NBCE ACUPUNCTURE EXAM 2026/2027 Practice Examination
NBCE ACUPUNCTURE EXAM
QUESTIONS AND ANSWERS
Comprehensive Practice Examination
Aligned with the National Board of Chiropractic Examiners (NBCE) Acupuncture Test Plan
Total Questions: 150 Multiple-Choice Items
Sections: 7 Content Domains (per NBCE Test Plan)
Format: Single Best Answer (4 options A–D)
Cognitive Levels: 25% Recall | 50% Application | 25% Analysis
Style Mix: 70% Scenario-Based | 30% Direct Knowledge
Standard References: A Manual of Acupuncture (Deadman); Foundations of Chinese Medicine
(Maciocia); Clean Needle Technique Manual (CCAOM, 7th ed.)
This practice examination is designed for chiropractic candidates preparing for the NBCE Acupuncture
examination. Each question includes the correct answer and a concise rationale grounded in the NBCE
Acupuncture Test Plan and standard reference texts.
Aligned with NBCE
Standard
Acupuncture
references:
Test
A Manual
Plan of Acupuncture (Deadman); Foundations of Chinese Medicine (Maciocia); CNT Manual (CCAOM) Page 1
,NBCE ACUPUNCTURE EXAM 2026/2027 Practice Examination
Examination Overview
This practice examination comprises 150 multiple-choice questions distributed across the seven content domains of
the NBCE Acupuncture Test Plan. The number of questions per section reflects the official percentage weights
published by the National Board of Chiropractic Examiners (NBCE), ensuring that candidates' study time is
proportionally allocated to high-yield content. Each question includes four options (A–D), one correct answer
marked with the *[CORRECT]* tag, and a concise 2–3 sentence rationale that cites the relevant section of the
NBCE Acupuncture Test Plan alongside standard reference texts.
Section Breakdown (per NBCE Test Plan Percentages)
# Section % of Test Questions Question Range
1 History/Philosophy of Acupuncture in a Chiropractic Setting 5% 8 Q1–Q8
2 Organs, Qi, and Fluid 12% 18 Q9–Q26
3 Channels/Pathways 21% 32 Q27–Q58
4 Acupoints 30% 45 Q59–Q103
5 Acupuncture Techniques 5% 8 Q104–Q111
6 Basic Treatment Tenets/Protocols 18% 27 Q112–Q138
7 Safety and Hygiene 9% 12 Q139–Q150
Cognitive Level Distribution
Per NBCE Test Plan cognitive level guidance, the examination distributes questions across three taxonomic levels:
approximately 25% are recall items testing factual knowledge (e.g., point locations, meridian pathways, organ
correspondences); approximately 50% are application items requiring candidates to apply principles to clinical
scenarios (e.g., point selection for a given presentation); and approximately 25% are analysis items demanding
differential diagnosis and clinical reasoning (e.g., distinguishing between Liver Yang rising vs. Kidney Yin
deficiency headaches).
How to Use This Practice Exam
• Attempt all 150 questions under timed conditions (target 4–5 hours).
• Review rationales for both correct and incorrect answers to maximize learning.
• Cross-reference point locations and clinical reasoning with the standard references cited in each rationale.
• Pay particular attention to Section 7 (Safety and Hygiene) items, as these are non-negotiable in clinical practice and
frequently emphasized on the NBCE exam.
Aligned with NBCE
Standard
Acupuncture
references:
Test
A Manual
Plan of Acupuncture (Deadman); Foundations of Chinese Medicine (Maciocia); CNT Manual (CCAOM) Page 2
,NBCE ACUPUNCTURE EXAM 2026/2027 Practice Examination
Section 1: History/Philosophy of Acupuncture in a Chiropractic Setting
5% of NBCE Acupuncture Test Plan | 8 Questions | Covers Yin-Yang theory, Five Elements theory, historical development, and
foundational philosophical concepts in a chiropractic context.
Q1: A chiropractic intern is preparing a patient education handout describing how Traditional Chinese
Medicine (TCM) philosophy complements the chiropractic model of vertebral subluxation. Which statement
most accurately reflects the foundational nature of Yin and Yang?
A. Yin is associated with heat, activity, and the Fu (hollow) organs, whereas Yang is associated with cold, rest, and the
Zang (solid) organs.
