviously this new 2009 test is incredibly hard.

    Does anyone have the new NBCOT Castaldy book? I was wondering if the questions in the book are the same from the 2008 or different? Especially considering how hard the 2009 MCT questions are.

    • 31. katie  |  June 15, 2009 at 4:37 pm

      OMIGOD! I know what you mean. I feel like its a way for them to make money. I have spent over 4 grand on this exam…and of course I have no money because WE Cant work until we pass. I have no idea what is going on. I have taken it three times and not passed.

      I am so annoyed!!!!!!!!!!!!

  • 32. Eureka  |  May 6, 2009 at 3:21 pm

    Yes I do. Does anyone live in the DC MD VA area?

  • 33. Eureka  |  May 6, 2009 at 3:23 pm

    There are the same questions just mixed up between the three exams. Each exam has two CST problems each.

  • 34. Kimberly Wilshere  |  May 7, 2009 at 6:44 pm

    This new test is extreamly hard . I failed twice already . I live in Lancaster Pa if any wants to study email me. Kim 631-680-5830

  • 35. Kimberly Wilshere  |  May 7, 2009 at 6:44 pm

  • 36. Mandy  |  May 7, 2009 at 7:07 pm

    Thanks Eureka. I was going to buy it if it were similar questions to new test but I guess they didn’t update the questions besides the CST.

    I have been using the Morrison Media flashcards and it seems helpful so far but I haven’t studied everything. If you want to study something different from the Castaldy book, its a good guide.

    If anyone has a weakness in mental health on the test like I do, I ordered a book someone suggested to me. If you want…I can post it on here.

    • 37. Katie  |  June 1, 2009 at 8:44 am

      Hi Mandy,
      Can you post the book that you bought for mental health, or email me at ? I feel like it may be one of my weaker spots. I would love to know what was suggested to you for studying. At this point I will try anything to pass this exam!!

  • 38. Krista  |  May 13, 2009 at 6:54 pm

    Hi, I am really happy that I have found this site. I have taken the exam 3 times now and still have not passed. I have taken the old version 2x and this new 2009 version 1 time. Like the rest of you, I have also spent A LOT of money and am sick of it. The first time I scored a 439, 2nd time a 445 (so close!) and now this third time…my score went down to 426 😦 I am beyond frustrated and have no clue how to prepare. I can’t even begin to think about taking it again right now, but want to try to obtain some good resources before I get back into it. Is there anyone here from Chicago that is studying at this time?


    • 39. katie  |  June 15, 2009 at 4:36 pm

      Krista! Hi I am from Chicago. I would love to meet up and study. I have taken the exam three times too and not passed. I have no idea what is going on. Let me know what you think.

      • 40. Michelle  |  June 15, 2009 at 7:22 pm

        Hi Katie,

        I am from the Chicago area as well and would love to form a study group. Email me with your thoughts. I just took it and failed once and I want to do everything not to have to take it three times. Let me know what you think. Email me at


      • 41. Krista  |  July 4, 2009 at 8:56 pm

        Hi Katie,

        I really appologize for not getting back to you earlier. I thought that I would receive some sort of notification to my email if someone responded to me, apparently not. I would love to meet up. Send me an email at and hopefully we can meet up to discuss and vent about this very annoying situation 🙂

    • 42. Michelle  |  June 15, 2009 at 6:51 pm

      Hi Krista,

      I just took the exam on Saturday and am extremely upset that I failed. I live in the Chicago suburbs (Buffalo Grove area). If you would like to form a study group I would love to so I can pass this stupid exam. Like everyone else has said I think that they are in it for the money which is totally pathetic. I would love to hear from you soon. Please email me at

  • 43. Kerri  |  May 19, 2009 at 3:30 pm

    I am about to take the exam for the first time on Thursday (May 21st). Obviously, it will be the 2009 version. I have used TherapyEd as a study guide and for practice exams. I purchased the NBCOT exams (CST & MCT) found them very helpful in identifying my weaknesses. Also, I have found that with NBCOT, there seems to be a trend emphasizing mental health and for that reason, I might recommend purchasing the NBCOT focus area on mental health. Practicing the questions has been most helpful and reasoning out the rationales with another study mate has been immeasurably helpful. We take the exams separately then come together and analyze the right/wrong answers out loud. Our strengths and weaknesses compliment one another very well. Therefore, a study partner is much recommended. My practice tests predict passing scores, but I try not to become too complacent or stressed about the results. Anyway. Good luck everyone.

  • 44. Sarah Jones  |  May 26, 2009 at 2:16 am

    I took the online prep course from OT Advantage and found it helpful. The instructor goes over multiple choice and CST problems at length to try and help everyone understand what the question is REALLY asking. There is a lot of group work too, which I think helps.

  • 45. GB  |  May 30, 2009 at 11:56 pm

    Is anyone on this site an occupational therapy assistant who has taken/or will take the NBCOT exam or is everyone here taking the OTR exam?

  • 46. Katie  |  June 1, 2009 at 8:39 am

    I have taken the 2009 NBCOT exam three times, and i just found out that i failed again on my third try. Last time my score was 447. What are we supposed to do for those of us who just can’t pass this test? When will they realize that this test is almost impossible to pass? I keep checking the website hoping that they will change it to pass. I am calling NBCOT today and will post back what they say. I have 4 different study guide books and I have also used the NBCOT online practice tests too, but nothing seems to be helping me to pass. HELP!!! I live in southern NJ very close to PHiladelphia if anyone is interested in getting together to study… can email me at

    • 47. anisha  |  June 1, 2009 at 1:27 pm

      hi Katie, I am Anisha here. I also just experience thrid failure. i took 2008 1x and 2009 2x’s and did not pass. i wish to get together but unfortunately i had to rush back to my home country. Can we keep in touch via email and help each other out. I have used rita cottrell, johnson, karen sladyk, and nbcot online tests but nothing seemed to work. I really hope stud partners would help a lot. u can contact me at or

  • 48. Mandy  |  June 1, 2009 at 12:34 pm

    The book is called Mental Health and Concepts for the COTA by Mary Early. Although its for a COTA, its a really good read.
    I bought the OT cards by sladyk and studying that right now. I just think its up to you what you want to study from. I have spent too much money on study guides and practice tests and I think its the same info but in different format.
    Let me know what NBCOT says about the tests. I have talked to someone from there too but they were no help. I told them the statistics of the pass fail rate of the 2009 test which is 75% or so. They refuse to own up to it saying they dont know what I’m talking about but I found out this info from a really good source. So, update me. I would like to know what they have to say for themselves.
    I still need to take the exam but too scared b/c of the money and the potential to fail….good luck to everyone!

  • 49. anisha  |  June 1, 2009 at 1:33 pm

    katie, u r right.. i found out from a very reliable source that the passing rate has decreased from 95% to 60-65%. And the passing rate in Toms River is more than any other place in NJ. I too spent 1.5 grands for this test but am still gonna try once more. I really hope we can help each other!! gud luck!

  • 50. Katie  |  June 1, 2009 at 8:51 pm

    I called NBCOT and asked them if they had any advice for me. I explained to the customer service rep. that i took the test three times and bought the NBCOT study guide book, completed the online practice tests, and have three additional study guide books and i can’t seem to pass the test. The person that I spoke to just told me to call my school to see if there is a study group and/or a tutoring center on campus where i could go for extra help. She also told me to try the content exams from NBCOT. I am going to take her advice, but the NBCOT exams online are so expensive. At this point i will do whatever it takes to just pass!!! She also explained that the NBCOT online practice exams do not provide any rationale for the answers b/c some of the questions may be on the actual test…not sure if I believe that, but i guess it’s worth a shot! Here we go again….study study study until my 45 days passes!

  • 51. J  |  June 4, 2009 at 10:54 pm

    anyone else have any tips regarding the 2009? i am a first-time test-taker and am gearing to take the test in a few weeks. i have been studying for about 2 weeks now. i didn’t do so great on the Rita Cottrell Exam A, but i took the practice test on nbcot for $75 (200 mc questions and 2 simulations) and received a passing score. have also been reviewing with the johnson book…those questions seem a bit easier, but a good review of info nonetheless. any good suggestions from 2009 test-takers/passers?

  • 52. Taylor  |  June 5, 2009 at 8:18 am

    How much does it cost to take the exam, and how often can you take it? If you fail how long do you have to wait until the next time to take the exam?

    Thanks in advance for the answers!

    • 53. Katie  |  June 5, 2009 at 9:18 am

      The exam costs too much….about 500 give or take on if you notify your state and/or send scores to them. If you need to retake the examination, you must wait 45 days from the date of your test to retake. You also will have to resign up to take it, wait for the ATT letter, and then sign up through prometric website. I believe that you can take it as many times as needed…i’m on my fourth try. Hope this was helpful….all of the information is on

      • 54. Taylor  |  June 5, 2009 at 12:27 pm

        Edit: Good luck on taking the test again, Im sure youll pass it!

  • 55. Taylor  |  June 5, 2009 at 12:20 pm

    Thanks for the info Katie. I searched the NBCOT website and couldnt find any of this info, its a maze!

  • 56. Dave  |  June 14, 2009 at 6:11 pm

    Hey All,

    I’m glad i found this blog. I just recently took the exam for the first time and i should be able to find out the pass/fail results online in 2 days. The test was harder than i expected. I studied all the data in the study guides and my personal notes (diagnoses, evaluations, treatment approaches) and when i took the test i found out that it really didnt matter. Personally, it seemed really subjective. On a ton of occasions i would narrow down the possible multiple choice answers to 2, and then have to guess. I felt like i did a lot of guessing haha. I took some practice exams but apparently not enough. I guess we will see what happens. I hope all of you get through this soon, good luck.

    • 57. Katie  |  June 15, 2009 at 4:41 pm

      hey Dave,
      Did you find out of you passed? Good Luck
      Katie M

  • 58. katie  |  June 15, 2009 at 4:33 pm

    Alright- I am glad to know that there are some people out there having troubles with this exam. I have taken it three times and not passed. And I pass the practice exams. WHAT THE HECK. I have everythign to study for it and I even made 2000 flash cards. So why cant i pass.

    Seriously what am I doing. wrong. SOmeone please help me because I am not sure if I want to take it again because I have no money. but i cant work either unti lI pass this exam.

    So annoyed!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    • 59. Jiri  |  July 28, 2009 at 12:40 pm

      Katie i am beyond frustrated. I have takenit twice and studied 8 hours a day for 40 days and still did not pass. I made a 447 the first time and then a couple points less the second. It is too subjective. I feel like you cannot standardized a test that is subjectice it doesnot mix together and is unfair. I need to pass this time or i am going to go into depression becuase i will be out of work and homeless. They just dont care about the hard work people are putting in and want the money to help themselves. I bet they are grining with smiles. And why do they not reveal anything about the test. I believe they are passing people and failing on purpose because how will we know. I need to pass and will do anything possible too. When you find something out please let me know. by email

  • 60. kimberly wilshere  |  June 18, 2009 at 5:04 pm

    hey all. I just passed the exam on the fourth time.

    • 61. Michelle  |  June 18, 2009 at 5:08 pm

      Hey Kimberly,

      What did you study this time to help you pass? I just took it for the first time and didn’t pass….I hoping for good luck on the second try! Definitely look forward to your suggestions.


    • 62. ND  |  July 1, 2009 at 1:23 pm

      ‘Congrats’ Kimberly! that’s great news. pl let us know what helped this time around.

    • 63. Jiri  |  July 28, 2009 at 12:42 pm

      Can you give me some pointers. Email me if you can

    • 64. Caroline  |  July 31, 2009 at 5:37 pm

      Yes please give me some input on how you passed. I’m on my 4th time and I feel I have exhausted all my resources and my bank account.

  • 65. J  |  June 18, 2009 at 7:59 pm

    How long after taking the test does it take for the unofficial results to be posted online?

    • 66. Katie  |  June 18, 2009 at 9:04 pm

      Hey J,
      If you go to website, you can find the scoring calendar. it is under exam candidates, score reports…scroll to the bottom to the scoring calendar. It will tell you the scoring dates…it can take up to a few days after the scoring date for your online pass/fail to show…the first two times it was posted the date of the scoring date, but the third time it was posted two days after the scoring date. IT’s usually posted after 4:30 pm. Hope this helps.

      • 67. J  |  June 18, 2009 at 9:41 pm

        Thanks…what practice test have you been using? Any suggestions?

      • 68. Katie M.  |  June 30, 2009 at 9:58 pm

        Sorry it took so long to get back to you J…i have used many many flash cards, The official NBCOT study guide book, a study guide and questions from and the study guide book from therapy ed…it has many practice questions in it and i found it very helpful! Hope this helps.

  • 69. Julie  |  June 22, 2009 at 6:23 am

    Hi all,

    I am an OT from South Africa and I graduated in 2005. My fiance and I are moving to Chicago so I need to get registered as an OTR in order to work. My usual style of working is in a group but because I am in South Africa, there is no one here is writing the exam. Does anyone need an email study partner? I am looking to write the exam in Aug/Sep 2009. Also because I am a foreigner, are there any US specific tips that will help me? I really can’t afford to fail as it is really expensive for me to pay in dollars. Any help would be much appreciated. My email address in


  • 70. Mandy  |  June 22, 2009 at 9:29 pm

    Hey guys, I’m taking my test yet AGAIN this thursday. Pray for me for I have no other options but to pass this test and start my career!!! Wish me luck!

    • 71. Julie  |  June 23, 2009 at 2:41 am

      Good luck Mandy! Hope all goes well. Let us know how it goes? How long does it take to find out the results?

  • 72. Michelle  |  June 23, 2009 at 3:59 pm

    Did anyone have questions regarding validity, test re test and inter rater reliability on their exam? Can someone explain how to figure this out?

    • 73. Julie  |  June 25, 2009 at 5:36 am

      all that kind of info is in the Rita book on page 4.

  • 74. Mandy  |  June 23, 2009 at 10:49 pm

    Thanks Julie! I’ll find out the results next week.

  • 75. Sam Sabel  |  June 26, 2009 at 2:39 pm

    Selling the therapy ed book by Rita Fleming with 2 practice disk cds. If anyone is interested please contact me via THanks, Good Luck to All

  • 76. mandy  |  June 30, 2009 at 12:16 pm

    The exam is impossible to me. Failed again

    • 77. Julie  |  July 1, 2009 at 2:45 am

      So sorry 😦 by how many points did you miss? how many points are awarded per question? is the exam out of 600 and you need 450 to pass? how does the scoring work?

  • 78. becky  |  June 30, 2009 at 5:13 pm

    Hi. I just found out that I failed the exam I took last week. It was my first time and I didn’t finish all of the questions, even though I was completing the practice tests with an hour to spare. Knowing all of this, I’m still pretty devestated. How long do I have to wait before I take the exam again? I know 45 days, but is that 45 days total or 45 business days? The NBCOT website has not been much help to me. Thanks, becky

    • 79. Michelle  |  June 30, 2009 at 5:43 pm

      It is 45 days total from the day that you took the test. I am in the same boat as you. I failed a couple weeks ago on my first try and am devastated also. I have a perfect job waiting for me in August as well, which makes me even more upset. Get the NBCOT practice tests online or buy the book (they are a lot more similar to the actual exam) and if you can study with a friend I would totally recommend it. I just studied with a friend of mine today and it was so much more benefical than studying alone.

  • 80. Katie M.  |  June 30, 2009 at 9:48 pm

    Hang in there ladies! Def. study with a friend it helps a lot. I studied with two of my classmates and it was really helpful, and the NBCOT study guide is helpful too, but it doesn’t have that many questions. The online tests are great too from NBCOT, but you can only take them one time, which totally is annoying! I know what you are going through, i failed three times. This test is just impossible! I keep missing it by 3-5 points…ouch.

  • 81. Kathy  |  June 30, 2009 at 9:59 pm

    Hi to all!

    I’m so glad to find this blog. I think I’m in the same boat as many of you. I failed three times. I was wondering if any of you who purchased the NBCOT practice tests online can answer my question. Once you take the exam, can you able to go back to questions to review them? Also, can you take them as many times as you want to?

    Thank you.

    • 82. Katie M.  |  June 30, 2009 at 10:04 pm

      Hi Kathy,
      THe NBCOT practice exams are just like the real test which is great, but you can’t go back to see which questions were correct or incorrect, so there is no help there. You also can only take the practice exams one time…they charge you almost 50.00 for the darn test,a and then you can’t get any rationales for the correct/incorrect answers and you can’t take it more than one’s a rip off but it is just like the real test.
      I called NBCOT and they told me that they do not provide rationales for the practice tests, b/c some of the questions could possibly be on the real test…don’t think i believe that.
      HOpe this helps

      • 83. Kathy  |  June 30, 2009 at 10:35 pm

        Hi Katie,

        Thanks for the response. I think I will need rationales for the correct/incorrect answers since I already took the test three times. Have you try any review book from the NBCOT?

      • 84. Katie M.  |  July 1, 2009 at 7:07 am

        I have tried the official NBCOT study guide is a good book and the questions are similar to the actual test, but there are only about 100 practice questions…..this one does come with the rationales so i thought it was worth it to buy that book! You can purchase it off of the website…when do you take the test again? Mine is scheduled for July 22nd….my fourth try.

  • 85. Julie  |  July 1, 2009 at 2:47 am

    Hi, does any one have advice for studying on your own? There are no study groups where I am so I was just wondering if anyone studied alone?


  • 86. Kathy  |  July 1, 2009 at 8:27 am


    I haven’t set the date yet because I recently took the third one. How’re you studying differently this time around? I’m just afraid that I’m going to make the same mistake again. I really need to find out what I’m doing wrong. I used every study guide out there except for the NBCOT one. Do you have a study group or online study group that you’re involved in right now? I would love to get in a study group, but unfortunately there is no around where I’m…

  • 87. Eureka  |  July 1, 2009 at 10:17 am

    I am so sorry Mandy. But let’s not get discouraged, we’ll get it. I purchased the castle practice test package for $215 and the NBCOT study guide $60, in addition to the other study guides mentioned in previous comments. I got together with one of my classmates to study and it really helps, because you can discussed questions and answers from different perspective. Anyway don’t stop studying. Try to take the test again right at 45 days. It tends to be the same questions, however, reworded a little. Again, don’t worry, we’ll pass. I know money is tight.

    • 88. ND  |  July 1, 2009 at 1:19 pm

      I am in the same boat as many of u, did’nt make it twice. Have been studying to attempt it the third time. It freaks me out to think that the exam is harder now and the passing rates are lower than before…!
      I live in northern California, around the Bay Area. I was wondering if anyone lives around here and would like to form a study group.
      pl email me @ Also, is there any online study groups that are going on that i can join in….pl someone let me know, thanks.

  • 89. Mandy  |  July 1, 2009 at 5:32 pm

    The test is definitely graded differently for each question. They will not tell you how they come up with the scores. But I think that each test is graded on a norm score. If you pass the norm for that test, then you pass. Each test has a different norm. I have taken the old and new exams. I failed twice on the new exam but I thought the second one was much easier but I guess I still couldn’t pass. I haven’t found out my scores yet.

    Make sure you find out how many times you are able to take the test in your state. LA has a limit so if you go over that limit, you cannot practice in LA. Please make sure!

    Oh, here’s a new thing too. If you schedule you test and want to change the time or date, there’s a $35 charge. This is totally new and it freakin sucks.. Money hungry (b*) .

    I wanted to see if anyone was willing to study via skype. Maybe we could go over rationales or something. Let me know!

    I have been studying on my own and I can’t figure out why im not passing. It could be me just changing questions here and there. Who knows! No one tells us anything or willing to help.

    • 90. Sara  |  July 3, 2009 at 6:55 pm


      I would be interested in studying via Skype. My name on name on Skype is sara_lovett. My e-mail is Anyone who is interested please contact me. I am also interested in studying with others in the Western CT or eastern NY state area. I plan on taking the test in August. Thanks!


    • 91. Julie  |  July 6, 2009 at 3:13 am

      Hey Mandy, we could try and study via skype or email? I would I find out the limit per state? I need to know how many times i can take the test for Illinois.

  • 92. Elizabeth  |  July 2, 2009 at 9:57 am

    Is there anyone from New Orleans that is studying for the exam? I took the test two times before the format change, failed both times and have since been working outside the field. I graduated May 08. I am planning on trying to start studying again but am terrified b/c first, I have been away from it a year and second, hearing how difficult the test is now. I would love to study with someone if there is someone out there close by. I no longer live in the city where I attended OT school. I emailed one of the university’s here that has a program to see if there is anyone that would be willing to assist/tutor but havent found anything out yet.
    Please help!!
    I want to hopefully practice what my degree is from!!! Especially with all the money and time spent!
    Help help!

  • 93. Michelle  |  July 2, 2009 at 12:06 pm


    I live in the N.O. area and am in the same situation as you are. Did you graduate from N.O. or shreveport? If you still live in the area, we can possibly get together and study. I have taken the new exam and didn’t pass that one either.

  • 94. Elizabeth  |  July 2, 2009 at 12:21 pm

    Wow, I cant believe there is someone else out there in the same situation. I actually moved to N.O. in March. I graduated from University of Alabama Birmingham. I would love to possibly get together to study. I have not taken the new format and its been a while since I have taken the Boards. I took it the last time in December. I feel like I am going to have to completely over because I have forgotten everything! Anyway, let me know your thoughts. 🙂

    • 95. ND  |  July 2, 2009 at 12:52 pm

      For all those of u who have taken the new 2009 version of the test…any suggestions on how to do the CST [the new format] with good time. the Rita cotrell book recommend that u take 10-12 mins to complete that section and i find it impossible to do it in that time. The three practice tests that i did from the rita cottrell book i took more than 1/2 hr to complete 2 questions [with a,b,c and d] in each question. I think reading the questions, options given and the feedback takes much longer. Any suggestions on how to make good time on this and how to go about it.
      Also in the real exam is it 3 CST questions with [a, b,c, and d] in each question.
      would really appreciate any feedback on this. thanks

  • 96. Michelle  |  July 2, 2009 at 2:47 pm


    You can email me at and we can communicate that way. Hope to hear from you!

    There are 3 CST on the real exam. I wouldn’t take more than 30min to take all three questions.

    • 97. Elizabeth  |  July 7, 2009 at 4:48 pm

      Hey Michelle!
      Just wanted to see if you wanted to meet some time here in New Orleans to talk about possibly studying. Hope you are doing well!

  • 98. Erin  |  July 5, 2009 at 9:31 am

    Hi there,
    Would anyone be interested in studying in the Columbus, OH area?

    • 99. Miriam  |  July 16, 2009 at 5:21 pm


      I would be interested in studying. I live in Columbus, OH.

      • 100. Miriam  |  July 17, 2009 at 6:31 am

        Hi Erin,

        You can email me Stats and mental health are my weaknesses.

        Thank you,

  • 101. Mandy  |  July 6, 2009 at 10:19 am

    Call ur state board licensing dept and ask them.

  • 102. Michelle  |  July 6, 2009 at 8:10 pm


    If you would like, we could “study” or exchange info via email if you would like. Email me Even though we are not in the same area, studying with someone helps!

  • 103. Eureka  |  July 6, 2009 at 9:43 pm

    How does Skype work? What kind of microphone is needed?

  • 104. Michelle  |  July 7, 2009 at 5:12 pm

    I believe skype is like AIM. You could chat and webcam with more than one person at a time. My screen name is: simplytoocute23

    You can download it online for free.
    Look me up if you want to study Julie or anyone else.

  • 105. Lizette  |  July 15, 2009 at 11:59 am

    Hi guys, I am a first-time test taker who is planning on taking the exam in August. I was wondering about the test format for 2009; do the multiple choice questions have four different answers and you choose one or are there “both B and C” multiple selections type of choices? Thanks for your response!

  • 106. J  |  July 15, 2009 at 9:18 pm

    For all of the multiple choice you only choose one answer. There are no options which include more than 1 answer.

  • 107. Nik  |  July 17, 2009 at 1:28 am

    Hi I just took the OTR exam on July 2, and I found out tonight that I failed. I was devastated. I hate that I will have to fork over $500 to NBCOT. I’m agitated that I am going to have to quit my current OT job b/c my temp license will be revoked. Anyways, I studied from the TherapyEd book and the Pedretti’s textbook, but obviously they didn’t help. Anyone in the South Florida area want to start a study group. I’m willing to try anything now. I hope NBCOT takes note of the high failure rate.

    • 108. Fritz  |  October 10, 2009 at 6:19 pm

      Hey Nik, and everyone else out here, just to say I took the exam once in December, and just most recently in September, and both times I failed. IT is very frustrating. I reside in Florida if anyone is interested, my e-mail address is I have so far been using only the NBCOT study guide and review by Rita Castaldy. Are there any suggestions from anyone here? I mean I just want to pass this test and be able to start practicing. If anyone is interested in a study online group thing, I am down for it, and maybe we can share ideas. It’s nice knowing that other people are also facing this difficult situation, and I just wish we’d all make it because we know the material. Any ideas will greatly help. Thanks

  • 109. Ross Mynatt  |  July 17, 2009 at 1:48 am

    Just took my NBCOT on July 10th and failed…! I am so distraught over this and really really need to pass this test the 2nd time, I was wondering if anyone needs a online study/email back and forth study partner let me know. I was wondering if anyone is taking the prep course? I used the study book and found it really detailed and not helpful for my style of learning/reviewing. I hate that they changed the exam this year…

    • 110. Nik  |  July 17, 2009 at 2:05 am

      Ross, I used the therapyed book to study also. Obviously it didnt work because I failed. My new method is going to be studying diagnoses and their interventions. I’m waiting for the official report to arrive so I can see my area of weakness. I plan to re-take it in August.

    • 111. Caroline  |  July 31, 2009 at 6:47 pm

      i’m up for an online study group. I have failed three times already but KEEP passing all the prep exams. My email is

  • 112. Ross Mynatt  |  July 17, 2009 at 2:01 am

    how long does it take to get your official score report in the mail and yes i know it says 4-6 weeks, but i was wondering if anyone got it sooner. im curious to know how much I missed this pass by?

  • 113. Nik  |  July 17, 2009 at 3:33 pm

    Has anyone taken the TherapyEd live course? If so, how was it?

  • 114. Miriam  |  July 18, 2009 at 9:50 am

    I took the TherapyEd course and it did not help me prepare for the the exam (I took it for the first time last week and failed). I too am waiting for my official score report. If interested we could study via email ( I purchased the Rita book and found it too detailed.

    • 115. Nik  |  July 21, 2009 at 9:12 pm

      Miriam, when you are ready to study I can be reached at Thx.

  • 116. Shannon  |  July 20, 2009 at 5:51 pm

    I also just found out that I failed my first try. I’m filling your pain Nik I just found out I failed today but I’m thinking I am probably going to lose my job due to my temp license being revoked. I studied from the therapyEd book which i guess didn’t help and I took a few of the nbcot practice tests. Anyone live in the Dallas area that wants to form a study group?

    • 117. Caroline  |  July 31, 2009 at 6:49 pm

      I live in Dallas and I am totally down to study. email me Yeah!! Did you attend TWU by chance?

    • 118. Anna  |  August 6, 2009 at 9:47 am

      I’m from Dallas and would love to study! I’m going on my fourth try for this ridiculous exam. Keep passing all the NBCOT prep exams and I have taken the prep class and studied the Cotrell prep study guide. I feel like I should just read Trombly next. Call me and we can put our heads together. Thanks, Anna 214-335-8028

  • 119. Ross Mynatt  |  July 21, 2009 at 10:02 am

    Has anyone taken the OT Advantage Online prep/review course? I heard several good things about it and it is more realistic for me then traveling and paying 400 dollars for the TherapyEd prep course. I’d appreciate any input before i register for it. Thanks….

  • 120. arie  |  July 22, 2009 at 9:16 am

    WOW, just took the exam yesterday. I am so confused cause i have absolutley no idea how i did. (im hearing that is not good). The senerio questions took alot of time to the point that it threw my timing off. I finished very hurried and i guess that is the reason i dont feel good about it. Yet i think i answered the questions well. Who knows.
    For all you first time takers out there, I studied the old version of the Catrell-Flemming and did the practice test CD’s. I felt that it gave me a good foundation so that i really wasnt drawing blanks on many of the questions. STILL the test is WAY more than just knowing your stuff, its application and i really dont think there is anything out there that can prepare you for that except practice. Well the grading date for my exam is friday the 24th. Hears to hope.

  • 121. Jerod  |  July 24, 2009 at 5:53 pm

    To be honest, I don’t think anything will help! I’ve taken the exam twice and am getting pretty damn tired of taking this fucking test!

  • 122. Kathy  |  July 24, 2009 at 10:53 pm

    Has anyone used a study guide/practice exam from If so, is it worth to buy it? I think I’ve tried pretty much every study guide and practice exam out there except this one. I think doing more practice exams is only thing that will help me to get through this test at this point.

    • 123. Katie M  |  July 26, 2009 at 8:57 am

      Hi Kathy,
      I actually just took the test on Wednesday July 22nd for the 4th time, and i did pass this time. I studied again all of my flash cards, but i think the best thing that i did was to take the practice exams from I took all four content tests and the 2 hour practice exam…they really helped me a lot. I also bought the study guide from and it was just ok…nothing special, but it was cheap….i would def. recommend the products from!

