Page 1 of 131
TEXAS MASSAGE THERAPY LICENSING EXAM WITH 250 QUESTIONS
AND CORRECT DETAILED SOLUTIONS WITH RATIONALES LATEST
UPDATED VERSION THIS YEAR 2026-2027
Q1. A client reports severe low back pain that started after lifting boxes yesterday; today they
have numbness radiating down the left leg. What should the massage therapist do first?
A) Perform deep gluteal work to relieve sciatic tension
B) Recommend immediate medical evaluation before massage
C) Apply hot packs to the lumbar region for 20 minutes
D) Stretch the hamstrings to reduce nerve compression
Answer: B
Numbness radiating down the leg suggests possible disc herniation or nerve root compromise;
massage could worsen injury, so medical referral is essential first step.
Q2. During a Swedish massage, a client suddenly becomes short of breath, clutches their chest,
and breaks out in a cold sweat. What is the most appropriate immediate action?
A) Finish the massage slowly to avoid startling the client
B) Elevate the client’s legs and offer water
C) Stop the massage and activate emergency medical services
D) Apply firm pressure to the chest to relieve muscle spasm
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Answer: C
These symptoms indicate a possible myocardial infarction; rapid EMS activation and cessation of
massage are critical to prevent delaying life-saving care.
Q3. In Texas, a massage therapist renews their license every two years. How many continuing
education (CE) hours are required per renewal period?
A) 6 hours
B) 12 hours
C) 24 hours
D) 48 hours
Answer: B
Texas Administrative Board of Massage Therapy requires 12 CE hours biennially, including at
least 2 hours in ethics and 2 hours in human trafficking prevention.
Q4. A pregnant client in her third trimester asks for a massage to relieve ankle swelling. Which
position is safest and most appropriate?
A) Prone with a face cradle and abdominal cutout
B) Supine with a wedge under the right hip
C) Side-lying with pillows supporting the top leg and belly
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D) Seated upright in a massage chair
Answer: C
Side-lying prevents supine hypotensive syndrome (compression of vena cava) and avoids prone
pressure on the gravid uterus; pillows maintain neutral alignment.
Q5. During an intake interview, a client mentions they have HIV but are asymptomatic with
undetectable viral load. How should the massage therapist proceed?
A) Decline service citing risk of transmission through skin contact
B) Use standard precautions and provide full massage
C) Require a doctor’s note before each session
D) Wear double gloves and a mask during the entire massage
Answer: B
HIV is not transmitted by casual contact or massage; standard precautions (hand hygiene, no
open wounds on therapist) are sufficient, and refusal would be discriminatory.
Q6. A client with diabetes reports they took insulin two hours before the massage and now feels
shaky, weak, and dizzy. What should the therapist do first?
A) Continue massage with lighter pressure
B) Offer a fast-acting carbohydrate like juice or glucose tablets
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C) Apply cold packs to the forehead and neck
D) Position the client supine with feet elevated
Answer: B
These symptoms suggest hypoglycemia; oral fast-acting sugar can rapidly raise blood glucose; if
client cannot swallow, call EMS.
Q7. Which of the following is a contraindication to performing a full-body massage in a standard
spa setting?
A) Well-controlled hypertension
B) Localized sunburn on the shoulders
C) Contagious skin infection such as ringworm
D) Recent uncomplicated fracture that is casted
Answer: C
Ringworm (tinea) is highly contagious via direct contact; massage would spread infection to
other body areas or to the therapist.
Q8. A therapist in Texas accidentally drops a drape that touched a client’s unbroken skin. What
is the proper infection control action?
A) Launder the drape in cold water with detergent for reuse
TEXAS MASSAGE THERAPY LICENSING EXAM WITH 250 QUESTIONS
AND CORRECT DETAILED SOLUTIONS WITH RATIONALES LATEST
UPDATED VERSION THIS YEAR 2026-2027
Q1. A client reports severe low back pain that started after lifting boxes yesterday; today they
have numbness radiating down the left leg. What should the massage therapist do first?
A) Perform deep gluteal work to relieve sciatic tension
B) Recommend immediate medical evaluation before massage
C) Apply hot packs to the lumbar region for 20 minutes
D) Stretch the hamstrings to reduce nerve compression
Answer: B
Numbness radiating down the leg suggests possible disc herniation or nerve root compromise;
massage could worsen injury, so medical referral is essential first step.
Q2. During a Swedish massage, a client suddenly becomes short of breath, clutches their chest,
and breaks out in a cold sweat. What is the most appropriate immediate action?
A) Finish the massage slowly to avoid startling the client
B) Elevate the client’s legs and offer water
C) Stop the massage and activate emergency medical services
D) Apply firm pressure to the chest to relieve muscle spasm
, Page 2 of 131
Answer: C
These symptoms indicate a possible myocardial infarction; rapid EMS activation and cessation of
massage are critical to prevent delaying life-saving care.
Q3. In Texas, a massage therapist renews their license every two years. How many continuing
education (CE) hours are required per renewal period?
A) 6 hours
B) 12 hours
C) 24 hours
D) 48 hours
Answer: B
Texas Administrative Board of Massage Therapy requires 12 CE hours biennially, including at
least 2 hours in ethics and 2 hours in human trafficking prevention.
Q4. A pregnant client in her third trimester asks for a massage to relieve ankle swelling. Which
position is safest and most appropriate?
A) Prone with a face cradle and abdominal cutout
B) Supine with a wedge under the right hip
C) Side-lying with pillows supporting the top leg and belly
, Page 3 of 131
D) Seated upright in a massage chair
Answer: C
Side-lying prevents supine hypotensive syndrome (compression of vena cava) and avoids prone
pressure on the gravid uterus; pillows maintain neutral alignment.
Q5. During an intake interview, a client mentions they have HIV but are asymptomatic with
undetectable viral load. How should the massage therapist proceed?
A) Decline service citing risk of transmission through skin contact
B) Use standard precautions and provide full massage
C) Require a doctor’s note before each session
D) Wear double gloves and a mask during the entire massage
Answer: B
HIV is not transmitted by casual contact or massage; standard precautions (hand hygiene, no
open wounds on therapist) are sufficient, and refusal would be discriminatory.
Q6. A client with diabetes reports they took insulin two hours before the massage and now feels
shaky, weak, and dizzy. What should the therapist do first?
A) Continue massage with lighter pressure
B) Offer a fast-acting carbohydrate like juice or glucose tablets
, Page 4 of 131
C) Apply cold packs to the forehead and neck
D) Position the client supine with feet elevated
Answer: B
These symptoms suggest hypoglycemia; oral fast-acting sugar can rapidly raise blood glucose; if
client cannot swallow, call EMS.
Q7. Which of the following is a contraindication to performing a full-body massage in a standard
spa setting?
A) Well-controlled hypertension
B) Localized sunburn on the shoulders
C) Contagious skin infection such as ringworm
D) Recent uncomplicated fracture that is casted
Answer: C
Ringworm (tinea) is highly contagious via direct contact; massage would spread infection to
other body areas or to the therapist.
Q8. A therapist in Texas accidentally drops a drape that touched a client’s unbroken skin. What
is the proper infection control action?
A) Launder the drape in cold water with detergent for reuse
