Types of Multiple Choice Questions

Types of Multiple Choice Questions (with Examples)

When preparing for the MBLEx, it helps to learn about the structure and format of the questions you will see on the actual exam. Understanding the different types of multiple-choice questions can boost your performance, as well as give you a peak behind the curtain of how the FSMTB massage licensing exam is set up.

Different question types test different cognitive skills, from basic recall to more complex problem-solving. In this blog post, you will learn about the distinct types of multiple-choice questions that you could encounter on the MBLEx exam. With examples based on the MBLEx content areas, we’ll provide insights into how each question type functions and the best strategies to tackle them. This knowledge can be a practical tool in refining your study approach and boosting your confidence on exam day.

Types of MCQs on the MBLEx

Purpose of Varied MCQs

The MBLEx, like many professional licensing exams, incorporates different types of multiple choice questions (MCQs). This is to ensure a comprehensive evaluation of a candidate’s knowledge, understanding, and ability to apply what they’ve learned in their training to realistic scenarios. The MBLEx doesn’t merely test your ability to remember or recall random facts. It assesses how well you comprehend, analyze, and your proficiency in applying massage therapy knowledge in various situations. We’ve designed our MBLEx practice tests to reflect different types of questions on the actual exam, as well as their format and level of difficulty.

Depth of Knowledge (DOK)

The concept of depth of knowledge (DOK) is integral to understanding the design of questions on the MBLEx. DOK offers a structured framework for categorizing tasks according to their complexity. It ranges from Level 1, which is basic recall of information, to Level 4, which involves extended thinking and complex reasoning. The MBLEx features MCQs from various DOK levels, providing a multi-dimensional evaluation of a candidate’s capabilities and understanding.

Think of depth of knowledge as a way to measure how deeply you need to understand a topic to answer a question correctly. It’s like the difference between just knowing a fact and being able to use that fact in different situations. So, while some questions might just ask you to remember something, others might challenge you to apply what you know in a new way. By getting a handle on this, you can better prepare for all types of questions you’ll face on the exam.

Cognitive Load & Levels of Learning

The idea of cognitive load refers to the mental effort required to process information and complete tasks. It’s the strain on our working memory during problem-solving or learning activities. Not all questions are created equal in terms of the mental effort they demand. Some might be straightforward, requiring you to retrieve a memorized fact. Others, however, push you to engage more cognitive muscles, making you analyze, deduce, or solve problems. Recognizing this distinction can help you better manage your time and mental energy during the exam.

A similar concept called levels of learning, often associated with Bloom’s taxonomy of learning, provides a structured way to understand the depth and complexity of knowledge acquisition. These taxonomies classify learning objectives in a hierarchical manner, ranging from basic information recall, such as “remembering,” to intricate cognitive tasks like “evaluating” or “creating.” By recognizing where a particular objective falls within this hierarchy, educators can design appropriate assessment methods, and learners can tailor their study strategies for more effective knowledge retention and application.


Let’s briefly decode a few key terms related to multiple choice questions:

  • Stem: The main part of the question that presents a problem or scenario.
  • Distractors: These are the incorrect answer options, intentionally crafted to be plausible and challenge your understanding of the question topic.
  • Correct Option: Sometimes called the key, this is the accurate or best answer to the question presented.
  • Negative Question: An MCQ that asks for the item that doesn’t fit or is untrue, often using terms like “NOT” or “EXCEPT.”
  • Absolute Term: Words like “always” or “never” that can often hint at incorrect options.
  • Lead-in: The portion of the question that directly asks or instructs the candidate on what is needed.

Preparation Strategy

Understanding the specific type of multiple-choice questions you’ll encounter allows for a more targeted study approach. For example, when gearing up for scenario-based questions, immersing yourself in real-life case studies can be beneficial. On the other hand, factual recall questions often benefit from tools like flashcards or mnemonic devices. By aligning your preparation methods with multiple-choice test-taking strategies, you set yourself up for a more effective review and, ultimately, exam success.

Recall or Factual Questions

Recall or factual questions are straightforward. They are designed to gauge a student’s ability to remember and retrieve basic facts, specific details, terminology, or concepts they’ve previously studied. These questions do not require higher-order thinking skills but simply test if the examinee has retained certain pieces of information. Essentially, they are the bedrock of any standardized test, including the MBLEx.

