Massage and Bodywork Licensing Examination MBLEx Test Client Assessment and Planning 1 — Questions and Answers
Question 1: A client's health intake form reveals they are taking warfarin (Coumadin) for a heart condition. Which massage technique adjustment is most appropriate for this client?
- Avoid all massage due to cardiac risk
- Use deep tissue pressure to improve circulation
- Avoid deep pressure and vigorous techniques due to increased bleeding risk (Correct answer)
- Apply heat therapy over the chest region only
Correct answer: Avoid deep pressure and vigorous techniques due to increased bleeding risk
Warfarin is an anticoagulant that increases bleeding risk. Deep pressure or vigorous techniques such as deep tissue work can cause bruising or internal bleeding in clients taking blood thinners, so gentler pressure is required.
Question 2: During a postural assessment, a therapist observes that a client's right shoulder is elevated and their head is laterally flexed toward the right. Which muscle is most likely shortened on the right side?
- Serratus anterior
- Upper trapezius (Correct answer)
- Rhomboid major
- Subscapularis
Correct answer: Upper trapezius
The upper trapezius elevates the scapula and laterally flexes the cervical spine toward the same side. A shortened upper trapezius on the right would pull the shoulder up and tilt the head to the right.
Question 3: When performing range of motion testing, a therapist finds that a client's shoulder abduction is limited to 90 degrees with a firm, springy end-feel. What does this end-feel most likely indicate?
- Normal capsular restriction
- Muscular tightness or spasm (Correct answer)
- Bony block
- Ligamentous laxity
Correct answer: Muscular tightness or spasm
A firm, springy end-feel typically indicates muscular tightness or spasm. A capsular end-feel is firmer and leathery, a bony block produces a hard stop, and ligamentous laxity would produce an abnormally loose end-feel.
Question 4: A new client reports a history of deep vein thrombosis (DVT) in their right calf, resolved six months ago. What is the most appropriate course of action before massaging the lower extremities?
- Proceed with vigorous effleurage to improve venous return
- Avoid all lower extremity massage indefinitely
- Obtain physician clearance and apply only gentle techniques if approved (Correct answer)
- Focus deep work on the area to break up residual clots
Correct answer: Obtain physician clearance and apply only gentle techniques if approved
A history of DVT is a significant contraindication concern. Even a resolved DVT warrants physician clearance before massage because vigorous techniques could dislodge any remaining thrombus, potentially causing a pulmonary embolism.
Question 5: Which of the following is an example of a local contraindication for massage therapy?
- Uncontrolled hypertension
- Fever above 38°C (100.4°F)
- An acute sunburn on the client's back (Correct answer)
- First trimester of pregnancy
Correct answer: An acute sunburn on the client's back
An acute sunburn is a local contraindication — massage is contraindicated directly over the affected area but can be performed on unaffected areas of the body. The other options represent absolute or systemic contraindications requiring full avoidance or physician clearance.
Question 6: A therapist is documenting a session using the SOAP format. Which section would contain the therapist's professional interpretation of assessment findings, such as 'hypertonicity in the right cervical rotators contributing to restricted rotation'?
- Subjective
- Objective
- Assessment (Correct answer)
- Plan
Correct answer: Assessment
The Assessment section of SOAP notes contains the therapist's clinical interpretation and analysis of findings gathered in the Subjective and Objective sections. It reflects professional judgment about what those findings mean for the client's condition.
Massage and Bodywork Licensing Examination MBLEx Test Client Assessment and Planning 1
A client's health intake form reveals they are taking warfarin (Coumadin) for a heart condition.
Which massage technique adjustment is most appropriate for this client?