B. Yin and Yang are mutually exclusive opposites that never transform into one another, ensuring homeostasis.
C. Yang is associated with heat, activity, outward movement, and the Fu (hollow) organs, while Yin is associated with
cold, rest, interior, and the Zang (solid) organs. *[CORRECT]*
D. Yin and Yang describe only anatomical location, with no relevance to physiological function or pathology.
Correct Answer: C
Rationale: Per the NBCE Acupuncture Test Plan (History/Philosophy domain), Yang is hot, active, exterior, and Fu-organ
related, whereas Yin is cold, quiescent, interior, and Zang-organ related; they are mutually consuming, interdependent, and
capable of transformation (Maciocia, Foundations of Chinese Medicine, Ch. 2). Option A reverses the polarity; option B
denies transformation; option D ignores the dynamic functional relevance central to TCM.
Q2: A patient asks how the Yin-Yang theory explains the development of a high-fever, flushed-face condition
from an initial chill-and-aversion-to-cold presentation. This clinical transformation is best described by which
Yin-Yang relationship?
A. Mutual opposition only, in which Yin simply suppresses Yang.
B. Mutual transformation, in which Yin can convert to Yang when an extreme is reached ("extreme cold produces heat").
*[CORRECT]*
C. Mutual rootedness, in which Yin and Yang share the same origin but never change.
D. waxing and waning without any qualitative change in the patient's pattern.
Correct Answer: B
Rationale: The NBCE Test Plan expects candidates to apply the four Yin-Yang dynamics (opposition, interdependence,
waxing/waning, transformation) clinically; Maciocia (Foundations, Ch. 2) explicitly describes "extreme Yin producing
Yang" and vice versa, explaining how external cold invasions can transform into interior heat. Options A, C, and D each
describe only one static relationship and omit the qualitative transformation the scenario illustrates.
Q3: Within the Five Elements (Wu Xing) generating (Sheng) cycle, which sequence correctly describes the
mother-child relationship?
A. Wood generates Fire; Fire generates Earth; Earth generates Metal; Metal generates Water; Water generates Wood.
*[CORRECT]*
B. Fire generates Wood; Wood generates Water; Water generates Earth; Earth generates Metal; Metal generates Fire.
C. Wood controls Earth; Earth controls Water; Water controls Fire; Fire controls Metal; Metal controls Wood.
D. Earth generates Wood; Wood generates Metal; Metal generates Water; Water generates Fire; Fire generates Earth.
Correct Answer: A
Rationale: The Sheng (generating) cycle is Wood→Fire→Earth→Metal→Water→Wood, the mother-child sequence
required by the NBCE Test Plan (History/Philosophy, Five Elements) and described in Maciocia Ch. 3; option C instead
describes the Ke (controlling) cycle, and options B and D corrupt the canonical order, which is essential for point selection
in tonification/sedation strategies used in chiropractic acupuncture.
Aligned with NBCE
Standard
Acupuncture
references:
Test
A Manual
Plan of Acupuncture (Deadman); Foundations of Chinese Medicine (Maciocia); CNT Manual (CCAOM) Page 3
, NBCE ACUPUNCTURE EXAM 2026/2027 Practice Examination
Q4: In Five Element theory, the controlling (Ke) cycle ensures balance among the elements. Which
relationship correctly expresses the Ke cycle?
A. Fire controls Wood; Wood controls Earth; Earth controls Water; Water controls Metal; Metal controls Fire.
B. Wood controls Earth; Earth controls Water; Water controls Fire; Fire controls Metal; Metal controls Wood.
*[CORRECT]*
C. Water controls Wood; Wood controls Fire; Fire controls Earth; Earth controls Metal; Metal controls Water.
D. Metal controls Earth; Earth controls Fire; Fire controls Wood; Wood controls Water; Water controls Metal.
Correct Answer: B
Rationale: The Ke (controlling/over-acting) cycle is Wood→Earth→Water→Fire→Metal→Wood, matching NBCE Test
Plan expectations and Maciocia (Ch. 3); option C inverts to a violation pattern; options A and D mis-pair elements. This
cycle is the basis for treating excess patterns (e.g., Liver overacting on Spleen) and is referenced when applying five-element
point prescriptions in a chiropractic setting.
Q5: A chiropractic clinician is using Five Element theory to address a patient with chronic digestive weakness
(Earth deficiency) accompanied by anxiety and palpitations (Fire signs). Using the generating (Sheng) cycle,
which tonification strategy is most appropriate?
