22 Technique & Client Assessment Practice Questions & Answers

1. 1. A first-time client has completed the health history form, and the therapist has explained the findings and proposed working the anterior neck. What must happen before hands-on work on that area begins?

   • A.The client must sign a release-of-information form for her physician
   • B.The client must give informed consent for work on that specific area✓ Answer
   • C.The client must be draped and positioned prone on the table first
   • D.The client must mark that area on a pain diagram from 0 to 10

   Consent is what makes touch lawful and ethical, so it precedes contact and is specific to the area and approach proposed. A release of information governs sharing records with a physician, and draping or a pain diagram are procedural steps that do not create permission to touch.

   Source: FSMTB MBLEx Content Outline, Client Assessment, Reassessment and Treatment Planning — organization of a massage session and informed consentReport a problem with this question

2. 2. A therapist is organizing the assessment portion of a session. Which order of assessment steps is standard practice?

   • A.Interview, visual observation, range of motion, palpation✓ Answer
   • B.Palpation, interview, visual observation, then range of motion
   • C.Visual observation, palpation, interview, range of motion
   • D.Range of motion, palpation, interview, visual observation

   The history and what can be seen from a distance are gathered first so that contraindications such as a contagious rash, a suspected clot or an acute injury are identified before any hand lands on the client. Palpation comes last because it is the most invasive step and the one most likely to harm if a red flag was missed.

   Source: FSMTB MBLEx Content Outline, Client Assessment — client consultation, visual assessment, range of motion and palpation assessmentReport a problem with this question

3. 3. A client says, "My low back has hurt since Saturday, and this morning it is about a 7 out of 10." In which SOAP section does this belong?

   • A.Assessment, because it summarizes the client's current condition
   • B.Objective, because a number on a 0 to 10 scale is a measurable value
   • C.Subjective, because it is the client's own report of the complaint✓ Answer
   • D.Plan, because the rating sets the target for the next session

   What separates S from O is the source of the information, not whether it carries a number: a pain rating is generated inside the client's experience and cannot be verified by the therapist, so it is subjective. Objective data are what the therapist can see, measure or feel independently of what the client reports.

   Source: Thompson, Hands Heal: Communication, Documentation and Insurance Billing — SOAP charting, subjective dataReport a problem with this question

4. 4. The therapist writes: "Effleurage and petrissage to bilateral upper trapezius, 15 minutes, client side-lying." In which SOAP section does this entry belong?

   • A.Subjective, because it records everything that happened at the visit
   • B.Objective, because it records what the therapist did and observed✓ Answer
   • C.Assessment, because it documents the therapist's chosen approach
   • D.Plan, because the techniques listed guide the following session

   Techniques performed, areas treated, positioning and duration are all therapist actions that another practitioner could verify from the record, which is the defining feature of objective data. A frequent charting error is filing treatment performed under Plan; Plan holds only what is intended going forward, not what was already done.

   Source: Thompson, Hands Heal: Communication, Documentation and Insurance Billing — SOAP charting, objective dataReport a problem with this question

5. 5. After the session the therapist writes: "Right cervical rotation improved from limited to near full; reported pain went from 7/10 to 3/10." In which SOAP section does this belong?

   • A.Assessment, because it is the therapist's read on the response✓ Answer
   • B.Subjective, because the pain number came from the client
   • C.Objective, because degrees of rotation were measured
   • D.Plan, because improvement sets the next appointment

   The Assessment section holds the therapist's professional interpretation of change and progress, built by comparing findings before and after treatment. It is not a medical diagnosis, and a massage therapist who writes a condition name there has stepped outside the scope of assessment.

   Source: Thompson, Hands Heal: Communication, Documentation and Insurance Billing — SOAP charting, assessment versus diagnosisReport a problem with this question

6. 6. The therapist writes: "One session per week for four weeks; taught doorway pectoral stretch for home." In which SOAP section does this belong?

   • A.Objective, because the stretch was taught during the visit
   • B.Subjective, because the client agreed to the schedule
   • C.Plan, because it states what will happen going forward✓ Answer
   • D.Assessment, because frequency reflects the severity found

   Plan covers everything forward-looking: treatment frequency and duration, the focus of the next session, home care and any referral. Writing a vague plan such as "continue treatment" gives no measurable point at which the approach is reviewed.