      • 124. Kathy  |  July 26, 2009 at 4:03 pm

        Hi Katie,

        Congratulations! I’m so happy for you. I’m planning to retake the NBCOT exam on Aug 11th. I actually bought the practice exams (four content tests and the 2 hour practice exam plus the study guide) this time. I actually passed all those exams by like 50 points but that doesn’t guarantee anything so… Do you happen to have the questions from the practice exams? I was able to copy and paste the questions onto Word because I had some time left over at the end. I wonder each time you take the practice exam, you get different type of questions.
        I really do pray that I pass this time. Thanks a lot for your recommendation.
        Good luck with everything!

      • 125. Katie M  |  July 27, 2009 at 8:53 am

        Hi Kathy,
        Sorry but i don’t have the questions from the practice test. I think by taking the practice tests, it will really help you to prepare for your next exam. It’s really a shame that you can’t take the practice test more than one time. Best of luck on your next test!

      • 126. Jiri  |  July 28, 2009 at 12:55 pm

        Yes Katie i am so happy. I took it on July 21 and did not pass. I am so sad and fel like life is ending. I am so distraught but hopefully there is something that is helpful. Can you help me please. Somehow someway. I need some help. I would really appreciate it if you can email me back or reply with a way to contact you. I need to start working so i can support my family and as a man i feel torn because i am already working a job but it barely keeps the lights on and i had to loan money to take register again for the test in the first week of September. I dont know what to do but study hard and ask God for mercy.

  • 127. megan  |  July 27, 2009 at 11:07 am

    Hi, all. Can someone provide a link to NBCOT practice exam online because I can’t find it. Thanks.

  • 128. Jason  |  July 27, 2009 at 2:12 pm

    I used the Rita C book plus the study guide to pass the test. Study , study and more studying is the best thing I can say..

  • 129. sara  |  July 27, 2009 at 3:55 pm


    I also took the NBCOT practice exams. Would you be interested in going over our reasoning for questions over the phone or online?

    Feel free to e-mail me at

  • 130. jaybo  |  July 29, 2009 at 12:06 pm

    Everyone on this blog should carefully review this Powerpoint presentation given by Dr. Margaret Bent (NBCOT) to program directors in the spring of 2009. NBCOT cannot defend realibility/valididy issues with the 2009 OTR exam. The passing rate for first-time, new graduates with over 1,100 candidates taking the exam was 73.7 %; the failure rate of 26.3% (DOUBLE the 2008 failure rate) is not statistically defensible.(Reference slide 23/36)

    The scale score distribution bar graph for first-time graduates (Reference slide 20/26) indicates a mean score of 463.14; the absolute standard passing score is 450 which is only 13.14 points less that the mean. This results in a very skewed frequency distribution to the left of the mean which is not statistically defensible. NBCOT says it will put initiatives in place to help students who take the exam in late fall of 2009; this may help those sutdents and the colleges with low passing rates, but: The question to be asked is what is being done to assist those exam takers who have been caught in the middle??

    • 131. Amalia  |  November 4, 2009 at 1:06 pm

      Hey jaybo:
      Wow, this is interesting! Do you have any information of these new “initiatives”? If the passing rate from the old version of the test went from 85% to around 70% now, that should be a clear indicator that something is wrong and unfair. Anyways, thanks jaybo for the info.

  • 132. Caroline  |  July 31, 2009 at 6:03 pm

    Hey everyone! I am on my 4th try and I’m going broke. I have read the therapy ed review book, took the prep course, studied with friends, and ya know just about everything and no luck. I’m from Texas and would love to be part of an online study group or if your from around the area, perhaps, we could meet to study. I’m feeling pretty crappy about this whole thing and would appreciate any guidance. I wish everyone good luck if taking the exam soon. Please HELP!!! Thanks

  • 133. Michelle  |  August 2, 2009 at 1:19 pm

    Hey, I just took the exam for the second time on Thurs and found out that I failed. I bought the NBCOT book and all the content tests and passed them all. I also took the IER class and have the book that goes along with it. Does anyone have any other ideas or suggestions?

    Please email me at with any help!

  • 134. Kelly Hughes  |  August 18, 2009 at 10:33 am

    My gosh that was a Hard Test! I studied til my eyes bled.. haha.. Great Advice here!

    I bought every study material I could too…

    The offical books, and the NBCOT practice tests A+ study guide A (like having your own notes)
    MoMedia Flash Cards d- (old and bad)
    MoMedia Study Guide C (material was vague but the study tips were good)
    There are a few sites online that have some study info too including this one.. search them out…
    Red Bull A+ (Could not have studied without it).

    Good Luck Yall!

    • 135. Marie Antoniette Casals  |  September 5, 2009 at 7:44 am

      Hi kelly,
      I’m tonie from the philippines…I plan to take the nbcot exams by nxt yr…PLs2x i need to know the right review guides to buy that would help me pass the exams…

    • 136. charlotte  |  January 30, 2010 at 9:37 pm

      Hi, I am from Phils too, wil be taking the exam this 2010 as well, do you know any review group or review center from Phils?

  • 137. Michelle  |  August 22, 2009 at 10:00 pm

    I finally passed you guys!!! yay!!! after all the hard work and a lot of perserverence….i did it.

    Those of you out there, just keep trying. study the Rita book very well, take those online tests from….I think those tests really helped and are similar to the ones on the test. Good luck to everyone!

    • 138. Caroline  |  August 25, 2009 at 4:26 pm

      What text did you use to study from? Trombly?? I have Rita and the NBCOT study guide, but don’t know what else to study

    • 139. Marie Antoniette Casals  |  September 5, 2009 at 7:47 am

      congrats michelle!
      I’m tonie from the philippines…i’m planning to take the nbcot exam nxt yr…PLs 2x help me buy the best review materials available to help me pass the exams.

  • 140. Nik  |  August 23, 2009 at 4:45 pm

    I took the exam for the 2nd time today. I’m hoping and praying for the best.

  • 141. Ross Mynatt  |  August 23, 2009 at 4:51 pm

    Nik good luck and congrats!

    I take my 2nd go round on the 1st of sept. Best wishes/prayers and positive mojo your way. I feel like I have used alot more resources this time and varied it up which is important for me otherwise I loose interest. But in any case let us know and ill do the same send some positive chi my way on the 1st. Thanks and good luck to all

    Ross in Albuquerque, NM

    • 142. Nik  |  August 23, 2009 at 6:50 pm

      Thanks Ross. Good luck on your exam.

  • 143. Ross  |  August 30, 2009 at 8:15 pm

    Nik how’d you do on your exam?

    • 144. Nik  |  August 31, 2009 at 6:49 am

      Hey Ross. The results havent been posted yet. Hopefully, they’ll be posted this week.

    • 145. Nik  |  August 31, 2009 at 2:36 pm

      Failed for the 2nd time. I’m dissapointed, but I’ll try again.

  • 146. Eureka  |  September 1, 2009 at 10:44 pm

    Hi Nik, that is a great attitude. I know you will get it this time. I know you took the exam on the Aug 23rd, I thought NBCOT scoring date is not until the 15th of Sept. How did you get the results so fast.

    • 147. Nik  |  September 1, 2009 at 10:59 pm

      The results have been showing up before the scoring date. The same thing happened when I took it the first time. The results have been available within a week and you are able to reapply earlier than the designated 15 days.

  • 148. Jiri  |  September 2, 2009 at 2:49 am

    hey nik i take my exam for the third time. I know i am going to pass this time. I have studied extensively hopefull not too much because i made 447 the first time i took it and the second did worse and made a 441?

    • 149. Nik  |  September 2, 2009 at 2:40 pm

      Good luck Jiri. I’m sure you will pass it this time.

      • 150. Jiri  |  September 3, 2009 at 6:32 pm

        Thanks Nik i know i will. I am going to have three people help me while i take the test. The Holy Ghost, The Son, And The Father! LOL I may have studied too much.

  • 151. Sarah  |  September 8, 2009 at 1:24 pm

    Does anyone know if there is a limit to the number of times you can take the exam?? Live in NY

    • 152. B  |  September 11, 2009 at 7:14 pm

      you can take it as many times as you need to Sarah I called and asked the same question. good luck

  • 153. Ross  |  September 9, 2009 at 2:10 am

    Has anyone taken the exam around the first of sept (i took my 2nd attempt sept 1) and or the last of August and found out their unofficial score result yet?

    I took my first exam July 10th and found out on July 15 my unofficial result (even though the grading date was the 21st of July). I am starting to wonder if some computer just tosses out the result on the 15th and 30th of every month despite the “official grading date”. Let me know if anyone has any information…thanks

  • 154. B  |  September 11, 2009 at 7:13 pm

    I will be taking the exam in 2-3 weeks. I have been utilizing the Johnson CD-rom and Ritas questions as well. I will be using the NBCOT official studying guide and possibly a practice test from castleworld. I got a score of 441 my 1st attempt but I have focused on my reasoning skills this time so I am hopeful that I pass this time. Anyone taking the exam b4 sept 30th and want a studybuddy let me know. Good luck to all & congrats to those who have passed.

    • 155. Julie  |  September 12, 2009 at 3:14 pm

      Hey B, I am hoping to take the exam either end of september or beginning of october. if you want to bounce ideas back and forth let me know:

    • 156. Sabina Isabella  |  September 30, 2009 at 3:36 pm

      I just took the exam last week for the 1st time and found out today that I passed. I feel that taking at least 2 of the content exams as well as the 2 hour CST MCT practice exam from NBCOT (on really helped me. I know it is expensive, but keep in mind that is is a lot less than it would cost to retake the exam. They give you a lot of time on the content exams and I wrote down all of the questions as well as the rationale for the correct answer for each one.

      let me know if you have any questions or need advice.

      -sabina 🙂

    • 157. Sabina Isabella  |  September 30, 2009 at 3:48 pm

      oh, and i meant to say that i used the notes i took as well as the Johnson book and CD and the Rita book and CD to study.

      • 158. B  |  October 6, 2009 at 1:43 pm

        Thanks Sabina & Congrats. Which content areas did you take?

  • 159. Megan  |  September 11, 2009 at 11:46 pm

    I just took the test and was FLOORED by the so called “entry-level” questions on the test. The test questions were NOTHING like any study material that I studied, including the NBCOT practice tests (which I DO NOT recommend anyone paying the money for because it is not reflectve of the exam). I feel that nothing I could have studied could have prepared me. It is ridiculous how difficult it is! We are OCCUPATIONAL THERAPISTS not brain surgeons. It is NBCOTs way of making more dough…. too many people were passing before. I am just praying that I did enough to pass…. Good luck to everyone taking the exam. Thanks for letting me vent 🙂

    • 160. Mali  |  November 4, 2009 at 2:36 pm

      Megan, I agree. It wasn’t a question on the test, but in the Rita book, they asked a question about autonomic dysreflexia, and what should you do. Their answer? Empty the catheter bag. As an entry-level therapist I have no freaking clue how to do that. My solution? Call a nurse pronto! In fact, I’m sure I’d make the situation worse. Some of the specific splinting questions are also ridiculous, and only seem appropriate for those who have been working in a hand clinic, not entry-level therapists. Too many questions were very interpretive. Some of the questions I wouldn’t have done any of the options. I think one of OT’s biggest strengths and biggest weakness is how broad it is. There is just too much to know, that no entry level therapist could possibly retain.

      PS Does anyone else feel that their school should have done a little more to help with the test? Mine basically told us to just look over notes.

    • 161. Amalia  |  November 4, 2009 at 3:56 pm

      Is is unethical to talk about the test with others who have also taken it? Also if you have to take it again, is it very different?

      • 162. Jerod  |  November 24, 2009 at 11:34 pm

        Whats unethical is the questions that they ask and the cost of the test! No matter how you look at them they aren’t entry level questions! and that is a fact!

  • 163. Jess  |  September 12, 2009 at 12:04 am

    I just took the exam yesterday – hopefully find out on Wednesday the results! Wow – was a challenging exam! Good luck to everyone!!

  • 164. Julie  |  September 12, 2009 at 3:51 pm

    I took the NBCOT exam this summer and passed. I am selling several books that I used for studying on Ebay. Hopefully someone else can find them as helpful as I did! My ebay seller id is juleswatson

    Good luck!

  • 165. Jiri  |  September 15, 2009 at 1:46 pm

    I passed everyone through the power of God from constant work, prayer from myself and friends and also faith. Good work without faith is useless. Many blessings to everyone else!

    • 166. Nik  |  September 15, 2009 at 2:18 pm

      Congrats Jiri. I’m so happy for you. Congrats on starting your career.

      • 167. Jiri  |  September 15, 2009 at 7:23 pm

        Thank you Nik very much.

  • 168. Jess  |  September 15, 2009 at 6:17 pm

    I also passed – just found out today!! HOORAY!! You ALL can do it out there! Its just really a LOT of study – all the books that everyone has recommended, the practise exams and just going back to the text books! These comments have really helped me out – thanks everyone, and good luck to those who are taking the exam!!

    Jess 😀

  • 169. ASHWINI.R  |  September 16, 2009 at 1:35 am

    last sunday i had been appeared niit exam may i know what is my result

    • 170. Praveen Chopade  |  January 3, 2012 at 4:49 am

      Hi Ashwini,

      My wife is planing to come to US in coming month. she is an OTist with BOT degree(KEM Hospital , Mumbai) also having work expx 2+ years in India, she is on H4 dependent visa.
      could you please guide us. Like is ther any need of going or any certification/exam to work in UR OR she need to have H1\any organization is willing to file petiotons here.

      Praveen Chopade

  • 171. Ross  |  September 16, 2009 at 12:26 pm

    I passed as well on this second attempt! I would have to agree that the best tools are:

    – Variety of study materials (so you don’t get bored)
    – Rita/Fleming Study Guide
    – Flashcards (make your own, download them, whatever)
    – NBCOT Exam Secrets study guide
    – OT Advantage Online Study Course
    – NBCOT Practice Exams (Content and OTR exam) *** Best Tool

    I believe that it really comes down to the exam you get and how you tackle them, this is a tough test and how you utilize your time on the exam and really keep your mind active, analyzing the stem of each question!

    The best questions to ask for every test question is:
    – What is the question asking….take some time to figure this out look at everything they give you
    – What is NOT appropriate or indicated

    I hope this helps

  • 172. arie  |  September 16, 2009 at 10:52 pm

    Passed my exam on the second try and just found out yesterday! THANK GOD! Ok i want to relate what happened to me for all the lurkers out there as i was one of them so that you REALLY understand what this test is about. MOSTLY Because this site REALLY helped me cope.
    1. DONT FEEL bad if you dont pass the first time. If this site doesnt relate to you that its common then understand that in the event you dont pass (as i did) you HAVE a foundation of knowledge you just have to build on it.Plus what else can you do except try again

    2. The first time i felt like i new flemming inside and out but it did not make a difference. SO DO NOT JUST STUDY THAT. (i was passing the so called hard practice exams that come with it) Point is you have to diversify your knowledge. I found the NBCOT practice exams content and sim very helpful, NOT as a basis for studying but as I took the exam the second try, reasoning from the content exams was poping up in the Real test. I also used NBCOT study and JOHNSON’s practice exams. Yes i answered all 800 questions. and Yes, the stuff was stuff i knew, but it condensed alot of it and the pics put things in a visual format for your brain to absorb.

    3. The exam is timed as you should know so DO NOT waste time on one question as that one question will not make or break you! THIS MADE ALL THE DIFFERENCE FOR ME FROM THE FIRST TO THE PASSING TRY. the way i “chopped” the test up was 30min MAX for the simulated questions, 1hr and a half from 1-100, then really concentrate for 1hr for 101-170. mental fatigue is an issue so you really have to check in for this exam. Brain Gym helped me…look it up. This leaves you with 1hr. to review all marked answers carefully. Oh and do put a logical answer on your marked answers in case you cant make it back to review them at least you have a logical choice picked.

    3. STUDY YOU BUTT OFF. and i dont mean the night before as you want to go into the test mentally at rest. First time i went into the exam mentally exhausted and…well i failed with a 440.

    4. when you go home after the exam, write down the questions you remember as stumping you. Seek the answer as you may see it again or a version of it.

    5. Study with a partner. Worked for me and may for you.

    Finally THINK POSITIVE! YOU WILL EVENTUALLY PASS IT! it does NOT matter if its try one, two, three, etc. KEEP YOU EYE ON YOUR GOAL. you will be an OTR.

    I would like to thank everyone on this site for the advice shared as it helped me cope with the stress over this exam. I hope this helps someone out there…..

  • 173. Holly  |  September 17, 2009 at 12:38 am

    I will be taking the OTR exam for the 3rd time and would like to get a different approach or bounce ideas around through email or if anyone lives in or around West Bloomfield, MI please let me know if you’re interested.

    • 174. Teale  |  January 15, 2010 at 2:13 pm

      Hi, I live in Rochester, Michigan and I am looking for a study partner. I will be taking the exam aroung Feb or March 2010. Please contact me if you are interested!

  • 175. Jerrilynn T  |  September 17, 2009 at 1:11 am

    I finally passed. Thank You to the person who created this site. Great info in this thread. Ok, here is what I used:
    Rita study guide
    nbcot practice tests
    carol johnson book
    and a few internet sites.

    Congrats to those who just passed and good luck to all of you that are taking the test!

  • 176. Beth  |  September 17, 2009 at 8:09 pm

    Hey, I just took my test for the 2nd time and Thank G-d I passed. The first advice is to pray, because only He can ensure your passing. The second thing is learn how to read the questions. On the first test I picked answers that had to do with words in the question, however that is not always the answer. The therapy ed class helps you learn how to read and understand the questions. For example, my instructor said that if the question asks what action should the therapist take, the answer is not usually observe because that is more of a passive thing, it’s not a real action. After reading the question, say to yourself what is the question really asking me? Also I took notes on the questions after going over it, and later studied those notes. I wish you all the best of luck!

  • 177. Robert Moody  |  September 29, 2009 at 10:11 pm

    I rarely leave comments or post blogs but I had to comment on the Exam Prep course from OT Advantage. This class was great! Absolutely AMAZING!

    Feel free to check them out: http://www.ot-advantage.

    Thanks Alison!

  • 178. Sabina Isabella  |  September 30, 2009 at 3:14 pm

    I just took the NBCOT exam for the first time on September 25th, 2009 and found out today that I PASSED!!!!!!! I was sooo relieved (to say the least).The worst part was waiting to see if I passed.
    If anyone needs any advice at all, or tips or has any questions, I would be more than happy to help you out : )

    Ask anything about preparing for the NBCOT etc., and I will get back to you. (I feel I have some beneficial tips)

    I will be checking back on a daily basis for a while.

    • 179. caprica  |  October 1, 2009 at 4:42 pm

      It would be wonderful if you could tell your secret as i am sooo devastated that I failed the 1st time I took it…

      • 180. Sabina Isabella  |  October 1, 2009 at 6:32 pm

        oh, and a positive attitude is crucial. Don’t stress out. I did a lot of praying too! 🙂

    • 181. Sasha  |  October 1, 2009 at 5:20 pm

      Hey. Congrads on passing the exam. I would love to hear any tips or suggestions you have. I will be taking the exam sometime this month when I build up enough courage to schedule it. This wont be my first time, but hopefully this will be my last time.

      • 182. Sabina Isabella  |  October 1, 2009 at 6:16 pm

        caprica & sasha,
        I know that everyone studies in their own way and some people feel they benefit from prep courses and some don’t, but I didn’t even know where to begin studying for the exam, so….
        The very 1st thing I did was take the TherapyEd course. With the course you receive the newest version of the Rita Fleming-Castaldy review and study guide as well as a course manual which tells you what you need to know from each chapter and gives examples. What I got out of the class was a ton of information on understanding how to apply clinical reasoning to the questions to come up with the correct answer. It gives you general studying strategies for specifically answering both MCT as well as CST questions. (i also had friends in the course who had failed the exam before and passed it after taking the class and organizing their study plan).

        If you are not able to take the course before the exam, definitely purchase the Rita book (if u haven’t already) and do ALL of the CST questions on the CD mutiple times. These questions are more challenging than the CST questions you will likely see on the NBCOT exam, but I figured better to be over prepared, ya know? I didn’t do many of the multiple choice ones from RIta though. As far as the Rita book itself, i used it as a supplement to my studies. I did not read the whole thing. It is waaaay to detailed.

        The next thing I did was study the OT TREATMENT for each of the diagnoses. The treatment is what you really need to know and understand.

        I studied the OT Process chapter with all of the groups and stuff about program development as well as the different types of reviews that can be done i.e. utilization review, etc.

        Know different group types and how they evolve as well as the OT (facilitators) role in each of them…oh, and what types of settings you may see certain groups in i.e. usually in an acute psych setting you will only see parallel and/or project groups and the type of leadership in these 2 groups is directive leadership.

        I did all of the questions (all 800) in the Caryn Johnson book and reviewed the rationale for each. I used both the book and the CD. Do the questions multiple times. Up until a week before the exam I broke them into content exams i.e. peds, phys dis, mental health/cog and OT for populations.

        Make sure to have a general understanding of “typical” developmental levels. i didn’t stress out about the details, i just made sure i know what order major dressing, feeding, motor development, cog development and play stages progressed in.

        I then took 2 or 3 of the NBCOT content exams and wrote down what the question was about and later studied this along with the Johnson questions and Rita’s CST questions. The NBCOT content exams are well worth the money, in my opinion (i did not have any of the same questions on the exam, but they were VERY similar).

        I took the NBCOT $75 CST/MCT practice exam (2 hr). as well as the CST practice exam #2 on the castleworldwide website). They helped a lot.

        I also went onto youtube and watched OTs doing treats that i wasn’t that familiar with)

        Be familiar with all of the different FORs i.e. biomechanical, Neurodevelopmental, behavioral, etc.

        Look back at books from school regarding common hand injuries (CRPS, Carpel tunnel, etc.) as well as peripheral nerve injuries and how to splint them. also know how to splint for different burns and for flexor/extensor lacerations and injuries as well as RA and juvenille RA splinting.

        go over spinal cord levels and what the individual is able to do and what adaptations, modifications they need (especially C4-C8)

        you dont need to know specific MET levels for cardiac patients, but understand what they can and can’t do in different levels of cardiac rehab. and know cardiac precautions.

        know allen’s cognitive levels, especially 2-5

        i think i had one question in there about Rancho as well.

        Know the roles of a COTA as well as collaboration between OTR and COTA.

        know all of the ethical info

        know about OTR role as a consultant as well as OTR role in program development

        Know medicare stuff

        know that a school based OT must have goals that are relevant to school (not ADLs)

        i had many questions on my exam about hip replacements

        know when to treat someone individually and when to do grp treatment as well as how to solve group conflict.

        overall, never choose an answer that could even possibly harm or be detrimental to the pt. especially in the CST questions.
        *don’t go back in the exam and change your answers unless you are absolutely certain****this is very important!!! i only changed one answer on the exam and that was because i had a question later on in the exam that answered a previous one and i knew i got it wrong.

        they gave me 2 marker boards and some dry erase markers and an eraser at the testing site (if they dont give you anything to write on, request something) it is a good idea to write down key words in long questions like CST questions. ask them for earplugs as well, cause the earphones suck at blocking out noise.

        ok..i hope i helped you guys out : ) please let me know if you have any other questions or concerns

        -sabina : )

        Most of all, know that

  • 183. Elizabeth  |  October 1, 2009 at 7:28 am


    I am based in the UK and took the NBCOT exam last week for the 2nd time, and found out yesterday that I have passed!

    I used:
    TherapyEd Book
    Johnson OT Examination Review Guide
    Guide from
    All NBCOT content tests and practice test
    Visited various websites including Youtube, which helped for revising PNF and primitive reflexes

    The 1st time I think I messed up with my timing and I rushed at the end to finish the questions. I also hadn’t done any of the content tests. The content tests definitely helped this time because a couple of the same questions popped up in the exam.

    Good luck to all those taking the exam.

  • 184. Danielle  |  October 1, 2009 at 9:17 am

    Hi everyone,

    I have taken the NBCOT exam multiple times ( to say the least) and I am about to take the new 2009 exam at the end of this month. I attended the therapy ed course and I have the book. I just took one of the exams and received a 56% out of 100%. Please help in any way you can. I am sooooo tried of spending money on this exam. I need to pass this time.

    Thanks, Danielle

  • 185. caprica  |  October 1, 2009 at 4:38 pm

    Hey guys I’m new here but looking for some suggestions on how to pass this dreadful OT exam. I just got word yesterday that I failed so as u can imagine I am extremely devastated.. So any advice is welcomed as I dont have a clue what to do next….

  • 186. Michelle  |  October 1, 2009 at 6:26 pm

    Hi everyone,

    I just took the exam last Tuesday and found out yesterday that I passed the exam on the 3rd try!!! I want to get rid of a few books. I have the NBCOT Official OTR Study Guide and am selling it for $60.00. I also have the Occupational Therapy Examination Review Guide by Caryn Johnson, which I will sell for $45.00. They are both great books and I am positive it is the reason why I passed this time. The questions are VERY close to the actual test! Please let me know if you would be interested. Email me at

    Believe in yourself you will pass and get through this!
    Thank you,

  • 187. Tracy Stanley  |  October 2, 2009 at 2:40 pm

    I see someone has posted about OT Advantage and I had to put my own comments about how much the course has helped me. I would recommend it to anyone who really want to pass the NBCOT COTA exam for the first time. Alison really knows her stuff and is very helpful.


  • 188. lin  |  October 2, 2009 at 4:26 pm

    Hi I am interested in finding a study partner. I hope to take my exam in Feb 2010 Please email me at

  • 189. Lizette  |  October 4, 2009 at 3:34 pm

    Hey guys,
    I took the exam on 09/25 and found out that I passed on 09/30!!! Overall, I agree with most of the study strategies that others used for passing the exam. However, I really was on a budget and had to scrimp on resources as much as possible because I hadn’t started working yet. So, hopefully these tips will help for all of you who are really strapped for money too.

    First of all, I did purchase two study guides–(1) TherapyEd National OT Certification Exam Review & Study Guide by Rita Fleming-Castaldy for $85 and (2) OT Exam Review Guide by Caryn Johnson for $45. I also purchased one NBCOT practice exam for $75. This totaled about $205.

    I read through all of the Fleming-Castaldy book at least three times, once when I began studying, second time midway through the process and the week right before the exam. I chose to prepare for about 2 months before the exam but I have heard people pass who studied intensely for a few weeks prior to the exam. When I read the Fleming-Castaldy book, I focused mainly on knowing what the condition is and what OT intervention should be applied. Knowing any special contraindications is important because it can help you rule out an erroneous answer. Overall, there is a TON of information in the Fleming-Castaldy book and it’s easy to get obsessed about small details but stick to the basics because that is what will help you on the exam. You can’t know everything completely 100% so save memorizing only for really important information.

    I did take two of the four Fleming-Castaldy tests on CD but found that they were the most helpful for learning the format of the Clinical Simulation Test portion. Otherwise, the Multiple Choice questions were very difficult and not as good of a preparation for breaking down real exam questions. Don’t feel bad if you fail the Fleming-Castaldy exams, many people fail them and still pass the exam, as I did. I did not do a TherapyEd class again due to limited resources and also because I heard that some classmates who did it felt that they knew some more strategies for learning how to break down questions but that they felt more nervous about taking the exam!

    A better test-taking resource was the OT Exam Review Guide by Caryn Johnson because the questions are more stylistically written like the actual exam, there is an accompanying CD and the rationales are excellent. They include references if you need to look something up for a better explanation. I did ALL 800 questions (4 practice tests) at various points. The last couple of days leading up to the exam, I randomly selected various questions to test myself. It’s a good way to get into test mode.

    I also did just one practice exam from NBCOT about 3-4 days before taking the real exam. I know that other people spent hundreds on the content exams etc but I couldn’t afford that and I just wanted a rough idea of knowing whether I would pass or fail the real thing. I passed and it was a good confidence booster for knowing that I was on the right track.

    I would also recommend that you use the resources that you already have purchased!!! I went back and looked at/reread portions of Trombly, Willard-Spackman and Case-Smith, focusing on conditions and interventions. I did that with the mindset of increasing the ability to recognize conditions/treatment strategies not memorization. It was also helpful because the Fleming-Castaldy book is pretty good but it did have a few holes, such as vision. Also, don’t forget about the management questions because they are 20% of the exam, an easy way to boost your score.

    Find a system of studying that works for you and stick to it so that the info remains fresh and you’re adequately prepared. If you prefer to study alone, try to attend a few study groups. It’s a great way to pick up some more info and discuss the material. I tended to study alone but found that the group sessions were beneficial. Another very good strategy for group study is to study with classmates who are strong in areas that are weaknesses for you.

    As you approach test day, try to stay positive and calm as much as possible. Remind yourself of all the tests and challenges that you have passed successfully before. I wouldn’t recommend cramming the night before (I didn’t look at anything and tried to relax by watching mindless TV!). Be confident that you know the material and give your brain a rest break. Prayer and deep breathing also worked well for me.

    On test day, arrive early! The testing site requires that you arrive at least 30 minutes prior. You may even be able to begin early if there are seats available but that entirely depends on the site. Ask for the earplugs because it helps to block out extraneous noise. Keep track of your progress with some kind of system so that you finish–I did the CST + 20 MC questions in the first hour and that left 50 questions per hour afterward. Read each question carefully and ask yourself, what is being asked? Usually you can eliminate two wrong answers immediately and as you evaluate the two remaining choices, go back to the question and match the answers back to the question to find which one is the best fit. If you still don’t know, take a guess and move on. The important thing is to finish! If you have time to check your work, don’t change answers unless you noticed something new in the question that makes your first selection incorrect or a subsequent question helped to clarify this one.

