MBLEx Test Pathology and Contraindications Questions and Answers — Questions and Answers
Question 1: A new client presents with a localized, red, warm, and swollen area on their lower leg, reporting tenderness in the calf. Which of the following is the most appropriate action for the massage therapist?
- Perform light, soothing strokes on the area to assess tissue response.
- Apply a cold pack and proceed with massaging other areas of the body.
- Immediately postpone the massage and refer the client for urgent medical evaluation. (Correct answer)
- Vigorously massage the calf to break up the suspected muscle knot.
Correct answer: Immediately postpone the massage and refer the client for urgent medical evaluation.
The client's symptoms (localized redness, warmth, swelling, and tenderness in the calf) are classic signs of deep vein thrombosis (DVT), a blood clot in a deep vein. This is an absolute contraindication for massage. Massaging the area could dislodge the clot, leading to a life-threatening pulmonary embolism. The only safe and professional action is to stop immediately and refer the client for emergency medical care. [3, 5]
Question 2: Which of the following conditions represents a systemic contraindication for massage therapy?
- A small, healing abrasion on the knee.
- Chronic psoriasis on the elbows.
- Mild, stable varicose veins on the lower legs.
- An active influenza infection with a fever. (Correct answer)
Correct answer: An active influenza infection with a fever.
An active influenza infection with a fever is a systemic contraindication, meaning massage should not be performed at all. Massage can increase circulation and lymphatic flow, potentially spreading the infection throughout the body and worsening the client's symptoms. [5, 8] The other options are local contraindications, which require avoiding the specific area but do not necessarily prevent a massage session.
Question 3: A long-term client with type 2 diabetes mentions experiencing recent numbness and tingling in their feet. What is the most important treatment modification for the therapist to make?
- Use deep, stripping strokes on the feet to increase circulation.
- Apply firm pressure, as the client's pain sensitivity is reduced.
- Use gentle pressure and avoid deep work on the feet due to impaired sensation. (Correct answer)
- Focus the entire session on the feet using reflexology techniques.
Correct answer: Use gentle pressure and avoid deep work on the feet due to impaired sensation.
The client is describing peripheral neuropathy, a common complication of diabetes that impairs sensation. Because the client cannot provide accurate feedback on pressure, deep or firm work could cause tissue damage without them realizing it. The safest approach is to use gentle, cautious pressure on the feet and communicate frequently. [4, 7]
Question 4: A client's intake form indicates they are taking an anticoagulant (blood thinner). Which of the following techniques should be avoided or significantly modified?
- Myofascial release and deep friction (Correct answer)
- Gentle effleurage and petrissage
- Passive range of motion
- Superficial lymphatic drainage
Correct answer: Myofascial release and deep friction
Anticoagulants reduce the blood's ability to clot, significantly increasing the risk of bruising and internal bleeding. Techniques that involve deep, focused pressure, such as myofascial release, deep friction, or deep tissue stripping, can easily damage capillaries and should be avoided. Lighter, more superficial work is indicated. [7, 9, 12]
Question 5: Pitting edema, where an indentation remains in the skin after pressure is applied, should alert a massage therapist to a potential underlying pathology of which body system?
- Endocrine
- Integumentary
- Cardiovascular (Correct answer)
- Muscular
Correct answer: Cardiovascular
Pitting edema is a significant red flag for systemic issues, most notably cardiovascular problems like congestive heart failure. It can also indicate kidney or liver disease. [15, 22] Because massage affects fluid circulation, proceeding without medical clearance could dangerously overload a compromised system. This finding makes massage systemically contraindicated until the underlying cause is diagnosed and treatment is cleared by a physician.
Question 6: A client arrives for their appointment with an active, weeping cold sore (herpes simplex) on their lip. What is the most appropriate course of action?
- Proceed with the massage but avoid the face and head.
- Apply a small bandage over the lesion and continue the session.
- Wear gloves for the entire duration of the massage.
- Politely reschedule the appointment until the lesion is fully healed. (Correct answer)
Correct answer: Politely reschedule the appointment until the lesion is fully healed.
Herpes simplex is a highly contagious viral infection, especially during the active, weeping stage. The virus can easily be transmitted to the therapist's hands and then spread to other parts of the client's body, the therapist, or contaminated surfaces in the treatment room. [27, 30, 31] The most professional and safest protocol is to reschedule the appointment until the lesion is no longer active (fully crusted over).
MBLEx Test Pathology and Contraindications Questions and Answers
A new client presents with a localized, red, warm, and swollen area on their lower leg, reporting tenderness in the calf.
Which of the following is the most appropriate action for the massage therapist?