   Source: Thompson, Hands Heal: Communication, Documentation and Insurance Billing — SOAP charting, plan and treatment frequencyReport a problem with this question

7. 7. A client reports nausea and tingling down the arm, and the therapist observes swelling and bruising over the elbow. Which statement classifies these findings correctly?

   • A.All four are objective signs, because the therapist charted all of them
   • B.Nausea and tingling are signs; swelling and bruising are symptoms
   • C.Nausea and tingling are symptoms; swelling and bruising are signs✓ Answer
   • D.All four are symptoms, since they arose from the same complaint

   A symptom is felt and reported by the client and cannot be observed from outside, while a sign is something the therapist can see, measure or palpate. Charting a finding does not convert a symptom into a sign; the distinction rests on who can perceive it.

   Source: FSMTB MBLEx Content Outline, Client Assessment — client consultation and evaluation, signs and symptomsReport a problem with this question

8. 8. Why is active range of motion tested before passive range of motion?

   • A.The client controls the movement and stops at their own limit✓ Answer
   • B.The therapist can feel the capsule and ligaments of the joint better
   • C.Active motion always exceeds what passive motion can reach
   • D.Muscles and tendons are isolated when the client moves alone

   Active testing is the safest first step because the person who feels the pain governs how far the joint travels, which shows the real functional limit before the therapist takes over the movement. Passive range is normally slightly greater than active, not less, since the client's own effort and guarding no longer restrict it.

   Source: Magee, Orthopedic Physical Assessment — sequence of active, passive and resisted movement testingReport a problem with this question

9. 9. The therapist moves a fully relaxed client's shoulder through abduction while the client does nothing. Which tissues does this primarily test?

   • A.Contractile structures such as muscle, tendon and its attachment
   • B.Non-contractile structures such as capsule, ligaments and bursa✓ Answer
   • C.Motor nerves supplying the prime movers of that joint action
   • D.The client's strength and willingness to move the joint freely

   Because the muscles are silent during passive movement, whatever resists or hurts must come from the inert structures the motion stretches or compresses. Contractile tissue is isolated instead by resisted testing, where the muscle works against the therapist without the joint moving.

   Source: Magee, Orthopedic Physical Assessment — passive movement and inert tissueReport a problem with this question

10. 10. A client's active shoulder abduction is painful and limited, passive abduction is full and pain-free, and resisted abduction reproduces the pain. What does this pattern indicate?

    • A.A joint capsule restriction that limits the available motion
    • B.A contractile tissue problem in the muscle or its tendon✓ Answer
    • C.A bony block within the joint preventing full abduction
    • D.A nerve root irritation referring pain into the shoulder

    A full, pain-free passive range clears the joint surfaces, capsule and ligaments, so the pain has to arise from tissue that only hurts when it contracts. When the problem is inert instead, active and passive motion are limited in the same direction and to about the same degree.

    Source: Magee, Orthopedic Physical Assessment — interpretation of active, passive and resisted testingReport a problem with this question

11. 11. On resisted elbow flexion the client is clearly weak but reports no pain at all. What is the appropriate response?

    • A.Retest after tapotement to the biceps to wake up the muscle
    • B.Apply deep friction to the tendon to restore normal strength
    • C.Treat it as a minor strain and work the area at moderate pressure
    • D.Refer the client, since this suggests nerve involvement or rupture✓ Answer

    Weak and painless means the muscle cannot generate force yet nothing hurts, which points to lost innervation or a complete tear rather than an irritated but intact tissue. Strength that massage could influence would normally be painful when loaded, so this finding belongs with a physician, not under the therapist's hands.

    Source: Magee, Orthopedic Physical Assessment — Cyriax interpretation of resisted isometric testingReport a problem with this question

12. 12. During passive shoulder elevation the client stops the movement because of intense pain, and the therapist feels no mechanical resistance at that point. This end feel is best described as:

    • A.Firm, and it reflects a normal capsular stretch at end range
    • B.Empty, and it warrants referral rather than continued work✓ Answer
    • C.Boggy, and it reflects fluid accumulating inside the joint
    • D.Springy, and it reflects a fragment caught within the joint

    An empty end feel means pain alone halts the movement while the therapist's hands meet no barrier, so nothing mechanical explains why the joint stopped. That mismatch is associated with serious underlying conditions and is one of the clearest indications to send the client for medical evaluation.