    Put the test in perspective, it is one test that does not determine what kind of an OT you will be so even if you fail, it is not the end of the world. Most people pass right away and for those who fail, they usually pass the next time around. Good luck to everyone taking the exam, hope this helps! 🙂

  • 190. Sabina Isabella  |  October 6, 2009 at 2:10 pm

    I took the NBCOT peds, phys dis and mental health content exams. as for the OT for populations and ethics, i just did all of those questions multiple times in the Johnson book. Hope that helps : )

  • 191. B  |  October 10, 2009 at 5:45 pm

    Hey I took the 100 question mc test on castleworldwide. Does anyone have an answer key for that exam. I would really LOVE to go over my answers. I passed by 25points but really annoyed that I cannot go over the exam : /
    feel free to email me directly

    thanks again and good luck to all

  • 192. holly  |  October 16, 2009 at 1:17 am

    I took the exam on Oct. 8th and found out today that I passed!I mentally prepared myself the night before the exam by imagining myself confidently taking the exam and passing. I used the oficial NBCOT exam study guide, Rita study guide, ot review guide by Caryn Johnson’ exam secrets by morrison media, I did not utilize the therapy ed course and ot-advantage course. I also got together with friends to study and I found that really helpful in retaining all the material studied. I did a lot of praying also. During the exam I asked myself what is the problem or priority in the question and made sure the answer selected answered the question being asked. I saw a lot of questions regarding mental health eval and intervention, know groups, spinal cord injury levels of independence and equipment,also, peds eval and intervention. I am sellin my official NBCOT study guide for$ 55. 00 dollars and the mo-media exam secrets for$30. 00 dollars, and the 2008 study guide by for 20. 00 dollars. Email me at if you have any questions about preparing for the exam or if you’re interested in purchasing the study guides I’ve listed.

  • 193. Danielle  |  October 16, 2009 at 10:35 am

    I am wondering how long should one take to study for the exam to successfully pass it? Please give your thoughts and previous study habits. This information will help out alot.

    • 194. Julie  |  October 18, 2009 at 8:44 am

      Hey Danielle, I would recommend taking 6-8 weeks to study. If you have the time rather be consistent in order to remain focussed and reduce stressed. I originally booked my test date that would have given me a month to study and then I realised that rather than taking a risk and stressing myself out unnecessarily, I moved my test date by 3 weeks. If you need any tips or advice, you can email me at 🙂

  • 195. G$  |  October 17, 2009 at 5:02 pm

    Ok Im from NY i took the exam in July and failed..Took it last monday and found out i passed..Dont be discouraged it happens to the best of us..there must be struggle before sucess..its inevitable..DO NOT BUY the online tests NBCOT sell they are too easy…I used the JOHNSON BOOK initially and did pay too much attention the RITA BOOK because we were told in past years it more resembled the JOHNSON style questions, not true on the test i took in July but true of the test i took on Moday…i honestly cant tell if they have revised the test since this my suggestion is use both books and on the Johnson cd-rom take content tests as well as the regular ones…go OVER your wrong answers and rationale write down the right answers so you can look at it over and over again…study RESEARCH…not just the research section of your RITA book either..dont over do it though….STUDY SPLINTS not just primary splints also the seconary splints for diagnoses…change is good…change your testing site and the time of day you previously took the test….GOOD LUCK!!!!

  • 196. B  |  October 19, 2009 at 8:03 pm

    Hi all. I sat for the exam on saturday. Now I’m sitting, hoping, waiting, & praying I passed. Starting to look for jobs confidently. : ) Good luck to all and congrats who have passed.

    • 197. Eureka  |  October 20, 2009 at 9:01 pm

      I know you did it this time B.

      • 198. B  |  October 20, 2009 at 9:51 pm

        Aww thanks Eureka. CONGRATS on passing… you are an inspiration. xo

  • 199. Jill Hutchens  |  October 24, 2009 at 1:02 pm

    Whoo Hoo I passed… 🙂

    I used the Nbcot practice tests and the Rita Flemming Castaldy book as well. I practiced these so much I could almost read the question verbatim. I also purched the NBCOTexam com study guide as well. My favorite professor and mentor highly recommended it. I made bunch of flash cards from it on things I know I was weak on and study these for 2 weeks until my test. I read that study guide over and back all night the day before my test too. Study with your friends too, not only is it helpful, it can be fun too, kinda lessens the stress a little bit.

    One more thing, don’t drink Orange Juice before the test, it makes an upset tummy even more upset!! 😦

    Good Luck!


    • 200. Lindsay  |  October 25, 2009 at 6:47 pm

      Hi JJH

      Would you mind selling me all your study materials?


      • 201. Caroline  |  November 3, 2009 at 9:48 pm

        WOOO!! Found out I passed!! This was a long journey, but I believed in myself and got through this hump of disappointment. Thank you for this blog because I was able to contact other people in my situation. I have The NBCOT study guide that I would like to sell for $50: NBCOT content exam questions with answers for peds, physdys (rationale included), mental health, and management quest.for $35.00 and the study guide and questions from for $40.00. To all , these two study guides from NBCOT study guide and the other, along with researching info from text books, such as Trombly and Pedretti helped me pass. The Rita book had good general info but lacked detail. Good luck to all!! Pleas email me at

  • 202. Nae  |  October 28, 2009 at 3:36 pm

    I am so glad that someone recommended this site to me. It is good to know that I am not the only one out here that cannot passed this test. I as well have taken this test multiple times and not succeeded. Listening to the success stories of those who have pass has given me hope. Thanks to those who have left advice and words of encouragement-I now see the light at the end of the tunnel-be bless all!

    • 203. Danielle  |  October 28, 2009 at 9:24 pm

      Hey Nae, I know what you mean. I was going to give up, but I have been inspired to take this exam again at the end of November. Stay encouraged and remember you are already an OT.

  • 204. Nae  |  October 29, 2009 at 9:32 am

    Thanks Danielle,
    God bless you on your exam-I know you will pass!

  • 205. Ifetayo Blissett  |  October 30, 2009 at 1:08 pm

    Thanks all I Passed! Good Luck : )

  • 206. Mali  |  November 4, 2009 at 1:21 pm

    Hey guys,
    I just took the test the other day and am having EXTREME post test anxiety. I can’t stop thinking of the questions I got wrong, that as soon as I stepped out I was like “WHY did I put that?” And there is nothing worse when people say “I’m sure you did fine.” Isn’t that the worst? What do they know? Anyways, I’ve kinda accepted that I may have to take it again. Anyone have any tips for my post-test anxiety? Also, anyone in the upper South Carolina area (Greenville-ish) who needs to study?

    • 207. Katie  |  November 24, 2009 at 12:34 pm

      I took the exam on Sunday and I’ve been doing the same thing. I keep trying to tell myself “it’s out of my hands now”, but it’s not helping much. December 1st is Score Report Day.

      I’m just hoping the Thanksgiving holiday is going to make time pass quicker!

  • 208. Amalia  |  November 5, 2009 at 9:37 am

    Glad I found this blog too!
    Do you guys know for the first section if it was a “positive” option, but you don’t choose it, do you get either points rewarded, or points deducted? Also, does anyone know why the hell this exam is $500?!!!

    • 209. Amalia  |  November 5, 2009 at 9:38 am

      Sorry, I meant do you get points deducted?

      • 210. Lizette  |  November 8, 2009 at 8:58 pm

        Hi Amalia,
        If you select the positive response, then the point value is added to your overall score whereas if you don’t select it, your overall score remains unchanged but you miss out on those potential points. The only time that points are deducted from your score is if you choose a negative response, i.e. a course of action that could harm the patient, is unethical, etc. Just stay away from anything that is obviously wrong because once you select it, your score is adjusted accordingly. Hope that helps. 🙂

  • 211. Jessica  |  November 5, 2009 at 5:04 pm

    Does anyone in the San Diego area want to get together to study?

  • 212. Julie  |  November 6, 2009 at 12:45 pm

    Hi all prospective students!

    I have lots of great, relatively new study materials for the NBCOT 2009. I have the official NBCOT study guide, the Rita Cottrell Study Guide, the Johnson study guide and some others. If anyone is interested in buying them from me second hand, please contact me. They are all in very good condition.

    Contact me on

    • 213. charlotte  |  January 30, 2010 at 11:27 pm

      Hi How much do you sell them? how bout shipping in Philippines?

  • 214. ashley  |  November 10, 2009 at 4:21 pm

    I take my test this saturday.. I am freaking out! Any advice for my last few days?

    • 215. ND  |  November 10, 2009 at 7:37 pm

      I took the test on thursday the 5th nov. still awaiting my results.
      Stay calm and focused. The calmer u stay the better u can focus is what i felt.
      On the CST make notes and if u go back to refer to the main question be careful when u click the next button as u cant go back and make changes once u click the next button. Make sure u have answered all the questions before u click next.
      Last and most imp stay calm

  • 216. ashley  |  November 11, 2009 at 4:41 pm

    thank you ND =)
    i appreciate your advice

  • 217. Amalia  |  November 12, 2009 at 9:27 am

    Quick question: when you take the test again, is it completely different from the first version you took (e.g. any of the same questions, etc.)?

    • 218. Nik  |  November 12, 2009 at 4:12 pm

      I have taken the test more than once, and you always see some of the same questions. Even the simulations repeat.

    • 219. caprica  |  November 18, 2009 at 11:45 pm

      YAHOO I found out I passed on my second try… Someone asked is the test completely different every time you take it… Absolutely not… I thought I was taking the same test as the questions were the same until I for to number 70… Then they became different and harder but for the most part a large portion of questions were the same…..The only problem with that is… You dont know if you had gotten those questions right or wrong before… Well Good Luck to everyone… Remember daily prayer helps.. He needs to know you really want this and he will be there for you…

  • 220. Jenn  |  November 12, 2009 at 8:04 pm

    Ok guys I see all the OTR exam preperation information, what about the best information to study for the COTA exam. I have already taken it 12 years ago & now the state of Michigan wants me to take it again because I have been out for 6 years. Any suggestions???????

    • 221. Julie  |  November 13, 2009 at 12:12 pm

      I’m not sure about COTA but maybe try to do a refresher course on what’s current in the exam 🙂

  • 222. Nik  |  November 12, 2009 at 9:24 pm

    Finally passed the OTR exam after 3 times.

    • 223. Julie  |  November 13, 2009 at 12:11 pm

      congrats! You must be so relieved!!

  • 224. Tanya  |  November 13, 2009 at 4:04 pm

    What is the most amount of times anyone has taken the NBCOT exam and not passed? Has anyone ever taken it more than 5 times and still have not passed…. Im just curious..

  • 225. Cheryl  |  November 18, 2009 at 12:32 pm

    I am in my last semester of classwork and start fieldwork in Jan. I am thinking ahead for the exam and wonder if there are any “except” questions on the exam. Our tests have been geared with alot of these questions, but I read in one of the practice books that there are none of these questions as well as “none of the above” and combination answers. Is this correct? Any tips for successful fieldwork?

  • 226. Nae  |  November 18, 2009 at 3:19 pm

    Hi Cheryl, my advice to you for fieldwork is to keep a journal. Journal everyday the different diagnoses/conditions that you see as well as the interventions that you may use for that diagnoses/conditions. I believe this would help you once its time for you to study for the exam. You can go back to your journal and apply it to whatever you are studying. This is something I wish I would have done. I have heard journaling is a great tool. I hope this helps. Good luck w/ fieldwork-I know you will do well. Be bless!

    • 227. Cheryl  |  November 27, 2009 at 1:02 am

      Thank you Nae,
      That does help. I am doing a presentation to our class about getting the most of your fieldwork, do you mind if I share your advise?

  • 228. joe  |  November 22, 2009 at 11:18 pm

    I graduated in 1993 with a BS in OT. I am an OTR licensed in Florida since 1992. I have kept my license active but have been out of the work force for several years. I have never taken the nbcot exam. I am trying to understand who needs to take the exam. Where would I begin studying? Help.

  • 229. joe  |  November 22, 2009 at 11:21 pm

    Mistake. I graduated in 1983 with a BS in OT. I have been licensed in Florida since 1992. I have been out of the work force for awhile but have kept my license active. I have never taken the NBCOT exam. Where do I begin?

  • 230. Nae  |  November 29, 2009 at 10:48 pm

    Hi Cheryl, I don’t mind if you share the info with your class-I really hope it helps. Good Luck with everything:)

  • 231. Krista  |  December 1, 2009 at 11:34 pm

    Nobody seems to mention that actual clinical experience has helped them with the exam…. I am finishing up my last rotation and I plan to study and work/shadow in clinics until I take the time. Not only will this help me network with OT’s in the community, but I think hands on experience is the best way to develop clinical reasoning and learn the eval/treat process for many different dx in different settings.
    Any thoughts on this from those who have passed?

  • 232. Sitea  |  December 2, 2009 at 4:14 pm

    Hey, guys Iam planning to take my exam in January 2010, does anyone know if there is going to be a new study guide for 2010, or do i use the same study guide from 2009? Thanks again. Good website

  • 233. Kris  |  December 19, 2009 at 1:36 am

    Hello! I just want to express my frustration with this exam! I have taken the test twice and FAILED, I’m a COTA that has being practicing for 9 years and cannot pass. I was told to think and answer the questions as an entry-level practicioners but it’s hard. So I am very very very frustrated! I will be taken the new 2010 NBCOT exam and who knows what new things they are going to add. I’m running out resources and I can’t study anymore. Any suggestions?

  • 234. caprica  |  December 19, 2009 at 8:36 am

    Hi Kris…. I too was in your situation and know how frustrating it can be.. I finally passed anovember 2009. I had gotten to the point that I couldnt pick up another book for study, I just couldnt do it.. What I come to realize is that I was over studying. I know it sounds a little crazy but if you take a step back and focus mostly on diagnosis and their OT interventions as well as know the different types of splints and when they are used and lastly become familiar with the Allen cog levels (3.0 +), cardiac levels, a little of the glasgow coma scale and METS. If you really focus on these areas it should increase your score as a lot of the tests hae questions in these areas…. There are tons of study material out there but I truly believe the Rita- Fleming was the best for what I mentioned above but not so much for questions… Dont be discouraged you can do this and you will get there… Good Luck!!

    • 235. Teale  |  January 15, 2010 at 2:01 pm

      Hi I just wanted to comment and ask if you had any study recommendations? I have taken the exam 5 times and failed! I am sooo frustrated and I just wish I knew what it is that I am doing wrong! I cant tell you how much I have studied and I think I might be studying the wrong way. I have the Rita Flemming book and there is so much information! I think i need a study partner to study with. How did you get through it? I feel like giving up but I cant. I have come so far and I am only aroung 40 points away from passing. Any suggestions??

  • 236. Ann  |  December 30, 2009 at 7:57 pm

    Does anybody know how to find out when the dates are to take the exam??

  • 237. Tanya  |  December 30, 2009 at 8:44 pm

    You can go to the NBCOT website to find scoring calendar however they have not issued new 2010 calendar as of yet but here is the link…

  • 238. Canadian OT  |  January 7, 2010 at 12:07 am

    Anyone preparing to take the exam in the near future? I dont have a date set (Im a 1st timer from Canada) but have started to go through the infamous Rita text. Omg reading all these posts is really discouraging and I just feel so lost.I mean, if people are putting in the effort, its just not fair that they arent seeing the results.

  • 239. Northern OT  |  January 7, 2010 at 9:50 am

    Hi Canadian OT! I am also looking at taking the NBCOT in March 2010. Are you looking for a study group? I am currrently living in Toronto, ON and practicing.
    Let me know–you can e-mail me at

    • 240. Canadian OT  |  January 20, 2010 at 7:52 pm

      Unfortunately Im in the states so ill be studying here. But there’s always the internet. Have you gone through the OTED process yet? Im still waiting to hear from them that’s why im not in full study mode.

  • 241. Karen  |  January 8, 2010 at 3:45 pm

    Does anyone know if there is a difference between the old Rita Fleming and the newer version? I took the exam back in Dec. 2008 and failed! I’m looking to retake my exam again for the 2nd time here either the end of this month or beginning of Feb.! I would love to know if anyone is looking for a study partner as well?? Thanks!

    • 242. Teale  |  January 15, 2010 at 1:54 pm

      Hi, I am looking for a study partner for the NBCOT exam as well. Where do you live? I live in rochester Michigan. Let me know! Thanks

      • 243. Karen  |  January 15, 2010 at 5:15 pm

        I live in Maine unfortunately; however, if you’d like to chit chat back and forth on the internet let me know….

  • 244. Elizabeth  |  January 8, 2010 at 4:49 pm

    I am wondering the same thing as you. I last took the exam in Dec 2008 and beginning to study again using the old Rita Fleming book too.

    I am looking for advice on where to begin after being away from it all for so long, what to study from, where to begin, etc..
    I will be taking it probably in a few months or so–i will be able to tell more as I go along.
    I am looking for study partners too!! Is anyone from New Orleans?
    Thank you

    • 245. Karen  |  January 15, 2010 at 5:14 pm

      Hi Elizabeth,
      If you’re up to over the internet kind of study partner I’d be interested! Let me know what you think 🙂

  • 246. Teale  |  January 15, 2010 at 2:08 pm

    Does anyone live in Michigan near metro Detroit? I live in Rochester and I am desperately looking for a study partner. I plan to take the NBCOT exam in the next few months (Feb or March 2010). Please contact me if anyone is interested!!


  • 247. joan  |  January 18, 2010 at 9:50 pm

    I have been practicing for a few years and am nervous about taking the exam. If you fail the exam do you have to stop working as an OT?

    • 248. Karen  |  January 19, 2010 at 2:25 am

      Hi Joan,
      It depends on the state laws. I know here in Maine you can practice on a temp. license but once you take the exam and if you happen to fail then you can no longer practice under the temp license. You will have to look into your state laws to answer your question.

  • 249. Canadian OT  |  January 21, 2010 at 7:44 pm

    for anyone who has taken the exam or is taking it…which book is more helpful? The one by Trombly or Pedretti’s Occupational Therapy: Practice Skills for phy dys.?

    The Rita Book seems incomplete when looking at interventions for ppl with physical dysfunctions. It does alot of explaining of the anatomy but not about what one can do for them from an OT perspective. So im looking for a book to fill that gap.

    Any advice???

    Thanks alot!

    • 250. otprep  |  January 26, 2010 at 3:07 am

      Anyone who would like to discuss some questions for the NBCOT exam? I bought one test paper from the person who already passed this exam. It is without answers. So I am looking for someone with whom I can discuss those questions and know the answers. Email me at

  • 251. OTDE  |  January 27, 2010 at 1:25 pm

    Hi all I live in Delaware but went to OT school in NC, I have taken the test three times and failed…I am 15 points away from passing and so frustrated…my family and my husband are just as frustrated which doesn’t help as some of you may know. I have been reading on here about all the recommended books, which I have most of them, and are running out of ideas…I never thought about this but is the test going to change in 2010. Even on my third test I maybe had one new question, I feel better when I keep seeing the same questions over and over again…nothing new to expect that you may or may not know…The CST has been know problem for me I have passed every time…But money is very tight and I need help…does anyone have any suggestions or want to meet again I live in Delaware near the capital (Dover) Best of Luck to everyone!!!

    • 252. Maddy  |  January 28, 2010 at 3:03 am

      I feel your frustration as I have took the exam twice and have not yet passed. The CST has not been a prblem for me either. I think for me it’s the Intervention part I need to really focus on because I noticed some of the questions can be subjective. Have you practiced taking the exam in a 4-hr period? I really have to work on my time management because i literally rushed the last 15 questions on the exam. My collegues just advised me to keep on taking the practice exams and really study the INTERVENTION section for every diagnosis. Particulary psych (schiz, bipolar, mania, etc) I noticed a lot of psych questions on my last exam, and not having a psych rotation was a disadvantage on my part. I have all the books recommended and I understand it can be a painful process to keep on studying the same thing over and over. I’m over studying in great detail…I’m just focusing on the intervention part and i’m going to keep on taking those practice tests.

  • 253. CanadianOT  |  January 30, 2010 at 2:22 pm

    Anyone know how many times you can take the exam in California?

    • 254. Maddy  |  February 1, 2010 at 3:39 am

      From what i hear from other people, there isnt a limit. U can keep re-taking the exam. GOOD LUCK!

  • 255. charlotte  |  January 30, 2010 at 9:41 pm

    Hi Guys, i am from the Philippines and I will be taking the exam this year, hopefully by May or June..I am so nervous or afraid to fail, but then, I hope all the test takers for this year would pass! good luck to us!

    If you have any important information regarding test review materials please email me:


  • 256. CanadianOT  |  January 30, 2010 at 10:10 pm

    I was wondering if anyone taking the exam soon wanted to swap some info. Specifically to spinal cord injury. I made a chart just outlining some of the functional things people can do with a specific level injury (kind of stuff I saw on the practice tests). Just wanted to see if anyone wanted to exchange info to compare.

    • 257. charlotte  |  January 31, 2010 at 9:38 pm

      I would love to, but i am not on that topic yet, but hopefully I can catch up so that we can compare notes and brainstorm.. keep in touch~

      • 258. CanadianOT  |  February 1, 2010 at 7:16 pm

        Have you studied splints yet? Im doing that now and was wondering how much detail people are going into?
        There are a gazillion diff splints 😦

    • 259. charlotte  |  February 2, 2010 at 3:38 pm

      No not yet, I am just about to finish chapter 4 of cotrell.. I have to finish cotrell in a week but once i was on these topics I will message you so that we can brainstorm. According to my friends who took the NBCOT 4 years ago, there are questions about splints and SCI.

  • 260. OTDE  |  February 1, 2010 at 7:40 pm

    If you take the test in 2010, let us know how is was…haven’t taken the test yet this year…but my time is coming…two and half weeks…how does everyone feel about changing test sites?

  • 261. DUDE  |  February 2, 2010 at 3:08 pm

    Hello. I am an occupational Therapist. I am writing to offer advice to anyone who is struggling with the exam as I know how you feel. My last post on this forum was on April 16 listed under the name “dude”. Apparently, that advice was not enough for some. I was just browing and came across this forum and decided that I should be helpful as I was in your shoes not too long ago. My study time for the exam was 5 weeks. I did not take any review courses, and I passed very comfortably at first try. People, the exam is NOT just about memorization. When you study for this exam, you are not only studying the material, but also the actual exam itself. You need to understand how the exam is formulated, what the questions are designed to test, and what a question is going for. You need to understand their way of reasoning, their explainations, and their justifications. Don’t be stubborn and keep saying such and such was the right answer and i don’t know how this could be the right answer. The exam is not about being right or wrong, it is about giving them the answer they want, which can only be done by learning what they want. So practice exams that I listed in my first post are very helpful, because of the explainations and reasoning given for those answers. You need to understand that next time you come across a similiar question, this is the reasoning you need to use. Most people waste too much energy memorizing lenghty amounts of material and reading chapters from the text book…most of your time should be spent reviewing and understading the reasoning for the answers of the practice exams. If anyone wants to ask me anything in detail, you can email me please write something like OT help so i don’t delete it as Spam. Best of wishes

  • 262. DUDE  |  February 2, 2010 at 8:40 pm

    I am re-posting my post from April…This post has to do with what materials to use to study for the exam..If you are not interested…you are welcome to ignore it…
    1. OTR Study Guide and Study Guide Supplement, by NBCOT (pdf order form) THIS ONE IS A MUST. GIVES YOU A GOOD IDEA OF WHAT KIND OF QUESTIONS WILL BE ON THE ACTUAL EXAM..These questions were very close to the acutal exam..there are Other exams(along with this one) you can also purchase from NBCOT website..IF you are someone who is struggling, you MUST go NBCOT website and purchase these exams…as they are the closest thing to the actual thing!
    2.Occupational Therapy Examination Review Guide (3rd ed.), by Caryn Johnson. THIS ONE IS ALSO A MUST HAS A TOTAL OF 4 PRACTICE TESTS 800 QUESTIONS. YOU CAN DESIGN YOU OWN TESTS TO TEST YOU ON A SPECIFIC AREA OR DOMAIN I.E PEDS, MENTAL HEALTH ETC MY MENTAL HEALTH KNOWLEDGE WAS WEAK SO I USED THIS TO BRUSH MY SELF UP. Re-take all the exams a few times, understand each answer’s explaination (given in answer key) and take mental note to think that way next time you come across a similar question. NBCOT only has a limited number of possible questions it can come up with, so if you take enough questions, understand enough explanations, you will find that questions on the actual exam will be similar with small modifications. SO PLEASE A GOOD PART OF YOUR STUDY TIME IS ACTUALLY TAKING THE EXAMS AND DISSECTING THE ANSWERS GET IN THE NBCOTs mind set..THE TOUGHEST PART OF ANSWERING THESE QUESTIONS IS FIGURING OUT WHAT THE QUESTION IS TRYING TO DIG FROM YOU.ASK YOURSELF WHY SUCH AND SUCH INFORMATION IS GIVEN DO THEY WANT THIS INFORMATION TO BE A PART OF MY FORMULATING AN ANSWER OR IS IT A DISTRACT OR?
    3. National Occupational Therapy Certification Exam Review and Study Guide, by Rita Cottrell. THIS IS ANOTHER MUST HAVE, BUT MAKE SURE YOU BUY THE LATEST EDITION


    • 263. charlotte  |  February 4, 2010 at 11:19 am

      thanks for all the help dude… =) keep safe

  • 264. Tammy  |  February 4, 2010 at 9:39 am

    Thank you so much for your help DUDE.

  • 265. CanadianOT  |  February 4, 2010 at 4:15 pm

    Any one who has already taken the exam is taking it soon…here is a question.
    I’ve been randomly doing some of the Johnson’s quizzes (25 questions) just to go over the areas as I study them so I know what to focus on more. But Im scoring low 70’s. Is that average or am I scoring below average?

  • 266. Tammy  |  February 5, 2010 at 11:47 am

    I would say that’s close to the average. How long until you take the exam ?

    • 267. CanadianOT  |  February 5, 2010 at 3:53 pm

      I take it in about a month. Im very nervous.

  • 268. CanadianOT  |  February 6, 2010 at 12:46 am

    Hey everyone!
    Well I’ve been doing the Johnsons tests for physical dysfunction and I scored an 84 last time so Im feeling a bit better.
    Anyways, I was wondering if anyone has pointers for studying for pediatrics? I have the text by Case – Smoth (OT for Children) Not really sure where to start!

    Any advice will be appreciated. Honestly, this blog has helped me keep my sanity thus far. Im a first timer…but I also want it to be the last time 🙂
    Good luck to all who are busy prepping away!

  • 269. CanadianOT  |  February 6, 2010 at 12:47 am

    Hey everyone!
    Well I’ve been doing the Johnsons tests for physical dysfunction and I scored an 84 last time so Im feeling a bit better.
    Anyways, I was wondering if anyone has pointers for studying for pediatrics? I have the text by Case – Smoth (OT for Children) Not really sure where to start!
    Any advice will be appreciated. Honestly, this blog has helped me keep my sanity thus far. Im a first timer…but I also want it to be the last time
    Good luck to all who are busy prepping away!

  • 270. CanadianOT  |  February 6, 2010 at 1:29 am

    Also if someone could suggest resources for studying for the mental health part that would be helpful as well:)

    • 271. Julie  |  February 9, 2010 at 1:08 am

      Hey, Cara and MaCrae is an excellent resource which I used for mental health. Case-Smith is great for paediatrics: study feeding, positioning, autism and special schooling as well as IEPs. Good luck. let me know if you need anything else.

  • 272. DUDE  |  February 6, 2010 at 11:00 am

    If you guys are looking for an overall summary of the topics/diagnosis that you need to kno, look over Rita’s study guide. Especially for mental health, I felt that other books were not quite as organized on this topic. Look over chapter 12 of Rita especially from part IV onwards. For Peds, the same thing. You need to know the progression of skills not necessarily the age…what skill/ability comes after another..Rita gives you that progression in a clear and organized manner. You can use Rita just to know what topic falls under a given category. i.e Geriatrics…and then you can use a different source to study it in a little more detail. But like i said before…don’t kill yourselves with the details…worry about developing your exam taking strategies and eliminating the incorrect choices by the process of analytical thinking.

    • 273. Julie  |  February 9, 2010 at 1:11 am

      I absolutely agree, it’s strategy more than the details that count the most but… knowledge is power! so knowing as much as you can, increases your confidence in taking the exam.

    • 274. Canadian OT  |  February 9, 2010 at 8:17 pm

      Thank you so much DUDE for taking the time to help lost souls like us. It is definitely appreciated 🙂

  • 275. noone  |  February 7, 2010 at 5:15 pm

    DUDE thanks a million. I really appreciate your useful advice. Thanks for taking the time to help us out.

  • 276. noone  |  February 7, 2010 at 5:23 pm

    Above post was linked to me by DUDE. DUDE thanks once again.

  • 277. Cheryl  |  February 7, 2010 at 6:30 pm

    How about the COTA exam? We have had exams that had alot of “except” questions, but I read in one of the books that there are none of these. Is this true?

  • 278. OTDE  |  February 9, 2010 at 4:33 pm

    How is this damn thing even scored…I have no clue…why I am only 15 points away from passing this thing, I mean am I missing 3 questions or 15 questions…and has anyone taken the test in 2010…if so let me know I take it in two week~!!!

