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4. Joachim has a client who has requested hydrotherapy. As he interviews her, he learns that
she has a circulatory disorder and is hoping that therapy “will help with comfort.” Joachim
should:a. suggest only cold temperatures, keeping in mind that a 10-degree difference is the
minimum needed to create stimulation and change in the circulation.
b. use heat therapy to increase circulation and decrease pain and tissue stiffness,keeping in mind the importance of checking the client’s comfort and thirst levels
frequently.
c. refrain from hot or cold hydrotherapy unless a physician’s permission is provided.d. do a and b, on sequential visits.
ANS: C
REF: 455DIF: 3
5. In preparing a mineral herb bath, Maggie sets the temperature for 91 degrees F. This
temperature is most likely to:a. be painful or uncomfortable.
b. produce goose flesh.c. feel like skin temperature.
d. redden the skin.
ANS: B
REF: 456
DIF: 2
6. P.R.I.C.E.:
a. is a first aid application that excludes the use of hydrotherapy, which would onlyincrease the inflammatory response. b. is not appropriate for soft tissue injuries, except in the case of sprains or strains.
c. stands for protection, rest, ice, compression, and elevation.
d. is accurately described in b and c.
ANS: C
REF: 456
DIF: 3
7. In trying to let the cat out, while keeping the dog in, Erin has just this moment slammed her
knee in the door. (“Don’t ask,” she says. “This happens a lot.”) Her friend Maggie helps by:
a. applying heat to increase the blood flow and stimulate therapeutic inflammation.
b. applying an ice application for a 45-minute period through four sensations:appreciation of cold, warming, ache or throbbing, and skin anesthesia.
c. applying ice by immersion in ice water, massaging the knee with ice packs.
8. Ellen’s doctor sends her for a massage because of some swelling in her extremities,
especially her ankles and legs. There is no inflammation or any other health or medication
cause. Which of the following statements is true of Ellen’s case?a. Edema may be caused by lack of exercise, excess salt, or Ellen’s menstrual cycle.
b. Ellen should be made aware that lymphatic drainage massage may increase her
blood pressure.c. Ellen should feel more energized for the first 24 to 48 hours after the massage,
making it easier for her to begin any needed increase in exercise.
d. All of the above are true.
ANS: A
REF: 461-463
DIF: 3
9. Theo is giving a lymphatic drainage massage to Ellen, who has edema, especially in the
lower limbs, and who has been referred for massage by her physician. Which of thefollowing is true, assuming that Theo follows correct methods of lymphatic drainage
massage?
a. The greater the amount of fluid in the tissue, the more rapid Theo’s massagemovements must be to stimulate peripheral lymphatic contractions.
b. Theo will move lymph toward the nearest cluster of lymph nodes by first
massaging swollen tissue farthest from the cluster, then massaging the area around
the nodes themselves last.c. The massage session begins with a pumping action on the thorax, after the client
exhales completely.d. All of the above are true.
ANS: C
REF: 463-64DIF: 3
10. Erika is giving a circulatory massage to a healthy client who has been under some
occasional stress. Which is true of the circulatory massage for this client?a. Erika should apply compression over the main arteries beginning proximally (near
the heart) and moving distally to the tips of the fingers or toes.
b. To encourage venous circulation, Erika should stroke these vessels from proximalto distal, using a gliding motion.
c. Gliding strokes over the veins should be long and smooth to enable the blood to
move from valve to valve.d. All of the above are true.
11. Joachim is applying reflexology methods. Which of the following is true?
a. Joachim knows that stimulating nerve endings on the feet and hands helps to
depress the release of endorphins. b. Joachim should advise the client that because of all the small bones and joints in
these extremities, hand and foot self-massage should not be encouraged.
c. Joachim cannot tell whether a reflexive point is overactive or underactive, so heshould alternately use both approaches and let the body choose which to respond to.
d. None of the above is true.
ANS: C
REF: 467
DIF: 3
12. Maggie is assessing connective tissue dysfunction in a physician-referred client in order to
plan the best massage possible. Maggie knows that:
a. muscle spasms around a joint can indicate a destabilized joint caused by
understretched connective tissue; it is not possible, however, to overstretchconnective tissue.
b. decreased muscle tension does not cause actual misalignment because the body canadjust to this condition—unlike increased tension, which is less controllable.
c. it can sometimes be acceptable to introduce therapeutic inflammation by
deliberately reinjuring tissue.d. all of the above are true.