Such questions are often seen as the “first step” in understanding; before you can apply or analyze a piece of information, you must first remember it. They are the foundation, ensuring that massage therapists have a solid grasp on key facts and concepts essential to their practice.

For example, a recall question related to the Anatomy and Physiology section might be:

Which system is primarily responsible for transporting oxygen and nutrients to cells and removing waste products?

  • A) Digestive
  • B) Respiratory
  • C) Circulatory
  • D) Nervous

Correct Answer: C) Circulatory

Correct Answer Rationale: The circulatory system is the correct answer because it is primarily responsible for the transport of essential substances (in the blood) throughout the body. The heart pumps oxygenated blood, which carries oxygen and nutrients, to various tissues and organs. Simultaneously, the circulatory system helps in the removal of waste products like carbon dioxide and metabolic byproducts, transporting them to organs like the lungs and kidneys for elimination.

This example is a recall or factual question. It tests the examinee’s basic knowledge of anatomy and physiology, specifically the examinee’s foundational knowledge of the body systems. The answer to this recall question is straightforward and there’s no need for interpretation or application; the question merely asks the test-taker to recall a straightforward fact.

Comprehension or Interpretive Questions

Comprehension questions take a step further from the recall questions. While recall questions assess the memorization of information, comprehension questions challenge the examinee’s understanding of that information. Comprehension questions assess a learner’s ability to understand and interpret information, often requiring them to explain, paraphrase, or summarize a given concept.

Interpretive questions are closely related, and specifically focus on the learner’s ability to interpret, translate, deduce, infer, or extrapolate information based on provided data or context. It’s not just about recognizing the right answer; it’s about understanding the underlying concept, context, or relationship presented in the question.

Both types of questions gauge understanding, but interpretive questions dig a bit deeper into the nuances and implications of the material.

For massage therapists preparing for the MBLEx exam, facing comprehension questions means they are being assessed on their ability to truly grasp the broader implications, significance, or context of what they’ve learned. This is key in a profession where understanding the “Why” behind various treatments, techniques, and considerations is just as critical as knowing the “What“.

Considering the MBLEx Content Outline, let’s explore a comprehension question from the Benefits and Effects of Soft Tissue Manipulation content area:

A massage therapist uses effleurage strokes during a session. Which of the following best describes a primary effect of this soft tissue manipulation technique?

  • A) Break down muscle adhesions
  • B) Warm up superficial muscle tissues
  • C) Stretch muscle fibers
  • D) Activate deeper muscles

Correct Answer: B) Warm up superficial muscle tissues

Correct Answer Rationale: This is the correct answer because effleurage strokes are specifically designed to warm up and prepare the soft tissues, especially superficial layers of muscle and connective tissues for deeper work. These long, gliding strokes increase blood flow to the area, which in turn helps to relax the muscle fibers. Aside from warming up the tissues, effleurage also aids in distributing massage oil or lubricant, transitioning between different types of strokes or areas of focus, lymphatic drainage, promotes relaxation, and can be a tool for the therapist to assess muscle tone.

This example question is a comprehension type of MCQ because it goes beyond mere recall of facts. The test-taker must understand the purpose and effect of specific massage techniques, like effleurage, to choose the correct option, making it more focused on the comprehension of applied knowledge. This question goes beyond the simple identification of a technique and requires an understanding of the purpose behind using that technique.

Application Questions

Application questions in multiple choice exams like the MBLEx take evaluation to another level. While comprehension questions gauge understanding of concepts, application questions measure the examinee’s capability to use that understanding in practical scenarios. It’s about taking theoretical knowledge and applying it to real-world situations, especially ones they might face in their massage therapy practice.

These types of questions require the test taker to employ critical thinking, draw upon what they’ve learned, and figure out how to use that information effectively. In the realm of massage therapy, this means discerning the best techniques, recognizing contraindications for massage, and deciding the most appropriate course of action given a specific client scenario.

Let’s look at an example from the Pathology, Contraindications, Areas of Caution, Special Populations section of the MBLEx:

A client with a recent diagnosis of deep vein thrombosis (DVT) comes to you for a massage session. What is the most appropriate course of action for the therapist to take?