    • 279. Charlotte  |  February 9, 2010 at 5:04 pm

      goodluck OTDE! Just update us with any info you have regarding your exam!

  • 280. Charlotte  |  February 9, 2010 at 4:52 pm

    Dude, thanks once again for the tips and all the help.. Anyone here has taken the test this year? Any difference or feedback?

  • 281. D  |  February 10, 2010 at 6:41 pm

    hey all! i recently passed the exam and what i found most helpful was to do all the questions from johnson, the nbcot practice exam and the nbcot content exams. know these questions inside and out and research their rationale! this test is not about memorization, so don’t go crazy with the details from the rita book. doing lots of practice questions and figuring out the reasoning behind these questions was what helped me pass! good luck!

    • 282. charlotte  |  February 11, 2010 at 6:02 am

      COngratulations D!!!! I just hope other test takers like me this year will pass too!!!

    • 283. Maddy  |  February 11, 2010 at 6:08 am

      Congrats D! how long did u prep for the exam and how many hours did you study? were Rita and Johnson the only book u used to prepare for the exam?? Re-taking the exam and my nerves are starting to kick in again. Just wanted some advice. Thanks.

  • 284. D  |  February 14, 2010 at 11:53 am

    i studied for about 6 weeks, i didn’t have a job at the time, so i would study for most of the day. i also used pedretti and trombley to gain more info about interventions. the rita book doesn’t have info about interventions. i had some peds questions on my test, so i would also take a look at case-smith. good luck!

  • 285. D  |  February 14, 2010 at 11:58 am

    also, that johnson book is so good. i had a question about guillian barre that was verbatim from that book that was on the test!

  • 286. Ipshita  |  February 15, 2010 at 1:06 am

    Hi there, am planning to take the NBCOT exam some time around july this year. Am a practising OT at London. Am desperately looking for a study partner.If interested pl send me an email : furthermore, am also in the lookout for the study materials.Anyone who wants to sell them off at second hand price pl let me know..Thnx

  • 287. KC  |  February 15, 2010 at 10:56 am

    I just took the test and found out that I did not pass. I feel like my test had a ton of hand therapy questions which I know nothing about. I never had a hand therapy fieldwork, and it was not a focus in my schooling. Does anyone recommend any hand therapy resources that address splinting and posititioning? Thanks & Good Luck everyone. This test is seriously depressing.

  • 288. OTDE  |  February 16, 2010 at 12:15 pm

    KC I did an internship under a CHT and have info. for you or can tell you things to look up you can email me at…i would be glad to share that with you. Sorry you didn’t pass better luck next time, but don’t feel bad I take it next monday…ugh!!! for the 4th time…so email me!!!

  • 289. DMK  |  February 16, 2010 at 1:56 pm

    Does anyone know if NBCOT scored yesterday (2/15) as scheduled? I am wondering since they were closed some last week due to the snow storms. I took the exam last week, and because I am taking it for “licensure purposes” (ie, I haven’t practiced/renewed in 7 years and TX makes you retake the exam) NBCOT won’t give me an online account to check for pass/fail like everyone else gets. :(. If they didn’t score yesterday it won’t be until 2/26….I kind of want to know when to be watching the mail. SO, if anyone has taken it since the last scoring and gets their score posted online (or not) from yesterday PLEASE email me and let me know. THANKS!

  • 290. dude  |  February 17, 2010 at 8:49 pm

    For those still studying. Forgot to mention. Don’t forget that the exams can be unevenly skewed towards one practice area. Depending on the particular version you take, some exams can be a lot of mental health, others can be a lot of peds, or hand etc. Mine was a lot of peds. So make sure you work on your weaknesses. Mine was mental health, so i did pay special attention to it while studying to go over ranchos, groups, etc..Peds nowadays is big, and the NBCOT exam can reflect that. Depends on the exam you get. Questions relating to positioning (writing on vertical surface for wrist extension), wheelchair bound children (CP), and kids with sensory regulation issues. Remember light touch is a no no….firm touch/deep touch/pressure is the way to go. It depends on the particular version of the exam you’ll get. Remember hypo vs hyper sensitivity and what to do and avoid for each kind of child. Symptoms: what does a hypo-sensitive child look like/behave vs hyper-sensitive….if someone has high tone will you use tapping? No! simple stuff..but must still remember to avoid making silly mistakes in the exam and miss what they want to get out of you. …..

  • 291. Canadian OT  |  February 19, 2010 at 1:16 pm

    Thank you so much to everyone providing tips and strategies!
    All this info is appreciated.

    I just took the pediatrics OTR test on castle worldwide. I was wondering if it is representative of the peads questions on the exam?

  • 292. OTDE  |  February 27, 2010 at 9:48 am

    I passed…now good luck to everyone…you all can do it~!

    • 293. Ipshita  |  February 27, 2010 at 11:10 am

      Hi there, congrats!! would you mind telling me how many times you had to take the test?sorry if am sounding too nosy..its not so, i need some assurance if it can be done at one shot..and if so, what are the techniques to follow?

      • 294. OTDE  |  February 28, 2010 at 11:03 pm

        This was my forth try…but it can be done in one shot…study all the areas that OT covers ex. Peds…and take lots of practice test…also read DUDE’s suggestions he helps a lot…good luck~!!!

  • 295. OTDE  |  February 28, 2010 at 11:01 pm

    This was my forth try and I did lots of practice test…and really read DUDE’s suggestions his are great.

    • 296. CanadianOT  |  March 1, 2010 at 12:32 am

      My exam is in a week (EEEEK!)
      Also doing it the first time. Im going through ALL of the Johnson’s questions…did the peds and phys dys tests from castleworld. Will do the 4 hour one end of this week. What other resources do you recommend? I just don’t feel confident. I don;t know EVERYTHING …which is impossible..but im making sure I do as many tests as possible and that I try to cover a diverse range of areas…i.e. peds, splinting, phys-dys, wheelchairs etc.
      Any last minute tips to help me not go crazy this last week. O and I still need to go over mental health…for which I think 2 days will be enough.
      Thanks a ton!!

      • 297. OTDE  |  March 3, 2010 at 11:43 am

        You need to be confident…you know this…Also, remember to only take no longer than 30 min. on the stiumulation part of the test…and I always tried to finish with 30min. to an hour left so that I could have plenty of time to go over my flag questions and the whole test. The Johnson’s questions are great and make sure you really know the ranchos levels, glascow leverls, SCI, TBI, Burns and Hand Injuries and Splints…also a lot of group treatment questions and some MOHO and Research questions. Good luck and let me know how you do.

  • 298. dude  |  March 2, 2010 at 9:06 pm

    Hey congrats OTDE…i am really happy for you…now its time for you to help out those people who are in the position you were not too long ago…congrats once again..

    • 299. OTDE  |  March 3, 2010 at 11:44 am

      Thanks DUDE all of your suggestions were a big help…and I def. plan on helping others.

      • 300. nr  |  April 21, 2010 at 2:16 pm

        I am looking for some assistance. can you send me your contact info at offitoff at gmail i would be much appreciated.


  • 301. dude  |  March 2, 2010 at 9:15 pm

    Canadian OT…i wouldn’t underestimate mental health…there’s a very real chance that your exam may very well be a mental health exam…many people who end up with the version with a lot of mental health are unprepared…another mistake a lot of people make is to keep re-studying their strength areas because it makes them feel good to know that they know the content area…it is a very basic mistake…I wanted to figure out my weaknesses, and to not let them be weaknesses anymore.. I actually started my preparation for this exam with areas i thought were my weaknesses.i would not just keep going over material which i knew pretty well…i was thinking what is it that i do not know..need to know…i am sure you know this already but a reminder can’t hurt…

  • 302. CanadianOT  |  March 3, 2010 at 7:00 pm

    Thank DUDE and OTDE. I completely understand how easy it is to get caught up in studying stuff you already know. Anyways have been focusing on Mental Health now and did the test on castle
    I was wondering if anyone knew how to print out the questions? I saved the pages but every time I go to print it, it doesn’t come up. So if anyone has printed questions from that, please let me know. I will be doing the 100 Q MCQ test in a few days so just wanted to know how to print stuff if I needed to.

  • 303. HIMANSHU  |  March 6, 2010 at 9:20 am

    i am also preparing for NBCOT. i will be giving it first time.

    my skype id is himdewan

    we can study in a group

    • 304. Lynda  |  March 12, 2010 at 11:48 am

      Hi HIMANSHU,

      Where are you? When are you planning to take the exam? I am interested in finding people to study with…thinking about taking the exam in April. What’s your timetable like? Email me:


  • 305. Ryan  |  March 7, 2010 at 1:09 am

    im an OT from the looking for a reviewmate thru Skype or YM for NBCOT exam.. = )

    • 306. Lynda  |  March 12, 2010 at 11:43 am

      Hey Ryan,

      When do you plan on taking the exam? I’m planning on taking the exam in late April. Maybe we can study together! Email me:


    • 307. Charlotte  |  April 2, 2010 at 8:51 am

      Ryan, im from Phils me..charlotte.arroyo…thanks

  • 308. Rohan  |  March 7, 2010 at 6:54 am

    i am looking for a used NBCOT review book . any edition. will do.

  • 309. CanadianOT  |  March 8, 2010 at 6:55 pm

    My exam is tomorrow! And I am very very anxious. The last minute studying is not happening well b/c I cannot focus.
    Any last minute tips to deal with pre-exam anxietY?

  • 310. CanadianOT  |  March 10, 2010 at 2:20 pm

    Well I wrote my OTR exam yesterday. While Im glad its over…I keep going over stuff in my head to see if I did it right or not.
    Anyways, I felt like having extra time to study would have made no difference in how I performed on the test. There are no direct questions…they are all embedded in scenarios. Which gets challenging sometimes since some questions were 4 sentences long and by the time I read the Q’n, I forgot what I was asked (they give u eraser boards so u can make notes on that). Also, paying attention for 4 hours was challenging for me. I got tired half way through so needed to tell myself to FOCUS.
    I had done ALL the JOhnsons practice Q’s, 3 content exams, and I’m still unsure how I performed. There was only ONE question that had been on some practice test that I saw on the exam.

    So for those who are going to take it soon…I would say really focus on reading the Q’n rather than memorizing everthing b/c it really doesnt matter.

  • 311. adarsh  |  March 12, 2010 at 12:11 am

    i am in final yr of bot i wan star preparin for otr license
    whr sud i start frm ??
    nd whr r d centres near india for takin xamz

  • 312. adarsh  |  March 12, 2010 at 12:12 am

    thank u

  • 313. Elizabeth  |  March 12, 2010 at 5:19 pm

    Is anyone studying for the Boards that lives in New Orleans? I am studying for the next few months because I have been away from the material a while. I plan to hopefully take it in July. I would love a study partner!! Thank you!

  • 314. Elizabeth  |  March 12, 2010 at 5:20 pm

    one more question 🙂
    Is the 3rd edition of the Johnson OT Examination Review Guide different from the second edition? Different questions?

  • 315. Ipshita  |  March 12, 2010 at 6:10 pm

    Hi Elizabeth, i am also at a similar position as you…out of touch for a couple of years, and aimimg at june-july…if interested, pl get in touch wid me …my email id is thnx.

  • 316. Ipshita  |  March 13, 2010 at 12:59 pm

    How much detailed study r we expected to do for the anatomy and physiology sections of the various systems?Am reading the chapters from rita. Are the portions covered in there about anatomy and physiology enough or more than needed? Pl suggest

  • 317. DUDE  |  March 14, 2010 at 11:06 am

    ipshita stay away from studying those you are wasting your time…you need to know zero physiology and basic anatomy for this exam …trust me there are no questions that ask you for muscle attachments or the activation of ACTCH don’t bother…read what people are saying about the exam from the previous posts…

    • 318. nr  |  April 21, 2010 at 2:15 pm

      my wife has been trying to clear this over 3 attempts unsuccessfully. I am exploring if i can get some help can you please email me your contact info? offitoff at gmail


  • 319. Ipshita  |  March 14, 2010 at 2:09 pm

    Thnx Dude, that really is going to make life so easy 🙂

  • 320. Kelly  |  March 15, 2010 at 5:29 pm

    Thank you all the great advice! I passed. For me, I used flashcards for all of my weak points. I used the books and practice tests noting what I was week on and put them on flashcards. I used the nbcotexam com 1000 things you should know and put what I forgot on flashcards. I then went over and over until I remembered. Then I read all the comments here, plus all of my notes until I was sick and tired of it. Boy I was ready! 🙂 I hope this helps someone as this thread helped me!

  • 321. Sam  |  March 30, 2010 at 5:54 pm

    Selling all my OT board study material that helped my pass. Questions, books, and CDs with sample questions. If interested contact me at

  • 322. DMK  |  April 5, 2010 at 11:24 am

    Hi everyone, hope that your studying is going well! I recently passed the exam on the first try, after having been out of the OT world for over six years. I graduated in 1994! I had to not just study, but actually re-learn so much information. This exam was TOUGH, but if I can do it after having been out of school for so long, you guys can DEFINITELY do it!

    I am selling all of my review books, which are a MUST for everyone. The Rita/Therapy Ed book (for $45), the Caryn Johnson book ($18), and the NBCOT Official OTR Study Guide ($30). All priced at about half of new. Will save you a lot of money, considering how expensive this process is! I also have a set of approx 130 FLASHCARDS which helped me so much in the learning process. You can study them anywhere which gives you an edge. Even if you don’t want mine, make your own because they make a world of difference. Buying them just saves so much time. Email me at

    Also, take the review tests online (despite what some folks might say), because it gives you a better feel for the direction the questions are taking that the author-written questions in the books.

    • 323. Karen  |  April 5, 2010 at 12:24 pm

      Hi DMK, congrats on passing!! I was wondering where did you even begin to start studying and for how long did you study before taking the exam??? I graduated back in ’08 and I feel like I’m lost! I’ve already taken the exam once and failed and then I just got financially strapped so here I am ready to take the exam again but I haven’t a clue where to begin or what some of the key points to study! Thanks for you words of wisdom!!!

      • 324. DMK  |  April 5, 2010 at 1:02 pm

        I was totally lost as well. I couldn’t even remember the function of the Median nerve! I started with the NBCOT study guide, did about ten of the questions and made a list of those topics (because I missed almost all of them). Then I went to the textbooks and made notes/highlighted the info on those topics. Then I did it again. One topic would lead to another (ie, studying spinal cord injuries would discuss splinting, then I would turn to the section on splinting and study that, etc). I studied on-and-off that way for a few weeks, then really hit it hard in Jan. Bought the other two review books and that made all of the difference. ALWAYS study the review books and your textbooks together. The topics make more sense that way, since the TherapyEd book is in outline form. After you do all of the NBCOT questions, go to the Johnson book and start hers. Do a set of questions, write down the topics of the ones you weren’t solid on and study/flashcard those. EtcEtc. Don’t worry about the TherapyEd questions, they are too detailed. But the scenario questions are good. Hope that helps!!

  • 325. Elizabeth  |  April 5, 2010 at 12:46 pm

    I am in the same boat as Karen. I graduated Dec. 08 and have been frustrated beyond belief. I took the Boards two times after graduating and gave up for a while. I am studying again but am so scared. I cant take it until I feel completely ready b/c I am financially constrained. I am going to try and purchase the NBCOT bundle with the content tests, practice tests, etc. What did you do first to prepare yourself again? Have you been working in the field since you graduated 8 years ago or a different field?
    Any advice at all would be great!!
    Thank you so much and congrats on your passing!

    • 326. DMK  |  April 5, 2010 at 1:18 pm

      Hi Elizabeth,
      For part of your question, read my answers to Karen…:). I haven’t practiced since 1999! I actually graduated 16 years ago. Yikes! Since 1999 I obtained my MBA, sat for the CPA exam (the toughest certification exam in existence!!), and have been a practicing CPA. One suggestion is that you have to have a positive attitude about what you DO know and HAVE learned so far. Otherwise your doubts will undermine your ability to think through the questions.
      There were odd topics that I never would have paid attention to, if I hadn’t seen them discussed on this blog (see “DUDE”s Feb 2 blog above, and a few above that). Mine had a lot of psych questions, possibly some of their trial questions because there were so many.
      Test taking tips – take about 30 mins for the scenario questions. After you finish those you have 9 minutes for the MC portion tutorial. The tutorial only takes about 2 minutes so use this time for a potty/mental break. You get those minutes free, they don’t take away from your test time so take advantage of them. Even if you don’t have to go to the bathroom yet, just go. It will give you time to stretch and re-group. My testing facility did not allow watches of any kind, so I had to watch the computer clock. Time wasn’t a problem for me, though, as I finished with an hour to spare. Hope this helps!!

      • 327. Karen  |  April 5, 2010 at 5:35 pm

        Thanks I really appreciate the help 🙂

  • 328. Lynda  |  April 5, 2010 at 3:23 pm

    Hi everyone,

    Ipshita and I have a sample test question…any thoughts and feedback on the answer would be appreciated!

    An OTR is providing consultative services to a long term care facility that is renovating the Alzheimer’s care unit. The environmental adaptations that would BEST support the functional needs of this population are:

    A putting locks on all doors to prevent residents from wandering into other residents’ rooms.

    B placing maps of the area on walls throughout the hallways so that residents can re-orient themselves if they get lost.

    C minimizing personal belongings to reduce clutter and the probability of losing valuable items.

    D providing self-contained, safe indoor and outdoor spaces where residents can walk independently without risk.

    We are trying to decide between answers B and D. What are your ideas?


    • 329. Mary  |  May 18, 2010 at 6:51 pm

      It is D the exam has priority on safety issues for sure

      anyone need a partner to study please contact me

      I have the NBCOT exam, CD with questions, flashcards and I took the prep course

      Thanks 🙂

  • 330. Cheryl  |  April 5, 2010 at 6:49 pm

    A. definitely not. B. Maps do not help. They would need to be reminded of where the maps are over and over. Eyesight is bad, and the maps are at eye level. Most residents are in either wheelchairs or walking with their eyes downward. C. Is not an environmental adaptation that is due to the renovation, although it is a great idea to limit personal items because they do go into other residents rooms and carry belongings off. This would probably be a suggestion made to the families upon admission to the unit by the staff. D. Would probably be my choice. They love to walk or wheel around in their wheelchairs with no obstacles. The outdoor area would of course have to be supervised by Nursing or CNA’s. Some residents can really be quick at climbing fences!

  • 331. DUDED  |  April 10, 2010 at 3:54 pm

    HEy guys. Just checking in after a break. Glad to see to you guys are helping each other out. Cheryl thanks for that break-down of the question. This is exactly how the rest of you need to think when dissecting a question in the exam. Whether the choice you made actually answers the question asked. Like B, although apparently correct, is not the best answer as mentioned by Cheryl. For each of the choices, you should think why NOT this answer. Calthough an environmental adaption, is not correct under the context of a renovation. C would not take full advantage of the fact that the facility is being renovated, B can be done without a renovation. You will see that you will have a hard time rejecting when you get to the correct choice. When you have two questions that look apparently the same or correct, know that there is some factor that you are overlooking. Of course, one needs to know the basic manifestations of an Alzheimer patient. Do maps and Alzheimer patients go together? Additionally, you’d better have a really really good reasons to reject an any answer that has words like “independently” (such as choice D) “observe patient actually doing the task” or “observe patient in his/her natural environment” any choice that focuses on “client factors” etc..

  • 332. Ipshita  |  April 10, 2010 at 4:09 pm

    thnx everyone for the ans….

  • 333. DUde  |  April 10, 2010 at 4:17 pm

    In addition to above, D has words like “without risk” and “independently” If you haven’t learned anything in OT school, you would still know that safety and independence are arm and arm with OT. When you see these words, you’d better find other words like “kill” patient ” in the same sentence to justify rejecting the answer. I am joking of course, but you get the point. Your eyes should immediately light up when answers that address safety, independence, saving time etc show up.

  • 334. mandeep  |  April 13, 2010 at 3:25 pm

    Thank you for all the valuable information that all of you have shared here. I am preparing for NBCOT OTR Exam . I am currently in the process of OTED. Would like to find an online study partner or someone in Sacramento preparing for the exam. Pls e-mail me at

    • 335. Mary  |  May 18, 2010 at 6:53 pm

      I am in Massachusetts and looking for a study partner too

      I can study with you online if you would like 🙂

      • 336. LJ  |  June 2, 2010 at 9:03 pm

        I am currently in Medford completing my level II fieldwork… are you anywhere close?

  • 337. Rafi  |  April 17, 2010 at 8:31 am

    Hi everyone, I recently passed the exam on the second try. This blog helped me tremendously! The following is what I did to pass:
    I studied with a friend over the phone (we live in different areas). We studied at least three times a week going over practice questions. We rationalized each question without looking at the answers. The multiple-choice items came from the NBCOT study guide, Caryn Johnson and Rita books. We also used our texts (Pedretti, Case-Smith, Zoltan, Trombly, Willard and Spackman). Going back into the text books was key! I could not have passed the exam without the text books.
    We made up a study guide and split up the diagnoses/conditions/interventions/treatments/equipment in back of the NBCOT study guide book.
    I took the online OT Advantage course which was extremely helpful. The instructor taught me how to dissect the questions and really understand what the question was really asking.
    I hope this helps and good luck all of you! You will pass!

  • 338. amy  |  April 21, 2010 at 11:18 am

    Thank you all for posts, i am planning to take my exam in june. Is met level really important. In my review course the lady said forget about them, they are not in the exam

  • 339. Ipshita  |  April 21, 2010 at 11:49 am

    Hi Amy, am also stuck with the MET levels. I can see the need to know Met levels from table 6-6 (pg 187-188) of Rita to plan our interventions at various stages, but am struggling with the table6-7 (pg 189-190) that speaks about the approximate metabolic cost of activities…heyy, its just so difficult to remember the huge list of various activities as per their metablocia cost…i did bring it up with two other applicants, who suggested that its important and we need to have a generic idea about that table, but can pl someone suggest me, how to sort of get that bit sorted??? its just so confusing to remember the list of activities as per their MET cost…DO WE REALLY NEED TO DO THAT TABLE?

  • 340. ND  |  April 21, 2010 at 2:21 pm

    I graduated from OT school in 2006 and have been trying to pass this exam since then. [3 attempts so far with no luck.]. Have done 2 internships while in college and since graduating have’nt been really involved in OT other than just studying and preparing for the exams.
    My question to all is…..
    Was wondering if doing some volunteering will help in preparing for the exam in terms of thinking like an OT. any advice? I am thinking of volunteering in a peds clinic and a nursing home or something.

    Thanks for this blog and all the posts out here. real help with tips and feedback. DUDE, thanks for all the tips. Hope its ok if i get in touch with u for more advice and guidance.

    • 341. traci  |  June 11, 2010 at 5:47 pm

      i have been trying to pass since then as well. where r u from?

  • 342. canuck  |  April 22, 2010 at 10:16 am

    Hey all.. I’m planning on writing the NBCOT exam this June. I’m a practicing OT in Canada, having passed our certification exam recently with no difficulty, but I’m very worried about the NBCOT exam. Can anyone tell me how familiar I should be with the American health care system for this exam – more specifically, topics related to Medicare, working with COTA’s, etc.? And how do you find time to study while working full time?

    Also, any Canadians out there… how does NBCOT compare to the CAOT certification exam?

    Would appreciate any help you can give! I can be reached by email: tarynw7 at yahoo dot ca

    • 343. joayla  |  October 18, 2013 at 5:44 pm

      Hi there,
      What did you use to study for the CAOT exam? Ive written it four times and failed. Any advice would help.

      • 344. Nina  |  October 19, 2013 at 7:51 am

        pray, pray and pray. I took it many times. Just keep swimming.

  • 345. Elizabeth  |  April 22, 2010 at 6:33 pm

    Just wondering– Does anyone know if you can sit for COTA exam even if your degree is in occupational therapy and not occupational therapy asst .

    Also, wondering–is there anyone in New Orleans studying?

  • 346. DUDE  |  April 23, 2010 at 8:37 am

    Don’t go crazy over MET levels. You most likey will not be asked to give specific numerical values of MET levels. Use your judgment and understand the progression of MET levels, especially the activities that define a trasitional stage in a patient’s independence…climbing stairs..etc..decide which activity will come after the other when you see the choices..the easiest activity (least energy required) to the hardest….and keep safety in mind…dont’ skip a step for a cardiac patient…make sure patient in question fits the description of someone who is fit (especially a cardiac patient) at THIS STAGE in his recovery to activities that involve such thigns as lifting weights over shoulders, climbing stairs…etc…They are not concerned with your memorizing lenghty amounts of material and regurgitating it…you have to keep key words in your head the whole time of the exam…SAFETY, INDEPENEDENCE, CLIENT FACTORS, EFFICIECNY (TIME, MONEY) MET levles =cardiac patients=safety=when is this person ready to make the major transitions in independence …lifting arms over shoulder …UE /LE dressing…etc…think in these terms…

  • 347. dude  |  April 23, 2010 at 8:44 am

    Don’t go crazy over MET levels. You most likey will not be asked to give specific numerical values of MET levels. Use your judgment and understand the progression of MET levels, especially the activities that define a trasitional stage in a patient’s independence…climbing stairs..etc..decide which activity will come after the other when you see the choices..the easiest activity (least energy required) to the hardest….and keep safety in mind…dont’ skip a step for a cardiac patient…make sure patient in question fits the description of someone who is fit (especially a cardiac patient) at THIS STAGE in his recovery to activities that involve such thigns as lifting weights over shoulders, climbing stairs…etc…They are not concerned with your memorizing lenghty amounts of material and regurgitating it…you have to keep key words in your head the whole time of the exam…SAFETY, INDEPENEDENCE, CLIENT FACTORS, EFFICIECNY (TIME, MONEY) MET levles =cardiac patients=safety=when is this person ready to make the major transitions in independence …lifting arms over shoulder …UE /LE dressing…etc…think in these terms…CANUK you dont’ have to be too familiar with the U.S healthcare system..know what facility has what population…you do need to know the role of COTAs and what they can and cannot do with or without supervision..again this goes back to SAFETY

  • 348. dude  |  April 23, 2010 at 8:48 am

    sorry for double post my first post didn’t show initially so i re-posted. Sorry of the redundancy

  • 349. amy  |  April 25, 2010 at 8:02 am

    Thank you dude for your advice. i really appreciate it.

  • 350. amy  |  April 28, 2010 at 10:06 am

    Hi all, Did anyone took the castleworldwide practice exam ? If you did was it helpful? thanks

  • 351. Shelly  |  April 29, 2010 at 10:48 am

    My two big tips on passing the exam:

    1. ON the morning of the test, eat a decent breakfast. I didn’t and boy I felt like a was going to faint! 🙂

    2. Make flash cards on everything you think you are a little bit weak on. Read the nbcotexam . com study guide and if you don’t know it , put it on a index card. Read the Rita book, anything that doubts you, put it on a card. This works!!


  • 352. Shelly  |  May 3, 2010 at 8:54 am

    just an FYI, I saw on facebook that if you use “facebookgrads” on the NBCOTexam . com site you can get an additional 2 dollars off the study guide.

  • 353. Mike  |  May 3, 2010 at 1:02 pm

    Did anyone use the 45 days books? Is it a good idea to purchase or not.

  • 354. npswissgear  |  May 3, 2010 at 10:47 pm

    i just recently failed the nbcot exam, and have studied from the rita book, has anyone taken the exam twice, if so is it very different or very similar to the first exam you took? I have also taken all the pratice exams on line at castleworld. Please help what should i do?

    • 355. Mary  |  May 18, 2010 at 7:08 pm

      I took it twice to at a different site than my first one and it was totally different

      I have a friend that took it twice but at the same site and she said it was almost identical but a few questions were changed

  • 356. Julie  |  May 22, 2010 at 8:38 am

    new OT website/blog to help you tackle the NBCOT exam from first applying to take it, which textbooks to use and which study guides to buy (or not), tips and advice from OTs who have recently taken the exam at the end of 2009. hope you will all check it out

    google conquering the NBCOT and find the blog

    • 357. Julie  |  May 22, 2010 at 8:40 am

      type in conqueringthenbcot dot blogspot dot com

  • 358. Brianna L  |  May 27, 2010 at 7:57 pm

    Another good blog is nbcotexam blogspot com . Also OTstudyguide com is good for a cheap guide that makes great flash cards.

  • 359. traci  |  June 11, 2010 at 5:41 pm

    well everyone, this is my first time to this site. I used to be embarrassed to say but I’m not now. I have taken this exam quite a few times and still have not passed. i would like any suggestions on what I can do differently this time around?

    • 360. amy  |  June 15, 2010 at 4:31 pm

      what books are you using to study?

    • 361. Julie  |  June 16, 2010 at 2:59 am

      a list of book resources is available at

      http://conqueringthenbcot dot blogspot dot com

      it explains which textbooks to reference for the foundations of the exam per section

      e.g paediatrics use this book

      physical use this book


  • 362. Nae  |  June 26, 2010 at 7:40 am

    My story: I graduated from OT school in 07′. From 07′ to 09′, I have taken the exam many times and of course failed. I thought about given up on OT because I felt that passing the test was impossible. I was discouraged and I was out of ideas. One day I was on the computer just trying to find any and everything on OT and I came across OTadvantage-to make a long story short,I ended up finding a study partner through OTadvantage. I will admit that I was a little hesitant about studying with someone else because of my past experiences. But believe me it was God sent! My study partner and I studied everyday on the phone about 3 hours. We started off studying from NBCOT study guide book looking at the diagnosis/conditions in the back of the book and from there going back into our textbooks and finally taking OTadvantage course. End result: I passed my exam! Trust me, going back in the textbooks and having a study partner really does work-I could not have done it without my study partner. I truly thank God! For those who still studying for this exam- it is possible-you can pass and you will pass-just believe in yourself and believe in God!

