Massage & Bodywork Licensing Examination (MBLEx) — Questions and Answers

Question 1: A non-compete agreement signed by a massage employee MOST commonly restricts the employee from:

Continuing their education
Practicing massage within a defined geographic area and time period after leaving the employer (Correct answer)
Maintaining their professional license
Joining a professional association

Correct answer: Practicing massage within a defined geographic area and time period after leaving the employer

Non-compete agreements typically prevent former employees from competing within a specified area and timeframe, designed to protect the employer's client base.

Question 2: The long shaft of a bone is called ____________________.

Endosteum
Epiphysis
Periosteum
Diaphysis (Correct answer)

Correct answer: Diaphysis

Explanation: The epiphysis is the end of a long one. The endosteum is the thin layer of connective tissue that makes up the medullary cavity. The periosteum is a sheath of connective tissue enveloping the bone except at articulation.

Question 3: Which Swedish massage stroke is best used to address specific muscle adhesions and scar tissue?

Tapotement
Nerve strokes
Friction (Correct answer)
Effleurage

Correct answer: Friction

Friction is applied in circular or transverse movements to create heat and break down adhesions within soft tissue.

Question 4: Which of the following is the MOST important factor in determining whether to accept insurance reimbursement for massage services?

The age of the client
Whether the therapist's state license allows billing insurance and whether the therapist has appropriate billing credentials (Correct answer)
Client preference
The type of massage table owned

Correct answer: Whether the therapist's state license allows billing insurance and whether the therapist has appropriate billing credentials

Insurance billing depends on state law, the type of insurance, the therapist's credentials, and often requires documentation such as a physician's referral.

Question 5: When a bone turns on its own central axis making a circular movement, it is called ________________.

Angular
Rotation (Correct answer)
Circumduction
Gliding

Correct answer: Rotation

Explanation: Circumduction is a combination of abduction and adduction as well as flexion and extension, a conical movement usually originating at a ball and socket joint. Gliding is a planar joint (where two bones meet at a majorly flat articular surface) allowing bones to move along the joint's plane in any direction. Angular movements are defined by the fixed point from which they move, like a pendulum.

Question 6: Which massage stroke uses long, gliding movements applied with the palms and is typically used to begin and end a massage session?

Petrissage
Tapotement
Effleurage (Correct answer)
Friction

Correct answer: Effleurage

Effleurage consists of long, gliding strokes used to warm tissue, assess tone, and transition between techniques.

Question 7: Which of the following is the safest approach when performing massage on a pediatric client?

Focus exclusively on deep tissue work to address growth-related discomfort
Limit sessions to the back only
Use the same pressure as with adult clients
Obtain parental or guardian consent and use very light, gentle strokes (Correct answer)

Correct answer: Obtain parental or guardian consent and use very light, gentle strokes

Pediatric massage requires parental consent and lighter, age-appropriate pressure due to the developing musculoskeletal system of children.

Question 8: A massage therapist operating as an independent contractor is responsible for:

Receiving employee benefits such as paid vacation
Paying self-employment taxes and managing their own business expenses (Correct answer)
Having taxes withheld by the spa or employer
Following employee work schedules set by the business owner

Correct answer: Paying self-employment taxes and managing their own business expenses

Independent contractors are self-employed and are responsible for paying self-employment taxes, managing their own schedule, and covering business expenses.

Question 9: The AMTA Code of Ethics requires massage therapists to:

Provide services regardless of personal limitations
Share client information with other healthcare providers freely
Diagnose medical conditions when qualified
Maintain professional boundaries with all clients (Correct answer)

Correct answer: Maintain professional boundaries with all clients

The AMTA Code of Ethics mandates that therapists maintain professional boundaries to protect client welfare and the integrity of the therapeutic relationship.

Question 10: The hypodermis is directly below what layer of skin?

Stratum Germinatvium
Stratum Corneum
Dermis (Correct answer)
Epidermis

Correct answer: Dermis

Explanation: The order from superficial to deep goes stratum corneum (mostly dead, non-nucleated skin), epidermis, dermis, hypodermis, and stratum germinativum (the 5th layer and the basal layer).

Question 11: A client comes in with a sprain that occurred "3 or 4 days ago". How do you treat the area?

Massage the whole area gently placing a little more pressure at the injury site.
Massage distal to encourage refreshed circulation and healing.
Do not massage that limb of the body.
Massage proximal to encourage refreshed circulation and healing. (Correct answer)

Correct answer: Massage proximal to encourage refreshed circulation and healing.

Explanation: Massaging proximal to the sprain will encourage more efficient healing and any residual swelling to be handled by the lymphatic system. Answer option A is incorrect, as it is fine to massage the limb. Answer option D would likely irritate or re-inflame the injury and B may encourage swelling below and around the injury.

Question 12: AMTA's Standards of Practice require therapists to maintain continuing education primarily to:

Maintain competency and provide safe, effective care (Correct answer)
Qualify for insurance reimbursement
Increase earning potential
Avoid malpractice lawsuits

Correct answer: Maintain competency and provide safe, effective care

Continuing education is required to ensure therapists maintain and advance their knowledge and skills for the benefit of client safety and care quality.

Question 13: Which research design is generally considered HIGHEST in the hierarchy of evidence?

