NBCOT Certified Occupational Therapy Assistant (COTA) Quiz: Infection Control
20 questions · exam conditions
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Infection ControlQuestion 1 of 20

A patient with suspected TB is ready for OT. Which room setup does infection control require?

Negative-pressure therapy room
Open gym with good ventilation
Shared atrium with air flow
Private room with door open
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NBCOT Certified Occupational Therapy Assistant (COTA) Quiz

NBCOT Certified Occupational Therapy Assistant (COTA) Quiz: Infection Control

Practice Infection Control in NBCOT Certified Occupational Therapy Assistant (COTA) with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Infection Control, giving you a quick way to practice the rules, question types, and explanations that matter most for NBCOT Certified Occupational Therapy Assistant (COTA).

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

A patient with suspected TB is ready for OT. Which room setup does infection control require?

  1. Negative-pressure therapy room (correct answer)
  2. Open gym with good ventilation
  3. Shared atrium with air flow
  4. Private room with door open
Explanation: TB spreads by airborne droplet nuclei, so infection control requires airborne precautions in a negative-pressure room that keeps contaminated air from escaping. A private room with the door open is tempting but wrong because opening the door lets potentially infectious air circulate to other areas.

Question 2

A used needle in a patient's bag punctures the COTA's finger. First action:

  1. Finish session, then report
  2. Squeeze to force out blood
  3. Apply alcohol and cover it
  4. Wash site with soap and water (correct answer)
Explanation: Immediately wash the puncture site with soap and water to reduce infection risk after a needlestick. Squeezing to force out blood is wrong because it can damage tissue and spread contaminants. Finish the session then report also delays care. Apply alcohol and cover may be done later, but soap and water washing is the first recommended step.

Question 3

Which item would require high-level disinfection between patients?

  1. Blood pressure cuff
  2. Oral probe thermometer (correct answer)
  3. Wheelchair armrest
  4. Exercise mat surface
Explanation: An oral probe thermometer touches mucous membranes, making it semi-critical, so it needs high-level disinfection between patients. The blood pressure cuff is the tempting wrong answer because it contacts intact skin only, but that is noncritical and requires low- or intermediate-level cleaning, not high-level disinfection.

Question 4

Using universal precautions, after bulk blood is wiped from the floor, what should the COTA do next?

  1. Apply hand sanitizer to it
  2. Rinse the area with warm water
  3. Use EPA-registered disinfectant (correct answer)
  4. Notify housekeeping, and wait
Explanation: After bulk blood is wiped away, the floor must still be decontaminated with an EPA-registered disinfectant effective against bloodborne pathogens. Wiping removes visible soil but not viruses. Rinsing with warm water is the tempting error because it seems like cleaning, but it can spread contamination without killing pathogens. Hand sanitizer isn't for surfaces, and waiting leaves a biohazard.

Question 5

After removing gloves used with a C. difficile patient, the COTA's hands look clean. Next:

  1. Alcohol sanitizer for 20 sec
  2. Soap and water wash for 20 sec (correct answer)
  3. Hand sanitizer for 10 sec only
  4. Use disinfectant wipes only
Explanation: C. difficile forms spores that alcohol-based sanitizers cannot kill, so soap and water washing for 20 seconds is required to physically remove them from your hands. The tempting wrong choice is alcohol sanitizer, which leaves spores behind and increases spread risk.

Question 6

A COTA is concluding a toileting and hygiene session with a client who is on contact precautions for Clostridioides difficile (C. diff).

What is the MOST appropriate method for the COTA to perform hand hygiene after removing gloves?

  1. Use an alcohol-based hand sanitizer, rubbing until dry.
  2. Wash hands thoroughly with soap and water. (correct answer)
  3. Wipe hands with a disinfectant wipe used for surfaces.
  4. Don a new pair of clean gloves over the unwashed hands.
Explanation: The correct answer is B. Clostridioides difficile produces spores that are resistant to alcohol-based hand sanitizers. The friction from washing with soap and water is required to physically remove the spores. Therefore, it is the only effective method for hand hygiene in this situation. Alcohol-based rubs (A) are ineffective against C. diff spores. Disinfectant wipes (C) are not intended for skin use. Donning new gloves (D) is not a substitute for hand hygiene and would lead to cross-contamination.

