Free COTA Practice Test (NBCOT Occupational Therapy Assistant Exam)
Occupational therapy assistant practice questions written to the NBCOT COTA content outline, with an explanation for every answer.
A client with spastic hemiplegia shows a sudden increase in tone and agitation during a session. What should the COTA consider FIRST?
414 original questions · 227 intervention questions on modalities, ADL, orthotics and equipment · 53 six-option multi-select questions like the real exam’s
COTA practice questions by exam domain
NBCOT’s content outline fixes each domain’s share of the exam. Each domain has a guide with free sample questions and a free ten-question drill; Domain 2, more than half the exam, also has five topic drills. Every drill shows an explanation after each answer.
Domain 1: Collaborate and Gather Information (27%)
About 51 of 190 items · 5 tasks
Development and conditions across the life span, the occupational profile, assessments and screening, activity analysis, working with the client, family and team, health literacy, and monitoring the plan with vital signs, precautions and safety concerns.
Domain 2: Interventions (55%)
About 105 of 190 items · 6 tasks
Physical agent modalities and wound care, ADL and IADL training, cognition, vision, feeding and groups, exercise and neuromuscular techniques, orthotics and prosthetics, wheelchairs and assistive technology, and home and workplace modifications.
Domain 3: Professional Standards (18%)
About 34 of 190 items · 4 tasks
Evidence-based practice and quality improvement, infection control and emergencies, risk management, supervision, documentation and reimbursement, HIPAA, ethics and the NBCOT standards, and service competency.
Modalities and Wound Care
33 questions · Domain 2
Hot packs, paraffin, cryotherapy, ultrasound, TENS, NMES and biofeedback with their contraindications, pressure injury stages, wound healing, and setting up a safe treatment space, including lines and telehealth.
ADL, Cognition and Groups
73 questions · Domain 2
Dressing and bathing methods and devices, joint protection and energy conservation, cognitive and visual strategies, sensory input, feeding and swallowing, transfers, groups and mental health interventions.
Exercise, Edema and Neuro Rehab
37 questions · Domain 2
Grading exercise by muscle grade, edema and scar management, burn positioning, sensory reeducation and desensitization, constraint-induced movement therapy, balance, tone and breathing techniques.
Orthotics and Prosthetics
31 questions · Domain 2
Choosing orthoses for carpal tunnel, de Quervain, mallet finger, boutonniere, swan-neck and nerve injuries, fabrication and fit checks, and upper limb prosthetic training before and after fitting.
Assistive Technology and Home Modification
53 questions · Domain 2
Wheelchair measurement and seating, tilt and pressure relief, switches and access methods, driving and community mobility, ADA ramp, door and grab-bar dimensions, ergonomics and universal design.
Ready for the full exam?
190 items in 4 hours, drawn in the outline’s share for each domain, with multi-select items and an explanation for every answer.
Or start with a free drillThe COTA exam at a glance
Answer COTA practice questions written to NBCOT’s 2022 COTA Examination Content Outline, read the explanation for every answer, then take a timed 190-question, 4-hour practice exam in the real format with a score for every domain.
The COTA exam is the national certification exam for occupational therapy assistants, given by NBCOT, the National Board for Certification in Occupational Therapy. The content outline in force came from NBCOT’s 2022 practice analysis and has been used for every exam since January 2, 2024; NBCOT runs a practice analysis every five years and has not announced a new COTA outline (checked November 2026).
- Exam
- The COTA certification exam of NBCOT, the National Board for Certification in Occupational Therapy. Passing it earns the Certified Occupational Therapy Assistant (COTA) credential
- Format
- 190 items of two types: single-response multiple choice with three or four options and one correct or best answer, and six-option multi-select items with three correct answers, where you select three. Scored and unscored field-test items are mixed at random; NBCOT does not publish how many are unscored
- Time
- 4 hours. The optional tutorial does not count against the clock. You may take breaks, but the clock keeps running
- Content
- The 2022 COTA Examination Content Outline, used for every exam since January 2, 2024: Domain 1 Collaborate and Gather Information 27%, Domain 2 Select and Implement Interventions 55%, Domain 3 Uphold Professional Standards and Responsibilities 18%
- Scoring
- A scaled score from 300 to 600; 450 passes. The exam is criterion-referenced (Modified Angoff), with no domain-level passing standards. Multi-select items give credit for each correct option you select, and wrong selections lose no points
- Where
- Computer-based at Pearson VUE test centers in the United States and internationally (Pearson VUE since January 2, 2024). You can flag items for review, change answers, highlight text and strike out options
- Fee
- $540 for the online application ($595 on paper); $430 for an online retake application ($485 on paper)
- Retakes
- Wait 30 days from your last exam before attempts 2, 3 and 4, 60 days before attempts 5, 6 and 7, and 90 days before attempt 8 and later. Each retake needs a new application
- Eligibility
- Graduate of an ACOTE-accredited occupational therapy assistant program, agree to the NBCOT Code of Conduct and pass the character review. Your Authorization to Test letter is active for 90 days
- Renewal
- NBCOT certification renews every three years with at least 36 units of professional development or competency assessment
Where the exam fits in becoming a COTA
- Graduate from an ACOTE-accredited occupational therapy assistant program.