ANS: C
REF: 468-469DIF: 3
13. Maggie has made use of deep transverse friction. This procedure:a. restructures connective tissue and increases circulation to the area.
b. induces an analgesic state.
c. should be followed by painlessly contracting the frictioned area using a broadeningcontraction.
d. is accurately described in a, b, and c.
ANS: DREF: 469
DIF: 2
14. Carol’s client is being treated for myofascial adhesions. Her physician has recommended
therapeutic massage. In administering this massage, Carol:
a. uses 15% to 20% more lubricant, to protect the myofascial tissue. b. uses primarily tapotement and abrupt compression.
c. stops and maintains pressure or tension if she senses movement in the myofascial
tissue and further understands that vasomotor responses on other parts of the skin
are nothing to be alarmed about.d. uses both a and b.
19. Adam is applying the polarity method to a client. He must remember that:
a. brisk stimulation is to be avoided. b. he must not cross his hands over the client’s body.
c. force creates energy and blocks tension.
d. all of the above are true.
ANS: B
REF: 491DIF: 3
20. Maggie has started working in a resort spa, where she sometimes wraps the body as part of
some spa “packages.” She must keep in mind that:a. mylar foil is ideal for heat-generating treatment and because it is disposable.
b. space blankets are ideal because they can be reused and are easily disinfected.
c. lavender and jasmine added to massage oil can have a stimulating effect.
d. a and c are true.
ANS: AREF: 495
DIF: 2
21. A new massage graduate has just begun her first job in a local day spa. She has completed
her orientation on the properties of the various products used in the spa that are for sale,
and she has observed the various treatments other than massage that are used. It is
requested that she promote the sale of the products and encourage clients to experience theother treatments. She wonders if this is a dual role. Which of the following best explains
why it is not?a. She receives a commission on each product she sells. b. She does not use the products herself.
c. Management informs clients that products and services are marketed.
d. Management expects a sales quota each month for products and services.
ANS: C
REF: Entire Chapter
DIF: 3
22. A massage professional is concerned about his performance on a cruise line. Clients seem
satisfied, and he is booked for all of the available appointments. The supervisor is in chargeof the entire spa service and very busy. The massage therapist would like some sort of
validation from the supervisor on his performance. However, when he made this request,
the response was, “I will tell you if there is a problem.” What is likely the underlying issuewith the massage professional?
23. During postural assessment, it becomes evident that the client is twisting into a torsion
pattern at both the shoulder girdle and pelvic girdle. Both are anteriorly rotated on the right.The problem is both short muscles and connective tissue. What is the best treatment plan?
a. Identify the major pain and symptom areas and concentrate stretching in these
locations.b. Identify the areas that are inhibited and long, and use massage to reduce spindle cell
firing.
c. Identify the attachment trigger points and treat them to lengthen tissue.
d. Apply massage methods to the short structures to address both neuromuscular andmyofascial shortening.
ANS: D
REF: Entire Chapter DIF: 3
24. A client has an outcome goal of being less stiff. Palpation assessment indicates that there is
mild superficial edema almost everywhere. Upon questioning, the client indicates that she
has been eating more salt than normal and has worked extensively in the garden the pastfew days. Which methods would best alleviate her stiffness?
a. Lymphatic drain
b. Myofascial release
c. Reflexologyd. Shiatsu
ANS: CREF: Entire Chapter
DIF: 3
25. A client is experiencing pain along her scapula down to the elbow and sometimes
extending into the little finger. She is also complaining of a sore throat, and her face is
puffy. Which meridian is most affected?
a. Spleenb. Kidney
c. Bladder
d. Small intestine
ANS: D
REF: Entire Chapter DIF: 3
26. During palpation assessment, the massage practitioner notices that the area from the axilla,
down the anteromedial aspect of the arm, to the end of the little finger by the nail is tender to the touch on both sides. She suspects that a meridian pathway is the cause. Which of the
c. Have you had any low back pain?d. Have your ears been ringing?