Question 7

A COTA is working with a client in a hospital room who is on droplet precautions for influenza. The client needs to be transported to the therapy gym for an intervention.

What is the MOST important infection control measure to implement during the client's transport?

  1. The COTA must wear an N95 respirator during transport.
  2. The client must wear a surgical mask. (correct answer)
  3. The wheelchair must be covered with a sterile drape.
  4. The hallway must be cleared of all other personnel and patients.
Explanation: The correct answer is B. For patients on droplet precautions, the primary method to contain respiratory secretions during transport is to have the patient wear a surgical mask. This is a form of source control. An N95 respirator (A) is for airborne precautions, not droplet. A sterile drape (C) is unnecessary. Clearing the hallway (D) is impractical and not required for droplet precautions.

Question 8

A COTA is assigned to treat a client who has active pulmonary tuberculosis (TB) and is in an airborne infection isolation room (AIIR) with negative pressure.

Which action is required for the COTA to safely enter the room and work with this client?

  1. Wear a standard surgical mask and eye protection.
  2. Wear a fit-tested N95 respirator. (correct answer)
  3. Keep the door to the client's room open to improve ventilation.
  4. Ensure the client is wearing a surgical mask during the session.
Explanation: The correct answer is B. TB is transmitted via airborne particles, which requires anyone entering the patient's room to wear a properly fit-tested N95 respirator (or higher level of protection) to filter these small particles. A surgical mask (A) does not provide adequate protection. Keeping the door open (C) would defeat the purpose of the negative pressure room. While having the client wear a mask (D) can help, it does not replace the COTA's need for an N95 respirator.

Question 9

While assisting a client with oral hygiene, a small amount of the client's saliva splatters onto the COTA's intact skin on their forearm.

According to standard precautions, what is the COTA's most appropriate immediate response?

  1. Report the exposure to the supervising OTR immediately.
  2. Apply alcohol-based hand sanitizer to the affected area of the arm.
  3. Wash the affected area of the arm with soap and water as soon as possible. (correct answer)
  4. Ignore the splatter as saliva is not considered a risk on intact skin.
Explanation: The correct answer is C. Standard precautions dictate treating all body fluids (except sweat) as potentially infectious. When body fluids contact skin, the area should be washed with soap and water as soon as feasible. Reporting to the OTR (A) is not necessary for a minor exposure to intact skin. Alcohol-based sanitizer (B) is primarily for hands and less effective on visibly contaminated skin. Ignoring the splatter (D) is a violation of standard precautions.

Question 10

A COTA is stripping a therapy bed after a session. The linen protector has a moderate amount of blood on it from a client's leaking wound dressing.

What is the correct procedure for handling this soiled linen?

  1. Shake the linen vigorously to remove any dried debris before laundering.
  2. Roll the linen with the soiled side inward and place it in the designated laundry hamper. (correct answer)
  3. Place the linen in a red biohazard bag for incineration.
  4. Carry the linen away from the body, held at arm's length, to the laundry room.
Explanation: The correct answer is B. Soiled linens should be handled with minimum agitation to prevent contamination of the air, surfaces, and clothing. Rolling the soiled part inward contains the contaminants. Shaking the linen (A) can aerosolize infectious particles. Red biohazard bags (C) are for regulated waste, and most soiled linen does not meet this criterion unless saturated to the point of dripping. While carrying it away from the body is good practice (D), the primary step is to contain the soiled area by rolling it.

Question 11

A COTA is teaching a client how to use a buttonhook. During the session, the client accidentally drops the buttonhook, and the metal hook breaks off from the handle.

What is the correct way to dispose of the broken metal hook piece?

  1. Wrap it securely in paper towels before placing it in the regular trash bin.
  2. Place it directly into the designated sharps container. (correct answer)
  3. Leave it on the counter for the housekeeping staff to handle.
  4. Put it in an empty soda can and seal the top before discarding.
Explanation: The correct answer is B. Any object that is sharp enough to puncture skin and has been used in a patient care setting is considered a sharp and must be disposed of in a puncture-resistant, leak-proof sharps container. This prevents injury and potential exposure to anyone handling waste. Wrapping it (A) or putting it in a can (D) are not approved methods and pose a risk of injury. It is the COTA's responsibility to dispose of it properly, not to leave it for housekeeping (C).