Case study
Randomized controlled trial (RCT) (Correct answer)
Expert opinion
Observational cohort study

Correct answer: Randomized controlled trial (RCT)

Randomized controlled trials minimize bias through random assignment and are considered the gold standard for evaluating treatment effectiveness.

Question 14: Where bones meet to form a joint:

Ligament
Articulation (Correct answer)
Enthesis
Bursa

Correct answer: Articulation

Explanation: Articulation is where two bones meet to form a joint. A ligament is a connective tissue that attaches bone to bone. Enthesis is connective tissue between a ligament and bone or between a bone and a tendon. The bursa is the fluid-filled sac found between bones at the joint to counter friction.

Question 15: Transference in the therapeutic setting refers to:

The client projecting feelings from past relationships onto the therapist (Correct answer)
The therapist's emotional response to the client
Transferring a client to another therapist
Referring a client to a specialist

Correct answer: The client projecting feelings from past relationships onto the therapist

Transference occurs when a client unconsciously redirects feelings from a past significant relationship onto the therapist.

Question 16: Myofascial Pain Syndrome is associated with which of the following?

Bone Spur
Pain arising in the region of the face
Muscle tenderness arising from a trigger point (Correct answer)
Reflux Disease

Correct answer: Muscle tenderness arising from a trigger point

Explanation: Muscle tenderness arising from trigger points is the correct answer. It can be caused by overuse, injury, or other stimulus which creates trigger points and referred pain. While pain can happen in facial muscles, MPS does not refer to the face in any way. Bone spurs can be painful as they are extra bony growths on the edges of bones. Reflux disease or GERD can present as a burning sensation in the chest usually after eating or while lying down or inverting.

Question 17: If a client is injured in your massage therapy office and makes a claim, which type of coverage would MOST likely respond?

General liability insurance (Correct answer)
Health insurance for the client
Workers' compensation
Professional liability (malpractice) insurance only

Correct answer: General liability insurance

General liability insurance covers bodily injury and property damage occurring on the business premises, such as a client slipping and falling.

Question 18: Client records and personal health information must be kept confidential under:

IRS tax codes
OSHA standards
HIPAA regulations (Correct answer)
ADA guidelines

Correct answer: HIPAA regulations

HIPAA (Health Insurance Portability and Accountability Act) governs the privacy and security of client health information.

Question 19: Which of the following BEST defines informed consent in massage therapy?

Signing a waiver releasing the therapist from liability
Verbal permission given at the first session only
A physician's referral authorizing massage treatment
The client's voluntary agreement after receiving relevant information about treatment (Correct answer)

Correct answer: The client's voluntary agreement after receiving relevant information about treatment

Informed consent requires that clients voluntarily agree to treatment after being fully informed of its nature, risks, and alternatives.

Question 20: A client reports pain that is described as 'burning and shooting down the leg.' This symptom pattern MOST suggests:

Bursitis
Nerve involvement or radiculopathy (Correct answer)
Ligament sprain
Local muscle strain

Correct answer: Nerve involvement or radiculopathy

Burning, shooting pain radiating along a limb is characteristic of nerve irritation or radiculopathy, suggesting caution before applying massage.

Question 21: The main purpose of draping is ______.

to keep the client's tissues warm, so they are easier to manipulate.
to help protect the therapist from seeing the full exposure of the client's body.
to help the client feel comfortable and safe with professional boundaries. (Correct answer)
to help bring a safe work environment for the therapist.

Correct answer: to help the client feel comfortable and safe with professional boundaries.

Explanation: < A massage therapist's drape serves the purpose of maintaining professional boundaries to help the client feel comfortable and safe. While draping may serve to keep the client warm, this is not its primary purpose. Draping's main purpose is not to help protect the therapist.

Question 22: A client discloses they are taking blood thinners (anticoagulants). Which massage modification is most appropriate?

Use lighter pressure to reduce bruising risk (Correct answer)
Use only deep tissue techniques
Avoid massage entirely
Focus exclusively on reflexology

Correct answer: Use lighter pressure to reduce bruising risk

Anticoagulants impair clotting, making clients prone to bruising and hematoma formation; lighter pressure reduces this risk while still providing therapeutic benefit.

Question 23: Scope of practice for massage therapists is PRIMARILY determined by:

The therapist's personal training and experience
Insurance company policies
State licensing laws and regulations (Correct answer)
Client demand and preferences

Correct answer: State licensing laws and regulations

State licensing boards define the legal scope of practice for massage therapists through statutes and regulations.

Question 24: When a client is unable to provide written consent (e.g., sedated), the therapist should:

Perform only light effleurage and document it
Obtain consent from a legal guardian or authorized representative (Correct answer)
Proceed if a session was previously scheduled
Cancel and reschedule when the client can consent

Correct answer: Obtain consent from a legal guardian or authorized representative

When a client cannot provide consent, it must be obtained from a legally authorized representative such as a healthcare proxy or guardian.

Question 25: Which cardiovascular condition requires physician clearance and modified massage with no stimulating techniques?

Recent myocardial infarction (within 4 weeks) (Correct answer)
Well-controlled hypertension
Mild orthostatic hypotension
Resolved thrombophlebitis from 2 years ago

Correct answer: Recent myocardial infarction (within 4 weeks)

A recent heart attack means the myocardium is healing and cannot tolerate the increased circulatory demands associated with stimulating massage techniques.

Question 26: What is the meaning of the Greek root "derm"?

