NCBTMB Client Assessment and Treatment 3 — Questions and Answers
Question 1: During intake, a client mentions chronic fatigue, cold intolerance, and weight gain. The therapist should recognize these as possible symptoms of:
- Hyperthyroidism
- Hypothyroidism (Correct answer)
- Cushing's syndrome
- Addison's disease
Correct answer: Hypothyroidism
Hypothyroidism is characterized by a slowed metabolism, presenting as fatigue, cold intolerance, and unexplained weight gain.
Question 2: A client reports a 'pins and needles' sensation along the lateral forearm and into the thumb and index finger. Which nerve is most likely involved?
- Ulnar nerve
- Median nerve
- Radial nerve (Correct answer)
- Musculocutaneous nerve
Correct answer: Radial nerve
The radial nerve supplies the posterior forearm and the dorsal surface of the thumb and first two fingers, matching this distribution.
Question 3: When assessing a client's breathing patterns, paradoxical breathing (chest falls on inhalation) may indicate:
- Asthma
- Diaphragmatic dysfunction or respiratory distress (Correct answer)
- Normal breathing during relaxation
- Upper chest dominance
Correct answer: Diaphragmatic dysfunction or respiratory distress
Paradoxical breathing, where the chest moves opposite to normal mechanics, can indicate diaphragm dysfunction or serious respiratory compromise.
Question 4: A client has a visibly swollen, hot, and reddened joint in the knee following a sports injury two days ago. The appropriate response is to:
- Apply deep tissue massage to reduce inflammation
- Avoid the area and recommend physician evaluation (Correct answer)
- Use ice massage directly on the joint
- Perform passive ROM to assess joint integrity
Correct answer: Avoid the area and recommend physician evaluation
Acute inflammation with heat, redness, and swelling is a local contraindication; massage could worsen tissue damage and the client needs medical evaluation.
Question 5: Which muscle is most commonly assessed for trigger points that refer pain to the temporal region and mimic tension headaches?
- Sternocleidomastoid
- Upper trapezius (Correct answer)
- Masseter
- Temporalis
Correct answer: Upper trapezius
Upper trapezius trigger points classically refer pain up the posterior neck and into the temporal region of the head.
Question 6: A client with type 1 diabetes arrives for their appointment and seems confused and shaky. The therapist should first:
- Begin a calming Swedish massage to reduce stress
- Offer the client a source of fast-acting sugar and postpone massage (Correct answer)
- Call emergency services immediately without assessment
- Proceed with light massage and monitor the client
Correct answer: Offer the client a source of fast-acting sugar and postpone massage
Confusion and shakiness in a diabetic client suggest hypoglycemia, which requires immediate glucose administration before any treatment.
Question 7: In the context of massage therapy, what does 'endangerment site' refer to?
- Any area with active pathology
- Areas where major nerves, vessels, or organs are superficial and vulnerable to injury (Correct answer)
- Regions with thin skin prone to bruising
- Bony prominences where pressure causes pain
Correct answer: Areas where major nerves, vessels, or organs are superficial and vulnerable to injury
Endangerment sites are anatomical areas where nerves, blood vessels, or organs lie close to the surface and can be damaged by direct pressure.
NCBTMB Client Assessment and Treatment 3
During intake, a client mentions chronic fatigue, cold intolerance, and weight gain.
The therapist should recognize these as possible symptoms of: