MBLEx Pathology and Contraindications Questions and Answers — Questions and Answers
Question 1: A new client arrives with pronounced pitting edema in both lower legs. What is the most appropriate course of action for the massage therapist?
- Perform light, upward strokes on the legs to promote venous return.
- Proceed with a full-body massage but avoid the lower legs entirely.
- Postpone the massage and refer the client to a physician for diagnosis. (Correct answer)
- Apply deep friction to the affected areas to break up fluid congestion.
Correct answer: Postpone the massage and refer the client to a physician for diagnosis.
Pitting edema, especially when bilateral, can be a sign of a serious underlying systemic condition such as congestive heart failure, kidney failure, or liver failure. It is considered a systemic or absolute contraindication until a medical diagnosis is made and massage is approved by a physician.
Question 2: A client with a diagnosis of osteoporosis requests a deep tissue massage to relieve muscle tension. Which of the following is the primary concern for the therapist?
- Causing an exacerbation of joint inflammation.
- Increasing the client's blood pressure to unsafe levels.
- Spreading a potential underlying infection.
- Risk of causing a bone fracture due to bone fragility. (Correct answer)
Correct answer: Risk of causing a bone fracture due to bone fragility.
Osteoporosis is a condition that causes bones to become weak and brittle. Applying deep pressure or aggressive techniques creates a significant risk of causing a bone fracture. Massage should be modified to use only light, gentle pressure.
Question 3: Which of the following conditions is considered a systemic, absolute contraindication for massage therapy?
- A localized, non-contagious skin rash.
- Chronic, well-managed hypertension.
- Fever. (Correct answer)
- A sprained ankle after the first 72 hours.
Correct answer: Fever.
A fever is a sign that the body is fighting a systemic infection. Massage increases circulation, which can potentially spread the infection and place additional stress on the body, making the condition worse. Therefore, it is an absolute contraindication, and the session should be postponed.
Question 4: A long-time client arrives for an appointment and points out a large, tender varicose vein on their calf that they hadn't noticed before. The appropriate action is to:
- Apply firm, stripping strokes over the vein to improve blood flow.
- Proceed with the massage but avoid applying any pressure directly over the affected vein. (Correct answer)
- Use hot stones on the area to reduce tenderness before proceeding.
- Gently massage the vein to help reduce its appearance.
Correct answer: Proceed with the massage but avoid applying any pressure directly over the affected vein.
Varicose veins are a local contraindication for deep or direct pressure. Massaging directly on them can cause pain, damage the vein, or potentially dislodge a blood clot (thrombus). The therapist should avoid the specific area.
Question 5: For a client with active phlebitis in the right leg, massage is:
- Indicated, as it can help reduce the inflammation.
- Locally contraindicated, so the left leg can receive deep tissue work.
- Systemically contraindicated due to the risk of embolism. (Correct answer)
- Permitted if the client's doctor has prescribed blood thinners.
Correct answer: Systemically contraindicated due to the risk of embolism.
Phlebitis is the inflammation of a vein, often associated with a blood clot (thrombophlebitis). Massage is systemically contraindicated because of the severe risk of dislodging the clot, which could travel to the lungs and cause a life-threatening pulmonary embolism.
Question 6: A client presents with an undiagnosed, localized skin rash that is red and itchy. Which of the following is the correct classification for this contraindication?
- Systemic contraindication requiring medical clearance.
- Relative contraindication requiring lighter pressure.
- Local contraindication requiring avoidance of the affected area. (Correct answer)
- An endangerment site requiring only effleurage.
Correct answer: Local contraindication requiring avoidance of the affected area.
An undiagnosed skin rash is a local contraindication. The therapist must avoid touching the affected area to prevent irritation, exacerbation of the condition, or the potential spread of infection to other parts of the client's body or to the therapist. Massage can be performed on other areas of the body.
MBLEx Pathology and Contraindications Questions and Answers
A new client arrives with pronounced pitting edema in both lower legs.
What is the most appropriate course of action for the massage therapist?