Skin (Correct answer)
Ligament
Muscle
Bone

Correct answer: Skin

Explanation: Ligament translates from Latin, “to bind, tie.” Bone comes from old English, bon. Muscle is a Middle French/Latin derivative translating to “muscle, sinew”/“little mouse”.

Question 27: Smooth muscle is also known as ___________________.

Striated muscle
Visceral muscle (Correct answer)
Cardiac muscle
Skeletal muscle

Correct answer: Visceral muscle

Explanation: Visceral muscle is smooth muscle associated with the organs, especially those in the abdominal cavity. Skeletal muscle is a form of striated muscle. Cardiac muscle is only found in the heart and is its own classification. Striated muscle is composed of sarcomeres which form contractile fibrils and then run parallel to one another in small groupings creating muscle marked in dark and light bands. It includes skeletal, cardiac muscle, and most of our other muscles.

Question 28: Which of the following is OUTSIDE the typical scope of practice for a licensed massage therapist in the US?

Assessing postural imbalances
Diagnosing a medical condition (Correct answer)
Applying hot and cold therapies
Performing soft tissue work

Correct answer: Diagnosing a medical condition

Diagnosis of medical conditions is reserved for licensed medical professionals and falls outside the scope of practice for massage therapists.

Question 29: Hot packs used in hydrotherapy treatments should ALWAYS be wrapped in which way before application?

Wrapped in multiple layers of toweling to prevent burns (Correct answer)
Placed under the client rather than on top
Applied directly to skin for maximum heat transfer
Covered with plastic wrap to retain moisture

Correct answer: Wrapped in multiple layers of toweling to prevent burns

Hot packs must be wrapped in several layers of toweling to dissipate heat and prevent thermal burns to the skin.

Question 30: When working with a client who has fibromyalgia, the most appropriate adjustment is:

Apply deep tissue work to release trigger points aggressively
Use very light pressure and shorter sessions, monitoring client feedback carefully (Correct answer)
Avoid massage entirely as it worsens symptoms
Focus only on the areas of greatest pain with sustained pressure

Correct answer: Use very light pressure and shorter sessions, monitoring client feedback carefully

Fibromyalgia clients are hypersensitive to pressure; lighter techniques and shorter sessions reduce the risk of post-massage flare-ups.

Question 31: Which skin condition requires the massage therapist to use universal precautions and potentially avoid contact?

Milia
Psoriasis
Herpes zoster (active shingles) (Correct answer)
Dry skin

Correct answer: Herpes zoster (active shingles)

Active shingles involves contagious viral lesions; direct contact can spread the virus to the therapist or other body areas of the client.

Question 32: Manual lymphatic drainage (MLD) uses which type of pressure to move lymph fluid?

Percussive tapotement
Cross-fiber friction
Light, rhythmic, pumping strokes (Correct answer)
Deep firm pressure

Correct answer: Light, rhythmic, pumping strokes

MLD employs very light, rhythmic, wave-like strokes that mimic the natural pumping action of the lymphatic vessels.

Question 33: Skeletal muscles normally work __________________.

in groups (Correct answer)
isometrically
one at a time
automatically

Correct answer: in groups

Explanation: Muscles have to work in at least pairs as antagonists because they pull bones without pushing them. So, one muscle works to flex and the other to extend. Isometrically is one version of how we can use our muscles. This just means that we can use more or less pressure but the distance will stay the same. An example is pushing on a locked door. While we have some muscles that move automatically, like our heart that moves without intention, our skeletal muscles are not among them generally.

Question 34: Which of the following is considered an absolute contraindication for massage therapy?

Active deep vein thrombosis (DVT) (Correct answer)
Mild muscle tension
Delayed onset muscle soreness
Healed surgical scar

Correct answer: Active deep vein thrombosis (DVT)

Active DVT is an absolute contraindication because massage can dislodge the clot and cause a life-threatening pulmonary embolism.

Question 35: A therapeutic relationship is BEST characterized by which of the following?

Power balanced equally between client and therapist
Shared personal information between therapist and client
The therapist holding a position of trust and authority to serve the client's wellbeing (Correct answer)
Mutual friendship and social interaction

Correct answer: The therapist holding a position of trust and authority to serve the client's wellbeing

The therapeutic relationship is characterized by a power differential where the therapist holds trust and authority specifically in service of the client's wellbeing.

Question 36: For a client recovering from a recent ankle sprain (acute stage), what is the MOST appropriate action?

Perform aggressive joint mobilization
Refer out and avoid the area until the acute phase resolves (Correct answer)
Apply deep cross-fiber friction to the ligament
Apply hot packs and deep compression

Correct answer: Refer out and avoid the area until the acute phase resolves

In the acute inflammatory phase, massage to the injured area should be avoided; the therapist may work proximal to the injury and should refer if needed.

Question 37: Petrissage techniques include which of the following?

Effleurage and gliding
Kneading and wringing (Correct answer)
Vibration and rocking
Tapping and hacking

Correct answer: Kneading and wringing

Petrissage encompasses kneading, wringing, rolling, and picking-up movements that lift and compress soft tissue.

Question 38: Which principle guides therapists to act in the BEST interest of the client, even at personal cost?

Autonomy
Non-maleficence
Beneficence (Correct answer)
Justice

Correct answer: Beneficence

Beneficence is the ethical principle of acting in the best interest of the client and actively doing good.

