Massage & Bodywork Licensing Examination (MBLEx) Quiz: Contraindications
20 questions · exam conditions
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ContraindicationsQuestion 1 of 20

A client arrives for their appointment with a fever of 101.2°F (38.4°C), body aches, and chills. They state they want a massage to help them 'sweat out the sickness.' What is the appropriate course of action for the massage therapist?

Perform a light, circulatory massage to support the immune system.
Provide a full-body massage but avoid the head and neck.
Reschedule the appointment, as a fever is a systemic contraindication.
Use cool compresses during the massage to help lower the fever.
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Massage & Bodywork Licensing Examination (MBLEx) Quiz

Massage & Bodywork Licensing Examination (MBLEx) Quiz: Contraindications

Practice Contraindications in Massage & Bodywork Licensing Examination (MBLEx) with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Contraindications, giving you a quick way to practice the rules, question types, and explanations that matter most for Massage & Bodywork Licensing Examination (MBLEx).

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

A client arrives for their appointment with a fever of 101.2°F (38.4°C), body aches, and chills. They state they want a massage to help them 'sweat out the sickness.' What is the appropriate course of action for the massage therapist?

  1. Perform a light, circulatory massage to support the immune system.
  2. Provide a full-body massage but avoid the head and neck.
  3. Reschedule the appointment, as a fever is a systemic contraindication. (correct answer)
  4. Use cool compresses during the massage to help lower the fever.
Explanation: A fever is a sign of a systemic infection or inflammation. Massage can increase circulation, potentially spreading the infection and exacerbating the client's condition. Therefore, it is a systemic contraindication, and the session should be rescheduled.

Question 2

A new client is in her first trimester of pregnancy (9 weeks) and reports experiencing moderate morning sickness and fatigue. She has not yet received clearance from her doctor for massage. The most cautious and professional action is to:

  1. proceed with a gentle side-lying massage, avoiding the abdomen.
  2. postpone the massage and recommend she obtain physician clearance before her first session. (correct answer)
  3. perform deep tissue massage on her back and legs while she is in the prone position.
  4. use aromatherapy with peppermint to alleviate her nausea during the session.
Explanation: The first trimester is a delicate period in pregnancy. While massage is not absolutely contraindicated, the presence of symptoms like morning sickness and the lack of physician clearance make it necessary to postpone the session. This ensures client safety and professional liability.

Question 3

A client is actively undergoing chemotherapy and has a port-a-cath implanted in their right upper chest. They have received clearance for a gentle massage from their oncologist. Which action is appropriate?

  1. Perform deep tissue massage over the entire body to flush out toxins.
  2. Avoid the area around the port and use a light, soothing touch for the session. (correct answer)
  3. Refuse to treat the client because chemotherapy is an absolute contraindication.
  4. Massage directly over the port to reduce local inflammation.
Explanation: With physician clearance, gentle massage can be beneficial for clients undergoing chemotherapy. However, implanted devices like ports are local contraindications. The therapist must avoid direct pressure on and around the site to prevent pain, dislodgement, or infection.

Question 4

While working on a client's calf, the therapist palpates a small, hard, warm, and painful lump the client was not aware of. The area is also slightly red. What is the therapist's most appropriate action?

  1. Apply deep pressure and friction to break up the nodule.
  2. Inform the client that it is likely an ingrown hair and continue the massage.
  3. Immediately stop the massage, avoid the area, and refer the client to a physician for evaluation. (correct answer)
  4. Apply ice to the lump and then continue with lighter massage over the area.
Explanation: An undiagnosed lump with signs of inflammation (heat, pain, redness) is a significant local contraindication. It could indicate a localized infection, a cyst, or deep vein thrombosis (DVT). The therapist must avoid the area and refer the client for a medical diagnosis to ensure their safety.

Question 5

A client with a history of systemic lupus erythematosus (SLE) arrives for her massage complaining of severe joint pain, a low-grade fever, and a distinct facial rash, indicating a flare-up. Which of the following is true?

  1. A deep tissue massage is indicated to address the client's joint pain.
  2. Massage is systemically contraindicated during an acute inflammatory phase of an autoimmune disease. (correct answer)
  3. The massage should proceed as planned, focusing only on the muscles and avoiding the joints.
  4. Only the area of the rash is a local contraindication.
Explanation: An acute flare-up of an autoimmune condition like lupus involves widespread systemic inflammation. Massage can exacerbate this inflammatory state and worsen the client's symptoms. Therefore, it is a systemic contraindication, and the session should be postponed.

