NCBTMB Client Assessment and Planning 3 — Questions and Answers
Question 1: A client reports taking warfarin for a heart condition. Which assessment consideration is most important before proceeding with massage?
- Assess blood pressure levels
- Assess for bruising tendency and avoid deep pressure techniques (Correct answer)
- Assess skin condition for dryness
- Assess range of motion in all joints
Correct answer: Assess for bruising tendency and avoid deep pressure techniques
Warfarin is a blood thinner that increases bruising risk, so deep pressure and techniques that could cause tissue trauma must be avoided.
Question 2: During a postural assessment, you observe that a client's right shoulder is elevated compared to the left. This finding most likely indicates:
- A congenital bone deformity
- Possible muscle imbalance or hypertonia on the right side (Correct answer)
- Normal anatomical variation requiring no treatment consideration
- A contraindication to all massage techniques
Correct answer: Possible muscle imbalance or hypertonia on the right side
Elevated shoulder typically suggests hypertonicity or shortening of the upper trapezius and levator scapulae on that side.
Question 3: A client presents with edema in both lower legs following a long flight. The therapist's FIRST action should be to:
- Begin effleurage immediately to stimulate circulation
- Rule out deep vein thrombosis before proceeding with any massage (Correct answer)
- Apply cold compresses to reduce swelling
- Perform passive range of motion on the ankles
Correct answer: Rule out deep vein thrombosis before proceeding with any massage
Edema after prolonged immobility raises concern for DVT, which is a contraindication to massage and requires medical clearance first.
Question 4: When documenting a client's pain using a SOAP note, where would you record the client's verbal description of their pain as 'a 7 out of 10, burning sensation'?
- O — Objective
- A — Assessment
- S — Subjective (Correct answer)
- P — Plan
Correct answer: S — Subjective
Client-reported information, including verbal pain descriptions and ratings, is recorded in the Subjective section of the SOAP note.
Question 5: A new client has a history of recent (2-week-old) muscle strain in the lumbar region. The appropriate treatment planning response is:
- Avoid the area completely until 6 months have passed
- Apply deep transverse friction to break up adhesions
- Limit treatment to gentle techniques in the acute-subacute transition phase (Correct answer)
- Proceed with full deep tissue work as the muscle needs stimulation
Correct answer: Limit treatment to gentle techniques in the acute-subacute transition phase
A 2-week-old strain is in the subacute phase where gentle, supportive techniques are appropriate, but aggressive deep work remains contraindicated.
Question 6: Which question during a health intake is MOST useful for identifying systemic contraindications to massage?
- What is your preferred massage pressure?
- Do you have any diagnosed medical conditions or take any medications? (Correct answer)
- Have you received massage before?
- What areas of the body would you like focused on today?
Correct answer: Do you have any diagnosed medical conditions or take any medications?
Medical conditions and medications are the primary indicators of systemic contraindications that would require treatment modifications.
Question 7: A client mentions they have fibromyalgia and are experiencing a flare-up today. The BEST planning decision is to:
- Cancel the session as fibromyalgia is a complete contraindication
- Perform deep tissue massage to break the pain cycle
- Use lighter pressure, shorter session, and focus on relaxation techniques (Correct answer)
- Focus only on trigger point therapy on the most tender areas
Correct answer: Use lighter pressure, shorter session, and focus on relaxation techniques
During fibromyalgia flare-ups, clients are hypersensitive to pressure, so gentle, shorter sessions focused on relaxation are most appropriate.
NCBTMB Client Assessment and Planning 3
A client reports taking warfarin for a heart condition.
Which assessment consideration is most important before proceeding with massage?