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

Question 1: In a SOAP note, where would you document the client's report of 'tension headaches three times per week'?

S — Subjective (Correct answer)
P — Plan
O — Objective
A — Assessment

Correct answer: S — Subjective

The Subjective section records what the client reports about their symptoms, history, and experience—information that cannot be directly measured.

Question 2: Which of the following BEST describes a 'control group' in a massage therapy study?

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

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

ABMP
FSMTB (Correct answer)
AMTA
NCBTMB

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 4: 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
Clearly stating the professional nature of the relationship and, if needed, ending the session (Correct answer)
Transferring the client to another therapist without explanation

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

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

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 6: Which direction should effleurage strokes be applied to promote venous and lymphatic return?

Laterally, across the midline
Distally, away from the heart
Superiorly, toward the head only
Proximally, toward the heart (Correct answer)

Correct answer: Proximally, toward the heart

Effleurage applied toward the heart (proximal direction) follows the direction of venous and lymphatic flow, enhancing circulation.

Question 7: Which of the following is an ABSOLUTE contraindication for massage therapy?

Acute deep vein thrombosis (DVT) (Correct answer)
Stable hypertension
Mild chronic low back pain
Controlled type 2 diabetes

Correct answer: Acute deep vein thrombosis (DVT)

Acute DVT is an absolute contraindication because massage could dislodge the thrombus, causing a potentially fatal pulmonary embolism.

Question 8: Which massage modality specifically incorporates assisted stretching and joint mobilization along energy lines?

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

Correct answer: Thai massage

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

Question 9: An outcome measure commonly used in massage therapy research to assess pain intensity is:

The APGAR score
The Visual Analogue Scale (VAS) (Correct answer)
The Glasgow Coma Scale
The SOAP note format

Correct answer: The Visual Analogue Scale (VAS)

The Visual Analogue Scale (VAS) is a standardized tool where clients rate pain intensity on a continuous line from 'no pain' to 'worst imaginable pain,' widely used in massage research.

Question 10: 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?

Dual Relationship
Transfeeling
Transference (Correct answer)
Countertransference

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

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

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 12: What is the primary concern when performing massage on elderly clients with osteoporosis?

Reduced effectiveness of deep tissue work
Poor response to effleurage strokes
Heightened risk of bone fracture from excessive pressure (Correct answer)
Increased risk of muscle cramping

Correct answer: Heightened risk of bone fracture from excessive pressure

Osteoporosis reduces bone density and makes bones fragile, requiring therapists to use gentle pressure to avoid fractures.

Question 13: Which cardiovascular condition requires physician clearance and modified massage with no stimulating techniques?

Well-controlled hypertension
Recent myocardial infarction (within 4 weeks) (Correct answer)
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 14: Countertransference refers to:

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

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 15: When a client has uncontrolled high blood pressure (hypertension), which massage approach is most appropriate pending physician clearance?

Deep tissue work to release vascular tension
Vigorous percussion (tapotement) to stimulate circulation
Gentle, relaxation-focused massage avoiding stimulating techniques (Correct answer)
Avoid all massage until blood pressure is controlled

Correct answer: Gentle, relaxation-focused massage avoiding stimulating techniques

Gentle, parasympathetic-promoting massage can be beneficial for hypertensive clients, but stimulating techniques should be avoided until blood pressure is well managed.

Question 16: When a bone turns on its own central axis making a circular movement, it is called ________________.

Angular
Circumduction
Gliding
Rotation (Correct answer)

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 17: Where bones meet to form a joint:

Articulation (Correct answer)
Enthesis
Ligament
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 18: Which of the following BEST defines informed consent in massage therapy?

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

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

Antagonist (Correct answer)
Abductor
Bipennate
Sacromere

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

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

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 21: Applying ice directly to bare skin for extended periods can cause:

Permanent relaxation of muscle spasm
Increased circulation and healing
Improved range of motion immediately
Frostbite and tissue damage (Correct answer)

Correct answer: Frostbite and tissue damage

Prolonged direct ice contact can freeze superficial tissue, causing frostbite, tissue damage, and impaired circulation.

Question 22: Which of the following are voluntary muscles ________________.

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

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 23: Which of the following conditions is a LOCAL contraindication requiring the therapist to avoid only the specific area?

Systemic infection
Skin rash of unknown origin over one leg (Correct answer)
Acute stage of cancer
Fever

Correct answer: Skin rash of unknown origin over one leg

A local rash of unknown origin is a local contraindication—massage can proceed on unaffected areas while the affected area is avoided.

Question 24: The long shaft of a bone is called ____________________.

Diaphysis (Correct answer)
Epiphysis
Endosteum
Periosteum

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 25: A dual relationship in massage therapy occurs when:

The client receives two different modalities in one session
Two therapists treat one client simultaneously
A therapist works in two different clinics
The therapist has a personal relationship with a client outside of the professional context (Correct answer)

Correct answer: The therapist has a personal relationship with a client outside of the professional context

A dual relationship exists when the therapist and client have a secondary relationship (e.g., friend, employer) beyond the professional therapeutic one.

Question 26: When a massage therapist hires employees, which federal form must new employees complete for income tax withholding purposes?

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

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

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

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 28: 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 29: Cold application (cryotherapy) is MOST indicated in which situation?

To increase overall circulation before massage
During acute inflammation immediately following injury (Correct answer)
Before stretching tight muscles
To treat chronic muscle tension

Correct answer: During acute inflammation immediately following injury

Cold reduces acute inflammation, swelling, and pain immediately following injury by causing vasoconstriction and slowing metabolic activity.

Question 30: During postural assessment, a high left shoulder and low right hip may suggest:

Lordotic lumbar curve
Bilateral pes planus
Thoracic kyphosis
A lateral spinal curvature or scoliosis (Correct answer)

Correct answer: A lateral spinal curvature or scoliosis

Uneven shoulder and hip heights in the frontal plane are classic visual indicators of lateral spinal curvature or scoliosis.

Question 31: If a massage therapist writes, "hyperkyphosis of the thoracic spine" in his SOAP notes, what is he referring to?

Scoliosis
An exaggerated curve in the lower spine
A flat back
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 32: When a client is unable to provide written consent (e.g., sedated), the therapist should:

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

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 33: The AMTA Code of Ethics requires massage therapists to:

Provide services regardless of personal limitations
Diagnose medical conditions when qualified
Share client information with other healthcare providers freely
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 34: A cancellation policy should PRIMARILY be included in which document shared with clients?

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

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.

Question 35: Which behavior by a massage therapist would be considered MOST unethical?

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

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 36: 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 37: A massage therapy business is required to post which of the following in client areas under most state regulations?

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

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

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

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

Pain arising in the region of the face
Muscle tenderness arising from a trigger point (Correct answer)
Bone Spur
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 40: General liability insurance for massage therapists PRIMARILY protects against:

Failure to maintain continuing education
Identity theft of client data
Client injury or property damage claims resulting from your practice (Correct answer)
Employee payroll disputes

Correct answer: Client injury or property damage claims resulting from your practice

General liability insurance covers claims of bodily injury or property damage that occur as a result of your professional activities.

Question 41: Which of the following is OUTSIDE the typical scope of practice for a licensed massage therapist in the US?

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

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

Systematic case documentation
Continuing education credit accumulation
Reflective evidence-based practice (Correct answer)
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 43: Massage over varicose veins is considered:

A local contraindication requiring avoidance of the area (Correct answer)
Safe with light effleurage strokes only
Required to prevent further pooling of blood
Beneficial due to improved circulation

Correct answer: A local contraindication requiring avoidance of the area

Varicose veins are fragile and prone to damage; direct pressure can cause injury, pain, or bruising, making the area a local contraindication.

Question 44: Aromatherapy in massage uses essential oils that are MOST commonly derived from:

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

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

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

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

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

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 47: Transference in the therapeutic setting refers to:

The client projecting feelings from past relationships onto the therapist (Correct answer)
Transferring a client to another therapist
The therapist's emotional response to the client
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 48: AMTA's Standards of Practice require therapists to maintain continuing education primarily to:

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

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

Focus only on reflexology to avoid tumor sites
Apply modified, gentle techniques tailored to the client's current treatment phase (Correct answer)
Use standard deep tissue protocols
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 50: The plexus is responsible for nervous innervation to the upper extremities and certain neck and shoulder muscles.

Brachial (Correct answer)
Sacral
Lumbar
Cervical

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

Fidelity
Veracity (truthfulness) (Correct answer)
Beneficence
Autonomy

Correct answer: Veracity (truthfulness)

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

Question 52: If a client is injured in your massage therapy office and makes a claim, which type of coverage would MOST likely respond?

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

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

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

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

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

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

Massage distal to encourage refreshed circulation and healing.
Massage the whole area gently placing a little more pressure at the injury site.
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 56: The physiological response of reddening of the skin in response to heat application is called:

Edema
Erythema (Correct answer)
Pallor
Cyanosis

Correct answer: Erythema

Erythema is the reddening of the skin caused by vasodilation in response to heat, friction, or irritation.

Question 57: Tapotement techniques are CONTRAINDICATED over which of the following areas?

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

Correct answer: The kidney area

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

Question 58: Which spa treatment involves applying seaweed or mineral-rich mud to the body and then wrapping the client?

Lymphatic drainage
Dry heat sauna
Thalassotherapy or seaweed/mud wrap (Correct answer)
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 59: OSHA's Bloodborne Pathogen Standard requires massage therapists to:

Refuse service to clients with communicable diseases
Use standard precautions and have an exposure control plan when blood or body fluid exposure is possible (Correct answer)
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 60: Which business structure provides the MOST personal liability protection for a sole massage therapist?

Sole proprietorship
DBA (Doing Business As)
Limited Liability Company (LLC) (Correct answer)
General partnership

Correct answer: Limited Liability Company (LLC)

An LLC separates personal assets from business liabilities, offering personal liability protection while maintaining flexibility for a solo practitioner.

Question 61: A body wrap treatment that uses heated linen sheets around the client is called:

Seaweed wrap
Salt glow
Wet sheet pack (Correct answer)
Dry brush exfoliation

Correct answer: Wet sheet pack

A wet sheet pack involves wrapping the client in hot wet sheets to induce sweating and promote relaxation through sustained heat application.

Question 62: The movement of the sole towards the median plane:

Angular Movement
Inversion (Correct answer)
Abduction
Rotation

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

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

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 64: Research showing that massage therapy reduces cortisol levels MOST directly supports its use for:

Increasing bone density
Enhancing visual acuity
Reducing physiological stress responses (Correct answer)
Improving grip strength

Correct answer: Reducing physiological stress responses

Cortisol is the primary stress hormone; research demonstrating its reduction following massage supports massage's role in alleviating physiological stress.

Question 65: 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 66: Skeletal muscles normally work __________________.

isometrically
one at a time
in groups (Correct answer)
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 67: While assessing a client, a massage therapist asks that they move their arm against a light-applied resistance. What is this called?

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

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 68: Which massage modality is based on the theory that reflex areas on the feet correspond to organs and body parts?

Rolfing
Reflexology (Correct answer)
Shiatsu
Craniosacral therapy

Correct answer: Reflexology

Reflexology applies pressure to specific reflex zones on the feet (and sometimes hands) believed to correspond to other body systems.

Question 69: When standing still in front of a closed door and pushing on it without it moving, the muscle action/tension is called:

Eccentric
Concentric
Isometric (Correct answer)
Isotonic

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

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

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

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

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 72: What is the meaning of the Greek root "derm"?

Muscle
Ligament
Bone
Skin (Correct answer)

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

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

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 74: Massage is contraindicated in the acute phase of which condition?