  • A) Proceed with a gentle Swedish massage, to gently melt away the blood clot
  • B) Recommend that the client seeks clearance from their physician before providing massage
  • C) Perform lymphatic drainage techniques to help alleviate the symptoms of DVT
  • D) Use deep-tissue massage techniques, focusing on the unaffected areas

Correct Answer: B) Recommend that the client seeks approval from their healthcare provider before proceeding with any massage

Correct Answer Rationale: DVT is a serious medical condition that can lead to severe complications, including a pulmonary embolism. Massage therapy, particularly techniques that involve manipulation of the deep tissues, may dislodge a thrombus, putting the client at risk. Therefore, it’s crucial to consult with a healthcare provider for an appropriate treatment plan, especially if it is a recent diagnosis.

This example question is an application question because it presents a real-life scenario a massage therapist could encounter. It tests the candidate’s ability to apply their understanding of contraindications and pathology to make an appropriate decision for client care.

Analysis Questions

Analysis questions in exams, particularly in the MBLEx, are designed to push test-takers a step beyond simple comprehension or application. These questions wade into the nuances of situations, requiring the examinee to break down information into its constituent parts to discern underlying patterns, principles, or structures. It’s about seeing the bigger picture, but also understanding the intricate details that make up that picture. For someone preparing for the massage exam, this means parsing complex client cases, evaluating different symptoms or conditions, and determining how they might interrelate.

For a massage therapist, successfully tackling analysis questions indicates a strong ability to not only gather information but to also critically interpret it in the context of providing holistic care for their clients. Such questions can test a deeper knowledge of topics like anatomy, physiology, or ethical considerations inherent in therapeutic practice.

Drawing from the Kinesiology section of the MBLEx, let’s examine an example of an analysis question:

A client comes in complaining of difficulty in abducting their arm. Which muscle would you suspect is likely weakened or compromised?

  • A) Pectoralis Major
  • B) Latissimus Dorsi
  • C) Deltoid
  • D) Biceps Brachii

Correct Answer: C) Deltoid

Correct Answer Rationale: If a client is having difficulty with abducting their arm at the shoulder (glenohumeral joint), it would be reasonable to suspect that the deltoid or the supraspinatus is weakened or compromised in some way. The other listed muscles are involved in different types of arm and shoulder movements but are not specifically responsible for abduction.

This is an analysis question because it asks the examinee to interpret the information given in the scenario (difficulty in arm abduction) and then analyze which muscle would be most likely affected. The question tests the candidate’s ability to use critical thinking skills to analyze kinesiological concepts, rather than just recalling facts.

Synthesis Questions

Synthesis questions on the MBLEx or other tests are aimed at assessing the examinee’s ability to combine various pieces of information to form a cohesive, new whole. Rather than just recalling facts or analyzing given data, synthesis pushes the test-taker to integrate their knowledge and apply it in innovative ways. For someone gearing up for the FSMTB massage licensing exam or the NCBTMB board certification exam, this could mean comprehending multifaceted client scenarios, integrating different therapeutic techniques, or tailoring a unique treatment plan.

A massage therapist’s aptitude in answering synthesis questions reflects their capability to take in diverse client information, apply a broad spectrum of their knowledge, and generate a holistic solution. These questions typically challenge the depth and breadth of one’s grasp over multiple domains (anatomy, physiology, pathology, benefits, ethics, etc.).

Consider the following example from the Benefits and Effects of Soft Tissue Manipulation section of the MBLEx test:

A client has recently undergone joint surgery and is now in the rehabilitation phase. They come to you, a licensed massage therapist, seeking relief from post-surgical pain, stiffness and residual swelling. Which combination of soft tissue techniques would be most effective for this client?

  • A) Deep tissue massage followed by hot stone therapy
  • B) Neuromuscular massage followed by hydrotherapy
  • C) Sports massage with intermittent PNF stretching
  • D) Gentle lymphatic massage and assisted stretching/ROM

Correct Answer: D) Gentle lymphatic massage and assisted stretching/ROM

Correct Answer Rationale: Gentle lymphatic massage is particularly effective in reducing post-surgical swelling by facilitating the drainage of accumulated lymphatic fluid. Assisted stretching and range-of-motion (ROM) exercises can alleviate stiffness and help restore mobility in the affected joint. These techniques are directly suited for a client in the rehabilitation phase after joint surgery, focusing on pain relief, reducing swelling, and improving mobility. *Note: if the client is also receiving physical therapy, it is important to take this into consideration to avoid overdoing treatment.