  • 363. Marrin  |  June 26, 2010 at 11:41 am

    I feel great relief to have discovered this wonderful blog. The endless dialogue and support is helpful and deeply appreciated. I am very curious to know how great the Caryn Johnson OT Exam Review book source is being the copyright is 2001. Are the questions similar wording and relevant info to the actual exam? I feel the exam has changed dramatically since then. After spending an abundance on resources and the exam itself is this the best bang for your buck??

  • 364. Katrina  |  June 29, 2010 at 8:23 pm

    Are you selling any of your textbook? Which books do I need to study? I think I need to go back to textbook. Is anybody out there selling their textbook…Been grad a long time my books are so outdated…TNX

    • 365. Nae  |  June 29, 2010 at 9:51 pm

      Hi Katrina, Im sorry but Im not selling my books. The textbooks that I studied from were Pedretti, Trombly, Case-Smith, Cole, and Willard and Spackman. I hope this helps:)

  • 366. Deb  |  July 1, 2010 at 5:07 pm

    Which mental health text book are people using to revise in this area? The Bruce and Borg? The Cara and McRae? Any mental health OT study recommendations?

    • 367. Julie  |  July 2, 2010 at 3:52 am

      I used Cara and McRae and found it sufficient. i have a list of books on my blog for each section if you want to take a look

      conqueringthenbcot dot blogspot dot com

      • 368. Deb  |  July 6, 2010 at 4:27 pm

        Thanks Julie

  • 369. Marrin  |  July 2, 2010 at 8:17 am

    ANYBODY SELLING Caryn Johnson OT Exam Review book??? I want one ASAP. Email

  • 370. ipshita  |  July 5, 2010 at 2:23 pm

    Is there any book to study the professional ethics, reimbursement standards, legislative guidelines, service delivery models and practice settings from? As am from a different country, am not quite familiarised with the information needed for NBCOT purpose. Is Rita study guide good enough? pl suggest.

  • 371. Deb  |  July 6, 2010 at 4:31 pm

    Hi, I’m in the middle of exam prep, have the suggested texts and am doing prep questions from the texts amongst the usual memorising. Am thinking it might be time to get a study partner to help focus and refine, I’m in Los Alamos New Mexico, could skype study, anyone keen? I’m hoping to sit the exam in the next month.

    • 372. ND  |  July 7, 2010 at 12:11 am

      Deb, I would be interested in studying together. send me your email add or num. I live in california. My # is 650 564 9848.

  • 373. Marrin  |  July 6, 2010 at 7:09 pm

    I am sadden that nobody answered my question from June 26 asking about the bang for the buck on Caryn Johnson reference. Somebody out there answer please

    • 374. Julie  |  July 7, 2010 at 3:04 am

      hey Marrin, I would definitely recommend Caryn Johnson – the questions are not as difficult as Rita but give a good overview of the types of questions asked. I also used the Johnson book to look up references for specific things and followed up topics using the books that Johnson sights.

      go to conqueringthenbcot dot blogspot dot com

      • 375. Marrin  |  July 18, 2010 at 9:42 am

        Thanks Julie for replying

  • 376. maddy  |  July 9, 2010 at 12:08 am

    sample question! Please provide feedback.

    An individual who had a severe burn to the dominant upper extremity 10 months ago is attending OT. The patient wears a continous pressure garment, has resumed all premorbid roles, and is independent with the OT home program. The OTR should:

    1) discontinue weekly outpt services and schedule a follow-up in one yeat to check progress.

    2) Provide the pt with information on how to order replacement garments and d/c the pt. from outptatient OT

    3.) continue weekly sessions to monitor compliance with the home program and garment use.

    4.) schedule monthly follow-up visits to monitor scar maturation

    • 377. Julie  |  July 9, 2010 at 3:37 am


      scars can remodel for up to 2 years so you want to check that everything is going well and no new growth of the scar is inhibiting function. the patient may also need new pressure garments at some point depending on how they wear.

      it’s not 1 because:
      one year is too far in advance for burns

      it’s not 2 because:
      it’s not the patient’s role to provide pressure garments – what if the needs change and they require something new – you need the clinical reasoning of a therapist

      it’s not 3 because:
      they can do all premorbid roles so it’s overkill to see them once a week and insurance probably won’t pay for that – after 10 months they would know their home programme and it’s obviously working if you’re getting the results mentioned in the question

  • 378. maddy  |  July 9, 2010 at 7:16 pm

    To enhance kitchen safety and independence for a 43-year-old individual who has diabetes mellitus with peripheral neuropathy, retinopathy, and macular degeneration, the OTR should:

    a.) reducing the temp of the water heater
    b.) storing heavy food packages in cabinets below the counter
    c.) using visual cues to compensate for sensory loss
    d.) minimizing lighting over the stove to decrease glare

    An OTR employed by the state department of vocational rehabilitation is asked to give a presentation to the school board on the rold of OT in the program. THe MOST EFFECTIVE method of communicating the value of OT to this audience is by:

    a.) describing the impact of OT on student employability
    b.) discussing the disabilities seen most frequently in such programs
    c.) demonstrating adaptive equipment typically used in OT programs
    d.) simulating an OT group using students who have participated in the program

    A child who has mild figure-ground deficits is having trouble copying from the classroom chalkboard. THe teacher asks the OTR for recommendations to minimize this problem. THe OTR’s FIRST recommendation to the teacher would be to:

    a.) provide the child with a printed handout
    b.) use chalk of the same color for all lessons
    c.) clean the chalkboard frequently
    d.) use an overhead projector as well as the chalkboard

  • 379. Julie  |  July 10, 2010 at 3:13 am

    First question:

    2) a

    3) c

  • 380. maddy  |  July 11, 2010 at 9:45 pm

    Thanks Julie for responding! It helps to know that we have the same answers. I will keep posting questions! This question, Im debating between A or D.

    An OTR is planning tx intervention for a child whose movements are influenced by the tonic labyrinthine reflex. To minimize the impact of this reflex on function, the OTR should select activities the child can complete in prone to promote:

    a.) stability of the trunk, which will encourage reaching activity
    b.) trunk rotation to promote functional reach out of midline
    c.) distribution of weight over a center of gravity to encourage symmetry
    D.) extension of the neck, which allows free movement of the head in space

    • 381. Julie  |  July 12, 2010 at 3:39 am


    • 382. amy  |  July 16, 2010 at 12:05 pm

      I will go with D

      • 383. Julie  |  July 16, 2010 at 12:16 pm


        that is a tough one. when do you take the exam?

  • 384. Npotter24  |  July 15, 2010 at 5:59 pm

    I just found out I passed the OTR exam, the first time!!! To all those out there doubting themselves it can be done!!! I used the tips from this blog and 4 weeks of preparation and it resulted in success!!!! I highly recommend the NBCOT materials and the Caryn Johnson study guide!!! Both of these tools are great examples of what to expect on the real deal!!! Good Luck all!!!!

  • 385. Jill  |  July 16, 2010 at 8:21 pm

    Hi…I just found out that I failed the exam. I am glad I came upon this blog. It seems to have a lot of information and a lot of people who are very helpful. I wanted to know if any of you are in the tristate area and would like to start a study group? I’m working on a temp license, but they demoted me and I can’t afford to be demoted again. Student loans are unaffordable!!

    • 386. otprep  |  July 17, 2010 at 12:36 pm

      I live in TX state. I am preparing for the NBCOT exam. Also preparing to get temporary license but I am not sure about that how easily you can get job on temporary license. Any idea ?

      • 387. Jill  |  July 18, 2010 at 10:00 am

        I had a job months before I got my temp license. There are a lot of places willing to hire before you apply for your license as long as you have a specific timeline of when you will apply for it.

  • 388. Deb  |  July 18, 2010 at 5:21 pm

    Hi, I’m thinking of taking the OTAdvantage online 1 day exam prep session. Any advice on its worth would be appreciated. It’s pretty pricey, but if it can improve likelihood of passing exam……thanks.

  • 389. otprep  |  July 18, 2010 at 11:37 pm

    Thanks Jill, do you know any company or recruiters who do hiring on temp license? If so then plz send me the link on my email id I would appreciate your help.

    • 390. Jill  |  July 20, 2010 at 9:10 am

      Which population are you interested in working for? And which location are you looking to work at?

      • 391. Ipshita  |  July 20, 2010 at 3:57 pm

        Hi Jill,
        I have no idea about this temp license.Can you please enlighten me on this?If we can get one, thats valid for how long?Am interested for job opportunities at california.Do you possibly know any recruiters there who can issue a temp license?many thnx, in advance.

      • 392. otprep  |  July 27, 2010 at 6:02 pm

        I live in Dallas, Tx. I am interested in working for peds and geriatrics. If you know someone then plz let me know.

  • 393. Vicky  |  July 19, 2010 at 11:40 am

    I just took the exam for the second time and failed. One recruiter said, “I think there is something terribly wrong with the exam as so many OTs are failing it. I would encourage you to keep trying!” KNOW THAT WE ARE NOT ALONE in this.

    The first time I scored a 439 and I’m not sure yet about my new score. I met the standard for the simulation questions the first time as well. I have studied from TherapyEd, the Johnson book, took 2 NBCOT content tests and the multiple choice exam from NBCOT online. I have lost my job (first as an OT and then downgraded to a tech), and am now going to work outside of the field for a bit to take a break from this test.

    If you’re in the Chicagoland area and are interested in a study partner – email me at I will probably re-take it at the end of the year and would love to study with someone.

    • 394. emily  |  July 22, 2010 at 11:59 am

      hI Vicky i took the test first time and failed my score was 420. I think u should try again because u were close the first time. I definitly agree with u that something wrong with the test. But we have to try our best to finish with this road. good luck

      • 395. Vicky  |  July 22, 2010 at 12:13 pm

        Hi Emily, I’m sorry to hear about your score. I actually found out earlier this week that my new score was 447 out of 450. I could not believe how close I came. It’s just so devastating. Thank you for your words of encouragement. Good luck to you as well.

  • 396. Alice M  |  July 19, 2010 at 3:03 pm

    I taken the test July 9,2010 and fail by 51 point. you need 450 to pass. I had not work for ten years and now coming back into the work force. I move from MIchigan to Alabama. I am getting ready to take it again.

  • 397. Karen  |  July 27, 2010 at 1:34 pm

    I was wondering if anyone knew where to purchase the 5th ed. rita book at a reasonable price??

  • 399. ND  |  July 27, 2010 at 2:10 pm

    can anyone tell me if OT’s can do Manual Muscle Test on CVA, CP, and Head injury patients. or is it a contraindication to do MMT on these pt’s.

    • 400. emily  |  July 28, 2010 at 8:07 am

      I think yes u can apply MMT on cva CP and TBI you can not apply it to a fracture (unless told by doctor) not to an inflammatin, spasticity or cardio or MS patients. i hope it helps

  • 401. Jill  |  July 28, 2010 at 12:29 pm

    You can apply for a temp license through your state. You can work with it for one year as long as you agree to take and pass the exam within that time. If you fail the exam, the facility that you work with will determine whether you can continue to work for them or if you will be terminated. Most companies are willing to hire with a temp license. When you apply, they ask if you have a license or not and inform them that you have or will be applying for a temp license.

  • 402. LCG  |  July 29, 2010 at 9:15 pm

    I just found out that I passed the exam today after taking it for the first time. This blog has been extremely helpful. I would like to share my personal study strategies that might be helpful to those who are just about to take the NBCOT. I did a 6-week intensive review, studying at least 4-5 hours a today. I do a full-time job in a university, so I couldn’t do more than 4-5 hours each day except on weekends when I’d do up to about 6 hours. On some days, I just do 3. I try not to do less than 2 hours each day.

    Here was my study plan:

    Week 1-2:
    – Took Rita’s practice test 1
    – Read the entire Rita Study Guide (just mainly familiarization, taking notes and highlighting, no memorizing yet).
    – identified strengths and weaknesses

    Week 3-4:
    – Reviewed Pedretti Chapters on Eval and Intervention of Performance Areas, Different approaches, all the conditions, orthotics, feeding, ambulation etc.
    – Read Rita’s Study Guide the 2nd time, this time focusing on more details
    – Took Rita’s Practice Exam 2-3
    – Took Johnson’s Practice Test 1-2

    Week 5:
    – Read Case-Smith Chapters on ADL, Feeding, SI, Writing and Pre-writing; Fine Motor Development and common conditions
    – Read through Spackman’s summary chapter on conditions and practice settings, legislation and frames of reference.
    – Took NBCOT Online Practice Exam (100 items and 1 CST)
    – Did Johnson’s Practice Test 3-4 and CD test (5)

    Week 6:
    – Breezed through Rita’s Study Guide the 3rd time, this time trying to recall details and analyzing details that frequently come out of the practice tests (it was helpful to go back to this study guide after you have done so many practice tests; helps you recall details more effectively since you have analyzed these on actual test items)
    – Did Rita’s practice tests 1-3 again
    – Did Johnson’s CD practice tests making combinations of my weak areas
    – Reviewed notes taken from readings of Pedretti, Spackman, Case-Smith
    – Breezed through rationales again of the different practice tests (do this everytime you take a test; helps a lot with connecting and applying concepts)

    2 days before exam:
    – I stopped reading, went to the movies, ate out and reinforces myself for the hard work and tried to make myself feel good.

    Practice crossing out items on a sheet of paper for both the CST and multiple choice questions. Write the numbers and/or letters, then cross out and rationalize those that are obviously wrong choices until you are down to 2 options. Then analyze the question again and finalize your answers. Take and re-take the practice exams. Rita’s practice tests are good for analyzing and understanding theories and concepts. Johnson’s tests are very similarly written with the actual test. The NBCOT Online exam gives you a good feel of what to expect.

    Do not be harsh on yourself. Take frequent breaks but be sure to adhere to your study plan. Reinforce yourself. Treat yourself to dinner, buy shoes, and shop whenever you fulfill your study goals. Psych yourself to mentally prepare for the test. Write your name on a post-it or on pages of your reviewers with the OTR/L suffix and envision it.

    Hope this is helpful.

  • 403. emily  |  August 3, 2010 at 4:16 pm

    thank you fot the info LCG

  • 404. Sandy  |  August 9, 2010 at 5:38 pm

    I am an internationally trained OT and I am in the process of taking the nbcot exam for the first time and I could use a little advice:
    1) While I have several years of overseas experience is it worth it to volunteer at a US/local hospital as part of my exam preparation or am I better off concentrating on the various study guides?
    2) How many questions were there on the exam about professional ethics, reimbursement standards, legislative guidelines, service delivery models and practice settings? Any recommendations on a good source for studying the aforementioend topics?

    • 405. LCG  |  August 10, 2010 at 4:21 pm

      Sandy, I never had US experience prior to taking the NBCOT although I have been in the US for a while, and so I’m a little familiar with the practice settings already. I guess more than memorizing the practice standards and processes, applying them to case situations will be more essential, in which case you can use Willard and Spackman. Rita outlines these information too, byt taking practice tests from Johnson and the online NBCOT tetsts will be helpful. Just my cents’ worth.

  • 406. Julie  |  August 10, 2010 at 5:49 pm

    Hey Sandy, I am also an international OT and I have started a blog to tackle all these issues. if you would like to take a look and send me questions in that way the address is

    conqueringthenbcot (dot) blogspot (dot) com

    I agree with what LCG has said though – you dont need to volunteer in the US to get to know the procedures – Rita and some web browsing and willard and spackman should be sufficient.

  • 407. Linds  |  August 14, 2010 at 7:36 pm

    Hi everyone,

    I just found out that I passed the OTR exam and I am selling all of my study materials. I used just the items listed below and referenced textbooks such as Pedretti and Case-Smith.

    – Official NBCOT study guide 2010
    – Official NBCOT study guide 2006
    – Rita Flemming-Castaldly Study Guide from the therapy ed course
    – OT study cards in a box
    – study guide
    -OT Exam Review Guide- Caryn Johnson

    I am asking $125 for everything. Let me know if you are interested.

    • 408. Jill  |  August 20, 2010 at 12:38 pm

      I wanted to know if you are still selling your study materials. I am interested in some of the materials.


      • 409. Linds  |  August 26, 2010 at 8:20 am

        All I have left is the official NBCOT study guide. It is a good book and has about 100 questions in it.

  • 410. Magen  |  August 27, 2010 at 6:59 pm

    I didn’t care for the Johnson review guide. I’d definitely buy the official guide, Rita’s and the otstudyguide com one to make flash cards.

  • 411. Magen  |  August 27, 2010 at 7:00 pm

    I just noticed that nbcotexam,com and otstudyguide,com are the same.

  • 412. foreign trained OTR  |  August 27, 2010 at 11:40 pm

    I can believe that alot of people are failing the exam including US OT graduate. I thought only foreign trained OTs are the only one having problems passing the exam. For foreign trained OTs, We have to pass the TOEFL, TSE and TWE which for me alot harder to pass as I took it many times more than the NBCOT exam.

    Good luck to all. OT is one of the most rewarding jobs in the US.
    believe me ! they will find instead of finding them. Obtaining an OTR is like a crown.

  • 413. emily  |  September 2, 2010 at 8:56 am

    i have a question
    what is the contraindication for peripherla neuropathy and myositis ossification is it
    3.pressure aesthesiometry

  • 414. Deb  |  September 2, 2010 at 3:21 pm

    MMT, because the tx for MO is rest, immobilization and anti-inflammatories?

  • 415. Maddy  |  September 9, 2010 at 9:20 pm

    An OTR is working with a client who has mild hemiparesis secondary to a CVA. The OTR suspects that the client also has ideomotor apraxia. During which task of a meal preparation assessment would this deficit be MOST EVIDENT?

    A. Holding a measuring cup filled with water
    B. Making a cup of instant iced tea
    C.Following instructions on a carton
    D. Describing how to prepare a sandwich

  • 416. Maddy  |  September 9, 2010 at 9:43 pm

    Hi guys! Would love your input on these questions! Thanks!

    A client has flexor synergy of the dominant upper extremity after having a CVA 4 weeks ago. The client is currently in Brunnstrom’s stage 4 of motor recovery. One of the client’s goals is to be independent with self-feeding. Using the affected upper extremity, which self-feeding activity is BEST for the client to practice during this phase of motor recovery?

    A. Grasping and releasing a drinking cup
    B. Cutting meat with a rocker knife
    C. Reaching for eating utensils
    D. Stabilizing a dinner plate

    An OTR is beginning to evaluate a client who has rheumatoid arthritis. Which method would be BEST for the OTR to use for gathering information about the client’s occupational performance?

    A. Observe the client during morning self-care tasks.
    B. Have the client complete an ADL checklist.
    C. Ask the client about current problems, needs, and priorities.
    D. Complete baseline goniometric and strength measurements.

    An OTR receives a referral from a pediatrician that reads, “2-month-old infant s/p birth trauma. Evaluate and treat.” History and initial screening results are as follows:
    • Breech birth
    • Apgar scores of 4 and 9, respectively at birth
    • Right Upper Extremity: Low muscle tone, No spontaneous movement of the right upper extremity, Fingers of right hand move in response to touch, Absent biceps reflex
    • Left Upper Extremity: Normal muscle tone, Spontaneous movement, Age-appropriate reflexes
    Which diagnosis is consistent with the screening results and the infant’s birth history?

    A. Cerebral palsy
    B. Muscular dystrophy
    C. Erb’s palsy
    D.Neural tube deficit

    31 / 100
    An OTR is interpreting the results of a standardized developmental assessment administered to a school-age child. Results indicate the child achieved a percentile score of 16 on the assessment. What does this score indicate?

    A. The child passed 16% of the items on the test.
    B. 16% of the children in the normative group scored higher.
    C. The child passed 84% of the items on the test.
    D. 84% of the children in the normative group scored higher.

    An OTR is evaluating a client who is in Stage II of amyotrophic lateral sclerosis. During a mealtime assessment in the client’s home, the OTR observes the client has mild bulbar involvement impacting the ability to swallow and finish eating a meal. What advice should the OTR provide caregivers based on this observation?

    A. Recommend the client use a nosey cup when drinking liquids.

    B. Prepare the client foods that have a thin consistency.

    C. Provide a relaxed and unhurried atmosphere for the client during mealtimes.

    D. Position the client during meals in a chair that reclines back 30°-40°.

    An individual who has macular degeneration is participating in OT. During a home evaluation in the individual’s kitchen, the OTR observes that the individual rummages through kitchen drawers looking for utensils, turns on cabinet-mounted lights to see better, and holds canned goods and packages approximately 12 inches (30.5 cm) from the face to read the cooking instructions. Which of the following should the OTR do to improve the individual’s functional performance?

    A Move all commonly used items in the kitchen to shelves positioned at eye level.

    B Adhere large print labels to commonly used items and provide a magnifier.

    C Assist the individual to simplify and organize workspace in the kitchen.

    D Replace light bulbs with higher wattage bulbs to brighten the kitchen.

    n OTR working in a large rehabilitation facility plans to have an OT student accompany the OTR on a client home assessment. The OT student has a full scheduled caseload. What action should be taken to cover the OT student’s caseload at the facility while attending the home visit?

    A Cancel the intervention sessions scheduled during this time.

    B Reschedule client sessions to occur before or after the home assessment.

    C Provide the rehabilitation aide with detailed instructions for the interventions.

    D Ask the COTA to include the scheduled clients in a group session during this time.

    A client who had a distal radius fracture 8 weeks ago continues to have moderate edema and generalized hand stiffness. The client is a homemaker and wants to resume homemaking tasks as soon as possible. Which of the following activities would be MOST BENEFICIAL for the client to do at home prior to beginning daily ROM exercises?

    A Wash dishes by hand in water that is approximately 100°F (37.8°C).

    B Firmly massage the affected hand moving in a proximal to distal direction.

    C Wrap the hand in a moist towel heated to approximately 96°F (35.6°C).

    D Constrain the non-affected hand then fold small bath towels from a laundry basket.

    68 / 100
    An OTR is designing a research study to evaluate the effects of a leisure-time management group on the life satisfaction of individuals who have Parkinson’s disease. What is the BEST way to obtain quantifiable data?

    A . Administering activity checklists pre- and post-group

    B Observing participants during a group activity

    C Reviewing medical records of participants

    D Obtaining life histories by interviewing participants

    A client who is recovering from a radial head fracture is participating in OT. During an intervention session, the OTR applied ice to the injured area for 20 minutes. How long does the client continue to benefit from the analgesic effect of the ice when engaging in functional intervention activities?

    A Approximately 30 minutes after removal of the ice

    B Two times the length of time of the ice application

    C 5-10 minutes or until the redness disappears from the skin surface

    D Until the client feels a burning sensation in the affected area

    An OTR is working with a student in high school who has cerebral palsy with mild spastic hemiplegia, moderate dysarthria, and age-appropriate cognition. The student reports that the teacher typically erases notes from the blackboard before the student is able to copy critical information for tests and quizzes. Which type of assistive technology is MOST EFFECTIVE for promoting the student’s success with this task?

    A Computer with a QWERTY arranged keyboard and hands-free mouse

    B Personal computer with keyboard key guard and disabled repeating keys

    C Electronic notebook with voice recognition software and a tracking ball mouse

    D Laptop computer with a one-handed keyboard and enabled short keys

    An inpatient with a T8 spinal cord injury uses a wheelchair for mobility and lives in a federally subsidized housing community apartment. After completing a home health evaluation, the OTR reports that several minor modifications are needed to ensure the individual’s functional independence. According to ADA, who is legally responsible to ensure completion of the required modifications?

    A Housing director

    B State office of health and human services

    C Patient

    D Federal housing authorities

    A client had a tendon repair of the flexor pollicis longus in the dominant hand 12 weeks ago. Which of the following activities would be MOST BENEFICIAL for maximizing pull-through of the involved tendon during this phase of recovery?

    A. Completing a macramé belt

    B. Pressing buttons on a handheld game controller

    C. Typing on a desktop computer keyboard

    D. Embossing leather with a leather tool and mallet

    A 6-year-old child who has Down syndrome has been participating in OT to promote visual-motor integration. Standardized tests of visual attention indicate the child scored –1.0 standard deviations from the norm. Based on the hierarchy of visual-skills development, which client factors should be addressed NEXT?

    A Visual imagery

    B. Visual discrimination

    C Visual cognition

    D Visual memory

    During a feeding evaluation, an OTR notes that a 4-year-old child who has a developmental delay spits out most food, has a hyperactive gag reflex, and prefers foods that have a soft texture. To improve feeding skills, what should be the INITIAL focus of the intervention program?

    A Reducing the gag reflex

    B Increasing food intolerance

    C Improving oral-motor delays

    D Decreasing oral defensiveness

    An inpatient who has an L1 spinal cord injury is preparing for discharge from a rehabilitation unit to home. The patient’s home has a wheelchair-accessible bathroom with a bathtub that has a wall-mounted showerhead and shower curtains. Which home modification should the OTR recommend for this patient?

    A Replace the shower curtain with a tub-mounted sliding door.

    B Place a shower chair with suction feet in the bathtub.

    C Use a tub-transfer bench for getting into and out of the bathtub.

    D Fasten a removable grab bar to the side rim of the bathtub.

    A wrist extension splint with a low-profile dynamic MCP joint extension outrigger would be MOST BENEFICIAL for a patient with which of the following conditions?

    A High radial nerve axonotmesis

    B Low radial nerve neuropraxia

    C Posterior interroseous nerve neuropraxia

    D Anterior interroseuos nerve neurotmesis

    An OTR is removing electrodes from a client who has just received iontophoresis. Within several minutes of removing the electrodes, what should the OTR do to the skin surface that came in contact with the electrodes?

    A Wipe the area with an alcohol pad.

    B Vigorously massage the area.

    C Apply a lotion with a neutral pH.

    D Rub an analgesic lotion into the area.

    • 417. Deb  |  September 13, 2010 at 1:37 pm

      Hi Maddy, my study buddies and I have looked at these questions and will post our answers, but I have a question for you, would you mind emailing me so I can chat with you on email please? 🙂 thanks heaps, it was great you posted these, really appreciated it.

  • 418. Jill  |  September 10, 2010 at 11:28 am

    These are my answers, and I just found out that I passed the NBCOT exam!!!!

    B. Making a cup of instant iced tea

    C. Reaching for eating utensils

    A. Observe the client during morning self-care tasks.

    C. Erb’s palsy

    D. 84% of the children in the normative group scored higher.

    D. Position the client during meals in a chair that reclines back 30°-40°.

    B Adhere large print labels to commonly used items and provide a magnifier.

    B Reschedule client sessions to occur before or after the home assessment.

    A Wash dishes by hand in water that is approximately 100°F (37.8°C).

    A . Administering activity checklists pre- and post-group

    A . Approximately 30 minutes after removal of the ice

    C Electronic notebook with voice recognition software and a tracking ball mouse

    D Federal housing authorities

    B. Pressing buttons on a handheld game controller

    B. Visual discrimination

    A Reducing the gag reflex

    C Use a tub-transfer bench for getting into and out of the bathtub.

    A High radial nerve axonotmesis

    A Wipe the area with an alcohol pad.

  • 419. otprep  |  September 11, 2010 at 1:45 am

    I am applying for the OT temporary license. It says that this license is issued by TBOTE to an applicant who meets all the qualification for a license except taking the first available examination after completion of all education requirements.
    But I have already taken the NBCOT exam and unfortunately did not pass. All those candidates who are taking the exam second or third time they cannot apply for OT temp license. Is that true? Is there anyone who can tell me about this?

    • 420. Jill  |  September 11, 2010 at 5:41 pm

      Yes it is true. Unfortunately since you have already taken the NBCOT exam, you are no longer eligible to apply for a temporary OT license.

      • 421. otprep  |  September 11, 2010 at 6:44 pm

        So there is no way of getting the temp license. I don’t believe I thought that for 6 months you can get temp license and within that period if you pass the exam your license will become permanent. But that is for 1st time exam taking candidate. I am upset !!!

  • 422. Maddy  |  September 11, 2010 at 12:47 pm

    An OTR is evaluating a 3-year-old child who has arthrogryposis. Evaluation indicates that the child ambulates with a walker, has good sitting balance, and interacts appropriately with others. The child is able to flex both shoulders actively from 0°-100° and both elbows from 45° – 90°. The child currently requires assistance with feeding due to the upper extremity functional limitations. A goal of the parents is for the child to become independent with self-feeding. Which compensatory strategy is BEST for promoting progress toward this goal?

    A. Train the child to use a table mounted mobile arm support.

    B. Teach the child to use a mechanically operated feeder.

    C. Provide the child with eating utensils that have elongated and angled handles.

    D. Elevate the surface on which the plate and eating utensils are placed.

    A client who has been diagnosed recently with thoracic outlet syndrome is participating in OT. The client, who works as a telemarketer, reports that current symptoms interfere with the ability to complete a full day of work. Which intervention is MOST IMPORTANT to include as part of the client’s home program?

