Free NCBTMB Client Assessment and Planning Questions and Answers — Questions and Answers
Question 1: A new client's intake form lists 'uncontrolled hypertension' as a condition. What is the most appropriate course of action for the massage therapist?
- Proceed with the massage but use only light, soothing strokes.
- Require written medical clearance from their physician before proceeding with massage. (Correct answer)
- Perform the massage but avoid the neck and shoulder areas to prevent blood pressure elevation.
- Reschedule the appointment for a time when the client's blood pressure is lower.
Correct answer: Require written medical clearance from their physician before proceeding with massage.
Uncontrolled hypertension is a systemic contraindication for massage because massage can increase circulation and potentially put extra strain on a compromised cardiovascular system. The safest and most professional action is to postpone the massage until the client can provide written clearance from their physician, ensuring the treatment is safe and appropriate for their specific condition.
Question 2: During a gait assessment, a therapist observes that the client's left foot excessively slaps the ground during the swing phase of walking. This observation, known as 'drop foot,' could indicate weakness in which muscle group?
- Plantar flexors (gastrocnemius, soleus)
- Hip flexors (iliopsoas, rectus femoris)
- Knee extensors (quadriceps femoris)
- Dorsiflexors (tibialis anterior, peroneus tertius) (Correct answer)
Correct answer: Dorsiflexors (tibialis anterior, peroneus tertius)
Drop foot is characterized by the inability to lift the front part of the foot off the ground due to weakness or paralysis of the dorsiflexor muscles. These muscles, including the tibialis anterior, are responsible for dorsiflexion, the action of lifting the foot towards the shin, which is necessary to clear the ground during the swing phase of gait.
Question 3: In a SOAP note, where would a massage therapist document their visual observations of a client's posture and any palpable muscle tension?
- Subjective
- Assessment
- Objective (Correct answer)
- Plan
Correct answer: Objective
The Objective section of a SOAP note is for recording the therapist's own measurable and observable findings. This includes visual assessments like posture, as well as information gathered through palpation, such as muscle tone, texture, and areas of tenderness.
Question 4: A client complains of pain in the front of their shoulder. To help differentiate between biceps tendonitis and other shoulder issues, the therapist asks the client to hold their arm straight out, supinated, and resist downward pressure applied by the therapist. This is known as which special test?
- Neer's Test
- Hawkins-Kennedy Test
- Speed's Test (Correct answer)
- Drop Arm Test
Correct answer: Speed's Test
Speed's Test is used to assess for biceps brachii strain or tendinitis. A positive test, indicated by pain or weakness in the anterior shoulder (bicipital groove) during resisted shoulder flexion, suggests inflammation or injury to the long head of the biceps tendon.
Question 5: When assessing a client's range of motion, the therapist moves the client's limb through a specific movement pattern without any assistance from the client. What type of range of motion is being tested?
- Active
- Passive (Correct answer)
- Resisted
- Active-Assisted
Correct answer: Passive
Passive Range of Motion (PROM) testing is when the therapist moves the client's joint through its range without the client's muscular involvement. This type of assessment helps to evaluate the inert structures of the joint, such as the ligaments, joint capsule, and cartilage, and to determine the quality of the 'end-feel'.
Question 6: The primary goal of the initial client assessment and consultation is to:
- Provide a definitive medical diagnosis for the client's condition.
- Select the most advanced massage techniques to impress the client.
- Gather information to develop a safe and effective treatment plan. (Correct answer)
- Determine the client's financial ability to pay for multiple sessions.
Correct answer: Gather information to develop a safe and effective treatment plan.
The fundamental purpose of a client assessment is to gather all necessary information—including health history, client goals, and physical observations—to create a treatment plan that is both safe for any conditions the client may have and effective in addressing their stated goals. It is not within the massage therapist's scope of practice to diagnose medical conditions.