Question 6

A client diagnosed with fibromyalgia is experiencing a flare-up with heightened pain sensitivity and fatigue. They have booked their usual deep tissue appointment. What is the best treatment modification?

  1. Proceed with the deep tissue massage as requested to address the muscle pain.
  2. Refuse to treat the client until the flare-up has passed.
  3. Suggest a very gentle, soothing relaxation massage to avoid overstimulating the nervous system. (correct answer)
  4. Use vigorous tapotement and friction to increase circulation and energy.
Explanation: During a fibromyalgia flare-up, the central nervous system is sensitized, and deep or aggressive massage techniques can easily overwhelm the client and increase their pain and fatigue. A gentle, calming massage is more appropriate to help soothe the nervous system and provide comfort without causing a post-massage exacerbation.

Question 7

During a visual assessment, the therapist observes a single, annular (ring-shaped), red, and scaly patch on the client's upper back. The client says it is mildly itchy. The therapist suspects tinea corporis (ringworm). What is the proper action?

  1. Apply massage oil to the patch to moisturize it.
  2. Cover the patch with a bandage and proceed with the massage.
  3. Avoid the affected area due to its contagious nature and advise the client to consult a doctor. (correct answer)
  4. Use friction on the lesion to exfoliate the flaky skin.
Explanation: Tinea corporis is a contagious fungal infection. It is a local contraindication. The therapist must avoid contact with the lesion to prevent spreading it on the client or contracting it themselves. Referring the client to a physician for diagnosis and treatment is the correct professional response.

Question 8

A new client's intake form lists a blood pressure of 165/105 mmHg. When asked, the client states they are not taking medication for it and have not seen a doctor recently. This condition is considered:

  1. a local contraindication requiring avoidance of the neck.
  2. an indication for a vigorous, stimulating massage.
  3. a systemic contraindication requiring physician clearance before massage. (correct answer)
  4. safe for a standard 60-minute relaxation massage.
Explanation: Uncontrolled hypertension (high blood pressure) is a systemic contraindication. Circulatory massage can further elevate blood pressure, posing a risk to the client. The therapist should refer the client for medical evaluation and require physician's clearance before providing a massage.

Question 9

A client's health history form indicates they take warfarin, an anticoagulant.

What modification is necessary for this client?

  1. Avoid all forms of massage as it is systemically contraindicated.
  2. Use gentle techniques and avoid deep tissue, friction, and percussive strokes. (correct answer)
  3. The medication has no bearing on massage, so no modifications are needed.
  4. Focus primarily on stretching and joint mobilizations.
Explanation: Anticoagulants (blood thinners) like warfarin increase the risk of bruising and bleeding. Therefore, deep or aggressive techniques that could cause tissue damage are contraindicated. Gentle, relaxing massage is generally safe, but modifications are essential.

Question 10

In the middle of a massage session, a client casually mentions that their doctor diagnosed them with scabies yesterday and they just started treatment. What is the therapist's most appropriate and immediate action?

  1. Put on gloves and continue the massage.
  2. Stop the massage, explain why, and follow procedures for sanitizing the room and all linens. (correct answer)
  3. Finish the session quickly, avoiding any areas that look irritated.
  4. Ask the client to shower in the facility before completing the massage.
Explanation: Scabies is a highly contagious parasitic skin infestation. Upon learning of this condition, the therapist must stop the massage immediately to prevent transmission. The client should be educated politely, and the therapist must then follow strict protocols for decontaminating the treatment room, linens, and any equipment used.

Question 11

A client indicates on their health history that they have end-stage renal failure and are on dialysis. What is the primary concern and necessary step for the massage therapist?

  1. There is no concern; a standard relaxation massage can be performed.
  2. The therapist should perform a deep, vigorous massage to assist the kidneys in flushing waste.
  3. The only contraindication is to avoid the arm with the shunt or fistula.
  4. The condition is a systemic contraindication requiring physician approval before any massage. (correct answer)
Explanation: End-stage renal failure is a serious systemic condition that affects fluid balance, blood pressure, and waste removal. Massage could potentially overwhelm the client's compromised system. Therefore, it is a systemic contraindication, and the therapist must obtain clearance from the client's physician before proceeding.

Question 12

A client arrives for their appointment with a persistent cough, sneezing, and a runny nose. They say they were diagnosed with influenza yesterday. The most appropriate action is to:

  1. proceed with the massage, but ask the client to wear a face mask.
  2. perform the massage, but the therapist should wear a mask and gloves.
  3. explain the contraindication and reschedule the appointment for when they are no longer ill. (correct answer)
  4. provide a shorter session focused on lymphatic drainage to speed recovery.
Explanation: Influenza is a contagious viral illness and a systemic contraindication for massage. Proceeding with the session puts the therapist and other clients at risk of infection. Additionally, massage can worsen the client's symptoms. The professional standard is to reschedule the appointment.

Question 13

A client has a large, dark ecchymosis (bruise) on their thigh from a recent impact. For the purposes of massage, this specific area is considered a:

  1. systemic contraindication.
  2. trigger point.
  3. local contraindication. (correct answer)
  4. general endangerment site.
Explanation: A bruise is an area of localized tissue damage and bleeding. Applying pressure can be painful and may worsen the damage. Therefore, it is a local contraindication, meaning the therapist should avoid direct work on the bruised area but can massage the rest of the body.

Question 14

A client with a history of Raynaud's phenomenon and controlled hypertension presents for a session. Their health history form indicates they take a beta-blocker for their blood pressure. The client requests the application of a therapeutic cold pack on their shoulder to address chronic inflammation.

Based on the client's presentation and health history, what is the most appropriate action for the massage therapist?

  1. Apply the cold pack for a shorter duration, no more than 5 minutes, to mitigate risks associated with hypertension.
  2. Explain that cryotherapy is contraindicated due to the combined effects of Raynaud's phenomenon and beta-blocker medication. (correct answer)
  3. Proceed with the cold pack application as requested, as the client's hypertension is well-controlled by their medication.
  4. Use a moderately cool pack instead of a therapeutic cold pack to reduce the intensity of the thermal stimulus on the shoulder.
Explanation: This question requires multi-step reasoning. Raynaud's phenomenon causes extreme vasoconstriction in response to cold, making cryotherapy a significant contraindication. Beta-blockers can also cause peripheral vasoconstriction as a side effect. The combination of these two factors makes the application of therapeutic cold a serious risk for this client. The therapist must recognize this absolute contraindication. The other options represent insufficient or incorrect modifications.

Question 15

A client who is 6 months post-mastectomy on the left side presents with diagnosed lymphedema in their left arm. During the intake, they point to a new, localized area on the affected forearm that is red, warm to the touch, and tender. They ask for a manual lymphatic drainage session.

What is the primary contraindication present, and what is the therapist's most critical course of action?

  1. Lymphedema is a contraindication; perform the session on the contralateral limb only to promote systemic fluid movement.
  2. The client has an active thrombosis; postpone the session and recommend bed rest until symptoms subside.
  3. The client has signs of acute infection (cellulitis); postpone the massage and refer them for immediate medical evaluation. (correct answer)
  4. The area is acutely inflamed; apply a cold compress and perform gentle proximal lymphatic work on the affected arm.
Explanation: The combination of redness (erythema), heat, and tenderness in a limb with lymphedema strongly suggests an acute bacterial infection like cellulitis, which is a medical emergency and an absolute contraindication for massage. The therapist's primary responsibility is to recognize these red flags and refer the client for immediate medical care. While MLD is appropriate for lymphedema, it is contraindicated during an active infection.

Question 16

A client with a long-standing diagnosis of rheumatoid arthritis (RA) is experiencing an acute flare-up, with several joints being visibly swollen and painful. They are taking a high dose of an oral corticosteroid. The client requests deep tissue massage, believing it will help relieve the stiffness.

Which of the following is the most significant reason to refuse the requested deep tissue massage?

  1. The systemic inflammation of an RA flare-up contraindicates deep work, and corticosteroids increase tissue fragility. (correct answer)
  2. Deep tissue massage can increase synovial fluid production, which is undesirable in a client with rheumatoid arthritis.
  3. The client's pain perception is altered by the corticosteroid, making accurate feedback about pressure impossible.
  4. Massage is systemically contraindicated for all autoimmune conditions regardless of the client's current state.
Explanation: This scenario presents two major contraindications. First, an acute systemic inflammatory condition like an RA flare-up contraindicates deep or vigorous massage. Second, long-term or high-dose corticosteroid use makes connective tissue more fragile and prone to damage. Combining these factors makes deep tissue massage especially dangerous. The other options are either less accurate or overly generalized.

Question 17

A client with a known history of kidney stones calls to book an emergency appointment. They describe a sudden onset of severe, spasmodic pain in their right flank and lower back that began two hours ago. They are convinced it is a quadratus lumborum spasm and want deep, focused massage.

What is the most appropriate response from the massage therapist?

  1. Schedule the appointment and plan to use thermotherapy to relax the muscle before performing deep tissue work.
  2. Decline to provide massage and advise the client to seek immediate medical evaluation for suspected renal colic. (correct answer)
  3. Book the client and explain that only a gentle relaxation massage can be performed to avoid exacerbating the spasm.
  4. Instruct the client to take an over-the-counter analgesic and come in once the most acute pain has subsided.
Explanation: The client's symptoms (acute, severe, spasmodic flank pain) combined with a history of kidney stones are classic red flags for renal colic, a medical emergency. Massage is absolutely contraindicated. The therapist's professional and ethical duty is to recognize the potential for a serious medical event and refer the client for immediate medical care. Any form of massage would be inappropriate and potentially harmful.

Question 18

During a visual assessment, a therapist notes a mole on a client's back that is approximately 7mm in diameter, has an irregular border, and displays multiple shades of brown and black. The client says they have had it for years but thinks it might have gotten bigger.

Given these observations, what is the therapist's primary professional responsibility?

  1. Document the mole's characteristics in the session notes and monitor it for changes at subsequent appointments.
  2. Avoid applying lubricant or pressure directly on the mole, treating it as a local contraindication, and proceed with the massage.
  3. Inform the client of the observation, explain that it should be evaluated by a physician, and treat the area as a local contraindication. (correct answer)
  4. Complete the massage as planned but provide the client with a brochure on skin cancer awareness before they leave.
Explanation: The described mole exhibits several warning signs for melanoma (asymmetry, border irregularity, color variation, diameter >6mm, evolution). While a therapist cannot diagnose, they must recognize red flags. The primary responsibility is to advise the client to seek medical evaluation while also treating the mole as a local contraindication. Simply avoiding it or documenting it without communication is insufficient.

Question 19

A new client who is 12 weeks pregnant reports aching and heaviness in her lower legs. A visual assessment reveals several prominent varicose veins on both calves. She requests a deep tissue massage specifically on her calves to alleviate the discomfort.

Which of the following represents the most critical contraindication to the client's request?

  1. Deep tissue massage is systemically contraindicated during the first trimester due to the risk of miscarriage.
  2. Deep pressure on varicose veins is contraindicated due to the risk of vascular damage and thrombus formation, especially in pregnancy. (correct answer)
  3. Massage on the lower legs should be avoided entirely during pregnancy because of pressure points that can induce labor.
  4. The client requires a physician's release for any massage during pregnancy, regardless of the techniques used.
Explanation: The most significant and immediate risk is applying deep pressure directly over varicose veins. These veins have weakened walls, and deep work can cause damage or dislodge a blood clot (thrombus). This risk is elevated during pregnancy due to hormonal changes and increased blood volume. While caution is advised in the first trimester, a blanket contraindication is an outdated concept. The specific, localized risk is the primary concern.

Question 20

A client with hemophilia A provides a doctor's note clearing them for 'gentle, relaxing massage.' During the session, the client indicates their hamstrings feel exceptionally tight and asks the therapist to use a handheld percussive device on the area.

How should the therapist respond to the client's request for the percussive device?

  1. Use the device on its lowest setting, as the doctor has cleared the client for massage.
  2. Agree to use the device for a very brief period, monitoring for any signs of adverse reaction.
  3. Decline to use the device, explaining that its aggressive mechanical action poses a significant risk of bruising and internal bleeding. (correct answer)
  4. Explain that the doctor's note does not specifically approve the use of mechanical devices.
Explanation: Hemophilia is a severe bleeding disorder, making the client highly susceptible to hematomas from minor trauma. Percussive devices, even on low settings, create micro-trauma in the muscle tissue. This is an absolute contraindication for this client. The therapist must recognize that the doctor's clearance for 'gentle' massage does not extend to inherently aggressive tools. The core reason for refusal is the specific risk of the pathology, not a semantic interpretation of the doctor's note.