    A. Weight training 3 times per week to strengthen the upper quadrant

    B. Intrinsic strengthening exercises using therapy putty several times per day

    C. Postural exercises to be performed hourly throughout the day

    D. Desensitization activities using immersion particles 3 times per day

  • 423. Jill  |  September 11, 2010 at 7:52 pm


    I just found out that I passed the OTR exam and I am selling all of my study materials. I used just the items listed below and referenced textbooks such as Pedretti and Case-Smith.

    – Official NBCOT study guide 2010
    – Official NBCOT study guide 2003
    – Rita Flemming-Castaldly Study Guide from the therapy ed course
    – study guide
    -Study guide packet of most important info from Rita Flemming-Castaldly Study Guide
    -Note cards
    -Rationals to Content exams from
    -Copy of Caryn Johnson study guide, but I don’t have the CD.

    I am selling all of these items for a total of $150 OBO. Please e-mail me if you only want certain items and I will give you the individual prices. Contact me at

    • 424. otprep  |  September 12, 2010 at 1:53 pm

      Congratulation!!! Wow you must be relief now no more stress for OTR exam. Any advice ? Your study pattern and how much time did you spend for this exam?
      Would appreciate your advice?

      • 425. Jill  |  September 12, 2010 at 8:31 pm

        Thanks OTprep. I must say that I am relieved! I will say that I studied for about 3 months. All of the study materials I listed were very helpful to me. The Rita book was good at giving me an overall review of what I needed to know for the exam, but since it is so extensive, I used a 50 page study guide of all of the important info from the Rita book, to read over once I had read the Rita book from cover to cover. Once I had finished reading the Rita book in entirety, I found that I had kind of zoned out on parts of it and probably needed to read it again, but I didn’t have the
        time, so that’s why I read over the 50 page study guide to kind of reinforce what all the Rita book was saying. I also have the note cards, which I did make myself. They include some terms that were confusing to me such as: agnosia, apraxia, ataxia, astereognosis, etc; developmental levels; MET levels; right vs. left hemisphere; grasp patterns, and etc. I also used the green Caryn Johnson book to give myself quizes, but I borrowed that CD from a classmate, so I don’t have that. I do have a copy of the Johnson book, which has the questions and the rationals. The questions were good knowledge based questions. They tested your ability to retain the material from the Rita book, but they do not reflect they style of questions that are on the NBCOT exam. Finally, I used the content exams from to test my ability right before I took the exam. If I had have done horrible on those exams, I would have seriously considered moving my test date back. Anyway, that just about sums up everything that I did to study. Good Luck!

  • 426. kanu  |  September 13, 2010 at 1:52 pm

    most of my answers are same as the above post but i do hv a few different ones. @ Maddy plsmay we hv the correct answers n rationales

    C.Following instructions on a carton
    (as the pt has ideomotor praxixs he will hv difficulty performing motor tasks on command in this case following instructions)

    D. Stabilizing a dinner plate

    A. Observe the client during morning self-care tasks.

    C. Erb’s palsy

    D. 84% of the children in the normative group scored higher.

    A. Recommend the client use a nosey cup when drinking liquids ( to prevent aspiration)

    D Replace light bulbs with higher wattage bulbs to brighten the kitchen.

    B Reschedule client sessions to occur before or after the home assessment.

    A Wash dishes by hand in water that is approximately 100°F (37.8°C).

    A . Administering activity checklists pre- and post-group

    A . Approximately 30 minutes after removal of the ice

    D Laptop computer with a one-handed keyboard and enabled short keys

    D Federal housing authorities

    A. Completing a macramé belt ( promotes Thumb flexion at MCP and IP)

    B. Visual discrimination

    A Reducing the gag reflex

    C Use a tub-transfer bench for getting into and out of the bathtub.

    A High radial nerve axonotmesis

    A Wipe the area with an alcohol pad.
    C. Provide the child with eating utensils that have elongated and angled handles.
    C. Postural exercises to be performed hourly throughout the day

  • 427. Maddy  |  September 13, 2010 at 3:56 pm

    sorry guys I dont have the rationale to this. These questions were given to me from a fellow OT that has passed.

  • 428. kanu  |  September 13, 2010 at 4:07 pm

    @ Maddy. No worries. The questions were really thought provoking. Thank u for posting them. Good luck for the exam 🙂

  • 429. jaytee  |  September 13, 2010 at 4:35 pm

    anyone wana study through online??? Email me at I could use a study partner…I took the test twice and failed…and its been almost three years since I graduated OT school. Looking for something else to help me through this. I have lots of study guides and made my own study guides to each section…I have flashcards and practice exams etc. Nothing has helped. I live in NH but would be willing to even share thoughts and ideas over the internet. Let me know.

  • 430. StephA  |  September 14, 2010 at 12:07 am

    Hi everyone, I’m trying to help my boyfriend pass his OTR exam, so far he has taken it twice and has not passed. He has come pretty close (441). We are both getting frustrated because the cost of the exam is so high, well I have purchased the OTstudyguide (1000 things to know, the PDF online source) and it seemed to help but the questions are not that similar to the ones on the actual exam. Has anyone used the NBCOT EXAM SECRETS by memorix, website: I found that online and it cost $50 but I dont know whether or not to purchase it for him. I have been trying to read as much about this test but since I am not an OT I have no idea how to help him. I can’t believe how difficult this test is. I am studying to be a teacher for the visually impaired and should be finishing this year but out of the 4 exams I need to take to get my license only 1 is very difficuly, the others I barely studied for and did quite well.
    i wish everyone lots of luck studying for this test, and any tips/advice/anything would be helpful right now, because I see how much work my boyfriend is putting into this test and seeing no results.

    • 431. Denise R  |  September 14, 2010 at 4:44 pm

      I have not taken the exam, however; I did purchase the NBCOT Exam Secrets flashcards & they are very detailed. I am also using Pedretti’s, Johnson’s & Rita’s material to study; a lot of students have passed using the material listed above.

  • 432. Maddy  |  September 16, 2010 at 7:39 pm

    anyone take the nbcot recently and have any last minute advice or strategies to pass this exam?? I am taking it next week..anxiety is kicking in. Any suggestions would be greatly appreciated. Thanks. Good luck to the rest of you who are prepping for this exam. It’s a long process but we can do it!

    • 433. Jill  |  September 17, 2010 at 12:21 pm

      I just took the exam for the 2nd time earlier this week. There was a lot of pediatrics on it but much of the information I studied was not on it. Ethical dilemmas were a major portion of the questions so it was very thought-provoking. I will find out the results next week.

  • 434. Maddy  |  September 16, 2010 at 8:34 pm

    A client is participating in Phase III of an outpatient cardiac rehabilitation program. During a meal preparation activity, the client begins to perspire excessively and has dyspnea. After stopping the activity, what action should the OTR take NEXT based on the client’s symptoms?

    A. Teach the client more effective work simplification methods.

    B.Activate the facility’s emergency medical response team.

    C. Monitor the client’s pulse and blood pressure.

    D. Advise the client to breathe in through the nose and out through pursed lips.

    Is this answer B or C??

    • 435. Jill  |  September 17, 2010 at 12:19 pm

      I think it’s C

  • 436. Lola  |  September 16, 2010 at 10:06 pm

    could it be d?

  • 437. Deb  |  September 17, 2010 at 6:12 pm

    So these are signs of exercise intolerance, except that the descriptor for the sweating is “excessive” so that means its more than would be expected? Given he is in Phase III we know he is expected to be able to tolerate at least 3.5 MET level, isn’t meal prep at 3.5 METs? So aren’t these symptoms “unexpected”, and if symptoms persist after rest or are unexpected that is an indication to alert physician? activate emergency medical repsonse team? He could be having an MI? Maybe if he was lifting weights or something in this same question you would take his vital signs but with meal prep? Tricky…

    • 438. Jill  |  September 22, 2010 at 1:38 pm

      But it didn’t say that symptoms persisted after stopping activity. It just asked what to do after stopping the activity

  • 439. emily  |  September 19, 2010 at 2:05 pm

    definitly B

  • 440. Jill  |  September 19, 2010 at 10:19 pm

    I agree with the other Jill. I think it’s C.

  • 441. Kathy M  |  September 27, 2010 at 6:08 pm

    I think it’s C too…

    I didn’t like the momedia flash cards and tried to return them to no avail. I should have read some of the review that were out there but didn’t. Oh well… I could have just bought the otstudyguide com and made my own for 1/2 the price. Also check Ebay for Rita’s book. I found it on there for a bargain.


  • 442. Rachel  |  October 8, 2010 at 6:08 am

    Hello Everyone! Is there anyone looking for a study buddy in the Hermitage, TN area?

  • 443. Ash  |  October 8, 2010 at 12:00 pm


    Anyone looking for a study patner in Rockville, MD area ?

    • 444. shannon  |  October 22, 2010 at 8:45 am

      Are u still looking for a studying partner…I live in Rockville too?

  • 445. JessF  |  October 11, 2010 at 11:25 pm

    Hi StephA: Did you end up getting the NBCOT Exam Secrets by
    mo-media for your boyfriend? I just found that site and it looks very helpful but am not sure if it actually is since I have not seen it recommended by anyone else on different blogs I have been on. I just found out last week that I did not pass, it was my first time taking it.

    DeniseR: Did you find the NBCOT Exam Secrets flashcards helpful? I was thinking about getting the book, but wanted to know how the flashcards were. Did it have practice questions as well?

    I am looking for someone to study with. I think that studying with someone would be really helpful. I live in NY (Long Island) and was wondering if anyone was near the area. If not, anybody who currently has a study group via email/chat/skype can I join? Thanks: )

    • 446. Crystal  |  February 15, 2011 at 11:22 pm

      Don’t get the Exam Secrets material. It’s expensive and poorly written. Get the nbcotexam com one instead. You save 50 bucks and get a guide written by OT students which make great flash cards!

  • 447.  |  October 13, 2010 at 1:12 pm

    Anyone in the CA area willing to study via email/chat?

  • 448. Deb  |  October 15, 2010 at 12:08 pm

    Hi, I passed my exam, nice relief, so am selling my books 🙂

    I am willing to sell at a good discount:

    1. JB Review : 45 days and counting – $20 + $4.90 shipping (new $34+shipping)

    2. NBCOT OTR Official Study Guide – $45 + $4.90 shipping (new $60+$8 shipping)

    3. Johnson, OT Exam Review Guide (no CD, I didn’t find this a problem) $20+ $4.90shipping (new $30+shipping)

    4. Rita – Therapy Ed National OT Cert Exam Review and Study Guide – $65+ $4.90 shipping (new $85+shipping)

    I paid ~ $219 + a stack of shipping costs, all latest editions (the Johnson is 3rd edition but the only book I didn’t buy new), all in near perfect condition. I’d love to get rid of them, it’d be great to get $125 + $14.50 shipping for the lot, or any variation of the above. Make me an offer 🙂 please,

    I also have the Casesmith (peds), Cooper (hands), Trombly (phys dys), McCrae (mental Health), Fazio (community OT). All books are in near perfect condition, I bought them all new just to study for the exam as I had no textbooks (graduated many years ago). I am considering getting rid of them all, you may know someone who wants the lot? A good complete study package?

    Goodluck everyone, happy studying.

  • 449. Jules  |  October 16, 2010 at 11:51 am


    I am an OT in the UK wanting to move and really struggling with exam preparation! I have been using the Johnson book and scoring around 80%, I took the NBCOT online practice tests today which i found much harder than the Johnson book, and failed as I got 435 out of 450….Really annoying!

    Does anyone know how the online test and the Johnson test compare to the real tests?

    Also, can i take the online test again or is it exactly the same? And….(sorry for a million questions, it’s such a nightmare!) if I took the NBCot 2 days before a scoring date do you think it would get scored 2 days later?!

    Anyone who can help I appreciate that so much! Thanks,


    • 450. Denise R  |  October 16, 2010 at 12:05 pm

      Great questions. As far as the online test, yes you can take it again but there is only 1 format & b/c it was submitted you cannot review the questions again; only the score. According to NBCOT taking the exam 2 days prior to scoring does not guarantee receipt of test results so best practice is at least 5 days prior to the scoring date. I read this info on facebook and I am waiting for the answers to the other question. Hopefully the above info was helpful.

    • 451. Rachel  |  October 16, 2010 at 3:17 pm

      Hey Jules. You can take the online exam again. I took the online exam in January of 2010 and again in September of 2010. I failed the on-line practice exam in Jan (version 3) and passed the second one in Sept (version 6). So yes, you can take the practice test again, but you will have to pay for another version. Once you have taken the exam and press submit, you can not retake the same exam. ;(….Oh and don’t freak out over not passing the practice exam, I passed the second one and scored a 460…took the real exam and failed it by 11 pts. So annoying… I hope this helps you!

      • 452. Jules  |  October 16, 2010 at 5:37 pm

        Thank you both for the help!

        Rachel did you find the practice questions were like the questions in the exam, as in a similar level?

        i kind of find that with some questions it wouldn’t matter how hard I revised, I would still find that a difficult question and i know how much studying I do just wont help in those cases! I think I’m going to hope for some luck… I’m sorry to hear you didn’t pass!

  • 453. Jules  |  October 17, 2010 at 4:04 am

    I’ve just been going through the practice questions listed above (which are the same as on the current NBCOT online practice test), on this question:

    A wrist extension splint with a low-profile dynamic MCP joint extension outrigger would be MOST BENEFICIAL for a patient with which of the following conditions?
    A High radial nerve axonotmesis
    B Low radial nerve neuropraxia
    C Posterior interroseous nerve neuropraxia
    D Anterior interroseuos nerve neurotmesis

    Two people said A, why is this? As it was a dynamic splint I guessed it was a radial nerve injury, but had no idea if it was high or low!


    • 454. Denise R  |  October 18, 2010 at 2:20 pm

      My assumption is: A. High radial nerve axonotmesis because

      Neuropraxia- is a contusion, recovery occurs in few days or wks without intervention

      Axonotmesis- the injury requires intervention ie splint

      Neurotmesis- surgery intervention is required

  • 455. Jules  |  November 6, 2010 at 10:19 am

    Thank you! That helps a lot! I have the exam on tuesday and am so nervous! I’m slightly stuck on a revision question as the way services run in America is so different to England. If a client had been discharged from a psychiatric ward, and the OT observed the return of symptoms and non-compliance with meds, would you tell the primary care physician their symptoms or would you work with the case manager to readmit?

    I guess i’m not sure of readmittance procedures, whether it would be through the primary care provider or case manager?

    Thanks for any help!!

  • 456. Danielle  |  November 16, 2010 at 6:52 pm

    Truly asking for prayer. I took the exam for the 7th time today. I pray that I pass it this time. Please pray

    • 457. S.Wright  |  December 2, 2010 at 2:05 am

      Hi Danielle,

      I am in a similar situation…did you pass it? Please email me when you are able.


      • 458. Danielle  |  December 2, 2010 at 7:04 am

        Hi S. Wright, No I did not pass. But I will take it again in Feb. Thanks

  • 459. Dee  |  November 20, 2010 at 7:26 am

    Hey guys I really appreciate all the post on here!!! I have taken the exam 2 times and have failed the 3rd time will be a charm. I am taking the exam in a month. I have decided to do majority practice questions this time from the Johnson book! I am considering purchasing the 45 days and counting book! If anyone wants a study partner feel free to contact me

    • 460. Rachel  |  December 18, 2010 at 4:27 pm

      Hello Dee. Did you ever purchase the JB Review 45 days and counting book? If so, how is that book working for you? Helping any?

  • 461. Vicky  |  December 2, 2010 at 11:25 am

    I finally passed the board exam after taking it three times. So there is hope! I would like to thank the creator of this website and everyone on here for your support and the opportunity to network for study tips, study buddies, etc.

    My advice for anyone in a similar position is to buy as much of the study materials as you can. I used these: TherapyEd, Johnson’s book, the NBCOT official guide, and JB Review 45 Days and Counting.

    I truly feel that each guide helped me in a specific way to pass the exam. Good luck to everyone and please believe that you CAN do it!

  • 462. hannah  |  December 13, 2010 at 12:21 pm

    i am a qualified OT from the UK, living in knoxville, TN.
    I am planning to sit the test in approx March/April 2011
    Is anyone looking for a study partner in the knoxville area?
    my email is
    Also is the same each time you take the test if you need to re-take it?
    thanks, Hannah

  • 463. hannah  |  December 13, 2010 at 12:22 pm

    sorry i meant is it the same fee each time you take the test ?

  • 464. hannah  |  December 13, 2010 at 12:30 pm

    Just seen the post from Rachel living in Hermitage TN – if you are still studying for the exam and would like to study together in the next couple of months maybe we could meet up somewhere between hermitage and knoxville ?

    • 465. Rachel  |  December 18, 2010 at 4:24 pm

      Hey Hannah. That sounds great! I’m sure we could meet up somewhere between Hermitage and Knoxville.

      • 466. hannah  |  January 17, 2011 at 6:39 pm

        hi rachel
        just seen your message and i am back in the uk now until feb
        but would love to meet up when im back if you are still studying.
        when are you planning to taken the exam?

  • 467. hannah  |  January 17, 2011 at 6:45 pm

    hi – in london for 4 weeks
    if there are any other londoners out there revising who want to meet up let me know
    my email is
    i need some motivation!

  • 468. Deb  |  January 24, 2011 at 10:55 pm

    Hi, I passed my exam, nice relief, so am selling my study books

    I am willing to sell at a good discount:

    1. JB Review : 45 days and counting – $20 + $4.90 shipping (new $34+shipping)

    2. NBCOT OTR Official Study Guide – $45 + $4.90 shipping (new $60+$8 shipping)

    3. Johnson, OT Exam Review Guide (no CD, I didn’t find this a problem) $20+ $4.90shipping (new $30+shipping)

    4. Rita – Therapy Ed National OT Cert Exam Review and Study Guide – $65+ $4.90 shipping (new $85+shipping)

    I paid ~ $219 + a stack of shipping costs, all latest editions (the Johnson is 3rd edition but the only book I didn’t buy new), all in near perfect condition. I’d love to get rid of them, it’d be great to get $125 + $14.50 shipping for the lot, or any variation of the above. Make me an offer 🙂

  • 469. Christina  |  February 3, 2011 at 3:02 pm

    Just passed the NBCOT, first try!! I am selling the study materials that I used and helped me pass the test. I have the Johnson book (with CD), Rita (with CD), official OTR study guide, OT advantage flash cards, exam guide and questions. I also took the OT advantage course (highly recommend). I am selling everything for $150..includes S & H (everything cost me up to $250 plus). I will also throw in my flashcards that I made for free (if you would like them). The study tools helped me pass with great ease!

  • 470. BELLA  |  February 9, 2011 at 12:15 am

    I want to first say this is the first time Ive felt I wasnt alone. I always thought why me, what am I doing wrong. I have failed the exam 3times already, and I havent taken the exam since January of 2010. Its been almost 2 years since I have graduated and I am depresate to get my career started. I been nervous, scared, more scared and stressed out in taking this exam again. I have put those feelings aside and I have been studying for the past 3 weeks now. I plan on taking this exam late of this month (feb) and all the post has made me feel more confident. I have read numerous of time the Rita book and I began reading through it again, mostly things I know I have difficulty in such as neuro and peds. I have been taking some of the exam questions 25 at a time from the Johnson book and only averaging around 60-70% on the questions. I must admitt, I have all the knowledge base I can get, but multiple choice testing was never my forte. I can always eliminate two answer I know is incorrect, but when I get to two possible answers, I tend to overthing, try to justify in my own way or just second guess myself totatly and end up getting the question wrong.I know my weakness in test taking. Does anyone have any advice in helping me with the question, how to identify the correct answer between two, what am I doing wrong. I want this 4th time to be a winner for me, i want this to be my year, please help. Thanks for all your post, it was well-worth reading and you can email me also at .

  • 471. Jasmine  |  February 15, 2011 at 11:18 pm

    Whoo I Passed!! Thanks everyone for the help! I’ve followed what everyone said, the Official Study tests, the Rita book and I made great flash cards from otstudyguide com’s guide. Thanks again!

  • 472. NBCOT  |  March 1, 2011 at 12:20 pm

    can someone help me solve this mystery??

    Wha tis the most appropriate w/c for C4?
    sip and puff or chin use??
    is both apporpriate??? or sip and puff is more of C3? i ahve looked everything and most of the textbooks say both.

    • 473. BELLA  |  March 1, 2011 at 4:14 pm

      out of the two choices, the most appropriate for a c4 would be a chin use

  • 474. Nadia  |  March 6, 2011 at 11:20 pm

    Siiiighhh just found out I failed the exam….its not fun its entirely devastating…I thought I had studied and was ready but like some other poster said on the test it was SOO much clinical reasoning…that I am unsure right now how to study to retake the test…obv I am not studying the right way…I mean I took the class, I took the content NBCOT exams, and the 75$ NBCOT practice exam and the therapy ed tests and the johnson tests and yet…I think I am not studying right…any suggestions?

  • 475. Lisa  |  March 13, 2011 at 12:06 pm

    Has anyone used the NBCOT prep book called Preparing for the OT National Board Exam: 45 Days and Counting? I am deciding if I should get that, which supposedly has detailed outlines of info on the exam, or the RIta Fleming-Castaldy book…

    (Deb- if you look at this blog again, please answer- I saw that you used both. which did you find more helpful?)

    • 476. Deb  |  March 29, 2011 at 9:03 pm

      The 45 days and counting was not a good investment in my opinion, the practice question CD was OK, but the book itself no where near as good as Rita. Goodluck

      • 477. Vicky  |  March 30, 2011 at 7:11 pm

        I actually really liked the 45 Days and Counting book. I used Rita the first time and did not pass. I thought the 45 Days and Counting had excellent practice questions that in my opinion closely mirrored the exam more than the Rita book did. I would get both study materials and use them. You can never study too much. Good luck!

  • 478. Jess  |  March 14, 2011 at 12:19 am

    I am sooo sorry to hear that you did not pass. I fell across this webiste and am in the process of applying to OT school but after reading what you said and knowing that i am the worst test taker i’m re-thinking my choice. How was OT school for you? Any ideas or advice would be great!!!

  • 479. Nadia  |  March 17, 2011 at 8:38 pm

    Oh Jess, the OT profession and the OT career is fantastic. I love the aspect and the job I have waiting for me once I can pass these freaking boards :P. I HIGHLY RECOMMEND THE OT PROFESSION. I dont like what I am doing to prepare for these boards but I LOVE the reason why I am doing it, to finally become an OTR 🙂

    Even the worst test taker should not put off such a promising career 🙂

  • 480. Lisa  |  March 17, 2011 at 10:36 pm

    Hi Jess, I definitely agree with Nadia- OT is the BEST profession ever. There are so many areas of practice you can go into, it’s easy to fit into your lifestyle: pediatrics, geriatrics, spinal cord injury/stroke/orthopedic inpatient or outpatient hospital, mental health, sports medicine, etc etc etc. It’s so rewarding and exciting to see patients’ lives improving due to your interventions. There are also so many job opportunities available, you probably won’t have trouble finding employment once you’re finished with school. The studying and test taking is hard, but it’s definitely doable and worthwhile!

  • 481. Jess  |  March 23, 2011 at 10:40 pm

    You guys are great but I am going to head into speech. I didnt get into any of the grad schools I applied for AND I would have to move my whole family(husband and son) for two years away from our home to become an OT. I live in a small town and dont have any access to a school close. I am able to go online for my masters in speech but am not able to do that for OT and I dont know why 😦 If i could belive me I would but its just not in the cards. Thanks for everyones help.

  • 482. OT student  |  March 28, 2011 at 7:32 pm

    Hi Nadia, i took the test. Im waiting for the result. the wait seems to be really hard. im very nervous and i think i didn’t do too well. or maybe i did??? i have no idea. its scary.
    When do u plan on taking the exam?

  • 483. Patty  |  March 29, 2011 at 10:46 am

    I saw a great article when searching on google on about studying for the NBCOT http://searchwarp com/swa299853.htm. Put a perion after searchwarp and infront of com. Its an older article but has good tips. I agree with a lot of it, it helped me pass. I bought the official pratice tests too from nbcot and make flashcards from otstudyguide com as well. Hope this helps you all!

  • 484. Patty  |  March 29, 2011 at 10:47 am

    period* instead of perion

  • 485. Danielle  |  March 31, 2011 at 7:21 am

    Hey everyone, I am planning on taking the exam AGAIN in April and wanted to know if it would be a good idea to get the NBCOT study guide or the take the practice exams. I am kind of low on funds and I already have the old NBCOT study guide. I can’t see how it would have changed that much in 2 years. Please give me your input or any suggestions. I am desperate to pass this exam this time. Thank you

  • 486. Bridget  |  April 3, 2011 at 8:07 pm

    I’m a O.T. who hasn’t worked in YEARS! Have to take the exam to become certified again and am dreading this. I have used the Rita book to familiarize myself with the details (overwhelming to say the least) and went to their course. I’m looking for some other study materials. Anyone looking to sell their Caryn johnson book? Also if anyone is interested in studying online or in person I live in the Ann Arbor area. I hope to take this the first week of May. So glad I found this site, it;s been really helpful!

  • 487. OT student  |  April 7, 2011 at 10:36 am

    Hi everyone!

    I got my score today and i passed! I took it for the second time. Here are some tips from my side:

    MUST HAVE materials:
    Therapy Ed By Rita C
    Occupational Therapy Examination Review Guide by Johnson
    Case Smith (MUST MUST MUST HAVE)
    NBCOT content tests ( at least 3)

    JB review (45 days and counting)
    NBCOT study (PDF)

    I failed the first time because of poor time management ( i rushed and I had 1 hr and 13 min left in the end, you can imagine!) I failed by two points. 😦

    As soon as I came home, i wrote down all the questions i had difficulty with during the exam. I searched for the answers in the book and sure enough it was all in CASESMITH. I made mistakes on the easy questions by second guessing myself. Do not second guess yourself. Be confidence, you have the knowledge!

    what helped me the second time around was that I was able to pin point my mistakes i made the first time in the test.

    To prepare myself for the second time i used the supplements.
    I highly recommend JB Review. JB review questions are very different from Therapy ed but it got me thinking in every angle. If your weakness is in Peds- please purchase this book. It has some great Peds intervention. (some of them even appeared in the actual exam)
    Studyguide.come (pdf) was okay. I think it had 300 questions, i found those questions to be close to Johnson and JB review. But if you want additional practice, no harm in buying this online guide, its very cheap.

    Just remember: Pt. safety comes first. Natural context is the best environment. Know how to treat someone who delusional versus dementia. DO NOT OVER STUDY! If you know you have studied extensively and all there is left to do is practice questions- then pace yourself well. Do 30 practice questions a day. I know 30 sounds so little but this helps you in retaining information.

    I can go on and on all day but I truly hope everyone passes this exam. Best wishes!

  • 488. OT student  |  April 7, 2011 at 10:50 am

    Sorry, one more thing

    anyone interested in purchasing my study guides??

    please do let me know.

    • 489. Sujee  |  April 12, 2011 at 8:08 pm


      I would be interested in purchasing your study guides, particularly the ones by Rita C, and Johnson. Please contact me at

      Thank You,

    • 490. Lola  |  May 9, 2011 at 8:37 pm

      Do you have any books left that you would like to sell?

      Thanks for your informative message.

      • 491. OT student  |  May 10, 2011 at 4:15 pm

        Hi Lola,

        I sold my johnson book. I still have JB Reviw:45 days and counting. are you intereted? Let me now. Provide me with your email address.

  • 492. Britany  |  April 7, 2011 at 12:09 pm

    I have just gotten news that I failed the exam for a second time. I’m not sure what I’m doing wrong, I’ve studied all the material. I’m thinking of taking the NBCOT Therapy Ed course to help prepare myself more. Has anyone taken this course and could give my more information on it? Is there any other books I should get…I have Therapy Ed by Rita P. Fleming-Castaldy, OT Exam Review Guide by Johnson, and The NBCOT official OTR Study Guide. Any suggestions would be helpful.

    • 493. OT student  |  April 7, 2011 at 3:24 pm

      I suggest buying JB review: 45 days and counting. It helped me a lot the second time around.

  • 494. Britany  |  April 7, 2011 at 12:14 pm

    Bridget- I live in Saginaw area, maybe we could work something out to help each other study?

  • 495. Bridget  |  April 7, 2011 at 2:18 pm

    Britany- I would welcome a study partner. You can contact me on my email at
    I’ve taken both the therapy ed. exams and a nbcot exam. Can anyone tell me how these compare to the real thing?

  • 496. BELLA  |  April 7, 2011 at 2:42 pm

    Hey, sorry to hear about those who didnt have much success with the exam, I know its tough, but you have to stay positive and only hope for the best next time.

    I have less than 2 weeks to take the exam for the 4th times. I have gone through the Rita book front to back, I have study the NBCOTexam packet, and I am working on the Johnsons questions as we speak. I am currently working at 50 questions at a time, sometimes 100 and only getting about 70% of the answers right. I will like to be at about 80% before the exam I will also be taking the NBCOT online practice exam next week before the exam. I heard it is well worth the buy, so I might as well try it.

    I must say Im nervous, if there is anyone who can over test advice, answering these questions correctly (because i tend to second guess myself), I would love that and if you want to chat or study strategies as well Im all for it.
    Goodluck everyone

  • 497. Sujee  |  April 12, 2011 at 8:10 pm

    I am a Canadian OT graduate. I’m planning to write the US exam for the first time this July. I’m looking for a study partner. I’m currently following the JB guide (45 days & counting).