This is a synthesis question, requiring the examinee to integrate multiple pieces of information: the client’s recent joint surgery, the rehabilitation phase, and the symptoms they are experiencing (pain, stiffness, and swelling). The question calls for the examinee to synthesize these factors and choose the most appropriate and effective combination of soft tissue techniques to address the client’s specific needs.

Evaluation Questions

Evaluation questions stand out as some of the most demanding on the MBLEx. Rather than merely asking for recall or synthesis of knowledge, these questions expect the candidate to make judgments based on criteria. In the massage exam context, this would mean assessing various therapeutic scenarios, weighing the pros and cons, and selecting the most appropriate intervention based on one’s comprehensive knowledge.

For prospective massage therapists, acing evaluation questions signifies a mature grasp of the profession’s nuances. It’s the point where they not only recognize and integrate knowledge but also critically evaluate it against real-world scenarios. This is a testament to their readiness to make informed decisions, taking into account the best practices in treatment planning, pathology, ethics, business practices, and other contexts.

Drawing from the Client Assessment, Reassessment & Treatment Planning section of the MBLEx, here’s an example of an evaluation type of MCQ:

A client, 3 days post car accident, presents with a stiff and painful neck, limited cervical ROM in all directions of motion, and tingling in the arms. You suspect a whiplash injury. What is your best course of action?

  • A) Refer the client to a physician for proper diagnosis
  • B) Proceed with a deep tissue massage targeting the neck
  • C) Perform a assisted stretching routine to increase neck mobility
  • D) Use heated pads to relax the neck muscles

Correct Answer: A) Refer the client to a physician for proper diagnosis

Correct Answer Rationale: Given that the client is only 3 days post-car accident and is experiencing symptoms such as a stiff and painful neck, limited cervical ROM, and tingling in the arms, it’s crucial to refer them for a medical evaluation. This is still an acute injury, which is a contraindication for massage. Having a physician examine and diagnose the injury ensures that any underlying injury or nerve damage is properly treated.

*Remember that the MBLEx will not ask you to diagnose medical conditions since diagnosis is not within the massage therapists’ scope of practice.

This is an evaluation question, as it requires the examinee to assess the situation based on the client’s symptoms and medical history. The examinee must use critical judgment to evaluate the options and determine the most appropriate and ethical course of action, which in this case, is beyond the scope of practice for a massage therapist and requires medical intervention.

Comparative Questions

Comparative questions are a unique breed of multiple choice questions. They challenge the test-taker to discern differences or similarities between two or more concepts, techniques, or scenarios. The aim is to assess a candidate’s ability to not just recognize individual items but to critically compare, contrast or differentiate between them. This is a skill of significant importance in the massage therapy field, where understanding the subtle contrasts between different modalities, anatomical structures, or therapeutic approaches can spell the difference between a successful and a potentially harmful treatment.

The essence of comparative questions lies in their demand for detailed knowledge and the capacity to swiftly and accurately differentiate. They underscore the importance of a comprehensive study plan and a keen understanding of the content. These questions test more than just rote memorization; they test a deep understanding of each topic’s nuances.

Consider this example from the Benefits and Physiological Effects of Techniques that Manipulate Soft Tissue content area of the MBLEx:

Which of the following massage techniques is primarily used to increase local circulation and resembles a kneading motion similar to kneading dough?

  • A) Friction
  • B) Tapotement
  • C) Petrissage
  • D) Effleurage

Correct Answer: C) Petrissage

Correct Answer Rationale: Petrissage is the correct answer because this massage technique involves kneading motions that are similar to kneading dough, which helps to increase local circulation. It accomplishes this by lifting, rolling, and squeezing soft tissue, thus facilitating the flow of blood and interstitial fluid in the targeted area. Friction is a massage technique that uses deep, targeted movements to generate heat and increase blood flow, often used to break up adhesions and smooth out scar tissue. Tapotement (AKA percussion) involves rhythmic tapping, usually performed with the sides of the hands, and is primarily used to stimulate nerves and muscles. Effleurage consists of long, gliding strokes generally used for warming up tissues and encouraging lymphatic drainage.

This is an example of a comparative question as it requires the examinee to differentiate between various massage techniques based on their primary uses and specific movements. The question assesses the candidate’s ability to recognize the distinct characteristics of each technique and identify which one best fits the criteria presented, in this case, increasing local circulation and having a kneading motion.