A. Tonify the Metal element to drain Earth.
B. Tonify the Fire element (mother) to nourish the Earth element (child), per the principle "tonify the mother to
strengthen the child." *[CORRECT]*
C. Sedate the Wood element to prevent it from over-controlling Earth.
D. Tonify the Water element to extinguish Fire.
Correct Answer: B
Rationale: Per NBCE Test Plan Five-Element application, in the Sheng cycle Fire is the mother of Earth; tonifying the
mother tonifies the child (Maciocia, Ch. 3). Option A misuses Metal; option C addresses a controlling-cycle imbalance, not
the deficiency; option D would extinguish Fire and worsen Earth's source. This mother-child rule underlies five-shu and
elemental point prescriptions commonly integrated with chiropractic visceral manipulation.
Q6: Which historical text is widely regarded as the foundational classic of acupuncture and moxibustion,
compiled around 200 BCE, that established the framework of meridians, Qi, and needling still used by today's
chiropractic acupuncturists?
A. The Shang Han Lun (Treatise on Cold Damage).
B. The Ben Cao Gang Mu (Compendium of Materia Medica).
C. The Huang Di Nei Jing (Yellow Emperor's Inner Classic), comprising the Su Wen and Ling Shu. *[CORRECT]*
D. The Nan Jing (Classic of Difficulties).
Correct Answer: C
Rationale: The Huang Di Nei Jing (Su Wen and Ling Shu) is the foundational text cited by the NBCE Test Plan
History/Philosophy domain and standard references (Deadman, A Manual of Acupuncture, App. 1) as the source of the
channel and Qi paradigm still applied in modern chiropractic acupuncture. The Shang Han Lun addresses cold-induced
disorders, the Ben Cao covers herbal medicine, and the Nan Jing expanded theoretical discussion but postdates the Nei
Jing.
Q7: A chiropractor integrating acupuncture into practice explains to a patient that the foundational
philosophical concept underlying both spinal subluxation correction and meridian therapy is the unobstructed
flow of Qi. In TCM, the functional concept most analogous to "innate intelligence" in chiropractic philosophy
is:
A. Jing (Essence), the fixed congenital reserves.
Aligned with NBCE
Standard
Acupuncture
references:
Test
A Manual
Plan of Acupuncture (Deadman); Foundations of Chinese Medicine (Maciocia); CNT Manual (CCAOM) Page 4
NBCE ACUPUNCTURE EXAM
QUESTIONS AND ANSWERS
Comprehensive Practice Examination
Aligned with the National Board of Chiropractic Examiners (NBCE) Acupuncture Test Plan
Total Questions: 150 Multiple-Choice Items
Sections: 7 Content Domains (per NBCE Test Plan)
Format: Single Best Answer (4 options A–D)
Cognitive Levels: 25% Recall | 50% Application | 25% Analysis
Style Mix: 70% Scenario-Based | 30% Direct Knowledge
Standard References: A Manual of Acupuncture (Deadman); Foundations of Chinese Medicine
(Maciocia); Clean Needle Technique Manual (CCAOM, 7th ed.)
This practice examination is designed for chiropractic candidates preparing for the NBCE Acupuncture
examination. Each question includes the correct answer and a concise rationale grounded in the NBCE
Acupuncture Test Plan and standard reference texts.
Aligned with NBCE
Standard
Acupuncture
references:
Test
A Manual
Plan of Acupuncture (Deadman); Foundations of Chinese Medicine (Maciocia); CNT Manual (CCAOM) Page 1
,NBCE ACUPUNCTURE EXAM 2026/2027 Practice Examination
Examination Overview
This practice examination comprises 150 multiple-choice questions distributed across the seven content domains of
the NBCE Acupuncture Test Plan. The number of questions per section reflects the official percentage weights
published by the National Board of Chiropractic Examiners (NBCE), ensuring that candidates' study time is
proportionally allocated to high-yield content. Each question includes four options (A–D), one correct answer
marked with the *[CORRECT]* tag, and a concise 2–3 sentence rationale that cites the relevant section of the
NBCE Acupuncture Test Plan alongside standard reference texts.
