NCBTMB MCQ Flashcards

A client with a history of deep vein thrombosis (DVT) in the left calf presents for massage. The DVT was diagnosed 6 weeks ago and the client reports they are now on anticoagulant therapy. Which approach is MOST appropriate?

Answer: Obtain physician clearance before providing any massage, as DVT within the past 3 months is a systemic contraindication

DVT within the past 3 months is a systemic contraindication to massage, not merely a local one. The risk of dislodging a thrombus and causing pulmonary embolism applies even with anticoagulant therapy. Physician clearance is mandatory before proceeding, regardless of the site or technique.

During a session, you notice a mole on a client's back that is asymmetrical, has irregular borders, contains multiple colors, and has a diameter larger than 6 mm. Which action BEST reflects the massage therapist's professional scope of practice?

Answer: Refuse to work the area, document your findings in the client's file, and refer the client to a dermatologist

The ABCDs of melanoma (Asymmetry, Border, Color, Diameter) describe a potentially malignant lesion. The therapist's role is to avoid the area, document observations objectively without diagnosing, and refer the client to the appropriate medical professional. Photographing and diagnosing exceed the therapist's scope.

A therapist applies sustained pressure to the origin of the right sternocleidomastoid (SCM) to address a trigger point. Which compensatory pattern is MOST likely to develop if left-side SCM hypertonicity is also chronically unaddressed?

Answer: Left cervical rotation with right lateral flexion and forward head posture

The SCM, when hypertonic on one side, rotates the head to the contralateral side and laterally flexes it to the ipsilateral side. Bilateral unaddressed hypertonicity, combined with asymmetric dominance on the left, produces left rotation, right lateral flexion, and the classic forward head posture associated with SCM shortening.

Under HIPAA regulations, which scenario permits a massage therapist to disclose a client's protected health information (PHI) WITHOUT obtaining prior written authorization from the client?

Answer: Disclosing information to a public health authority investigating a communicable disease outbreak

HIPAA permits disclosure of PHI without authorization for public health activities, including reporting to public health authorities investigating communicable disease outbreaks. All other scenarios require written authorization: verbal requests are insufficient (option A), legal proceedings require a court order or authorization (option B), and insurance reimbursement requires written consent (option D).

A massage therapist is working with a client recovering from a Grade II medial collateral ligament (MCL) sprain of the knee, now 5 weeks post-injury and cleared for soft tissue work. Which technique is MOST appropriate during this phase of healing?

Answer: Myofascial release applied to the IT band and quadriceps to reduce compensatory tension patterns

At 5 weeks post-Grade II sprain, the tissue is in the proliferative phase with immature collagen. Direct cross-fiber friction on the ligament is premature and risks disrupting new collagen formation. Addressing compensatory hypertonicity in the IT band and quadriceps via myofascial release is appropriate and supports functional recovery without stressing the healing ligament.

Which ethical principle is MOST directly violated when a massage therapist accepts a substantial monetary gift from a long-term client who has become emotionally dependent on the therapist for support beyond the scope of massage therapy?

Answer: Nonmaleficence — the therapist is allowing a dual relationship that may harm the client

Nonmaleficence (do no harm) is most directly at issue here. Accepting a gift within a dual relationship — where the client has developed emotional dependency beyond therapeutic scope — reinforces a boundary violation and may cause psychological harm. The therapist has a duty to recognize and address the inappropriate relationship dynamic rather than benefit from it.