Question 39: Which hydrotherapy application uses steam to open pores and soften tissue?

Wet sheet pack
Ice massage
Steam cabinet or sauna (Correct answer)
Cold mitten friction

Correct answer: Steam cabinet or sauna

Steam cabinets and saunas use moist or dry heat to raise skin temperature, open pores, promote sweating, and soften superficial tissue.

Question 40: Which condition requires physician clearance before massage may be performed?

Mild muscle soreness after exercise
Mild insomnia
Seasonal allergies
Recent heart surgery or cardiac event (Correct answer)

Correct answer: Recent heart surgery or cardiac event

A recent cardiac event or surgery requires physician clearance to ensure massage is safe and appropriate for the client's cardiovascular status.

Question 41: A client reports having lymphedema in the right arm. Which technique is most appropriate for this area?

Manual lymphatic drainage (MLD) (Correct answer)
Deep transverse friction
Myofascial release with heavy pressure
Tapotement to stimulate flow

Correct answer: Manual lymphatic drainage (MLD)

Manual lymphatic drainage uses light, rhythmic strokes to redirect lymph fluid and is the primary technique used for lymphedema management.

Question 42: The MBLEx (Massage and Bodywork Licensing Examination) is administered by which organization?

AMTA
NCBTMB
FSMTB (Correct answer)
ABMP

Correct answer: FSMTB

The MBLEx is administered by the Federation of State Massage Therapy Boards (FSMTB) and is the most widely accepted licensing exam in the US.

Question 43: In evidence-based massage practice, clinical expertise PRIMARILY contributes:

The ability to ignore research findings in favor of personal preference
The authority to make medical diagnoses
The skill to apply research findings appropriately to individual clients (Correct answer)
The justification for charging higher fees

Correct answer: The skill to apply research findings appropriately to individual clients

Clinical expertise allows practitioners to translate research findings into appropriate, individualized treatment decisions within the therapeutic context.

Question 44: A massage therapist reminds a client of a former high school teacher who was stern with his students, thus making it difficult for the client to relax. What is occurring in this situation?

Transference (Correct answer)
Transfeeling
Countertransference
Dual Relationship

Correct answer: Transference

Explanation: This is a situation of transference, where a client displaces feelings he or she has from someone from their past onto the therapist. A dual relationship describes a scenario where the massage therapist and that client have a relationship outside the context of the therapeutic relationship which may mar or confuse the professional boundaries. Countertransference is the opposite of transference, where the massage therapist transfers feelings from their past to the client.

Question 45: Which massage modality specifically incorporates assisted stretching and joint mobilization along energy lines?

Thai massage (Correct answer)
Swedish massage
Polarity therapy
Lomi Lomi

Correct answer: Thai massage

Traditional Thai massage combines acupressure, passive yoga-like stretching, and joint mobilization along Sen energy lines.

Question 46: Which of the following BEST describes the 'Plan' section of a SOAP note?

What you observed and measured during treatment
Treatment goals, frequency of sessions, and proposed future techniques (Correct answer)
Your clinical interpretation of findings
What the client told you before the session

Correct answer: Treatment goals, frequency of sessions, and proposed future techniques

The Plan section outlines treatment goals, session frequency, home-care recommendations, and adjustments for future sessions.

Question 47: A client arrives with a fever of 102°F. What is the appropriate action for the massage therapist?

Reschedule the appointment until the fever resolves (Correct answer)
Proceed with a lighter-pressure session
Apply cold compresses and continue
Perform only lymphatic drainage

Correct answer: Reschedule the appointment until the fever resolves

Fever indicates systemic infection, and massage can spread pathogens and further stress an already-taxed immune and cardiovascular system.

Question 48: Which of the following BEST describes a 'control group' in a massage therapy study?

The therapist supervising the trial
Participants who have the highest baseline pain scores
A group that does not receive the experimental treatment, used for comparison (Correct answer)
The group that receives the most intensive massage treatment

Correct answer: A group that does not receive the experimental treatment, used for comparison

A control group receives no treatment or a placebo, providing a baseline for comparing outcomes against the experimental group.

Question 49: During a spa body treatment, what is the PRIMARY reason for keeping the client properly draped?

To apply products more efficiently
To keep the treatment table clean
To prevent the treatment products from staining linens
To maintain modesty, warmth, and professional boundaries (Correct answer)

Correct answer: To maintain modesty, warmth, and professional boundaries

Proper draping during spa treatments protects client modesty, maintains appropriate professional boundaries, and regulates body temperature.

Question 50: While assessing a client, a massage therapist asks that they move their arm against a light-applied resistance. What is this called?

Active Assisted Range of Motion
Manual Resistance Range of Motion (Correct answer)
Active Range of Motion
Passive Range of Motion

Correct answer: Manual Resistance Range of Motion

Explanation: < In a manual resistance ROM assessment, a massage therapist applies light resistance to a client's movement. Passive ROM describes when the therapist moves the client's arm for them. In active ROM, the client moves her arm with no assistance from the therapist. Finally, during, active assisted ROM, the therapist helps the client move their arm through their full ROM.

Question 51: Evidence-based practice (EBP) in massage therapy integrates which THREE components?