- Apply to NBCOT online and pay the $540 exam fee. The application is valid for 90 days, and NBCOT issues your Authorization to Test letter once your academic verification and character review are approved.
- Schedule with Pearson VUE within the 90 days of your Authorization to Test letter and take the exam.
- Check your state’s licensing requirements: state boards license occupational therapy assistants, and NBCOT links to each state board.
- Renew your NBCOT certification every three years with at least 36 units of professional development.
Taking the occupational therapist exam instead? See the NBCOT OTR practice test.
How to use this COTA exam prep
- Take the free mixed drill to see where you stand across all three domains.
- Start with Domain 2, Select and Implement Interventions: it is 55% of the exam. Take its five topic drills and repeat your weakest.
- Drill Domain 1 (27%) for precautions, assessments and the COTA and OTR roles, then Domain 3 (18%) for safety, documentation and ethics.
- Practice multi-select items until choosing exactly three feels routine; each correct option earns credit.
- Take the full 190-question practice exam under the 4-hour clock, then drill your lowest domain and take it again. Each new sitting draws questions you have not seen first.
Common questions
How many questions are on the COTA exam?
190 items in 4 hours. Most are single-response multiple-choice questions with three or four options; the rest are six-option multi-select items with three correct answers. Some items are unscored field-test items that NBCOT mixes in at random, so answer every item as if it counts.
What score do you need to pass the COTA exam?
A scaled score of at least 450 on NBCOT’s 300 to 600 scale. NBCOT sets the standard with the Modified Angoff method and does not publish how many questions you must answer correctly, and there are no domain-level passing standards. Our mock exam therefore shows your percentage and your score in each domain, not a pass line.
How do multi-select questions work on the COTA exam?
A multi-select item has six options, three of them correct, and you must select three. You get credit for each correct option you select, and wrong selections lose no points. Our practice items work the same way: we count one point for each correct option you choose.
How much does the COTA exam cost?
$540 with an online application or $595 on paper. A retake costs $430 online or $485 on paper.
How soon can I retake the COTA exam?
You must wait 30 days before attempts 2, 3 and 4, 60 days before attempts 5, 6 and 7, and 90 days before attempt 8 or later. Each retake needs a new exam application, which you can submit 30 days before your next eligible date.
What is on the COTA exam?
The 2022 COTA Examination Content Outline, in use since January 2, 2024, has three domains: Collaborate and Gather Information (27%), Select and Implement Interventions (55%) and Uphold Professional Standards and Responsibilities (18%). NBCOT runs a new practice analysis every five years; the most recent was in 2022.
Does NBCOT sell an official COTA practice test?
Yes. NBCOT’s StudyPack ($85, per the exam handbook) includes a full practice exam, practice tests and mini tests, each usable once. These questions are separate: original practice written to NBCOT’s content outline. They are not NBCOT questions, and NBCOT does not allow its exam content to be shared.
Is this COTA practice exam the same format as the real exam?
Yes. The mock exam is 190 items in 4 hours, drawn in the outline’s share for each domain (51, 105 and 34 items), mixing single-response and six-option multi-select items. You can skip, go back, change answers and flag items for review. The result shows your percentage, your score in each domain and an explanation for every item.
Ready for test day?
190 items in 4 hours, drawn in the outline’s share for each domain, with multi-select items and an explanation for every answer.
Or start with a free drillSources
- NBCOT: Foundations of the OTR and COTA certification exams (item types, 190 items, 4 hours, scoring, field-test items)
- NBCOT: 2022 COTA Examination Content Outline
- NBCOT: 2022 Practice Analysis of the COTA (domain weights for exams from 2024)
- NBCOT: 2024 exam FAQs (content outline from January 2, 2024; Pearson VUE)
- NBCOT: Fees
- NBCOT: Certification Examination Handbook (eligibility, breaks, results, retakes)
- NBCOT: Renewal Handbook (36 units every three years)
Original practice questions for exam preparation, written to the NBCOT 2022 COTA Examination Content Outline; they are not NBCOT exam questions. Independent practice, not affiliated with or endorsed by NBCOT (the National Board for Certification in Occupational Therapy) or Pearson VUE. COTA and OTR are certification marks of NBCOT. Follow your supervising OTR, your state practice act and your facility’s policies in practice.