ANS: AREF: Entire Chapter
DIF: 3
27. An elderly client is beginning to experience signs of early stage Alzheimer’s disease. He is
very upset about the possibility of losing his independence. The stress symptoms are
aggravating the memory difficulties and confusion. What assessments would best identify
the area most likely to be addressed by massage to reduce the stress levels?a. Palpation of pulses and hot and cold of the extremities
b. Postural balance and gait assessment
c. Breathing pattern and upper chest breathing
d. Lower extremity firing patterns
ANS: CREF: Entire Chapter
DIF: 3
28. A client asks for an explanation for why a certain massage method is being used. The goal
for the massage is lymphatic drain. Which of the following best answers the client’s
question?
a. Mechanical movement of the skin helps fluid move into the lymph vessels.b. Reflexive drag of the tissue stimulates neurochemical responses, altering
circulation.c. Compressive force reflexively releases lymphatic pockets.d. The reflexive application of shear force alters movement of fluid from inside to
outside the cell.
ANS: A
REF: Entire Chapter
DIF: 3
29. During the history-taking aspect of the needs assessment, a client informs the massage
practitioner that she has been receiving acupuncture headaches. Which of the following
would be a likely treatment area due to yang meridian pathways in the head?a. Lung and liver
30. When responding to history questions about past experience with massage, a new client
indicates that he has had shiatsu sessions. The client describes how the practitioner
palpated his abdomen. What was the practitioner doing?a. Identifying the various doshas
b. Working with long-term constipation
c. Performing reflexologyd. Assessing the hara
ANS: DREF: Entire Chapter
DIF: 3
31. A client has mild swelling around the left knee after playing basketball. This has beenoccurring for years since an auto accident damaged his knee. The biggest complaint is a
stiff, fat feeling the next morning. He does notice improvement when the massage therapist
uses lymphatic drain in the area. Which of the following main lymphatic nodes would
process the fluid moved during massage?a. Great saphenous
b. Inguinalc. Central axillary
d. Tracheal
ANS: B
REF: Entire Chapter
DIF: 3
32. A massage therapist wants to use massage to enhance the arterial circulation and also
support lymphatic drain. What is the challenge in applying this massage?a. Directionb. Frequency
c. Rhythm
d. Duration
ANS: A
REF: Entire Chapter
DIF: 3
33. A client was hit in the midback during a family touch football game. She experienced
hyperextension at the thoracolumbar junction and woke up this morning with musclespasms. She went to the doctor, who did not find any serious injury, prescribed muscle
relaxants, and indicated that massage should avoid the area. What other method could the
massage practitioner use to provide relief?a. Firing patterns
34. A client has chronic low back pain and finds that massage provides temporary relief. He
experiences the most benefit with a general massage that has a substantial compressiveforce and includes various muscle energy methods but that does not include trigger points
or acupressure. What is the most logical reason for the client not benefiting from point-
specific massage application?a. The client tenses up and guards during this type of application.
b. The client does not actively participate during the massage.
c. The client relaxes best with a meridian-based massage.
d. The client is nervous about the energy-based near-touch application.
ANS: A
REF: Entire Chapter
DIF: 3
35. In Chinese medicine, Si zhen is the term used for the traditional method of physicalexamination. These methods include:
a. muscle testing.
b. establishing rapport.c. palpation.
d. SOAP charting.
ANS: CREF: Entire Chapter
DIF: 3
36. During assessment, the massage therapist notices that a client has a greenish color and sour
smell. Which of the five elements may be out of balance?
a. Pittab. Metal
c. Doa yin
d. Wood
ANS: D
REF: Entire Chapter
DIF: 3
37. A client is three years post-breast cancer treatment. She has made significant lifestyle
changes. She regularly meditates and practices qi gong and tai ji quan. Based on thisinformation, which of the following methods would she appreciate being added to the
38. A client has multiple tender areas around the joints. Which of the point systems would bestaddress the situation?
a. Trigger point
b. Reflexologyc. Ayurveda
d. Polarity
ANS: CREF: Entire Chapter
DIF: 3
39. A massage practitioner has been very busy. She has seen an increase in her client base, andat the end of the day she finds that she does not want to touch any more. This is especially
distressing to her pet cat, who enjoys being petted. If considering polarity therapy theory,which of the major body currents is out of balance?
a. Wood
b. Spleenc. Root chakra
d. Air
ANS: DREF: Entire Chapter
DIF: 3
40. A client is sleeping during the massage while in the supine position. She had indicated
during the assessment interview that her stomach was a bit upset. If using polarity, which
reflex association would you use to address the issue but not wake the client?a. Sole of the foot in the area of the arch
b. The points around the nose
c. Tips of the fingers
d. Rotation of the wrist and ankle
ANS: A
REF: Entire Chapter DIF: 3
41. A client is discussing with his massage therapist a “massage-intense” vacation he is planning to take. He will be traveling to the location and spending two weeks. What is the
42. A method used to tone or sedate acupuncture points without the use of needles is called:a. trigger point therapy.
b. acupressure.
c. myofascial release.d. tructural integration.
ANS: B
REF: 479DIF: 1
43. ________is a term that encompasses all the various forms of massage, movement, and
other touch therapies.a. Technique
b. Bodywork c. Treatment
d. Therapy
ANS: B
REF: 451
DIF: 1
44. Which of the following is a circulatory system that depends on the pumping action of the
skeletal muscle?a. Lymphaticb. Respiratory
c. Arterial
d. All of the above
ANS: D
REF: 465
DIF: 1
45. A specific rehabilitation technique that creates therapeutic inflammation by creating a
specific, controlled reinjury of tissues by applying concentrated therapeutic movement thatmoves the tissue against its grain over only a very small area is called:
60. A client feels stiff but is unable to obtain relief from stretching, so she has requested a more
effective approach to the massage. Which of the following treatment plans would be the
best choice?a. Muscle energy methods with lengthening
b. Lymphatic drain and support for the circulatory system
c. Polarity and hydrotherapyd. Shiatsu and qi gong
ANS: B
REF: 463DIF: 2
61. When assessing for the need to target the lymphatic and circulatory systems, which of the
following is the most effective assessment method?a. Palpation
b. Applied kinesiologyc. Passive movement
d. Near touch
ANS: A
REF:
DIF: 3
62. If a client has very flexible ankles and often complains of lower leg aching, which of thefollowing would be the most likely cause?a. Connective tissue binding
b. Connective tissue laxity
c. Connective tissue shorteningd. Dystonia
ANS: B
REF: 468DIF: 2
63. A client has a scar that is binding to the underlying tissue. The client feels the restrictionwhen attempting to fully flex the adjacent joint. Which of the following methods would
64. A client has had recent shoulder surgery to repair a rotator cuff injury. Which of thefollowing massage applications would have the potential to stimulate healing in the area
without disturbing the surgical area?
a. Massage of the foot near the small toeb. Massage of the foot at the larger toe
c. Massage of the foot in the center of the longitudinal arch
d. Massage of the heel
ANS: A
REF: 466
DIF: 2
65. A client loves to have her feet massaged. She says it is the best part of the session and
reports that she feels light on her feet and tingly all over. The best part, she says, is when
all the joints in the foot are moved and the massage therapist applies deep broad-basedcompression into the arch. Which of the following statements is most correct in response to
the client’s inquiring as to why this is the case?a. The point system of reflexology
b. The extensive nerve distribution to the foot
c. The arterial plexus in the sole of the footd. The simple joint complex of the foot
ANS: B
REF: 467DIF: 2
66. An athlete feels in better contact with the floor after a thorough foot massage. Which of thefollowing best explains this benefit of massage?
a. Flexor withdrawal reflex
b. Achilles tendon reflexc. Proprioceptive reflex
d. Contralateral reflex
ANS: CREF: 467
DIF: 2
67. A client is taking an anti-inflammatory medication. Which of the following connective
68. Which of the following most resembles connective tissue?a. Hammer and drill
b. Gelatin and plastic wrap
c. Rivers and streamsd. Flowers and herbs
ANS: BREF: 471
DIF: 2
69. When considering the tensegric form of the body, which of the following is most correct?a. The body skin is the major element of tensegrity.
b. The tension factors are the myofascial unit.
c. The compression element is not present.
d. Compression elements are like a tent canvas.