Client age, insurance coverage, and session length
Anatomy knowledge, technique variety, and marketing skills
Therapist experience, advertising claims, and peer recommendations
Best available research, clinical expertise, and client values/preferences (Correct answer)

Correct answer: Best available research, clinical expertise, and client values/preferences

EBP combines the best available research evidence with clinical expertise and respect for individual client values and preferences.

Question 52: Which of the following BEST describes malpractice as it applies to massage therapy?

Professional negligence that results in harm to a client (Correct answer)
Failing to maintain continuing education hours
Advertising services not offered
Practicing without a current business license

Correct answer: Professional negligence that results in harm to a client

Malpractice is professional negligence—failure to provide the standard of care expected of a competent practitioner, resulting in client harm.

Question 53: The Touch Research Institute (TRI), a pioneer in massage therapy research, was founded at which university?

Johns Hopkins University
Harvard Medical School
Stanford University
University of Miami School of Medicine (Correct answer)

Correct answer: University of Miami School of Medicine

The Touch Research Institute was founded by Dr. Tiffany Field at the University of Miami School of Medicine and has conducted extensive research on massage therapy benefits.

Question 54: If a client discloses abuse during a session, most state laws require the therapist to:

Report it as a mandated reporter (Correct answer)
Discontinue the session immediately without discussion
Refer the client to a psychologist only
Keep the information confidential and document it

Correct answer: Report it as a mandated reporter

Most states designate massage therapists as mandated reporters, legally requiring them to report suspected abuse of children or vulnerable adults.

Question 55: Which of the following is an example of appropriate self-disclosure by a massage therapist?

Sharing information about another client's similar condition
Sharing details about a recent personal crisis with a client
Briefly mentioning a relevant professional experience to support the client (Correct answer)
Discussing political opinions during a session

Correct answer: Briefly mentioning a relevant professional experience to support the client

Appropriate self-disclosure is brief, purposeful, and serves the client's needs rather than the therapist's need to share.

Question 56: Which behavior by a massage therapist would be considered MOST unethical?

Requiring intake forms for new clients
Performing massage without informed consent (Correct answer)
Charging a cancellation fee
Declining to work with certain conditions outside scope of practice

Correct answer: Performing massage without informed consent

Performing massage without informed consent violates a client's autonomy and is a fundamental ethical and legal violation.

Question 57: All muscles come in pairs, the agonist and the ________________.

Sacromere
Abductor
Bipennate
Antagonist (Correct answer)

Correct answer: Antagonist

Explanation: The antagonist works to counter the torque of the agonist, often used in slowing down a motion. Occurring in pairs, the agonist and the antagonist often balance each other, one contracts and the other relaxes.

Question 58: What does the term 'standard of care' mean in massage therapy?

The type of table and linen standards required by law
The minimum number of sessions required per treatment plan
The average price charged for a one-hour massage
The level of care expected of a reasonably competent massage therapist in similar circumstances (Correct answer)

Correct answer: The level of care expected of a reasonably competent massage therapist in similar circumstances

Standard of care describes the accepted level of competence and conduct expected from a reasonably skilled practitioner in the same field and circumstances.

Question 59: Skeletal muscle is attached to bone by __________________.

Ligaments
Epidermis
Joints
Tendons (Correct answer)

Correct answer: Tendons

Explanation: A tendon connects a muscle to a bone. It is typically a flexible but inelastic cord of strong collagen fiber tissue. Ligaments connect bone to bone. Epidermis refers to the skin. Joints are the articulating parts of our body like the elbows and the knees.

Question 60: Advertising massage services using misleading claims or implying medical outcomes violates which principle?

Veracity (truthfulness) (Correct answer)
Fidelity
Autonomy
Beneficence

Correct answer: Veracity (truthfulness)

Veracity, or truthfulness, requires that therapists represent their services honestly and avoid misleading claims about outcomes.

Question 61: When massaging a client with type 2 diabetes, which special consideration is most important?

Limiting sessions to 30 minutes maximum
Avoiding all massage below the waist
Monitoring skin integrity carefully, especially on the feet (Correct answer)
Using deep pressure on the lower extremities to improve circulation

Correct answer: Monitoring skin integrity carefully, especially on the feet

Diabetes can cause peripheral neuropathy and poor circulation, reducing the client's ability to detect skin damage, so careful skin inspection is essential.

Question 62: Which of the following BEST illustrates applying evidence-based practice in clinical decision-making?

Avoiding any technique not featured in a popular trade magazine
Using a technique because it was taught first in school
Selecting an approach based on current research, clinical experience, and client goals (Correct answer)
Copying a colleague's treatment protocol without review

Correct answer: Selecting an approach based on current research, clinical experience, and client goals

Evidence-based practice requires integrating current research evidence with the practitioner's expertise and the individual client's goals and values.

Question 63: Aromatherapy in massage uses essential oils that are MOST commonly derived from:

Synthetic chemical compounds
Animal-based lipids
Petroleum-based carriers
Plants, flowers, roots, and resins (Correct answer)

Correct answer: Plants, flowers, roots, and resins

Essential oils are highly concentrated volatile compounds extracted from plant materials including flowers, leaves, bark, roots, and resins.

Question 64: When working with an oncology (cancer) client, which approach is most appropriate?

Focus only on reflexology to avoid tumor sites
Use standard deep tissue protocols
Apply modified, gentle techniques tailored to the client's current treatment phase (Correct answer)
Avoid all massage due to metastasis risk

Correct answer: Apply modified, gentle techniques tailored to the client's current treatment phase

Oncology massage uses modified, gentle techniques adapted to the client's condition, treatment side effects, and any medically fragile areas.