Chronic low back pain
Acute muscle strain within the first 48–72 hours (Correct answer)
Healed whiplash injury
Completed stroke (CVA) with stable neurological deficits

Correct answer: Acute muscle strain within the first 48–72 hours

During the acute inflammatory phase of muscle strain, massage can worsen tissue damage and increase swelling; rest and ice are preferred initially.

Question 75: Skeletal muscle is attached to bone by __________________.

Epidermis
Tendons (Correct answer)
Joints
Ligaments

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 76: The main purpose of draping is ______.

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

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 77: The term 'placebo effect' in massage research refers to:

The harmful side effect of a massage technique
The therapist's therapeutic touch ability
The benefit derived solely from proper technique
Improvement due to client expectation or belief rather than the specific intervention (Correct answer)

Correct answer: Improvement due to client expectation or belief rather than the specific intervention

The placebo effect is an improvement in outcomes attributable to the patient's expectation of benefit rather than to the specific treatment being studied.

Question 78: The hypodermis is directly below what layer of skin?

Epidermis
Dermis (Correct answer)
Stratum Corneum
Stratum Germinatvium

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

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

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

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

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 81: Which of the following is a systemic contraindication for massage therapy?

Mild edema in one ankle
Plantar fasciitis
Uncontrolled congestive heart failure (Correct answer)
Acne vulgaris on the upper back

Correct answer: Uncontrolled congestive heart failure

Uncontrolled congestive heart failure is a systemic contraindication because increasing circulation can overload a failing heart.

Question 82: If a client discloses abuse during a session, most state laws require the therapist to:

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

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

Monitoring skin integrity carefully, especially on the feet (Correct answer)
Avoiding all massage below the waist
Limiting sessions to 30 minutes maximum
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 84: Which of the following is considered an absolute contraindication for massage therapy?

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

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

Apply hot packs and deep compression
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

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 86: Which of the following is NOT a documented physiological effect of hydrotherapy?

Influence on the autonomic nervous system
Altered circulation
Reduction of muscle tension
Permanent joint realignment (Correct answer)

Correct answer: Permanent joint realignment

Hydrotherapy influences circulation, muscle tension, and the nervous system, but it does not permanently realign joint structures.

Question 87: What is a LOCAL contraindication for massage therapy?

Systemic lupus erythematosus
Recent chemotherapy treatment
Open wound on the forearm (Correct answer)
Uncontrolled hypertension

Correct answer: Open wound on the forearm

An open wound is a local contraindication, meaning massage must avoid that specific area but can be performed on the rest of the body.

Question 88: A client reports pain that is described as 'burning and shooting down the leg.' This symptom pattern MOST suggests:

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

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 89: End feel during passive ROM testing refers to:

The pain level reported at end range
The point at which the client requests the therapist to stop
The therapist's subjective assessment of the session
The quality of resistance felt at the limit of range of motion (Correct answer)

Correct answer: The quality of resistance felt at the limit of range of motion

End feel is the quality of tissue resistance perceived by the therapist at the limit of passive ROM, helping classify normal vs. pathological joint restrictions.

Question 90: Scope of practice for massage therapists is PRIMARILY determined by:

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

Correct answer: State licensing laws and regulations

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

Question 91: In research, 'statistically significant' findings mean:

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

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 92: Which part of the SOAP note documents the therapist's objective findings from palpation and observation?

A — Assessment
P — Plan
O — Objective (Correct answer)
S — Subjective

Correct answer: O — Objective

The Objective section of a SOAP note records measurable, observable findings such as palpation results, range of motion, and postural observations.

Question 93: The Touch Research Institute (TRI), a pioneer in massage therapy research, was founded at which university?

Harvard Medical School
Stanford University
Johns Hopkins 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 94: 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
Osteomyelitis (Correct answer)
Osteopenia

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

Justice
Beneficence (Correct answer)
Non-maleficence
Autonomy

Correct answer: Beneficence

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

Question 96: Which assessment technique involves applying pressure perpendicular to muscle fibers to identify taut bands?

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

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 97: Smooth muscle is also known as ___________________.

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

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

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

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

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

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 100: 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 professional liability policy
A business license
A state massage board complaint form

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.

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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