ANS: BREF: 471
DIF: 2
70. When viewing the body as an interconnected tensegric form, which aspect does massage
most influence?
a. The tension units
b. The reflex pointsc. The elimination process
d. The exercise process
ANS: A
REF: 471
DIF: 2
71. During assessment, a massage practitioner identifies asymmetry in the shoulders and hips.
There seems to be a tight band from the right anterior aspect of the shoulder to the left
anterior iliac spine. If the location of individual muscles cannot describe this relationship,then which of the following is the most likely explanation?
a. The nature of the neurochemical response
b. The reflexive withdrawal from a pain responsec. The fascial network
76. A client has multiple trigger points in the anterior thorax muscles, which are primarily in
the belly, and has localized trigger points along the attachments of the scapula. Which is
the best treatment plan?a. Use myofascial release in the scapular region and stretch, and then monitor the
change in the trigger points.
b. Treat the trigger points in the thorax aggressively, and then stretch the posterior back muscles.
c. Treat the trigger points in the thorax with the least aggressive methods that are
effective, and monitor the trigger points in the posterior region.d. Treat only the latent trigger points, anterior and posterior, and stretch all muscles
involved.
ANS: CREF: 476
DIF: 2
77. After using positional release on a trigger point in the pectoralis minor, the massagetherapist is having difficulty moving the arm and shoulder to lengthen the area. What
would be the best alternative?a. Local tissue lengthening and stretching with bending force
b. Ice massage instead of stretching
c. Repeating the original treatment without lengtheningd. Having the client stretch the area
ANS: A
REF: 476DIF: 2
78. Which of the following statements is most correct?a. Only layer two muscles develop trigger points.
b. Trigger points in the extensors are seldom beneficial.
c. Trigger points are not part of resourceful compensation patterns.d. Trigger points may be an aspect of appropriate compensation patterns.
ANS: D
REF: 476DIF: 2
79. In the shiatsu methods, the energy should be balanced. If there is too much energy in anarea, it is called:
92. During assessment, a massage therapist is considering the emotional and mental influences
of a client’s symptoms. What is this called in Chinese theory?
a. Qi qingb. Doa yin
c. Wu zang
d. Si shi
ANS: A
REF: 484DIF: 2
93. What color is associated with the metal element?
a. Greenb. Red
c. White
d. Blue
ANS: C
REF: 484DIF: 1
94. During palpation assessment, a massage therapist identifies an area on the skin that isdamp, hot, and gets red when rubbed. The area is near a joint and on a meridian path. He
decides the area is an acupuncture point that should be sedated. Which of the following is
the most correct method?
a. Tapotement along the path of the meridian and tapping on the point b. Sustained inhibitory pressure until the sensation in the point changes
c. Ice massage along the referred pain pathway, with stretchingd. Skin rolling and myofascial stretching along the meridian pathway
ANS: B
REF: 486DIF: 2
95. Which of the following bodywork systems includes massage of about 100 pointsconcentrated at the junction of muscles, ligaments, and joints?
101. In polarity, what forms the central neutral energy axis?a. The long vertical currents
b. The positive and negative contacts
c. The head and spinal columnd. The finger and toe contacts
ANS: C
REF: 489DIF: 2
102. Which of the following is an essential treatment principle of polarity?
a. It has a concrete treatment sequence.b. The polarity protocol is applied without alteration.
c. The professional has no attachment to the outcome.d. The methods can be intense and painful.
ANS: CREF: 489
DIF: 2
103. If the massage practitioner is incorporating polarity therapy concepts and is gently holdingthe little finger and the little toe on the left, which is the most correct statement?
a. He is balancing the ether current.b. He is shifting positive polarity to neutral.c. He is balancing the chakras.
d. He is balancing the earth current.
ANS: D
REF: 490-491
DIF: 2
104. In polarity therapy, the toes and fingers most correspond to what?
a. Abdomen
b. Headc. Chest
d. Legs
ANS: B
REF: 491
DIF: 1
105. During assessment, the client informs the massage therapist that he has been craving fruit
and nuts. To balance the appropriate current, which fingers and toes would be held?