Question 12

After a client is safely seated, a COTA notices that the client's urinary catheter bag has leaked a large puddle of urine onto the smooth tile floor of the therapy clinic.

What is the COTA's FIRST action in managing this spill?

  1. Immediately begin cleaning the spill with paper towels.
  2. Notify the housekeeping department to clean the spill.
  3. Restrict access to the area and post a "wet floor" sign. (correct answer)
  4. Locate the facility's bloodborne pathogen spill kit.
Explanation: The correct answer is C. The immediate priority in managing any spill is to ensure the safety of others by preventing them from slipping or walking through the contaminated area. Restricting access and posting warning signs accomplishes this. Once the area is secured, the COTA can then take the next steps, which would include notifying housekeeping (B) or obtaining the proper cleaning supplies/kit (D) and PPE to clean the spill according to facility policy. Cleaning without first securing the area (A) puts others at risk.

Question 13

A COTA plans to use a set of weighted cuffs for a strengthening activity with a client who is in an isolation room on contact precautions.

Which of the following represents the BEST practice for using this equipment?

  1. The cuffs should be dedicated to the client and left in the room. (correct answer)
  2. The cuffs can be used and then wiped down with an alcohol wipe before use with another client.
  3. The cuffs should be placed in a plastic bag after use and sent to central supply for sterilization.
  4. The COTA should not bring any non-disposable equipment into the isolation room.
Explanation: The correct answer is A. Whenever possible, non-critical patient-care equipment (items that contact intact skin) should be dedicated to the use of a single patient when that patient is on contact precautions. This is the most effective way to prevent cross-contamination. Thoroughly disinfecting shared equipment is an alternative, but dedicating the equipment is preferred. Wiping down fabric cuffs (B) is difficult and often ineffective. Sterilization (C) is not necessary for this type of equipment. Prohibiting all non-disposable equipment (D) would severely limit therapeutic interventions.

Question 14

A COTA is wearing non-sterile gloves while changing a client's wound dressing. During the procedure, the gloves become heavily soiled with wound drainage. The COTA needs to get a clean bandage from a supply drawer.

What is the most appropriate action for the COTA to take?

  1. Use the soiled gloves to open the drawer since they provide a barrier.
  2. Remove the soiled gloves, perform hand hygiene, and don a new pair before opening the drawer. (correct answer)
  3. Wipe the gloves on a paper towel to remove the worst of the soil before opening the drawer.
  4. Ask the client to open the drawer and hand over the clean bandage.
Explanation: The correct answer is B. Gloves should be changed when they are heavily contaminated or when moving from a contaminated task (working with the wound) to a clean task (accessing clean supplies). This prevents the cross-contamination of the supply drawer and its contents. Using soiled gloves (A) would contaminate the drawer handle and supplies. Wiping gloves (C) is not an acceptable infection control practice. Asking the client (D) is inappropriate and could contaminate the client's hands.

Question 15

A COTA has symptoms of a contagious illness, including a fever and persistent cough. The COTA is scheduled to work in a skilled nursing facility.

What is the COTA's primary professional responsibility?

  1. Go to work, but wear a mask and gown during all client interactions.
  2. Notify their supervisor of the illness and stay home in accordance with facility policy. (correct answer)
  3. Go to work, but only perform documentation and avoid direct client contact.
  4. Take fever-reducing medication and work the scheduled shift as to not inconvenience coworkers.
Explanation: The correct answer is B. A healthcare professional's primary responsibility is to 'do no harm.' Working while sick with a contagious illness poses a direct threat to the health and safety of a vulnerable patient population. The COTA must follow facility policy, which invariably involves notifying their supervisor and staying home to prevent transmission. The other options (A, C, D) all involve coming to the facility while ill, which creates an unacceptable risk of spreading the infection to clients and colleagues.

Question 16

A COTA is moving between clients in a busy outpatient hand clinic. The COTA's hands are not visibly soiled.

