CNT WRITTEN EXAM VERSION 3 2025/2026
COMPLETE VERIFIED QUESTIONS AND ANSWER✔✨-S
WITH DETAILED RATIONALES
1) To reduce the risk of pneumothorax, needles inserted in points on the upper back and chest should
be:
A. Inserted perpendicularly.
B. Inserted up to the handle.
C. Inserted obliquely.
D. Documented in your needle count.
E. Inserted obliquely.
ANSWER✔✨-: C. Inserted obliquely.
Rationale:
A. Incorrect. Perpendicular insertion on the upper back and chest increases the risk of penetrating the
pleural cavity and causing pneumothorax. The perpendicular angle provides a direct path to the lung
tissue.
B. Incorrect. Inserting needles up to the handle on the chest and upper back is extremely dangerous and
contraindicated due to the thin tissue layers over the lungs.
C. Correct. Oblique insertion (angled away from the lung) reduces the risk of pleural penetration by
directing the needle parallel to the ribs and away from the lung tissue.
,D. Incorrect. While documentation is important for safety, it does not directly reduce the risk of
pneumothorax during insertion.
E. This is a duplicate of option C.
2) Insertion site pain may occur because alcohol was not allowed to dry before needle insertion.
ANSWER✔✨-: TRUE
Rationale:
TRUE: When alcohol is not allowed to dry completely before needle insertion, the alcohol can be carried
into the tissue, causing a stinging or burning sensation upon needle insertion. Proper technique requires
allowing the antiseptic to air dry completely (typically 30 seconds) to prevent this discomfort and ensure
proper disinfection.
3) Pneumothorax occurs at a rate of approximately 1 per 1,000 acupuncture visits in the US.
ANSWER✔✨-: FALSE
Rationale:
TRUE: Incorrect. This rate is far too high. The actual incidence of pneumothorax from acupuncture is
estimated to be much lower, approximately 1 in 10,000 to 1 in 1,000,000 visits.
FALSE: Correct. Pneumothorax from acupuncture is extremely rare. Studies indicate the rate is
approximately 0.001% to 0.01% of acupuncture visits, significantly less than 1 per 1,000 visits.
4) Someone taking anticoagulant medications should never be needled because the risk of bleeding is
too high.
,ANSWER✔✨-: FALSE
Rationale:
TRUE: Incorrect. While caution should be exercised, patients on anticoagulants are not absolute
contraindications for acupuncture. The risk of significant bleeding is generally low with proper
technique.
FALSE: Correct. Patients on anticoagulant medications can receive acupuncture with appropriate
precautions including using smaller gauge needles, shallower insertions, avoiding vascular areas, and
applying firm pressure after needle removal. The practitioner should also inform the patient about
increased bruising risk.
5) Severe adverse events to acupuncture needleings are very rare.
ANSWER✔✨-: TRUE
Rationale:
TRUE: Correct. Severe adverse events from acupuncture are indeed very rare. The vast majority of
acupuncture treatments result in only minor, temporary side effects such as slight bruising, minor
bleeding, or temporary soreness.
FALSE: Incorrect. The safety record of acupuncture is well-documented, with serious complications
occurring in fewer than 1 in 10,000 treatments when performed by properly trained practitioners.
6) Needles from multipacks can be used for more than one patient as long as they are used within 30
minutes of opening the packaging.
ANSWER✔✨-: FALSE
Rationale:
, TRUE: Incorrect. This is a serious violation of Clean Needle Technique standards. Once opened, needles
are considered contaminated for use with another patient regardless of time elapsed.
FALSE: Correct. Needles from multipacks are single-use only and must never be used on more than one
patient. This practice would constitute a serious infection control violation. Each patient must receive
needles from a new, sterile package.
7) CNT requires that new table paper and new table drapes/sheets (if used) are replaced for every
patient visit.
ANSWER✔✨-: TRUE
Rationale:
TRUE: Correct. According to Clean Needle Technique standards, all table coverings that come into
contact with the patient must be replaced between each patient. This includes table paper, drapes,
sheets, and pillowcases. This practice prevents cross-contamination and maintains a clean treatment
environment.
FALSE: Incorrect. The requirement is clear in CNT guidelines that all linens and barriers must be fresh for
each patient.
8) Which of the following is the correct order for cleaning a needle insertion site?