Problem-solving Questions

Problem-solving questions on the massage licensing exam stand out because they challenge test-takers to apply their knowledge in practical scenarios. These questions are less about recognizing a specific term and more about using the information learned to find solutions to real-world challenges that massage therapists might encounter. Such questions genuinely gauge a candidate’s readiness to tackle the day-to-day tasks in the field. In fact, the FSMTB periodically conducts a Job Task Analysis to gather data which is used to make sure that the exam content accurately reflects the current requirements by the profession.

The uniqueness of problem-solving questions is embedded in their scenario-based structure. They present a situation, often followed by a challenge or complication, and require the candidate to draw upon their understanding of massage practices, therapeutic relationships, ethics, and more. Through these multiple choice questions, examiners can assess not only theoretical knowledge but the application of this knowledge in practical situations.

Drawing from the Guidelines for Professional Practice section of the MBLEx, consider the following example:

A client arrives 15 minutes late for a scheduled 60-minute session and wants to receive the full duration of the massage. You have another appointment immediately after. What is the most appropriate course of action?

  • A) Provide the full 60-minute session and reschedule the next client
  • B) Cancel the late client’s session and charge a cancellation fee
  • C) Ask the next client to wait and give the late client a full session
  • D) Offer a prorated session for the remaining time available according to your late policy

Correct Answer: D) Offer a prorated session for the remaining time available according to your late policy

Correct Answer Rationale: Offering a prorated session aligns with best practices and is the best option listed. This action respects the time of all parties involved: the late client, the therapist, and the next scheduled client. The inclusion of a late policy ensures that both clients and practitioners have pre-set guidelines to refer to, minimizing misunderstandings and maintaining a standard of professionalism.

This is a problem-solving question as it asks the test-taker to consider multiple variables: the client’s tardiness, the therapist’s schedule, the expectations of the next client, policies, and professional guidelines. The question involves evaluating the situation and choosing the best course of action that aligns with professional practice and ethical considerations.

Scenario or Case-Based Questions

In the broad spectrum of multiple choice questions on the MBLEx, scenario or case-based questions stand out as a potent tool to test the practical application of knowledge. Here, test-takers step into the shoes of a massage therapist and confront common situations, where theoretical knowledge meets practical demands.

The essence of such questions lies in presenting a specific client scenario or a case study, and then quizzing the participant on how best to address or analyze that situation. It’s not just about recalling facts; it’s about weaving facts into actions, as would be expected in an actual therapeutic setting. These questions are designed to assess a student’s ability to make informed decisions, offer relevant interventions, and exhibit critical thinking in a professional context.

Let’s look at the following example question based on the Ethics, Boundaries, Laws, and Regulations content area:

A client requests a deep tissue massage to relieve chronic back pain. During the session, the client winces and asks for lighter pressure, but then insists you should continue as before because they believe “pain means it’s working.” What is the most ethical course of action?

  • A) Ignore the client’s wincing and continue with the deep pressure as originally requested
  • B) Stop the massage immediately and suggest they consult a physician
  • C) Adjust the pressure according to the client’s comfort and your clinical judgement, regardless of their insistence
  • D) Continue the session but recommend they see a chiropractor for their back pain

Correct Answer: C) Adjust the pressure according to the client’s comfort and your clinical judgement, regardless of their insistence

Correct Answer Rationale: Ethically, a massage therapist must prioritize client safety and well-being. The client’s wincing is a non-verbal cue that the pressure may be too much, and continuing could lead to injury or increased pain. This course of action respects the client’s autonomy while also adhering to professional standards of care. This is also a good opportunity to educate the client on the fact that they can receive just as much therapeutic benefit from a treatment that is within their comfort limit.

This is a scenario or case-based question, as it presents a specific situation requiring the application of ethical principles and guidelines. The test-taker must evaluate the scenario and decide the most ethical course of action, taking into account both client wishes and professional standards. This type of question assesses the ability to apply theoretical knowledge to practical situations, especially where ethical considerations or clinical reasoning are involved.

Final Thoughts

Understanding the different types of multiple-choice questions on the MBLEx you know what to expect on test day. Each question type, from straightforward recall to scenario-based, is designed to assess your competence and gauge your readiness for real-world massage therapy challenges.

Ready to try some more practice questions? Try a free practice exam to get a feel for what awaits you on the actual MBLEx exam. Members get access to hundreds of practice tests and thousands of realistic practice questions to ensure that you pass the first time.

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