According to CDC guidelines, what is the preferred method for hand hygiene in this situation?

  1. Washing with soap and water for at least 20 seconds.
  2. Applying an alcohol-based hand rub. (correct answer)
  3. Using a disposable sanitizing wipe on the hands.
  4. No hygiene is needed if the previous client had no known infection.
Explanation: The correct answer is B. When hands are not visibly soiled, the CDC recommends using an alcohol-based hand rub as the primary method for hand hygiene. It is more effective at killing most germs than soap and water, faster to use, and less irritating to the skin. Soap and water (A) should be used when hands are visibly dirty or after caring for a patient with an illness like C. diff. Sanitizing wipes (C) are not a substitute for hand rub or washing. Standard precautions require hand hygiene between all clients, regardless of their known infection status (D).

Question 17

A COTA is leading a group craft activity where participants will be sharing tools like scissors and glue guns.

What is the most effective infection control strategy for the COTA to implement for the shared equipment?

  1. Have each participant wear gloves throughout the activity.
  2. Clean and disinfect the tools between each participant's use. (correct answer)
  3. Ensure there is good ventilation in the room.
  4. Ask participants to use hand sanitizer before the activity begins.
Explanation: The correct answer is B. When equipment is shared among multiple individuals, the most direct way to prevent the transmission of pathogens via fomites (contaminated objects) is to clean and disinfect the items between each use. While hand sanitizer (D) is a good practice, it does not decontaminate the tools themselves. Wearing gloves (A) can prevent a participant from contaminating a tool, but the gloves can become contaminated and spread germs to other surfaces. Ventilation (C) is important for airborne pathogens but does not address contact transmission from shared tools.

Question 18

A COTA has just completed an intervention with a client in a room requiring contact and droplet precautions. The COTA is wearing gloves, a gown, and a surgical mask and is preparing to exit the room.

Which sequence for removing (doffing) PPE is most appropriate to minimize self-contamination?

  1. Mask, gown, gloves, then perform hand hygiene.
  2. Gloves, gown, perform hand hygiene, then mask. (correct answer)
  3. Gown, mask, gloves, then perform hand hygiene.
  4. Gloves, mask, gown, then perform hand hygiene.
Explanation: The correct answer is B. The principle of doffing PPE is to remove the most contaminated items first. Gloves are considered the most contaminated, followed by the gown. The mask is removed last, often just after exiting the room, to protect the healthcare worker from inhaling aerosols during the doffing process. Hand hygiene should be performed after removing gloves and gown and after removing the mask. This sequence minimizes the chance of contaminating oneself.

Question 19

A COTA in an outpatient pediatric clinic uses therapy putty with a child. The COTA plans to use putty in the next session with a different child. The clinic's policy is to follow standard precautions.

What is the most appropriate action for the COTA to take regarding the putty?

  1. Wipe the putty with a hospital-grade disinfectant wipe.
  2. Provide the next child with a new, unused portion of putty. (correct answer)
  3. Place the used putty in an autoclave for sterilization.
  4. Instruct the next child to wash their hands before using the same putty.
Explanation: The correct answer is B. Therapy putty is a porous item that cannot be adequately cleaned or disinfected between clients. To prevent cross-contamination, it should be treated as a single-client-use item. Wiping the putty (A) does not clean it effectively. Autoclaving (C) would destroy the putty. While handwashing (D) is good practice, it does not decontaminate the shared item.

Question 20

After completing a dressing change, a COTA needs to dispose of the old dressing, which is saturated with blood.

What is the proper receptacle for this type of waste?

  1. The regular trash can, as long as it is double-bagged.
  2. The sharps container.
  3. A red biohazard waste container. (correct answer)
  4. A toilet, to be flushed away.
Explanation: The correct answer is C. Regulated medical waste, which includes items saturated or dripping with blood or other potentially infectious materials (OPIM), must be disposed of in specially marked, leak-proof biohazard containers (typically red bags or containers). This ensures the waste is handled and treated properly to prevent the spread of bloodborne pathogens. Regular trash (A) is incorrect. A sharps container (B) is only for items that can pierce the skin. Flushing dressings (D) can damage plumbing and is not a proper disposal method.