A. Clean with alcohol swab, then apply antiseptic, then insert needle.
B. Clean with antiseptic wipe using a circular motion from center outward, then allow to dry.
C. Apply antiseptic in a back-and-forth motion, then immediately insert needle.
D. Wipe with alcohol, then wipe with dry gauze, then insert needle.
E. Use iodine solution, then immediately wipe off with alcohol.
COMPLETE VERIFIED QUESTIONS AND ANSWER✔✨-S
WITH DETAILED RATIONALES
1) To reduce the risk of pneumothorax, needles inserted in points on the upper back and chest should
be:
A. Inserted perpendicularly.
B. Inserted up to the handle.
C. Inserted obliquely.
D. Documented in your needle count.
E. Inserted obliquely.
ANSWER✔✨-: C. Inserted obliquely.
Rationale:
A. Incorrect. Perpendicular insertion on the upper back and chest increases the risk of penetrating the
pleural cavity and causing pneumothorax. The perpendicular angle provides a direct path to the lung
tissue.
B. Incorrect. Inserting needles up to the handle on the chest and upper back is extremely dangerous and
contraindicated due to the thin tissue layers over the lungs.
C. Correct. Oblique insertion (angled away from the lung) reduces the risk of pleural penetration by
directing the needle parallel to the ribs and away from the lung tissue.
,D. Incorrect. While documentation is important for safety, it does not directly reduce the risk of
pneumothorax during insertion.
E. This is a duplicate of option C.
2) Insertion site pain may occur because alcohol was not allowed to dry before needle insertion.
ANSWER✔✨-: TRUE
Rationale:
TRUE: When alcohol is not allowed to dry completely before needle insertion, the alcohol can be carried
into the tissue, causing a stinging or burning sensation upon needle insertion. Proper technique requires
allowing the antiseptic to air dry completely (typically 30 seconds) to prevent this discomfort and ensure
proper disinfection.
3) Pneumothorax occurs at a rate of approximately 1 per 1,000 acupuncture visits in the US.
ANSWER✔✨-: FALSE
Rationale:
TRUE: Incorrect. This rate is far too high. The actual incidence of pneumothorax from acupuncture is
estimated to be much lower, approximately 1 in 10,000 to 1 in 1,000,000 visits.
FALSE: Correct. Pneumothorax from acupuncture is extremely rare. Studies indicate the rate is
approximately 0.001% to 0.01% of acupuncture visits, significantly less than 1 per 1,000 visits.
4) Someone taking anticoagulant medications should never be needled because the risk of bleeding is
too high.
,ANSWER✔✨-: FALSE
Rationale:
TRUE: Incorrect. While caution should be exercised, patients on anticoagulants are not absolute
contraindications for acupuncture. The risk of significant bleeding is generally low with proper
technique.
FALSE: Correct. Patients on anticoagulant medications can receive acupuncture with appropriate
precautions including using smaller gauge needles, shallower insertions, avoiding vascular areas, and
applying firm pressure after needle removal. The practitioner should also inform the patient about
increased bruising risk.
5) Severe adverse events to acupuncture needleings are very rare.
ANSWER✔✨-: TRUE
Rationale:
TRUE: Correct. Severe adverse events from acupuncture are indeed very rare. The vast majority of
acupuncture treatments result in only minor, temporary side effects such as slight bruising, minor
bleeding, or temporary soreness.
FALSE: Incorrect. The safety record of acupuncture is well-documented, with serious complications
occurring in fewer than 1 in 10,000 treatments when performed by properly trained practitioners.
6) Needles from multipacks can be used for more than one patient as long as they are used within 30
minutes of opening the packaging.
ANSWER✔✨-: FALSE
Rationale:
, TRUE: Incorrect. This is a serious violation of Clean Needle Technique standards. Once opened, needles
are considered contaminated for use with another patient regardless of time elapsed.
FALSE: Correct. Needles from multipacks are single-use only and must never be used on more than one
patient. This practice would constitute a serious infection control violation. Each patient must receive
needles from a new, sterile package.
7) CNT requires that new table paper and new table drapes/sheets (if used) are replaced for every
patient visit.
ANSWER✔✨-: TRUE
Rationale:
TRUE: Correct. According to Clean Needle Technique standards, all table coverings that come into
contact with the patient must be replaced between each patient. This includes table paper, drapes,
sheets, and pillowcases. This practice prevents cross-contamination and maintains a clean treatment
environment.
FALSE: Incorrect. The requirement is clear in CNT guidelines that all linens and barriers must be fresh for
each patient.
8) Which of the following is the correct order for cleaning a needle insertion site?
A. Clean with alcohol swab, then apply antiseptic, then insert needle.
B. Clean with antiseptic wipe using a circular motion from center outward, then allow to dry.
C. Apply antiseptic in a back-and-forth motion, then immediately insert needle.
D. Wipe with alcohol, then wipe with dry gauze, then insert needle.
E. Use iodine solution, then immediately wipe off with alcohol.