Question 65: Tapotement techniques are CONTRAINDICATED over which of the following areas?

The kidney area (Correct answer)
The gastrocnemius
The upper trapezius
The posterior thigh

Correct answer: The kidney area

Tapotement over the kidney area can cause direct trauma to the organs due to their superficial posterior location.

Question 66: Which hydrotherapy technique involves rubbing the body briskly with a coarse, dry mitt to stimulate circulation?

Dry brush exfoliation (Correct answer)
Cold mitten friction
Salt glow
Wet sheet pack

Correct answer: Dry brush exfoliation

Dry brush exfoliation uses a firm-bristled brush on dry skin before bathing to slough dead cells and stimulate lymphatic and circulatory flow.

Question 67: When planning treatment for a pregnant client in the second trimester, which position is MOST recommended?

Seated upright only
Supine with legs elevated
Side-lying with appropriate bolstering (Correct answer)
Prone with a flat table

Correct answer: Side-lying with appropriate bolstering

Side-lying position with adequate bolstering is safest for pregnant clients as it avoids uterine compression and aortic pressure associated with prone or supine positions.

Question 68: Which term describes the process by which massage therapists continuously evaluate and update their practice based on current evidence?

Continuing education credit accumulation
Reflective evidence-based practice (Correct answer)
Systematic case documentation
Scope of practice expansion

Correct answer: Reflective evidence-based practice

Reflective evidence-based practice is the ongoing process of critically examining one's own clinical decisions in light of current research and client outcomes.

Question 69: Which assessment technique involves applying pressure perpendicular to muscle fibers to identify taut bands?

Cross-fiber palpation (Correct answer)
Passive stretch assessment
Effleurage assessment
Percussion

Correct answer: Cross-fiber palpation

Cross-fiber palpation moves fingers perpendicular to muscle fibers to identify taut bands, nodules, and texture changes associated with dysfunction.

Question 70: Sports massage applied before an athletic event is intended to:

Reduce scar tissue from prior injuries
Assess range of motion deficits
Prepare muscles for activity and increase circulation (Correct answer)
Promote deep relaxation and recovery

Correct answer: Prepare muscles for activity and increase circulation

Pre-event sports massage uses brisk, stimulating techniques to warm tissue, enhance circulation, and prepare the athlete for performance.

Question 71: Which of the following is a legal requirement for most massage therapy businesses regarding employee records?

Sharing employee performance reviews with clients
Publishing employee schedules online
Maintaining accurate payroll and tax withholding records (Correct answer)
Posting employee home addresses

Correct answer: Maintaining accurate payroll and tax withholding records

Employers are legally required to maintain accurate payroll records and properly withhold and report employee taxes under federal and state law.

Question 72: Which of the following skin conditions is NOT a contraindication for massage?

Cellulitis with redness and warmth
Ringworm (tinea corporis)
Well-managed, non-inflamed psoriasis (Correct answer)
Active impetigo (bacterial infection)

Correct answer: Well-managed, non-inflamed psoriasis

Well-managed, non-inflamed psoriasis is not contagious and non-acute, so massage over stable plaques is generally acceptable with client permission.

Question 73: What plane divides the body into front and back regions?

Midsagittal (median) plane
Lateral (Sagittal) plane
Frontal (coronal) plane (Correct answer)
Tranverse (horizontal) plane

Correct answer: Frontal (coronal) plane

Explanation: Transverse refers to the plane dividing the upper trunk from the lower body horizontally. Lateral plane or sagittal plane divides the body into left and right sides vertically. The midsagittal plane is just like the lateral or sagittal, only it specifies the direct center of the body as the division line.

Question 74: Massage is generally contraindicated during which trimester of pregnancy according to many practitioners, due to increased miscarriage risk?

Second trimester
All trimesters equally
Third trimester
First trimester (Correct answer)

Correct answer: First trimester

Many practitioners exercise caution in the first trimester due to the elevated natural risk of miscarriage and organ formation during this period, often requiring physician clearance.

Question 75: The primary physiological effect of applying heat to soft tissue is:

Decreased metabolic rate
Reduced nerve conduction velocity
Vasoconstriction and decreased circulation
Vasodilation and increased tissue extensibility (Correct answer)

Correct answer: Vasodilation and increased tissue extensibility

Heat causes vasodilation, increases blood flow, and makes soft tissue more pliable, facilitating stretching and reducing muscle tension.

Question 76: Range of motion (ROM) testing performed by moving the client's joint without their muscular assistance is called:

Active ROM
Passive ROM (Correct answer)
Functional ROM
Resisted ROM

Correct answer: Passive ROM

Passive ROM is performed by the therapist moving the joint through its range while the client remains relaxed, assessing joint and tissue mobility.

Question 77: Which action BEST demonstrates professional boundaries with a client who expresses romantic interest?

Discussing personal feelings openly to build rapport
Ignoring the comment and continuing the session
Transferring the client to another therapist without explanation
Clearly stating the professional nature of the relationship and, if needed, ending the session (Correct answer)

Correct answer: Clearly stating the professional nature of the relationship and, if needed, ending the session

Clearly communicating the professional nature of the relationship—and ending the session if boundaries are not respected—protects both parties.

