The study was designed to develop a greater understanding of how test preparation practices/activities have changed in a state with an established testing program that has recently begun to use test scores for school-level accountability purposes. Teachers within 24 public high schools completed a questionnaire related to the use of test preparation activities, the ethicality of the activities, and motivational activities/incentives related to testing. Nonparametric statistics were used to compare responses among schools. The results of the study indicate that school achievement level is not related to the use of test preparation practices. However, the number of sources of pressure to increase test scores does contribute to the use of certain test preparation activities. Also, there were no state-wide trends in the use of motivational activities/incentives related to test scores, although over half of the schools in the sample did use some type of student incentives. Finally, there are suggestions related to future research and professional development regarding the appropriateness of certain test preparation activities.