Section Breakdown (per NBCE Test Plan Percentages)
# Section % of Test Questions Question Range
1 History/Philosophy of Acupuncture in a Chiropractic Setting 5% 8 Q1–Q8
2 Organs, Qi, and Fluid 12% 18 Q9–Q26
3 Channels/Pathways 21% 32 Q27–Q58
4 Acupoints 30% 45 Q59–Q103
5 Acupuncture Techniques 5% 8 Q104–Q111
6 Basic Treatment Tenets/Protocols 18% 27 Q112–Q138
7 Safety and Hygiene 9% 12 Q139–Q150
Cognitive Level Distribution
Per NBCE Test Plan cognitive level guidance, the examination distributes questions across three taxonomic levels:
approximately 25% are recall items testing factual knowledge (e.g., point locations, meridian pathways, organ
correspondences); approximately 50% are application items requiring candidates to apply principles to clinical
scenarios (e.g., point selection for a given presentation); and approximately 25% are analysis items demanding
differential diagnosis and clinical reasoning (e.g., distinguishing between Liver Yang rising vs. Kidney Yin
deficiency headaches).
How to Use This Practice Exam
• Attempt all 150 questions under timed conditions (target 4–5 hours).
• Review rationales for both correct and incorrect answers to maximize learning.
• Cross-reference point locations and clinical reasoning with the standard references cited in each rationale.
• Pay particular attention to Section 7 (Safety and Hygiene) items, as these are non-negotiable in clinical practice and
frequently emphasized on the NBCE exam.
Aligned with NBCE
Standard
Acupuncture
references:
Test
A Manual
Plan of Acupuncture (Deadman); Foundations of Chinese Medicine (Maciocia); CNT Manual (CCAOM) Page 2
,NBCE ACUPUNCTURE EXAM 2026/2027 Practice Examination
Section 1: History/Philosophy of Acupuncture in a Chiropractic Setting
5% of NBCE Acupuncture Test Plan | 8 Questions | Covers Yin-Yang theory, Five Elements theory, historical development, and
foundational philosophical concepts in a chiropractic context.
Q1: A chiropractic intern is preparing a patient education handout describing how Traditional Chinese
Medicine (TCM) philosophy complements the chiropractic model of vertebral subluxation. Which statement
most accurately reflects the foundational nature of Yin and Yang?
A. Yin is associated with heat, activity, and the Fu (hollow) organs, whereas Yang is associated with cold, rest, and the
Zang (solid) organs.
B. Yin and Yang are mutually exclusive opposites that never transform into one another, ensuring homeostasis.
C. Yang is associated with heat, activity, outward movement, and the Fu (hollow) organs, while Yin is associated with
cold, rest, interior, and the Zang (solid) organs. *[CORRECT]*
D. Yin and Yang describe only anatomical location, with no relevance to physiological function or pathology.
Correct Answer: C
Rationale: Per the NBCE Acupuncture Test Plan (History/Philosophy domain), Yang is hot, active, exterior, and Fu-organ
related, whereas Yin is cold, quiescent, interior, and Zang-organ related; they are mutually consuming, interdependent, and
capable of transformation (Maciocia, Foundations of Chinese Medicine, Ch. 2). Option A reverses the polarity; option B
denies transformation; option D ignores the dynamic functional relevance central to TCM.
Q2: A patient asks how the Yin-Yang theory explains the development of a high-fever, flushed-face condition
from an initial chill-and-aversion-to-cold presentation. This clinical transformation is best described by which
Yin-Yang relationship?
A. Mutual opposition only, in which Yin simply suppresses Yang.
B. Mutual transformation, in which Yin can convert to Yang when an extreme is reached ("extreme cold produces heat").
*[CORRECT]*
C. Mutual rootedness, in which Yin and Yang share the same origin but never change.
D. waxing and waning without any qualitative change in the patient's pattern.
Correct Answer: B
Rationale: The NBCE Test Plan expects candidates to apply the four Yin-Yang dynamics (opposition, interdependence,
waxing/waning, transformation) clinically; Maciocia (Foundations, Ch. 2) explicitly describes "extreme Yin producing
Yang" and vice versa, explaining how external cold invasions can transform into interior heat. Options A, C, and D each
describe only one static relationship and omit the qualitative transformation the scenario illustrates.
Q3: Within the Five Elements (Wu Xing) generating (Sheng) cycle, which sequence correctly describes the
mother-child relationship?
A. Wood generates Fire; Fire generates Earth; Earth generates Metal; Metal generates Water; Water generates Wood.
*[CORRECT]*
B. Fire generates Wood; Wood generates Water; Water generates Earth; Earth generates Metal; Metal generates Fire.
C. Wood controls Earth; Earth controls Water; Water controls Fire; Fire controls Metal; Metal controls Wood.
D. Earth generates Wood; Wood generates Metal; Metal generates Water; Water generates Fire; Fire generates Earth.
Correct Answer: A
Rationale: The Sheng (generating) cycle is Wood→Fire→Earth→Metal→Water→Wood, the mother-child sequence
required by the NBCE Test Plan (History/Philosophy, Five Elements) and described in Maciocia Ch. 3; option C instead
describes the Ke (controlling) cycle, and options B and D corrupt the canonical order, which is essential for point selection
in tonification/sedation strategies used in chiropractic acupuncture.
Aligned with NBCE
Standard
Acupuncture
references:
Test
A Manual
Plan of Acupuncture (Deadman); Foundations of Chinese Medicine (Maciocia); CNT Manual (CCAOM) Page 3
, NBCE ACUPUNCTURE EXAM 2026/2027 Practice Examination
Q4: In Five Element theory, the controlling (Ke) cycle ensures balance among the elements. Which
relationship correctly expresses the Ke cycle?
A. Fire controls Wood; Wood controls Earth; Earth controls Water; Water controls Metal; Metal controls Fire.
B. Wood controls Earth; Earth controls Water; Water controls Fire; Fire controls Metal; Metal controls Wood.
*[CORRECT]*
C. Water controls Wood; Wood controls Fire; Fire controls Earth; Earth controls Metal; Metal controls Water.
D. Metal controls Earth; Earth controls Fire; Fire controls Wood; Wood controls Water; Water controls Metal.
Correct Answer: B
Rationale: The Ke (controlling/over-acting) cycle is Wood→Earth→Water→Fire→Metal→Wood, matching NBCE Test
Plan expectations and Maciocia (Ch. 3); option C inverts to a violation pattern; options A and D mis-pair elements. This
cycle is the basis for treating excess patterns (e.g., Liver overacting on Spleen) and is referenced when applying five-element
point prescriptions in a chiropractic setting.
Q5: A chiropractic clinician is using Five Element theory to address a patient with chronic digestive weakness
(Earth deficiency) accompanied by anxiety and palpitations (Fire signs). Using the generating (Sheng) cycle,
which tonification strategy is most appropriate?
A. Tonify the Metal element to drain Earth.
B. Tonify the Fire element (mother) to nourish the Earth element (child), per the principle "tonify the mother to
strengthen the child." *[CORRECT]*
C. Sedate the Wood element to prevent it from over-controlling Earth.
D. Tonify the Water element to extinguish Fire.
Correct Answer: B
Rationale: Per NBCE Test Plan Five-Element application, in the Sheng cycle Fire is the mother of Earth; tonifying the
mother tonifies the child (Maciocia, Ch. 3). Option A misuses Metal; option C addresses a controlling-cycle imbalance, not
the deficiency; option D would extinguish Fire and worsen Earth's source. This mother-child rule underlies five-shu and
elemental point prescriptions commonly integrated with chiropractic visceral manipulation.
Q6: Which historical text is widely regarded as the foundational classic of acupuncture and moxibustion,
compiled around 200 BCE, that established the framework of meridians, Qi, and needling still used by today's
chiropractic acupuncturists?
A. The Shang Han Lun (Treatise on Cold Damage).
B. The Ben Cao Gang Mu (Compendium of Materia Medica).
C. The Huang Di Nei Jing (Yellow Emperor's Inner Classic), comprising the Su Wen and Ling Shu. *[CORRECT]*
D. The Nan Jing (Classic of Difficulties).
Correct Answer: C
Rationale: The Huang Di Nei Jing (Su Wen and Ling Shu) is the foundational text cited by the NBCE Test Plan
History/Philosophy domain and standard references (Deadman, A Manual of Acupuncture, App. 1) as the source of the
channel and Qi paradigm still applied in modern chiropractic acupuncture. The Shang Han Lun addresses cold-induced
disorders, the Ben Cao covers herbal medicine, and the Nan Jing expanded theoretical discussion but postdates the Nei
Jing.
Q7: A chiropractor integrating acupuncture into practice explains to a patient that the foundational
philosophical concept underlying both spinal subluxation correction and meridian therapy is the unobstructed
flow of Qi. In TCM, the functional concept most analogous to "innate intelligence" in chiropractic philosophy
is:
A. Jing (Essence), the fixed congenital reserves.
Aligned with NBCE
Standard
Acupuncture
references:
Test
A Manual
Plan of Acupuncture (Deadman); Foundations of Chinese Medicine (Maciocia); CNT Manual (CCAOM) Page 4