    Contact me at if anyone is currently studying.


  • 498. Britany  |  April 12, 2011 at 8:32 pm

    Is anyone looking to sell a used copy of the JB Review 45 days and counting??

  • 499. christina L.  |  April 14, 2011 at 6:58 am

    im planning to take the exam but dont know where to start.

  • 500. AMY  |  April 23, 2011 at 4:32 pm



  • 501. OT student  |  April 30, 2011 at 5:08 pm

    according to my supervisor, ROM is not a contraindicationfor cardiac patients. i was told to even perform MMT as appropriate with cardiac pts. however,if its an open heart surgery or something serious then def. no MMT or ROM. If its NOT an open heart surgery then i guess ROM is OKAY.

    for the board exam, just know that ISOMETRIC is a NO NO for cardiac pt..

    with burn patients, i wouldn’t do MMT esp if in an acute stage. any other thoughts?

  • 502. Bridget  |  May 3, 2011 at 9:50 pm

    Some help would be appreciated since I’m taking the exam at the end of the week. Could anyone give me insight as to what the simulation questions are like. I took the NBCOT sample test, but didn’t help me since there is no feedback. Seems like I got a lot of questions about splinting.

    • 503. ND  |  May 5, 2011 at 1:46 pm

      I am very happy to say i finally made it…..’ I PASSED THIS DAMN TEST’ !
      Just want to say thanks to this site and all the people who chip in here.
      Bridget, in my previous 2 test’s i should say i had quite a few questions on hands & splits…..
      Its hard to say how the CST questions are like….its mostly like what u would do in that situation and time in any particular case. The key things to remember in the CST is…
      – dont mark the answer if in doubt.
      – mark all the answers in the pad they give u at the center before u mark it on the real test….because once u mark an answer in CST u cant erase it.
      – Try not to take more than 30 – 45 min maximum for CST.
      – take your own ear plugs… the center might not have any [mine did’nt] …and its quite disturbing when people are walking in and out.
      Good luck

  • 504. ND  |  May 5, 2011 at 5:27 pm

    OH YES, I FINALLY PASSED ! Thanks to this site for all the input people provide. Was very helpful.
    I did tons of questions along with knowing the material [content]. Thanks to the ones who said to do lots of questions….THAT HELPED. [ANALYSING THE QUESTION AND BREAKING IT DOWN TO WHAT THE QUESTION IS REALLY ASKING AND THEN PRIORITIZING THE ANSWERS].

    I have quite a few questions and materials that i am giving away for a minimal cost.
    Pl let me know if anyone would be interested.

    here’s the list…
    2] OT EXAM REVIEW GUIDE [ CAROLYN JOHNSON, 2ND EDITION]….has 1000 questions.
    3] OT COURSE MANUAL [fr International Education Resource]…fr attending the prep course. has 40 questions and have highlights on whats the ‘most imp’ stuff to know in each chapter.
    – Exam prep workshop from my college. [has 125 questions]
    – SPECIAL REPORT: NBCOT sample questions [ 75 questions]
    – ONLINE CONTENT EXAMS: Peds, Mental Health, Phys Dis, Services [each topic has 35 questions].
    5] NBCOT OFFICAL OTR STUDY GUIDE [OLD AND NEW VERSIONS]. [has 150 Q in new and 100 Q in old book].
    6] JB REVIEW 45 DAYS AND COUNTING WITH CD. [this was helpful as the questions are a little different and the content was informative in vision, peds and hands topics ].
    7] NBCOT REVIEW AND STUDY GUIDE NEW 5TH EDITION WITH CD [BY RITA -CASTALDI]….has 3 updated and revised exams. [2 CST questions and 3 tests with 170 Q’s each].

    Total cost for all of these 150 $ + shipping.
    email me at … if u r interested.

  • 505. BELLA  |  May 5, 2011 at 8:04 pm

    i just dont understand what im doing wrong with this exam. 4th time taking it and still no success. i am totally discouraged and ready to give up. I have all the books, I read through all of them, I have done tons of questions, and I still dont know what im doing wrong. i just dont know anymore.

    if anyone has great study card they are willing to sell, i will be willing to buy it. email me

  • 506. Nadia  |  May 7, 2011 at 12:00 pm

    Heyyy fellow peeps, here are some questions I am really stuck on if anyone wants to take a shot at them be my guest, but PLEASE give rationle why you pick your answer!! Thanks!!

    A pt has a C6 SCI and wants to improve his tenodesis grasp, which activity would be best for this?
    A) Weight shifting in chair
    B) Washing face
    C) Turning pages of a book

    A kid has poor postural control and he cannot sit in his chair to do hw assignments, what is the best adaptation for him?
    A) Sit on a stool
    B) Kneeling next to a table
    C) Prone on forearms

    A kid has poor postural control and needs to increase his independent sitting ability, what is the INITIAL position to start in?
    A) prone on wedge
    B) side-lying
    C) supine

    An adult has a C4 SCI with a degenerative joint disease he wants to get a new communication device, what is the best device to help him control it?
    A) A joystick
    B) A sift and puff
    C) Chin control

    Kid with ADHD has a behavioral problem but with a new program he has improved 30% to 70%, what is the OTs next step?
    A) Tell teacher to continue plan till he plateaus
    B) Observe student to see if problem is solved
    C) Modify program since it was successful

    A kid has a tonic bite reflex…what is the best INITIAL modification for him during feeding?
    A) A rubber spoon
    B) proper positioning
    C) Hard food

    Thats it, let me know what you guys think!!

    • 507. poonam sawant  |  May 30, 2011 at 12:21 am

      hi Nadia, here are my suggestions to your questions:
      1st question: answer might b option A. wt shifting in a chair as pt must b having good proximal muscles to allow distal muscle action
      2nd question’s ans must be option C: prone on forearms as it will provide good developmental aidd for poor postural control
      3rd que’s ans will be opt A: prone on wedge
      4 th ans will beopt B: a sift and puff as chin control can aggravate upper cervical joint pain
      5th ans will be opt B: to check problem areas
      6 th ans will be opt B: proper positioning.
      these are my suggestions kindly check back into the books and do lemme knw abt the correct answers.

  • 508. Hilary  |  May 26, 2011 at 11:42 am

    Does anyone have any books they want to sell? Cheers

    • 509. Bridget  |  May 27, 2011 at 6:54 am

      I have the OT review book by Caryn Johnson I would love to unload. Contact me by email at

  • 510. poonam sawant  |  May 30, 2011 at 12:09 am

    hey guys, i am a post graduate OT from Mumbai,India. i saw this blog site which i found really helpful. i havnt started preparing for OTR exam yet but definitely want to write it in may b next couple of years. would somebody guide me for how to proceed .

  • 511. Hilary  |  June 1, 2011 at 11:23 am

    I’m still looking to buy OT books, ideally a package of many books. My email I live in the Manhattan area. THANKS!

  • 512. jennifer  |  June 12, 2011 at 7:17 pm

    Hello, EKU OT student finishing level II’s in 2 weeks!!! I am looking for additional study materials. I already have the Johnson book. Please e-mail me at if you want to sell anything else!

  • 513. onus  |  June 22, 2011 at 12:14 pm

    Thanks for everyones opinion and suggestions. It is ahard exams, but we wil all excel IJN!

  • 514. remit  |  June 22, 2011 at 6:18 pm

    Has any one used the “NBCOT-OTR Exam Flashcard Study System: NBCOT Test Practice Questions & Review for the Occupational Therapist ” and has it helped? I live in VA and need a study group. Thanks.

  • 515. asal  |  June 23, 2011 at 7:35 am

    Hi remit,

    I live in MD and I need a study partner too.. Presently I am out of town till 10th july. I would like to study together after that if possible.
    let me know if you would be interested.

  • 516. asal  |  June 23, 2011 at 1:32 pm

    @ Remit

    After 10th july if possible.
    Let me know if you are interested in studying together.

  • 517. Nadia  |  June 24, 2011 at 11:17 pm

    I started this….

    It really helps to destress 🙂 you guys should try it

  • 518. Bridget  |  June 28, 2011 at 8:38 pm

    Any one looking to buy the Caryn Johnson book?

    • 519. Marissa  |  August 29, 2011 at 9:51 pm

      Hi, I’m interested if you’re still selling it…How much and does it include the CD with working questions? Thanks! 🙂

  • 520. Exam Questions  |  July 7, 2011 at 7:13 am

    All Exam Questions exams are included in all following packs, now you have to decide that which pack is most suitable for you.

  • 521. Nadia  |  July 7, 2011 at 7:14 pm


    • 522. Vicky  |  July 8, 2011 at 4:44 pm

      Congratulations Nadia! It took me three times as well. We are of the fortunate OTR’s who have worked very hard for our licensure. Have fun in your first OTR endeavor 🙂

  • 523. Nadia  |  July 13, 2011 at 12:22 pm

    Thank you. I also wanted to tell anyone/everyone that I really think the OT Advantage course online really helped me. I tried to find comments on it before I took it but couldnt find any. So I am writing to tell people I THINK it is definitely worth the money.

  • 524. Daphnee  |  July 20, 2011 at 12:40 pm

    Cool thinking about changing my major from nursing to ot.

  • 525. Laa  |  July 25, 2011 at 12:25 pm

    Hey gangs, I am having so much difficulty passing this exam. I was three point shy, this time around and beginning to feel doubtful in my abilities. I have taken the exam 4x with NO success. If you have taken the exam and failed…what are you doing differently for your study habits. I have all books, notes, textbooks and everything is now repetitive bc Ive read through all of them. I need help. I just want to pass!!! PLEASE…im lost and dont know what to do.

    • 526. Laa  |  July 25, 2011 at 12:27 pm

      and I have take multiple exams, one from Caryn-Johnson, one from the 45 days n counting, one from the NBCOT exam book, and the online exam from the NBCOT website…ughhhh…and I know all the answers now, so there are really not much help anymore.

  • 527. Amanda  |  July 30, 2011 at 2:12 pm

    Hey, I took the NBCOT exam for the 2nd time and passed recently. I was crushed when I didn’t pass the first time and spent so much time preparing for it. The first time I took the exam I mostly used the TherapyEd National Occupational Therapy Cert Exam Review &Study Guide by Rita P. Fleming-Castaldy 5th ed. I studied that book inside and out and made flashcards and a review sheet for each chapter as well as did the practice tests. After not passing the first time I wanted a different approach, I noticed the questions, the way they were worded often got me, although I felt I knew the diagnosis and precations inside and out, so I bought the book Occupational Therpay Examination Review Guide 3rd Edition, which has 800 multiple choice questions. I feel like going through those, getting comfortable with the wording, because the test insn’t like any other test I’ve ever took, helped me be familiar with the way to think about the ?’s on the exam, and I think that book helped me pass my second time. I know it’s nerve racking and not to mention expensive, and I was worried I may have not passed the 2nd time as well, but I wanted to post this after I passed to tell people a farely cheap book that is really helpful. It doesn’t have CS ?’s but it’s kind of hard to prepare for those anyway, each CS ? the 2nd time I took the test I tried not to pick more than 2-3 options per section of each CS ?, which I think helped too. Don’t focus on material and content as much as generalizations, the test isn’t about rote memory. Know important generalizations, precautions for certain diagnosis’s, but practice being familiar with the ?’s I think is key cause the more ?’s I did, the more I felt confident reading the ?’s and knowing what they were looking for as an answer. Good luck to everyone!~

  • 528. NBCOT Help  |  August 1, 2011 at 12:08 am

    Hang in there guys you can do it! The only way I got by was with my 2 study groups. There were 10 of us in all and we all passed!! I wrote up everything we did and posted it online here

    Best of luck future OT’s!

  • 529. studying  |  August 3, 2011 at 9:31 pm

    I am having difficulty accessing that link, is there any other way i can get it?

  • 531. loretta  |  August 4, 2011 at 9:55 am

    i took the test twice. the first time i obviously failed and the second time i passed. here’s how i did it-i kept it simple:

    i only used the therapy ed book. i read it from front to back and took the practice tests. taking the practice tests allow you to train your body to sit for hours, see the timer and calculate restroom/snack breaks.

    the first time, i studied everything and anything. there is such a thing as “over studying” and i ended up feeling like my mind was cluttered.

    i studied 4 hrs. a day for a month. this was a good pace and adequate time for me.

    i studied material as if i was doing it for pleasure-to learn something. i didn’t look at it as learning it to take a test. i looked at is as i was learning in order to be a competent OT.

    in the actual test i:
    wore my headphones
    took two 5 minute breaks-i drank gatorade, used the restroom, stretched in the bathroom by bringing my head down to my waist to bring blood flow back to my head. it sounds silly and it is-thats why i did it in the restroom, but it worked for me.

    a week before the test, i started eating brain food and believe it or not, i feel like i was thinking clearly. i ate fish, spinach, etc.i also was sure to keep hydrated. i drank lots of water and gatorade.

    i also changed my sleep schedule a week before, to match when i would be taking the test, that way i was at my peak of wakefulness/alertness.

    when taking a test, we focus just on the test material, but i am living proof, that paying attention to biological stuff really is the key.

    break a leg kids…

  • 532. Amanda  |  August 7, 2011 at 5:40 pm

    Oh yeah and I also used the otstudyguide com guide to make flash cards too. They go back to the stuff we all learned in school too.

    P.S. I so agree about sleep. MAKE SURE YOU GET 8 HOURS at least the night before.

  • 533. Zippy  |  August 7, 2011 at 5:48 pm

    That otstudyguide is made by students too. It’s only 24.95 So it’s not really made for profit like the others out there.

    I’d like to put my 2 cents in that when I make flash cards from that guide. What I do is mark them when I get them right. Once the card has 3 correct marks on it, I discard it. So in a week, I went from hundreds down to 20-30. I worked on those the last night.

    Also, the day of the test, I don’t study much, I just try and relax and get to the test!

    Good Luck Everyone!

  • 534. Krystle  |  August 9, 2011 at 12:44 pm

    Hi! does anyone want to sell their NBCOT reviewers? kindly send me an email at
    thank you!!! 🙂

  • 535. Opal  |  August 10, 2011 at 8:08 am

    I am planning on taking the COTA exam soon, can anyone tell me what books to study from?

    • 536. OTlicensurexamhelper  |  August 10, 2011 at 12:08 pm

      I took the OTR exam but my friend studying for the COTA exam recommended two books

      National COTA Exam Review and Study Guide by Rita Fleming-Castalday

      National OTA Certification Exam Review and Study Guide by Rita Cottrell

  • 537. studying  |  August 10, 2011 at 8:50 pm

    Does anyone know if I take the test on Sunday and the marking day in Wednesday if my test will be marked?

    • 538. Bella  |  August 11, 2011 at 10:49 pm

      You may make it! Online it say if you take the test 1-2 days before exam dates, it will not be scored until the next exam date.

  • 539. 4 times taking  |  August 11, 2011 at 10:22 pm

    I have taken the exam 4 times and this time decided to review practice questions and rationales. I have the knowledge based down but have a problem selecting the BEST answer! Would you recommend purchasing the nbcot practice exams? Maybe one of the..I believe they are 45.00???

    • 540. Bella  |  August 11, 2011 at 10:48 pm

      Seems like we have the same problem. I have taken the exam 4 times as well. And I have taken everything available and really dont know what else to study (sheesh) I took the NBCOT online exam, it was worth it. To me the questions were a lot harder than the actual exam. I would definitely purchase the exam. It may help!

  • 541. garland  |  August 22, 2011 at 7:40 pm

    I recently passed the exam, it was not too bad honestly. First, I spent at least one month just learning the diagnoses/conditions commonly used on the actual exam( can be found at the back of the NBCOT certification examination study guide ( orange and blue book)…) I researched them on youtube to get a visual, I learned the evaluations, interventions and contraindications for each ( Can be found in the Therapy Ed, Rita- Cortrell book) I also used the 1100 questions from, ( it is like a summary of the Rita book, just easier to read and understand) next, 2 1/2 weeks before the exam I started taking practice exams on the Rita, Caryn Johnson and looked at the rationale after doing each question. I also looked at the questions in the NBCOT certification examination book paying close attention to the key words such as, INITIALLY, MOST APPROPRIATE, BEST etc…. I looked at what the answer should contain based on these words. The test seemed pretty easy to understand to me then I just looked at the key words and I could pick out the answer without reading the question over and over. I also took 2 one two weeks before and the other one the next week of the MCT practice exam from NBCOT (on really helped me. GOOD LUCK GUYS!!! hoped this helped …

  • 542. julia  |  August 31, 2011 at 11:57 am

    i have a tendency to over anaylize each question..b/c of that I failed 3x. i wish there was a way to know what i get wrong so i can learn from it. instead i keep repeating the same mistakes. i have all the material you listed above as well as flash cards. when it comes to intervention, i freeze every time. i graduated from college with high honors too. hunh…very frustrating.

    • 543. Bella  |  August 31, 2011 at 12:05 pm

      Hi Julia,

      I know the feeling of being overly frustrated. I struck out 4x already and taking the 5th in Sept. I have all materials, plus more, and have studied everything front to back. For this 5th time, I am just working on questions only. Trying to identify what kinds of questions I tend to get wrong and reading the rationale. I do over analyze the question myself, but now I am just going to pick what is right and not over think it. Dont get discouraged. There are many of us out there in the same situation. We went to thru too much schooling to stop now. Just formulated a different plan and stick to it. Good Luck!!!

      • 544. Wendy  |  April 21, 2012 at 11:01 pm

        How did you do in september. I keep hearing people say analyze the questions and what they are asking not spend so much time memorizing questions.

  • 545. Bridget  |  August 31, 2011 at 12:35 pm

    Yes, I’m still looking to sell the Johnson book. It has a CD and is in excellent condition. $25 which would include shipping.

  • 546. Karen  |  September 1, 2011 at 9:36 am

    Was wondering if anyone was selling any of their books especially the 5th edition National Occupational Therapy Certification Exam Review & Study Guide by Rita P. Fleming-Castaldy book. Any other book suggestions would be appreciated 🙂 Thank-you!

  • 547. Help!  |  September 7, 2011 at 4:11 pm

    Hey all, I just found out that i failed NBCOT by ONE POINT!! I’m so frustrated, any suggestions?

  • 548. Bella  |  September 13, 2011 at 9:15 am

    Hey Gang,

    I take my exam tomorrow (5th time), *crosses fingers* and I remember some questions from the last time and need some help with answers or suggestions Some questions I could remember the choices but if you could point in the right direction, that would help ALOT.

    Which wheelchair is appropriate for a 12 year old with T10?
    a lightweight
    b high back recline
    c standard
    d power

    Early intervention for children with motor impairments? Where would u conduct the intervention with parents?
    a. Hospitalbased pediatric unit
    b. self contained classroom
    c. inclusionary classroom
    d. outpatient rehab unit

    C4 wants to use a wheelchair, which should be used first?
    a. Sip and puff
    b. joystick
    c. chin control
    (since the question says first and c4 can use both a sip and puff and chin control depending on abilities, I would chose sip and puff – right?)

    What is the pam contraindication to use with lung cancer patients?
    (The only choice I remember was TENS and that’s what I chose)

    Woman talks about how unhappy she is about a nurse who won’t let her change her group? What would the ot do?
    a. Comfort the patient to avoid conflict
    b. ignore her
    c. change her group

    A woman shows up early, goes to supply and wants to begin several complex task? What should the ot do first?
    a. Ask her to help you set up
    b. give her a simple task to work on
    c. tell her about her behavior
    d. ask her to come back at the right time.

    Patient has max functioning and ready for discharge the rehab clinic wants you to continue tx..what should the ot do first?
    a. Ask the patient his options
    b. discontinue service
    c. continue service

    How do you inhibit tonic bite reflex -(it is a -rubberized spoon)

    Thanks in advance, this would really help!!!!

  • 549. Help!  |  September 13, 2011 at 10:29 am

    Here’s what I think.,
    1.c idea!
    4. I would say tens
    5. I guess comfort?
    Those are tricky

    • 550. Bella  |  September 13, 2011 at 11:52 am

      thanks so much, these were some of the questions that stuck out to me and was so hard to answer. but we are on the same track with some of the answer. I think number 2 is inclusionary because it includes the parents into treatment. But i had this question every time i took the exam and still dont know the answer.

  • 551. Help!  |  September 13, 2011 at 12:15 pm

    I looked it up from case smith..”inclusive early childhood provide opportunities to collaborate with caregivers including siblings” I think you’re right 🙂

    • 552. Bella  |  September 13, 2011 at 1:32 pm

      thanks, if I get that question again tomorrow, that will be my answer

  • 553. Bert M  |  September 13, 2011 at 12:58 pm

    Remember your 1st answer you choose is usually the right one, so don’t go back and second guess yourself. The NBCOT official practice test is great and gets you in test mode. the guide is made by students which really goes over what you learned in school. They make great flashcards. IF you don’t know it, write it down. It helps you remember. This really works!! Don’t waste your money on the MoMedia flashcards when you can make your own for 1/4 of the price by getting the one. Last tip, is rest all you can before the test and no caffiene in the morning. GOOD LUCK!!

    • 554. Bella  |  September 13, 2011 at 1:36 pm

      Thanks Bert M!!!

      Keeping my finger crossed for tomorrow…

  • 555. help!  |  September 13, 2011 at 1:26 pm

    The family of a pt with dementia wants to know if their family member can drive, what do you recommend?

    1. specialized driving assessment
    2. state driving assessment
    3. VP assessment

    any thoughts? I don’t remember the 4th option

    • 556. Bella  |  September 13, 2011 at 1:33 pm

      I am not too sure, but the first answer I would pick is state driving assessment

  • 557. help!  |  September 13, 2011 at 1:32 pm

    one more..
    A ct is participating in a card activity when they become particularly interested in attention to detail. What Allens Cognitive level is this an example of?
    a. 3
    b. 4

    • 558. Bella  |  September 13, 2011 at 1:35 pm

      I really dont understand the question, (attention to detail)…From what I am thinking I would chose Level 4 because they rely heavily on visual cues, but I am not sure if thats the same as attention to detail.

  • 559. Help!  |  September 13, 2011 at 3:26 pm

    What type of supervision should an entry level OT and an advanced COTA have?

  • 560.  |  September 21, 2011 at 6:34 pm

    if you have any supervision questions look at your state board FAQs – the california board it lays everything out and so does the Flemming book

  • 561. adult dating  |  October 11, 2011 at 5:36 pm

    adult dating…

    […]Preparing for the NBCOT Exam « Occupational Therapy – A Blog about OT[…]…

  • 562. Kavitha  |  October 15, 2011 at 4:04 am

    Hi Poonam,

    I am also an OT from India and I have already started the process of OTED and started prepping for OTR. If you want to form a study group and also need help in filling of forms etc and OTED process don’t hesitate to call me.

  • 563. Kavitha  |  October 15, 2011 at 4:11 am

    Hi all,

    I’m new to this blog and I find these conversations are really helpful and also thought provoking. Keep up with the good work.. and i will have plenty to share in future cos I’m planning to take my exam soon…

  • 564. Angelina  |  October 26, 2011 at 6:04 am

    how often is the cert. exam given each year?

  • 565. Nicki  |  October 27, 2011 at 4:51 pm

    Thanks for the tips and the links! I just bought otstudyguide com guide and been making a ton of flashcards!

  • 566. Help!  |  October 27, 2011 at 8:53 pm

    I passed a few weeks ago!! Feel free to ask any questions

    • 567. asal  |  November 7, 2011 at 10:15 am

      can u tel me ur study plan ?

    • 568. drew  |  January 28, 2012 at 1:49 am

      I failed, I was wondering if you could help me and give me some advice.

  • 569. kavitha  |  November 7, 2011 at 11:13 am

    If ur in india there won’t be a problem in having online study groups I’ve got few who are joining me for the preparation. if u want u can join us as well. still we haven’t started any plan if you have any please suggest and lets get started from there.

    • 570. asal  |  November 10, 2011 at 10:14 am

      Hi kavitha,

      I am presently living in US. can u give me ur e-mail id so that we can discuss further.

  • 572. mitch  |  November 7, 2011 at 3:35 pm

    Hey! Im finishing up my last level II mid decrember and Im going to be starting to study for the NBCOT!! Im taking a review course at my school in late January but if anyone has any recources that they know to be helpful (tried and tested!) please let me know! Im up for purchasing used materials as well. Please respond to this post!! If anyone has sample questions to post, that would be great!! Thanks comrads :*)

  • 573. Laurie  |  November 19, 2011 at 10:17 pm

    Hi All, can someone please share their sample study schedule? with a breakdown of what you did. What chapters in the textbooks are imperative to read through?
    Also, can you take a bathroom break during the 4 hour exam?
    thanks! 🙂

  • 574. Jessica  |  December 8, 2011 at 10:48 am

    Here is a good article someone wrote with timeline.

    It’s older but has someone good info in it.

  • 575. rachel ray cookware  |  December 16, 2011 at 5:08 am

    I’m extremely impressed along with your writing abilities and also with the layout to your weblog. Is that this a paid subject matter or did you customize it yourself? Anyway stay up the nice quality writing, it is rare to look a great weblog like this one nowadays..

  • 576. namagiri lakshmi  |  December 21, 2011 at 3:04 pm

    hi i am new to this blog, i am an ot from India, preparing for my caot(Canadian registration exams}, i am helpless since i do not have any friends or seniors to guide me and of course no materials too. i can find materials for nbcot but not for Canadian exams. i need a study partner and ay Canadian ot who can help me out Canadian system of there who can help me out? i need books too.

    • 577. ajr  |  February 1, 2012 at 11:40 pm

      I went to school and wrote the exam in canada, what i can tell you is that it is case based mutli choice. You should review med terms and conditions as well as everything you learned, adaptive aids, assessment tools, splints, theory (cmop-e).

  • 578. Praveen Chopade  |  January 3, 2012 at 4:53 am

    Hi ,

    My wife is planing to come to US in coming month. she is an OTist with BOT degree(KEM Hospital , Mumbai) also having work expx 2+ years in India, she is on H4 dependent visa.
    could you please guide us. Like is ther any need of going or any certification/exam to work in UR OR she need to have H1\any organization is willing to file petiotons here.

    Praveen Chopade

  • 579. priyanka  |  January 18, 2012 at 6:01 pm

    I am looking for study partner. Planning to take exam within couple of month


    • 580. ipshita das  |  January 19, 2012 at 11:45 am

      Hi Priyanka,
      Just read your ready to study with feel free to email me on

      • 581. priyanka  |  January 22, 2012 at 10:36 pm

        Hey just now i have emailed you check it out and reply me anything … and sorry abt your results 😦

  • 582. ipshita das  |  January 19, 2012 at 11:35 am

    Hi there,

    With the results coming out today, I have found that i couldnt passt the OTR exam. I dont know what more i need to do..have studied the therapy-ed book, did the qs along with other availbale qs frpm johnson. may be, where i lackd is a study partner, something that i have read repeatedly being mentioned on various blogs. I have rescheduled for a test in march again..anyone interested to study together would really be appreciated…pl get in touch with me on…thanks

  • 583. Faith  |  January 20, 2012 at 8:51 am

    Hang in there, you can do it! I found out that I passed yesterday, and I just wanted to share that I mostly use the Therapy Ed National OT Cert Exam Review and Study Guide. This book has everything you need to know to pass this exam and make sure you read and memorize those 14 chapters. Take the three practice tests a few times and review your scores to ensure that you clearly understand the rationale behind the correct answers as well as why the other choices are incorrect. It will be a little easier if you have fun studying and remember to take breaks (at least every few hours). Be kind to yourself and have faith in your ability to pass this exam. Wishing everyone all the very best and good luck!

  • 584. asal  |  January 26, 2012 at 2:18 pm

    Anyone interested in selling their therapy Ed – 5th Edition Book

    • 585. drew  |  February 1, 2012 at 1:49 pm

      I am.

      • 586. asal  |  February 1, 2012 at 3:55 pm

        Hi drew,

        you can e-mail me at

        and let me know how much $$$$ are you willing to sell it for.

        as well as the mode of payment.

      • 587. Karen  |  February 1, 2012 at 4:43 pm

        Is anyone selling any of their study materials especially the newest edition of the therapy ed. book???

  • 588. drew  |  January 28, 2012 at 1:52 am

    I failed my test and was wondering if anyone can help me and give me some advice, etc. I would also like to participate in a study group if any are out there. I’m registered to take the exam in the first week of march.

    • 589. Del Johnson  |  February 2, 2012 at 5:37 pm

      Hello Drew where do u live? I myself can use a study partner I failed my test also and by the way I am an COTA and u r?

      • 590. drew  |  February 2, 2012 at 6:49 pm

        I am an OT… send me you e-mail please

  • 591. Del Johnson  |  February 5, 2012 at 10:57 am

    Hello Drew it is

  • 592. Opal  |  February 6, 2012 at 10:08 pm

    I live in NY want a study partner e-mail address COTA exam. I want to take the test by June of 2012 let me know

  • 593. Pommy  |  February 9, 2012 at 12:06 pm

    I recently learned that NBCOT is offering the exam in Spanish – has anyone taken the spanish version of the exam? I am a native spanish speaker and I was wondering how difficult/easy it is to understand NBCOT’s “American Spanish”?