    Source: Magee, Orthopedic Physical Assessment — abnormal end feels, empty end feelReport a problem with this question

13. 13. Passive knee extension stops short of full range with a rebounding sensation, and the client says the knee "catches." Which end feel does this describe?

    • A.Springy block, suggesting something loose inside the joint✓ Answer
    • B.Hard bony, suggesting the joint surfaces have met each other
    • C.Soft tissue approximation, suggesting muscle bulk contact
    • D.Muscle spasm, suggesting protective guarding of the joint

    A springy block is a rebound felt before the joint's normal limit, produced by displaced tissue sitting between the joint surfaces, and the client's report of catching matches that mechanical obstruction. A normal hard end feel arrives at the expected end of range and is abrupt and painless rather than bouncy.

    Source: Magee, Orthopedic Physical Assessment — abnormal end feels, springy block and internal derangementReport a problem with this question

14. 14. A client's right calf is warm, red, swollen and painful, with no injury to account for it. What should the therapist do?

    • A.Use a lighter pressure on that leg and recheck next session
    • B.Work the calf gently with light effleurage toward the heart
    • C.Elevate the leg and apply ice before deciding about massage
    • D.Skip the leg entirely today and advise prompt medical evaluation✓ Answer

    Unilateral warmth, redness, swelling and pain without trauma raise the possibility of a clot in a deep vein, and any pressure or stroking along that limb could dislodge it into the circulation. Reducing pressure does not reduce that risk, so the whole limb is left alone and the client is sent for evaluation the same day.

    Source: Werner, A Massage Therapist's Guide to Pathology — deep vein thrombosis, contraindications and referralReport a problem with this question

15. 15. While working, the therapist finds an unusual, undiagnosed lump on a client's back. Which wording is appropriate?

    • A."That looks like a lipoma, but it is nothing to worry about."
    • B."I'd like your doctor to look at this before I work there."✓ Answer
    • C."It could be a tumor, so you should see a doctor right away."
    • D."I can massage around it and it should break down over time."

    The therapist may describe what was felt and recommend evaluation, but naming a condition, whether reassuring or alarming, is a diagnosis and lies outside the massage scope of practice. Neutral wording protects the client from unnecessary fear while still getting the finding in front of someone qualified to identify it.

    Source: FSMTB MBLEx Content Outline, Client Assessment — clinical reasoning, referral and scope of practiceReport a problem with this question

16. 16. Two clients arrive: one with a 101°F (38.3°C) fever and body aches, the other with an ankle sprained two days ago. Which statement describes the contraindications correctly?

    • A.Fever is a general contraindication; the sprain is a local one✓ Answer
    • B.The sprain is a general contraindication; fever is a local one
    • C.Both are general contraindications, so neither client is treated
    • D.Both are local contraindications and both may be treated today

    Fever signals a systemic process the whole body is already managing, and massage adds circulatory demand the client cannot spare, so no massage is given that day. A fresh sprain is confined to one structure, so the injured area is avoided while the rest of the body can be treated normally.

    Source: Werner, A Massage Therapist's Guide to Pathology — general versus local contraindicationsReport a problem with this question

17. 17. As the client walks, the pelvis drops on the left side each time the right foot is in stance phase. Which finding does this observation support?

    • A.Weakness of the right gluteus medius supporting the stance limb✓ Answer
    • B.Weakness of the left gluteus medius as that leg swings
    • C.Shortening of the right hip flexors tilting the pelvis forward
    • D.Weakness of the right ankle dorsiflexors during swing phase

    The gluteus medius on the weight-bearing side has to hold the pelvis level while the opposite leg is off the ground, so when that muscle cannot do its job the unsupported side sags. The pelvis drops away from the weak side, which is why the visible drop and the weak muscle are on opposite sides.

    Source: FSMTB MBLEx Content Outline, Client Assessment — gait assessment and observed deviationsReport a problem with this question

18. 18. A desk-based client presents with forward head posture and rounded shoulders. Which pattern of tight and weak muscles is expected?

