NBCOT Plan

NBCOT exam practice question: Domain 04: Competency and Practice Management

Domain 04: Competency and Practice ManagementDifficulty 3/5

An OTA reports that a client has met all goals and asks whether they can discharge the client. What should the OTR do?

  1. ARefer the discharge decision to the supervising physician for approval
  2. BAuthorise the discharge based on the OTA's report of goal achievement
  3. CReassess the client and determine discharge, using the OTA's data
  4. DAsk the OTA to complete a discharge summary and co-sign the document
Show answer and rationale

Correct: C. Determining discharge is the OTR's responsibility. The OTA may gather data and contribute to the process, but the reassessment and the decision belong to the OTR.

  • B — Delegating the decision itself exceeds the OTA's scope.
  • D — Co-signing a document does not substitute for the OTR's reassessment.
  • A — Discharge from occupational therapy is an OT decision, not a physician's.

Concept being tested

16% of the OTR exam. Managing professional activities of self and others — supervision of OTAs and aides, service competence, documentation and reimbursement, regulatory and ethical compliance, evidence-based practice, safety and infection control, and quality improvement. — 16% of the exam. Study guide for Domain 04: Competency and Practice Management.

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Primary references

  1. Certification Exam Handbook (2025) — National Board for Certification in Occupational Therapy (NBCOT) · primary · retrieved 2026-09-22, verified 2026-09-22
Last reviewed: 2026-10-07Reviewed by: Jessica Lin, OTD, OTR/L, Occupational therapy clinical practice & item reviewHow we verify facts