Question 78: When a massage therapist hires employees, which federal form must new employees complete for income tax withholding purposes?

Form I-9
Form SS-4
Form 1099-NEC
Form W-4 (Correct answer)

Correct answer: Form W-4

Form W-4 (Employee's Withholding Certificate) is completed by new employees to tell the employer how much federal income tax to withhold from paychecks.

Question 79: If a massage therapist writes, "hyperkyphosis of the thoracic spine" in his SOAP notes, what is he referring to?

An exaggerated curve in the lower spine
A flat back
Scoliosis
An exaggerated curve of the upper back (Correct answer)

Correct answer: An exaggerated curve of the upper back

Explanation: < Hyperkyphosis is present when the thoracic spine has an excessive forward curve. A person with hyperkyphosis will have rounded shoulders with the head and neck forward of the trunk. Answer option A describes lordosis. A flat back means the back has little to no natural curve of the spine and scoliosis creates more of a lateral 'S' shape of the spine.

Question 80: The primary purpose of maintaining accurate session notes and business records is:

To qualify for AMTA membership discounts
To meet legal, ethical, and insurance requirements and protect both client and therapist (Correct answer)
To advertise the practice on social media
To impress clients with professionalism

Correct answer: To meet legal, ethical, and insurance requirements and protect both client and therapist

Accurate records protect the therapist legally, fulfill ethical obligations, support insurance billing, and ensure continuity of client care.

Question 81: Which of the following are voluntary muscles ________________.

Visceral muscle
Spindle muscle
Skeletal muscle (Correct answer)
Cardiac muscle

Correct answer: Skeletal muscle

Explanation: Skeletal muscle is the correct answer, as voluntary refers to muscles that are generally under the control of the individual's will. The cardiac muscle is what makes up the heart and is an involuntary muscle. Visceral describes the muscle type making up the intestines and most of the organs. Spindle fibers are actually proprioceptors in the bellies of the muscles.

Question 82: Countertransference refers to:

Dual diagnosis documentation procedures
The ethical process of transferring care to another provider
The therapist's own emotional reactions to the client (Correct answer)
A client's refusal to follow treatment recommendations

Correct answer: The therapist's own emotional reactions to the client

Countertransference is the therapist's emotional response to a client, which may be influenced by the therapist's own unresolved issues.

Question 83: When reassessing a client's progress, which type of documentation compares current findings to the baseline intake findings?

Progress SOAP notes (Correct answer)
Insurance claim form
Initial intake form
Release of liability form

Correct answer: Progress SOAP notes

Progress SOAP notes document ongoing findings and compare them to baseline to track treatment effectiveness over time.

Question 84: When standing still in front of a closed door and pushing on it without it moving, the muscle action/tension is called:

Isotonic
Concentric
Eccentric
Isometric (Correct answer)

Correct answer: Isometric

Explanation: In isometric exercise and contraction, the muscle length does not change, but the tension does. In an isotonic exercise, the muscle length changes, but the tension does not. A concentric contraction is the shortening of the muscle fiber, whereas an eccentric contraction is the lengthening of a muscle fiber.

Question 85: Myofascial release is primarily designed to address restrictions in which tissue?

Bone
Synovial membrane
Cartilage
Fascia (Correct answer)

Correct answer: Fascia

Myofascial release targets the fascia—the continuous connective tissue network—to restore mobility and reduce pain.

Question 86: Which position is most recommended when massaging a client in the second or third trimester of pregnancy?

Prone (face down) with a pregnancy bolster
Seated upright throughout the session
Supine (face up) with legs elevated
Side-lying (lateral recumbent) (Correct answer)

Correct answer: Side-lying (lateral recumbent)

Side-lying is the safest position in later pregnancy as it avoids compression of the vena cava and accommodates the growing abdomen.

Question 87: The plexus is responsible for nervous innervation to the upper extremities and certain neck and shoulder muscles.

Sacral
Brachial (Correct answer)
Cervical
Lumbar

Correct answer: Brachial

Explanation: Lumbar is incorrect because the lumbar plexus innervates the legs, genitals, and parts of the abdomen. Sacral is incorrect because the sacral plexus innervates the glutes, perineum, and parts of the legs. Cervical is incorrect because the cervical plexus innervates the skin and muscles of the head and neck, cranial nerves, and diaphragm.

Question 88: A client has been diagnosed with cataplexy. What condition do they have?

Temporary muscle weakness (Correct answer)
Momentary fits of rage
Brittle bones
Sleepwalking

Correct answer: Temporary muscle weakness

Explanation: Temporary muscle weakness is the correct answer. It is usually a weakness triggered by the sudden expression of emotion like laughter. Brittle bones may be just that, osteogenesis imperfecta, or could refer to osteoporosis or osteopenia. Momentary fits of rage may be due to depression, intermittent explosive disorder, or just uncontrolled anger. Sleepwalking can be called somnambulism and describes activity or walking during sleep.

Question 89: A client undergoing active radiation therapy for cancer mentions their skin is red and tender in the treated area. What should the therapist do?

Avoid the radiation field entirely and work around it (Correct answer)
Proceed normally as radiation skin changes are cosmetic only
Apply oil liberally to hydrate the damaged skin during massage
Massage the area with light effleurage to soothe it

Correct answer: Avoid the radiation field entirely and work around it

Irradiated skin is fragile, sensitive, and prone to breakdown; direct massage in the treatment field can cause further skin damage or irritation.

Question 90: Which of the following outcomes is MOST supported by existing massage therapy research?

Short-term reduction of anxiety and perceived stress (Correct answer)
Permanent elimination of chronic disease
Prevention of cancer recurrence
Cure of structural spinal conditions

Correct answer: Short-term reduction of anxiety and perceived stress

Multiple studies support massage therapy's effectiveness in producing short-term reductions in anxiety, perceived stress, and related psychological symptoms.

Question 91: Which of the following is required in MOST US states before practicing massage therapy legally?

Membership in the AMTA
A state-issued massage therapy license (Correct answer)
A college degree in biology
Certification from a national board only

Correct answer: A state-issued massage therapy license

Most US states require massage therapists to hold a state-issued license, which typically involves completing an approved program and passing a licensing exam.

Question 92: All of the following are bone density and connective tissue disorders that require a doctor's approval to proceed with massage, except this disorder for which clearance cannot be given while the disorder is still present:

Osteoporosis
Osteogenesis Imperfecta
Osteopenia
Osteomyelitis (Correct answer)

Correct answer: Osteomyelitis

Explanation: < Osteomyelitis is an infection of the bone tissues and marrow caused by staph or strep resulting from a compromised bone from injury or surgery. Massage is contraindicated and a doctor's clearance cannot be given for massage while the infection is still present. For the other answer options, a doctor's clearance for massage is required. However, deep or high-pressure massage would be contraindicated even with a doctor's clearance. Osteogenesis Imperfecta is a defective development of connective tissue where the bones become fragile. Osteopenia is lowered bone density and is often the precursor to Osteoporosis, which is a loss of bone tissue causing fragile or porous bones.

Question 93: Which population requires EXTRA CAUTION or clearance before participating in hot tub or thermal spa treatments?

Pregnant women, especially in the first trimester (Correct answer)
Healthy adults aged 30–50
Trained athletes in recovery
Adults with mild seasonal allergies

Correct answer: Pregnant women, especially in the first trimester

Elevated core body temperature from hot tub use during early pregnancy is associated with increased risk of neural tube defects in the fetus.

Question 94: In research, 'statistically significant' findings mean:

The study was funded by a major institution
The results are clinically important and large in magnitude
The results are unlikely to have occurred by chance alone (Correct answer)
The sample size was very large

Correct answer: The results are unlikely to have occurred by chance alone

Statistical significance indicates that the observed results are unlikely to be due to chance, though this does not necessarily mean the effect is clinically meaningful.

Question 95: OSHA's Bloodborne Pathogen Standard requires massage therapists to:

Use standard precautions and have an exposure control plan when blood or body fluid exposure is possible (Correct answer)
Refuse service to clients with communicable diseases
Perform blood tests on all new clients
Wear surgical gloves during every session

Correct answer: Use standard precautions and have an exposure control plan when blood or body fluid exposure is possible

OSHA requires employers to implement standard precautions and maintain an exposure control plan to protect workers from bloodborne pathogens.

Question 96: Which document legally establishes the terms under which a client receives massage services, including consent and policies?

A client service agreement or informed consent form (Correct answer)
A state massage board complaint form
A business license
A professional liability policy

Correct answer: A client service agreement or informed consent form

A client service agreement or informed consent document outlines the terms of care, consent to treatment, and applicable policies, creating a legal record of agreement.

Question 97: Which spa treatment involves applying seaweed or mineral-rich mud to the body and then wrapping the client?

Thalassotherapy or seaweed/mud wrap (Correct answer)
Dry heat sauna
Lymphatic drainage
Aromatherapy massage

Correct answer: Thalassotherapy or seaweed/mud wrap

Thalassotherapy uses seaweed, mud, or mineral-rich water from the sea to nourish the skin and promote detoxification through occlusive wrapping.

Question 98: The movement of the sole towards the median plane:

Rotation
Inversion (Correct answer)
Abduction
Angular Movement

Correct answer: Inversion

Explanation: Inversion is the correct answer, as the sole would have to reverse its normal position to move toward the midline. Angular movement is any movement that changes the angle of the bones at the joint. Rotation is a pivotal movement, revolving around a single axis. Abduction is a movement away from the midline.

Question 99: A massage therapy business is required to post which of the following in client areas under most state regulations?

The therapist's license and client rights information (Correct answer)
A menu of all available services with pricing
Social media handles and reviews
Testimonials from previous clients

Correct answer: The therapist's license and client rights information

Most states require licensed massage therapists to display their license certificate where clients can easily view it, along with relevant client rights information.

Question 100: A cancellation policy should PRIMARILY be included in which document shared with clients?

Client intake and service agreement (Correct answer)
Employee handbook
Insurance claim form
Annual business tax return

Correct answer: Client intake and service agreement

The client intake and service agreement is the appropriate place to outline cancellation policies so clients understand and agree to them before treatment.

Massage & Bodywork Licensing Examination (MBLEx)

The MBLEx is the national entry-level licensing exam for massage therapists administered by the Federation of State Massage Therapy Boards (FSMTB) and endorsed by AMTA. It tests competency across seven content domains including anatomy, pathology, client assessment, ethics, and massage techniques.

100

Questions

120 min

Time Limit

70%

To Pass

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