    • A.Tight abdominals and hip flexors; weak spinal erectors and gluteus maximus
    • B.Tight rhomboids and lower trapezius; weak pectoralis major and upper trapezius
    • C.Tight deep neck flexors and serratus; weak levator scapulae and pectorals
    • D.Tight pectorals and upper trapezius; weak rhomboids and lower trapezius✓ Answer

    The muscles on the shortened, concave side of a postural deviation become hypertonic while their antagonists on the lengthened side are inhibited, which is the upper crossed pattern seen with forward head and rounded shoulders. The fourth option describes the lower crossed pattern at the pelvis, which involves different muscles entirely.

    Source: FSMTB MBLEx Content Outline, Client Assessment — postural assessment and upper crossed patternReport a problem with this question

19. 19. After four sessions the client's pain rating and cervical rotation are unchanged from baseline. What should the therapist do?

    • A.Increase pressure each visit until the tissue finally responds
    • B.Keep the same routine and add ten minutes to each appointment
    • C.Change the plan or refer, rather than repeat the same work harder✓ Answer
    • D.Stop measuring rotation and rely on how the client feels after

    Reassessment against the original baseline measures exists precisely so that a lack of progress is caught and acted on, and a reasonable trial that produces no change means the working strategy or the underlying assumption is wrong. More time or more pressure applies the same failed approach with greater force and raises the risk of harm without addressing why it is not working.

    Source: FSMTB MBLEx Content Outline, Client Assessment — evaluating treatment response and modifying the planReport a problem with this question

20. 20. A client wants general relaxation and improved venous return at the close of a leg sequence. Which stroke and rationale fit best?

    • A.Static compression on the belly, which lengthens the whole muscle
    • B.Rapid tapotement over the calf, which calms an overactive nervous system
    • C.Cross-fiber friction at the tendon, which drains fluid from tissue
    • D.Effleurage toward the heart, which assists venous and lymph flow✓ Answer

    Gliding strokes directed toward the heart move venous blood and lymph along vessels whose valves only permit flow in that direction, and their rhythmic quality favours a parasympathetic response. Rapid tapotement is stimulating rather than calming, and cross-fiber friction is a localized technique for realigning fibers, not a fluid-moving stroke.

    Source: FSMTB MBLEx Content Outline, Benefits and Effects of Soft Tissue Manipulation — effleurage and circulatory effectsReport a problem with this question

21. 21. A client's ankle inversion sprain happened 24 hours ago. Which hydrotherapy application and reason are appropriate?

    • A.Contrast, because alternating temperature restores joint motion
    • B.Heat, because vasodilation flushes the healing tissue with blood
    • C.Cold, because vasoconstriction limits swelling and dulls pain✓ Answer
    • D.Hot soak, because warmth relaxes the muscles guarding the joint

    In the acute stage the tissue is already inflamed and leaking fluid, so cold is chosen because narrowing the vessels slows that accumulation and reduces pain conduction. Heat in any form widens the vessels and adds to the swelling and throbbing at exactly the point where the injury is least able to tolerate it.

    Source: FSMTB MBLEx Content Outline, Benefits and Effects of Soft Tissue Manipulation — hydrotherapy, thermal effects in acute injuryReport a problem with this question

22. 22. A client's hamstring strain occurred eight months ago, is fully healed, and is painless at rest, leaving only long-standing tightness. Which plan matches this stage of healing?

    • A.Light indirect work only, since scar tissue must not be disturbed
    • B.Ice and lymphatic strokes proximal to the site, no direct work
    • C.Complete rest from the area until the tissue stops being tender
    • D.Deeper work with cross-fiber friction and stretching between visits✓ Answer

    In the chronic or maturation stage the tissue has repaired but the collagen laid down is disorganized and adhered, so techniques that load and remodel the fibers are both safe and useful. The ice-and-proximal-drainage approach belongs to the acute stage, and protecting a mature scar from any load leaves the restriction in place indefinitely.

    Source: FSMTB MBLEx Content Outline, Client Assessment — treatment strategy and stages of tissue healingReport a problem with this question

Practice questions based on the FSMTB MBLEx content outline and standard massage therapy curriculum. MBLEx is a mark of the Federation of State Massage Therapy Boards; this site is not affiliated with or endorsed by FSMTB. Licensing requirements — education hours, license title, continuing education, and fees — are set by each state board, so confirm your own state's rules before you apply. Nothing here is medical advice. About the MBLEx →