  • 594. drew  |  February 26, 2012 at 3:23 pm

    An OTR fabricated a forearm based thermoplastic thumb spica splint for an outpatient one week ago. On a follow up visit, the OTR removes the splint and notes small,red elevated, inflammed papules on the client’s forearm. What initial action should the OTR take in response to these findings.
    A.Change the splint to a prefabricated neoprene splint.
    B.Discontinue the use of the splint and contact the client’s referring physician.
    C.Line the splint with a 1/16-inch absorbent padding.
    D.Modify the splint wear times and educate the client about proper hygiene.
    A client had a TBI 4 months ago and has been participating in OT. The client feels as though recovery is complete and wants to resume work operating machinery in an industrial setting withing the next 2 weeks. Evaluation results reveal the client has moderate deficits in coordination and executive functioning. What initial action should the OTR take based on this information?
    A.Advise the jobsite supervisor about the client’s current cognitive abilities.
    B. Discuss with the client the potential risks of returning to his job.
    C. Talk with the case manager about arranging an on-site work evaluation.
    D. Teach compensatory strategies for the clients return to the job.
    A client who has multiple sclerosis is receiving short term rehabilitation in a skilled nursing facility under Medicare part A. The client plans to return home with the spouse in the next few weeks . The OTR is educating the client and family about adaptive devices and equipment for bathroom safety. The spouse reports financial concerns with obtaining the recommended devices. What action should the OTR take based on this report?
    A, assure the spouse that Medicare will reimburse for the purchase of the equipment the OT recommends.
    B. Provide the client with information about durable medical equipment coverage under Medicare part A.
    C. Recommend community-based organizations that typically donate medical equipment.
    A student in the first grade has moderate hypotonicity resulting in poor oral motor control. One of the students goals is to be able to eat the same foods as the other kids at lunch time in the cafeteria at school. Currently, the student requires moderate assistance when eating and eats a soft diet. What should be the INITIAL focus of intervention for progressing toward this goal?
    A, Asking the student to identify specific foods preferences from the cafeteria menu.
    B. Determining which cafeteria foods have the textures the student can eat.
    C. Identifying seating and positioning options for the student in the cafeteria.
    D. Providing the student with assistive devices to use when eating in the cafeteria.

    What’s your guys input on this?

    • 595. Jus  |  February 26, 2012 at 5:06 pm

      1. B 2. B 3. B 4. C…..I am not sure about 1 and 2. But 3 and 4 are correct I believe……i hope that helps

      • 596. drew  |  February 26, 2012 at 10:50 pm

        1. I was thinking D because inflammed red papules signifies inflammation and infection due to increased amount of wear time of splint and lack of proper hygien.
        2. I was thinking B because pt. isn’t aware of his cognitive limitations therefore you must discuss potential risks returning to the job.
        3. I was thinking B because pt. is in snf and therapist is educating pt. on adaptive devices therefore it is best the therapist also educate both spouse and pt. on what Medicare A covers.
        4. I was thinking C because initial focus of intervention 99% of the time in pediatrics is positioning therefore C would make most sense.

      • 597. lm  |  March 2, 2012 at 9:06 am

        i agree!!

  • 598. Laura C  |  February 28, 2012 at 4:38 pm

    I saw on facebook if you join the nbcotexam page, you can get a discount on the study guide. Or is it otstudyguide com. (I think they are the same)

  • 599. TI  |  March 6, 2012 at 8:20 pm

    Can I get some input on this.

    An inpatient recovering from pneumonia has decreased strength and endurance and functional active ROM. The patient ambulates independently for short distances with the use of a walker. Medical history indicates the patient has recently been diagnosed with moderate macular degeneration. The patient will be discharged in one day to live alone in a single-story home. Which service should OTR recommend as part of the patient’s discharge plans?

    A.. Extension of current hospital stay for comprehensive rehabilitation services.

    B. Home health services to assess ADL needs and teach compensatory strategies.

    C. Short-term placement in a skilled facility to maximize independence in ADL.

    D. Structured visual training exercises to improve central field viewing.

  • 600. TI  |  March 7, 2012 at 2:17 am

    A physician refers a preschool- age child to an entry level OTR with a request to administer the Sensory Integration and Praxis Tests. The OTR is not familiar with the administration and scoring procedures for the test. What INITIAL action should the OTR take based on this request?
    A.. Administer an alternative test consisting sensory-perceptual subtests.
    B. Obtain a copy of the evaluation manual to review prior to using the tool.
    C. Participate in an internet based session to learn about the test.
    D. Recommend a therapist who is certified to administer the test.

  • 601. TI  |  March 7, 2012 at 2:17 am

    A patient who has diabetes and neuropathy in both hands has been attending OT to maximize independence in administering insulin. At the end of one week , the OTR observes that the patient continues to have difficulty using both hands to hold the syringe and draw the insulin. What should the OTR do NEXT?
    A. Recommend that a family member administer the insulin.
    B. Provide a suction-based insulin bottle holder and syringe guide.
    C. Request that a nurse draw up daily injections for one week time periods.
    D. Suggest the patient ask the doctor about taking oral insulin.

  • 602. TI  |  March 7, 2012 at 2:18 am

    An OTR is teaching a caregiver various methods for improving feeding skills of an 8-month year old infant who was born 7 weeks premature. Oral hypersensitivity is interfering with the infants oral intake. Which sensory based method is MOST BENEFICIAL for the caregiver to use with the infant immediately before feeding time?
    A.. Apply low intensity mechanical vibration to the lower jaw and around the lips
    B. Gently rub the outside and inside of the infant’s mouth using a washcloth.
    C. Position the infant in a bean bag contouring the chair snuggly to the infant’s torso.
    D. Provide light touch to the lips, cheeks, and tongue using a gloved finger.

  • 603. TI  |  March 7, 2012 at 2:33 pm

    A patient who has diabetes and neuropathy in both hands has been attending OT to maximize independence in administering insulin. At the end of one week , the OTR observes that the patient continues to have difficulty using both hands to hold the syringe and draw the insulin. What should the OTR do NEXT?

    A. Recommend that a family member administer the insulin.

    B. Provide a suction-based insulin bottle holder and syringe guide.

    C. Request that a nurse draw up daily injections for one week time periods.

    D. Suggest the patient ask the doctor about taking oral insulin.

  • 604. IG  |  March 7, 2012 at 3:53 pm

    I believe the answer is B, patient is looking to maximize independence

    • 605. IG  |  March 7, 2012 at 4:04 pm

      (B) for a pt with diabetes

  • 606. TI  |  March 7, 2012 at 6:33 pm

    An inpatient with a TBI is functioning at Level V(Confused inappropriate) on the Ranchos Los Amigos Scale. Which environment is MOST CONDUCIVE for conducting the initial BADL evaluation with this patient?
    A.. Accessible bathroom on the neurology unit
    B. Patients room during morning ADL’s
    C. Patient’s room when family is available to assist.
    D. Simulated ADL apartment within the OT clinic.

    • 607. D  |  March 15, 2012 at 1:24 pm

      I have therapy ed 5th edition and Caryn Johnson 3rd edition for sale. e-mail me if interested

      • 608. Karen  |  March 15, 2012 at 7:53 pm

        How much for the 5th ed. Rita book? How good is the Caryn Johnson book??

      • 609. D  |  March 15, 2012 at 7:59 pm

        $60 for the Rita and $100 for both Rita and Johnson. Both are in good condition with minimal wear on the covers.

      • 610. Karen  |  March 16, 2012 at 7:19 pm

        I’m sorry I wasn’t clear enough, I was wondering what the Caryn Johnson book entailed and is the material good for studying?

      • 611. D  |  March 16, 2012 at 7:23 pm

        The Caryn Johnson book is great. It’s the closest thing to the actual exam itself. It provides you with thorough rationales to all answers to help you better prepare for the actual exam. It includes 4 exams 200 questions each.

      • 612. Dina  |  May 15, 2012 at 9:20 am

        Hi ,I’m interested in the therapy Ed book,is it the latest version?please contact me ASAP,Thanks

  • 613. Elizabeth Gonzalez  |  March 29, 2012 at 12:52 pm

    1)Preparing for the OT National Board exam: 45 Days and counting, BRAND NEW, INCLUDING DISC WITH QUESTIONS

    2)Occupational therapy examination review guide by: Johnson, Lorch, & DeAngelis, USED, with writings, INCLUDES DISC WITH 800 QUESTIONS, with detailed explanations to answers

    3)TherapyEd course manual book that narrows down the extensive content in the Rita Fleming Review and study guide, this book was very useful!

    4) i also have the Rita Fleming review and study guide but FOR RENT, not for sale, as i will like to keep that one for reference. i can loan it though with a deposit to guarantee its return. all the content is legible but there are writings all over the book as i read every bit of it.


    • 614. Dina  |  May 15, 2012 at 9:17 am

      I’m intereseted in the book ,please contact me at, Thanks Dina

  • 615. Mary  |  April 3, 2012 at 5:56 pm

    Hi, What are people using for the COTA? My professor said to use the offical guide and get the Otstudyguide com for making flashcards. But what else are people using?

  • 616. Elin  |  April 9, 2012 at 11:57 am

    Hi Everyone!

    I am wondering if anyone knows how to calculate the wheelchair measurements that we need to know on the exam? It is not clear how to do so in Pedretti.

    20″ from the butt to the popliteal and 17″ from the popliteal to the heal. With 1″ cushion. What is the seat height?

    *If pt is planning on propelling with feet:
    Don’t need to -/+ (right?)
    -If 1”cushion, answer should be 18” Right?

    *If pt is planning on propelling with arms:
    add 2” for foot clearance.
    -In addition to 1” cushion, answer should be 20” Right?

    Thanks in advance!

  • 617. Lin  |  April 17, 2012 at 11:38 am

    Correction: *If pt is planning on propelling with arms, take away 2” for foot clearance. Add 1” for cushion.

  • 618. Casey  |  April 22, 2012 at 1:32 pm

    you don’t have to join facebook to get the discount for the otstudyguide com site.. Just use ” aota2012 ” for the discount code and get 10 percent off.

  • 619. Melissa K  |  May 10, 2012 at 2:46 pm

    Thanks Casey.. I bought this yesterday! It’s great!

  • 620. Dina  |  May 15, 2012 at 9:28 am

    I took the test twice and failed , I got discouraged and terrified to even think about taking it again,I have studied so hard last time and dont know what went wrong.please do u have any suggestions for me .Is there a study group in Miami area

    • 621. ashley  |  May 18, 2012 at 1:21 pm

      Have you tried taking the tests offered on Castle world wide? they are about 45$ a piece but theres one that simulates the actual exam. Its 100 questions it times you for 2hrs and then lets you know what domains you have passed… i know this all gets expensive i have paid so much myself! failing 3x i take my fourth one next week.. but it is a good study technique

    • 622. BABLI  |  June 3, 2012 at 11:25 pm

      do not give up

  • 623. ashley  |  May 18, 2012 at 1:19 pm

    Hi my names Ashley…. This exam has to be the most discouraging thing ever. I have taken the exam 3 times… the first time i honestly did not study much because i did great in school and gave myself a “big head”.. The second time i studied really hard and received a 439, the third time i studied even more buying all the online practice tests, 3 of the testing booklets, using the cd’s and notecards, and received a 440. I take the test for my 4th time this may 22nd, in 4 days. i have studied for at least an hour minimum-4/5hrs max every day in may, plus seen my professor several times. I am doing great on the practice tests i just don’t know whats going on 😦 …. i get anxiety the day of the test, i feel like i’m super fidgety in my seat and then i’m overwhelmed and blank out, i’m also always nervous that i wont pass… but i’m so close! any suggestions? or insight? anything?!!!!! it would be greatly appreciated!!!!!!!

    • 624. BABLI  |  June 3, 2012 at 11:23 pm


  • 625. Rachel  |  May 19, 2012 at 5:38 pm

    How long do you have to wait to receive your score? I am planning on taking the test a few days prior to the scoring day on the NBCOT exam calendar. But after that scoring day, how long until you get the results?

    I am hoping to get results quickly so that I can know whether to keep studying (if I need to take it again) or to breath easy. Crossing my finger to be able to breath easy.

  • 626. Rachel  |  May 19, 2012 at 5:41 pm

    Also, what is everyone’s thoughts on what is a better online test….the one from Castle world wide or from NBCOT? Do either of these give rationale’s for the correct answer?

  • 627. MOA  |  June 25, 2012 at 9:38 pm

    dont give up ashley, am going through exact the same thing.Let stay focus and hopeful, we have come this far and I believe God is too faithful to fail. We will passed it next time.

  • 628. TJ  |  July 17, 2012 at 11:15 am

    I am looking for a study parnter via skype. So nervous about this thing as I feel as though I need EVERY resource available to study and pass but I know that is not true. Planning to take exam at the end of August.

  • 629. otrprep  |  August 2, 2012 at 1:09 pm

    I live in Dallas,Tx Looking for a study partner and planning to give exam in October. Presently, I am reading Pedretti, and Trombly text books.

  • 630. JUNIOR  |  August 3, 2012 at 3:21 pm

    Did miserable on my first two tries (NBCOT).I feel like i have anxiety or something when I take it, Never been a great test taker. THIS TEST IS CONSUMING MY LIFE!!!! Pray for me…

    • 631. ND  |  August 4, 2012 at 3:54 am

      JUNIOR and all of you test takers,
      I was in the same boat until last yr as u r in right now. Was never a good test taker. I passed my exam last yr in my 4th attempt. Yes i made it finally. The biggest relief ever! Yes, it did ‘ consume my life too’ but it is do-able. Never give up! Practice doing lot of tests, study with study partners [do questions and rationalise the answers], Visualize taking the test and passing it everyday [ all the things that u would go through before and during the test..[ this visualising technique helps to prepare for the ‘D’ day ].
      I’m working right now and enjoy every bit of it. so its worth the effort. Never give up!
      Good luck everyone

  • 632. rightcareermove  |  August 6, 2012 at 12:22 am


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  • 633. Randolph  |  August 23, 2012 at 12:29 pm

    Hello! I’ve been following your blog for some time now and finally got the courage to go ahead and give you a shout out from Houston Tx! Just wanted to mention keep up the excellent work!

  • 634. Sushil  |  September 19, 2012 at 4:22 pm

    Hello Guys. I have just received confirmation that I am eligible to take the OTR test. I have been reading this blog but most blogs are quiet old. Could someone please post must buy books and materials to prepare for the test. Thank you in advance.

  • 635. dreamz unlimited  |  October 1, 2012 at 10:20 am

    hi there,
    have recently moved into United States from in LA..Planning to sit for the NBCOT exam in Dec..Am really looking forward to have a studygroup/study buddy to start preparing for the test…anyone interested to study together?please email me. my id is

  • 636. Campgirl  |  October 4, 2012 at 10:39 am

    Passed the NBCOT!!! So excited. I highly recommend the Johnson book as well as the therapyed class! Taking the practice exams from castle (nbcot) is also very very helpful.

  • 637. 3rd party logistics companies  |  October 18, 2012 at 11:23 pm

    The blog post has been very useful for me as I have been keenly desirous to appear in NBCOT exam. I got all my doubts clarified and with the valuable guidance I believe that I will get success in the exam.

  • 638. Jess  |  November 6, 2012 at 8:59 pm

    Hey guys, i just took my exam, didn’t pass.

    I was wondering if any of you guys had any insight into these questions that I remember from the test-

    1. What is the least amount of a muscle grade a person would need to be able to release a cup from their hand?
    A. 2-
    B. 2
    C. 3
    D. 3+

    Something along the lines of.. you are fabricating a splint for a man with __ injury who also has a known substance abuse. You over hear him telling a friend he was going to go party this weekend and get “wasted?” What do you do?

    A.Do nothing
    B.Contact the physician
    C.Document what you heard in the chart and mention to the physician
    D.directly intervene and give advice

    What ethic code is this breaking? An OT copies and pastes a patients old HX because she realizes it is more informative and she copies it into the new system.
    A. Privacy
    B. Veracity
    C. Fidelity
    D. Justice

    Thanks guys. These were directly off my exam, minus some of the wording.

    • 639. SS  |  November 8, 2012 at 11:30 pm

      1) a
      2) a
      3) a

      • 640. Jess  |  November 9, 2012 at 3:41 pm

        I agree except for the last one …

        In the OT code of Ethics, privacy is technically not one of the specific principles… I put Veracity– because I thought it was a lack of providing accurate information, but privacy makes a lot of sense…

      • 641. Olabisi Abba  |  November 9, 2012 at 5:12 pm

        Hello guys, my name is ola and am in Texas. Is any way I can skpe or do phone review with y’all, am re taking my exam in Dec too and need serious people to study with. My emai is

  • 642. Aleandri  |  November 7, 2012 at 10:29 am

    Hi I am having an issue with passing this OTR exam. I have taken it 3 times and have yet to pass. It’s rediculous they can’t even offer a discounted rate for a re-take! I have no clue what I am doing wrong, and I have a lot of study materials and still can’t manage to pass. Is there anyone in the Sarasota FL area that needs a study partner? I need to try something different. You can email me at

    • 643. Jess  |  November 7, 2012 at 11:25 am

      Wish I was in Fl, I’m in Cali, I need a study buddy too!! We have to stay positive though.. We will pass. My goal this week is to learn what the questions are reallly asking and go from there. I would recc taking The OT advantage course online!

      • 644. SS  |  November 8, 2012 at 11:32 pm

        Hi Jess,

        I am in cali too and in need of a study partner.
        I am planning to give my exam in dec.

      • 645. dreamz unlimited  |  November 9, 2012 at 11:02 am

        Hi Jess, am at LA and I need a study partner too..

      • 646. Jess  |  November 9, 2012 at 9:52 am

        What part of Cali?

  • 647. Jess  |  November 9, 2012 at 3:35 pm

    I’m about 30 minutes from LA) . Is it the first time your taking the exam? I’m taking mine in Dec too.

    • 648. dreamz unlimited  |  November 9, 2012 at 3:37 pm

      my email id is dont we get connected?

      • 649. Jess  |  November 9, 2012 at 3:50 pm

        cool, I will email you

  • 650. Junior  |  November 10, 2012 at 7:03 pm

    What up y’all. I just wanna say,”Keep your head up”. At times I’m down but you gotta push on. The day I pass this test…idk what I’m gonna do. I’m just venting..LOL.

  • 651. Sherry  |  November 12, 2012 at 11:16 am

    I agree with everyone else; this test was not easy. I missed the mark by 5 points on my 1st attempt. It really was the nervousness that took over. So for anyone who is reading this and is taking this exam soon, please remember to just stay calm during the test and believe in yourself.

    OTR Exam Study Guides FOR SALE:

    1) The NBCOT Official OTR Study Guide
    -Like New, No markings
    -Includes 100MC practice questions and explanations from NBCOT themselves so you really get an idea how they are framing the questions on the actual exam.
    -Includes 10 scenarios that gives you 50 more MC questions. I remember having at least 3 scenarios on my exam so it is beneficial to practice.
    -If you were to get this book online, it takes about 2-3 weeks to receive so definitely contact me instead if you want to get this book quicker.

    2) Occupational Therapy Examination Review Guide 3rd edition by: Johnson, Lorch, & DeAngelis,
    -Like New, No markings
    -Includes 4 200-question stimulation exams with detailed explanations.

    In case you were wondering, I’m not selling my Rita Fleming book; it’s too marked up and I think it would be a good reference book for the future. But, there are some other study material that I would be willing to add if you were to buy both study guides from me.


    • 652. Jess  |  November 14, 2012 at 10:33 am

      Haha for sure! I feel the same, positive vibes ❤

    • 653. Jess  |  November 14, 2012 at 11:01 am

      So you passed on your second try??

    • 654. Jess  |  November 14, 2012 at 11:05 am

      Does anyone want to start a google doc and post practice questions or other material on there?

      • 655. SAP  |  November 14, 2012 at 5:26 pm

        For those who passed their exams… how much u guys used to score on jhonsons test or rita test…
        Me so nervous n tensed….

  • 656. OTstudent  |  December 4, 2012 at 3:05 pm

    help answer this question.

    OTR is evaluating client who is in stage II of ALS. during meal assessment in the client’s home, ORT observes that the client has mild bulbar involvement impacting the ability to swallow & finish eating meal. what should the OT advise the caregivers to include as part of client’s mealtime routine?

    a) arrange meals to take place in relaxed and unhurried atmosphere
    b) position the client during meals in a chair that semi-reclines 30 to 40 degrees
    c) prep the client food that have thing liquid consistency
    d) provide nosey cup for drinking fluids.

    • 657. Jess  |  December 11, 2012 at 2:53 pm

      A. Just looked this one up in The Trombley
      Book 🙂

      I noticed this question came from the nbcot exam tests on castle worldwide.

      Do you happen to have any of of these questions?!

      • 658. OTstudent  |  December 12, 2012 at 12:30 pm

        I got my answer from the trombley also. so I was picking “A” but doubted myself b/c i was iffy about “B” but overall i do not think you are suppose to recline a ALS pt who has any kind of bulbar involvement or feeding issues due to aspiration…??

        this question is from castle WW but I had wrote it down b/c the question was bothering me! so i do not have any of the questions.

        what is your email jess? or email me at

  • 659. Jess  |  December 18, 2012 at 11:07 am

    I promised if I passed on my second try I would write here. Well thank god I just found out I passed today.

    The only real advice I could give is to not just study Rita and Fleming. You need to understand the questions and what they are asking.

    I bought the Johnson book- thought it helped although not 1 of the 800 questions was even closely replicated. Ha

    I also took the OT advantage course. That really helped to understand the test questions.

    Don’t waste your time memorizing met levels or anything else.. Understand the concepts and apply them. There will not be a question that says what met level is 1.4.

    Biggest thing I would recc is to read your textbooks! Read case smith and read Willard and spackman- obviously not cover to cover but I read a lot of these books after not passing with Rita.

    Just stay strong. Keep studying, listen to your body! You guys can do it. Trust me, I cried everyday!!! I know it’s horrible if you don’t odd the first time. But you guys eventually will!!

    One more thing. I had 2 questions that are posted throughout this blog on my exam!!!

    Best of luck!!!!!!

    • 660. OTstudent  |  December 18, 2012 at 12:15 pm

      thank goodness someone passed! congratsssss! jess, can I please email you on more advice? do you mind leaving our email address? if not, can you email me at

  • 661. Clare  |  December 28, 2012 at 6:12 pm

    Hi everyone, I’m an OT from the UK, qualified in 2003 and specialised in neuro for the past 5 years. Have just sent my OTED application, hoping to get approved to take the exam. Looks like I need to start studying ASAP, and I haven’t studied for a long time so I’m looking for study partners! I live in the SF Bay Area (CA) but happy to do online – email me if interested at

    • 662. Kirstie  |  May 9, 2013 at 7:02 pm

      Hi Clare, I am in the same boat as you…
      (But in San Diego)
      Are you still looking for a(n online) study partner?

  • 663. Crystal Kelly  |  February 20, 2013 at 8:52 pm

    Thanks for all the tips!!! I passed!!! I used the Official Study Guide, TherepyEd book and Otstudyguide com guide. Plus all of your tips!! Thanks!!

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  • 668. Kirstie  |  May 9, 2013 at 7:01 pm

    Hi! SO happy to have stumbled across this! I’m Kirstie, have just moved to San Diego from South Africa! And after 2 years of paperwork I can officially take this test! And I am starting to freak out!

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  • 670. Kimmu  |  May 26, 2013 at 12:23 am

    We need more COTA sites.. 🙂 Even COTA books are slim.. at the AOTA, there were maybe 5 books to choose. I bought the ExamFacts and official book from the NBCOT to help me pass the COTA for you future test takers out there!

  • 671. Jessica B  |  June 11, 2013 at 7:52 pm

    use the ExamFacts com book for flashcards, the Rita’s book and the NBCOT org site for review and practice questions.

  • 672. MSOT  |  July 2, 2013 at 7:19 am

    Hi Should I buy NBCOT official guide or is Rita just fine??

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  • 684. Nina  |  September 23, 2013 at 3:52 pm

    Hello all of you who has not pass the exam, Don’t feel bad and don’t give up. I too have not pas the COTA exam. what I learned from the program is not really on the State Board, We back to my school for help and all they said was keep studying, I felt I was a burden to them and waste of their time, NBCOT, Shame on you. They are making money on us ,yes but that ok We have to continue to focus and not stray away to something else we don’t want. . Someone said that we need to “either to have pain of discipline or the pain of disappointment.” keep praying . don’t give up , and kick ass!

    PS congratulation on those who passed,

  • 685. Shelia  |  September 23, 2013 at 11:24 pm

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  • 686. joayla  |  October 18, 2013 at 5:34 pm

    Hi there everyone …

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    • 687. Nina  |  October 19, 2013 at 8:11 am

      I too had failed the test many time more than 4, sometimes I want to quit but I keep going. But then I know this is what I want. We work hard for this and we will make it. we to have discipline and eyes on the carrot. let kick the NBCOT in the chin and pass the state board.
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    Can you guys help answer these questions I remember from the OT exam:

    1.OT tries to give older man things to go. He tells people he doesn’t wanna see him no more cuz he keeps bugging him about leisure. Is this due to
    a).gap in age or b). Culture

    2. Man hasnt woken up and wife is rubbing feet with lotion, lights on etc …. Do u tell her to
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    3.Man with brain injury making inappropriate comments. What do u do first?
    a)Tell him it’s inappropriate? B). Request MRI? C). Tell family it’s part of injury?

    4.Leather work for a cardiac patient is Good cuz …
    a).Low cardiac output b). isotonic ) c).isometric contraleral

    5.Which activity is best for lateral extension and abduction?
    A). Badminton, b).Tai chi, C).Golf

    6.Girl is a nurse and has flashback of childhood sex abuse, how is this evident …
    a). Dress messy and doesn’t care, b). bad concentration, c). gives away possession???
    6B). Next she is told to write when important things at work happen so she wont forget .Is this
    a) skill learning, b). physical, c). environmental

    7. Socio-economical means what…
    a). Employment, b). insurance

    8. Wat do Stories (narrative) tell about the importance of using them?

    9. OT wants to get more funding for opening another burn program and need to submit evaluation as part of proposal… Do they
    a). choose what programs they want evaluated b). do a cost base analysis,C). ask hospital staff d). do client survey

    10.After 8 weeks the patients AROM is not as good as PROM, therapist should do
    a) Max resistance program, b). light resistance program, c). ROM to do at home exercises

    11.Left amputee, what do u include in wheelchair?
    a) Anti-tippers, b). supportive cushion, c). removable arm rests?

    12.Psychodynamic is ??
    13.Psychotherapy education is??

    14.Schizophrenia assessment .. what is the first thing you assess

    15.Mother depressed, what is the first thing you assess?

    16.Woman wants have baby, sends consultation for what?
    a).How to manage baby in wheelchair b). how pregnancy affects diagnosis

    17.Mental retardation, want to teach how to make simple meal,
    a) do had over hand guiding, b). demonstrate how to make sandwich

    18. Another mental retardation about sorting activity, what is this
    a). show sample design, b). give verbal or cues of 3 steps

    19. Person with depression gets angry, what’s best way to see this?

    20. Want to see if something effective of using eating tool,
    a). do u ask nurse on unit, b). ask husband, c).observe few sessions

    21. Ulcer on left hip, What do u assess first,
    a). bed or b). seating mobility

    22. Patient tells you the husband is not doing well with her diagnosis as she is dying, should she refer him to
    a). support group or b).get concent and speak to him about his coping mechanism

    23. Kid has disease ad progression and cannot hold joy stick firmly, what to do first?
    a). Get larger size, b). custom order new one,c). get him to try different sticks.
    23B). He feels lonely and wanna be involved, should OT
    a).encourage him to play, b).ask about his interests first?

    24. Hardest thing to measure when doing work simulation?
    A).Energy required, b). skills patient has, c). patients coping mechanism in real life situation

    25. OT wanna be case manager eventually for new program, what should she do now to prepare?
    a) literature review of being a case manager … cant remember other options
    26. Tremors and slow to initiate eating, what tool?
    a). Universal design, b).wrist weighters, c). adapted spoons, d). non slip mat

    27. Lady can’t pull socks, cut meat or hold cup! What is best equipment to give her?
    A).Cup with adapted handle bigger … cant remember other options

    28.Hardest thing to do if injure pinki,
    a).Grip test b).Spherical grasp test

    29.Define: Retrospective and Prospective

    30. Shoulder dislocations avoid :
    a). combined abduction and external rotation with anterior dislocations … cant remember rest

    31. Deep partial burn intervention difficulty most because of:
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    32. Colles fracture, after cast removed is it:
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    33.Wanna splint cuz a) maintain tendon gliding or b) stretch gliding

    34. Doing NDT on babies born in 3rd percentile, all babies already getting sensory.
    a).What is independent variable?
    b)Is this ethical?
    C)Is NDT good for babies??

    35. What’s developmental, NDT?

    36. Remittance and RA and OA treatment.

    37. Enfant needs feeding swallowing ax, do u need further consent ?

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  • 706. Felicity G  |  June 6, 2016 at 10:29 am

    Hey, is anyone studying for the NBCOT exam in Philadelphia. I’m seeking a study partner. I have taken the exams multiple times have yet to pass. I was thinking maybe a study partner could help me. I was aim to meet 2 or 3 times week.

  • 707. Mindy  |  July 10, 2016 at 3:36 pm

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