NCBTMB Client Assessment and Planning 4 — Questions and Answers
Question 1: A client with Type 1 diabetes arrives for a massage and mentions their blood sugar is currently at 55 mg/dL. The therapist should:
- Proceed with the massage but avoid the feet
- Postpone the massage and advise the client to address their hypoglycemia first (Correct answer)
- Begin the massage with light strokes only
- Check the client's feet for sores and then proceed
Correct answer: Postpone the massage and advise the client to address their hypoglycemia first
A blood glucose of 55 mg/dL indicates hypoglycemia, which is a medical concern that must be addressed before any massage treatment.
Question 2: During gait analysis as part of a client assessment, you notice the client's left foot externally rotates excessively. This may indicate tightness in which muscle group?
- Hip flexors
- Hip external rotators such as the piriformis (Correct answer)
- Hamstrings
- Tibialis anterior
Correct answer: Hip external rotators such as the piriformis
Excessive external rotation of the foot during gait often reflects shortening or hypertonia of the hip external rotators, including the piriformis.
Question 3: A client discloses a history of sexual abuse during the intake. The most appropriate therapist response is:
- Proceed with the full session without making any changes
- Immediately refer the client to a psychotherapist and decline to treat them
- Acknowledge the disclosure, adjust draping and boundaries as needed, and let the client guide comfort levels (Correct answer)
- Document the disclosure and avoid all abdominal work
Correct answer: Acknowledge the disclosure, adjust draping and boundaries as needed, and let the client guide comfort levels
Trauma-informed care requires acknowledging the client's disclosure and empowering them with control over boundaries and comfort during the session.
Question 4: When re-assessing a client after 4 treatment sessions, the therapist finds no measurable improvement in the client's chief complaint. The BEST next step is:
- Continue the same treatment plan for 4 more sessions
- Increase session frequency to twice per week
- Revise the treatment plan and consider referring to another healthcare provider (Correct answer)
- Discharge the client as massage is not effective for them
Correct answer: Revise the treatment plan and consider referring to another healthcare provider
Lack of measurable progress after multiple sessions warrants a treatment plan revision and possible referral to ensure the client receives appropriate care.
Question 5: Which of the following findings during a range-of-motion assessment would suggest a joint capsule restriction rather than a muscular restriction?
- Restriction in only one plane of movement
- A hard end-feel with restriction in all planes of movement (Correct answer)
- Pain only at the extreme end range
- Restriction that resolves immediately with gentle stretching
Correct answer: A hard end-feel with restriction in all planes of movement
A hard, capsular end-feel with restriction in all planes is characteristic of joint capsule involvement, such as adhesive capsulitis.
Question 6: A client presents with a recent burn (3 days old) on their forearm from a cooking accident. The appropriate assessment and planning decision is:
- Apply massage around the area to improve circulation and healing
- Treat the burn area with gentle friction to prevent scarring
- Identify the burn as a local contraindication and avoid the affected area entirely (Correct answer)
- Apply a warming cream to help with pain management
Correct answer: Identify the burn as a local contraindication and avoid the affected area entirely
A recent burn is a local contraindication — the damaged tissue is vulnerable to further injury, infection, and must not be massaged.
Question 7: A client reports pain that worsens with rest and is not relieved by position changes. This pattern of pain is most likely to suggest:
- Muscle tension from overuse
- Joint dysfunction from poor posture
- A possible systemic or pathological condition requiring medical referral (Correct answer)
- Trigger point activity in a local muscle
Correct answer: A possible systemic or pathological condition requiring medical referral
Pain that is constant, worsens at rest, and is unaffected by position can be a red flag for systemic disease or pathology requiring physician evaluation.
NCBTMB Client Assessment and Planning 4
A client with Type 1 diabetes arrives for a massage and mentions their blood sugar is currently at 55 mg/dL.
The therapist should: