NCBTMB Practice Questions (2026) — Free Sample Questions with Answers

Answer: A

R shoulder elevated; R upper trapezius hypertonic on palpation: Correct. The Objective section holds what the therapist observes, palpates or measures, plus the treatment given; an observed elevated shoulder and a palpated hypertonic muscle are objective findings.

Cervical rotation improved; client reports less pain after session: Changes and results after treatment belong in the Assessment (A) section.

Client to do neck stretches daily; return in 1 week: Self-care and future sessions belong in the Plan (P) section.

Client reports headaches 3x/week, worse at work: Information the client reports belongs in the Subjective (S) section.

SOAP: S = what the client reports; O = what the therapist observes or measures and the treatment given; A = changes and results; P = plan.

Answer: C

1. Medication: a beta-blocker lowers blood pressure and blunts the compensatory heart-rate rise.
2. Session effect: relaxation massage further lowers blood pressure.
3. Risk: orthostatic hypotension (dizziness, fainting) on rising.
4. Adaptation: sit up slowly, pause, then stand with support if needed.

Suggest skipping the dose on massage days: Advising a client to change or skip a medication is outside scope; questions go to the prescriber.

Check the pulse to see if the dose is working: Judging whether a medication dose is effective is outside massage therapy scope.

Have the client sit a moment before standing: Correct. Beta-blockers lower blood pressure and blunt the heart-rate increase that normally offsets a drop in pressure when standing. Massage also lowers sympathetic tone, so the client may feel dizzy (orthostatic hypotension) when getting up; sitting first and rising slowly reduces the fall risk.

Have the client stand up quickly to prevent stiffness: Standing quickly is the movement most likely to cause dizziness or a fall for this client.

Antihypertensives, especially beta-blockers, raise the risk of dizziness on rising after massage: have the client sit up slowly and pause before standing.

Answer: C

1. Context: recent lower-limb surgery increases DVT risk.
2. Findings: unilateral calf swelling, warmth, redness and tenderness.
3. Risk: massage could dislodge a thrombus and cause a pulmonary embolism.
4. Action: do not treat the leg; refer for prompt medical evaluation and document.

Apply light effleurage toward the knee to reduce swelling: Moving fluid out of a possibly clotted vein is exactly the risk; swelling from a suspected DVT is never treated with massage.

Apply ice and elevate the leg, then proceed: Ice and elevation do not rule out a clot; proceeding delays urgent referral.

Not massage the leg; urge prompt medical evaluation: Correct. One-sided calf swelling, warmth, redness and tenderness soon after lower-limb surgery are signs of possible deep vein thrombosis. Massage could dislodge a clot and cause a pulmonary embolism, so the leg is not treated and the client is referred for prompt medical evaluation.

Massage the other areas, then work the calf lightly: Working the other areas may be acceptable after clearance, but any pressure on the suspect calf is contraindicated.

Suspected DVT is a contraindication to massage of the area and needs prompt medical referral, especially after surgery or immobility.

Answer: D

1. In single-leg stance the stance-side hip abductors keep the pelvis level.
2. The client is standing on the right leg, so the right abductors are working.
3. A drop of the left (unsupported) pelvis means the right abductors cannot hold it: right gluteus medius weakness.

Left gluteus medius: Reversed side: the left gluteus medius stabilizes the pelvis when the client stands on the left leg, not the right.

Right gluteus maximus: The gluteus maximus is mainly a hip extensor; weakness typically causes a backward trunk lurch at heel strike, not a contralateral pelvic drop.

Left adductor longus: The adductors do not hold the pelvis level in single-leg stance; that is the stance-side abductors' job.

Right gluteus medius: Correct. The hip abductors of the stance leg hold the pelvis level. When the right gluteus medius is weak, the pelvis drops on the opposite (left, swing) side during right single-leg stance, a Trendelenburg sign.

Trendelenburg sign: the pelvis drops on the swing side because the stance-side gluteus medius is weak.

Answer: A

It may reduce perceived soreness and fatigue: Correct. Reviews of post-exercise massage report reduced delayed-onset muscle soreness and perceived fatigue.

It makes the muscles stronger for the next run: Massage has not been shown to increase muscle strength.

It repairs muscle micro-tears within hours: No evidence shows massage repairs tissue damage on that timescale.

It flushes out lactic acid that causes soreness: Lactate is not the cause of delayed soreness and is cleared within an hour or so without massage.

Post-exercise massage can reduce perceived soreness and fatigue; avoid the lactic acid myth when educating clients.

Answer: D

Remove the pillow so the neck can extend: The curve is fixed; letting the head drop forces the neck toward extension it cannot reach and strains it.

A knee bolster only, leaving the head free: A knee bolster eases the low back but leaves the head and neck unsupported over the gap.

Switch to prone with a standard face cradle: A fixed kyphosis cannot flatten prone; the chest and neck would be forced toward extension.

Pillows to support the head and neck: Correct. Supporting the head at the height its fixed posture requires, with pillows or a wedge, removes the neck strain; positioning never tries to force a fused spine toward neutral.

Bolster to the client's actual posture: fill the gaps created by fixed curves rather than trying to flatten them.

Answer: C

"Press your heel down into my shoulder.": This isometric contraction of the hamstrings themselves is contract-relax (post-isometric relaxation), not reciprocal inhibition.

"Relax completely while I bounce the leg.": Bouncing (ballistic) movement can trigger the stretch reflex and uses no antagonist contraction.

"Lift your leg further toward the ceiling.": Correct. Actively flexing the hip with the knee straight contracts the hip flexors and quadriceps, the antagonists of the hamstrings, which reciprocally inhibits the hamstrings as they lengthen.

"Bend your knee and pull your heel down.": Knee flexion contracts the hamstrings, the target muscle, so it cannot inhibit them reciprocally.

Reciprocal inhibition: contract the antagonist of the tight muscle; contract-relax: contract the tight muscle itself before lengthening it.

Answer: B

Effleurage along the length of the ligament: Gliding strokes are general and superficial; they do not specifically mobilize adhered ligament fibers.

Cross-fiber friction across the ligament: Correct. At 5 months the ligament is in the remodeling stage, and friction applied perpendicular to the fibers helps mobilize and organize scar tissue without gliding on the skin.

Light vibration around the ankle joint: Fine vibration relaxes and stimulates sensory receptors but does not address a localized fibrotic lesion.

Brisk tapotement over the lateral malleolus: Percussion is stimulating and is not a tissue-specific technique; striking over a bony prominence is uncomfortable.

Cross-fiber (transverse) friction is applied perpendicular to the fibers of a chronic, remodeling lesion to mobilize scar tissue; it is not used in the acute stage.

Answer: B

Eversion with plantarflexion: This combination tests fibularis longus and brevis, which pass behind the lateral malleolus.

Inversion with plantarflexion: Correct. Tibialis posterior passes behind the medial malleolus and both plantarflexes the ankle and inverts the foot, so resisting this combination loads it.

Inversion with dorsiflexion: This combination tests tibialis anterior, which runs in front of the ankle.

Eversion with dorsiflexion: This combination tests fibularis tertius and extensor digitorum longus.

Behind the medial malleolus = plantarflexion and inversion (tibialis posterior); in front = dorsiflexion (tibialis anterior inverts, fibularis tertius everts); behind the lateral malleolus = plantarflexion and eversion.

Answer: C

1. Identify the stance leg: the left.
2. The stance-side hip abductors (gluteus medius) keep the opposite side of the pelvis level.
3. A right-side drop while standing on the left = left gluteus medius weakness.

Left quadratus lumborum: The left quadratus lumborum would elevate the left side of the pelvis, the opposite side.

Right gluteus maximus: The gluteus maximus extends and laterally rotates the hip; it does not elevate the pelvis in the frontal plane.

Right quadratus lumborum: Correct. Hip hiking raises the pelvis on the swing side, and the quadratus lumborum elevates the pelvis on its own side, so the right quadratus lumborum works overtime and often becomes hypertonic and tender.

Right tensor fasciae latae: The tensor fasciae latae flexes, abducts and medially rotates the hip; it does not hike the pelvis.

Hip hiking (elevating the swing-side pelvis to clear a stiff or functionally long leg) overworks the same-side quadratus lumborum; check it in clients with this gait compensation.

Answer: B

1. Supine to standing: gravity pools blood in the legs, so venous return and blood pressure drop briefly.
2. Baroreceptors trigger a sympathetic increase in heart rate to restore pressure.
3. A beta-blocker blocks that heart-rate response, so the drop lasts longer: have the client sit, pause, then stand.

Plaque hardening the arterial walls: Plaque buildup (atherosclerosis) affects arteries, not superficial veins.

Failed valves letting blood pool: Correct. In varicose veins, weakened walls and incompetent one-way valves let blood flow backward and pool, so the superficial veins stretch and twist; gravity during prolonged standing makes them worse. The therapist avoids deep pressure directly over them.

Lymph backing up into the veins: A lymphatic backlog causes lymphedema (tissue swelling), not dilated, twisted veins.

A clot blocking a deep vein: A deep vein clot (DVT) causes a swollen, warm, tender calf; it does not explain chronic bulging superficial veins.

Varicose veins form when venous valves fail and blood pools in the superficial veins; avoid deep pressure directly over them.

Answer: B

1. Map the symptoms: medial forearm and digits 4–5 = C8–T1 fibers.
2. Locate the level: the interscalene triangle holds roots and trunks, not cords.
3. C8 and T1 join to form the lower trunk.

Upper trunk: The upper trunk (C5–C6) serves the lateral shoulder, arm and thumb side, not the ulnar side of the hand.

Lower trunk: Correct. Between the anterior and middle scalenes the plexus exists as roots and trunks; the lower trunk (C8–T1) carries the fibers serving the medial forearm and digits 4–5.

Posterior cord: Cords form below the clavicle, not between the scalenes, and the posterior cord gives the axillary and radial nerves.

Middle trunk: The middle trunk (C7) mainly serves the middle finger and posterior arm; it does not explain medial forearm and digit 4–5 symptoms.

Medial forearm plus digits 4–5 points to C8–T1; between the scalenes these fibers travel in the lower trunk of the brachial plexus.

Answer: B

Record nothing, as no money changed hands: Bartering is taxable even without cash.

Report the $320 fair market value as income: Correct. Barter is taxable income: the fair market value of the services received is reported as income, and the website work may be recorded as a business expense.

Report it only if the designer sends a tax form: The obligation to report barter income does not depend on receiving a form.

Report half the value, since both gave services: The full fair market value received is income; it is not split.

Bartered goods and services are income at fair market value and are recorded like any other transaction.

Answer: A

Stop and offer juice or another fast sugar: Correct. These are signs of hypoglycemia. Stopping the session and giving a conscious client who can swallow a fast-acting carbohydrate is first-aid care within scope; call EMS if symptoms do not improve or the client becomes less responsive.

Give the client a dose of their own insulin: Insulin lowers blood glucose further and would worsen hypoglycemia; giving a client's prescription medication is also outside scope.

Continue the session using lighter pressure: Continuing ignores a medical emergency; confusion means blood glucose needs to be raised now.

Turn the client prone so they can rest: Repositioning does not treat low blood glucose, and a confused client lying prone is at risk of falling or choking.

Sweating, shakiness and confusion in a client with diabetes suggest hypoglycemia: stop, give fast-acting sugar if the client is conscious and can swallow, and call EMS if there is no improvement.

Answer: D

Transference; discuss it with the client: Transference is the client's redirection of feelings onto the therapist; here the feelings are the therapist's.

Countertransference; keep extending sessions: The label is right, but continuing the extensions acts on the countertransference.

Transference; refer the client out at once: Wrong label, and immediate referral is premature before addressing the therapist's reaction.

Countertransference; seek supervision: Correct. The therapist is projecting feelings about her own son onto the client (countertransference). She restores normal session limits and seeks supervision or peer consultation to manage it.

Transference flows from client to therapist; countertransference from therapist to client. The therapist manages countertransference through supervision and firm boundaries.

Answer: C

Only as long as the jurisdiction's law requires: Meets the law but not the Standards of Practice; a Certificant is also bound by NCBTMB's longer minimum.

For the most recent 3 fiscal years: Three fiscal years is the SoP period for financial records, not client files.

At least 4 years after the relationship ends: Correct. NCBTMB's Standards of Practice (Standard III) require client files to be kept securely for at least 4 years after the therapeutic relationship ends. Following the longer requirement satisfies both rules; the file is then disposed of securely.

Until 6 months after the last session: Six months is the SoP's minimum interval before any sexual relationship after termination, not a records period.

When the law and NCBTMB's Standards differ, a Certificant follows the stricter rule: client files are kept at least 4 years after the relationship ends, then securely destroyed.