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Clean Needle Technique Exam 2025– 2026
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What is the risk for practitioners who work with patients with HIV? - answer>>>Secondary infections like Hep, Herpes virus and Staph
Initial infection is usually followed within 2-4 weeks by a febrile diagnosis thats like mono or the flu. This stage is pretty quick and most people just blow it off. This describes what diagnosis?
A. AIDS
B. HIV
C. HBV ( HEP B)
D. Hep C - answer>>>B. HIV.
these people stay healthy for long time then they get sick with HIV
This diagnosis spreads by skin to skin contact and is easily spread from one person to another including in medical environments. What is this diagnosis? - answer>>>MRSA Methicillin.- Resistant Staphylococcus Aureus
When a patient is first infected with HIV, how long does it take for it to become AIDS?
A. 50-150 days
B. 15-60 days
C. 8-10 years
D. 20-90 days - answer>>>C. 8-10 years aftern initial infection
What is the single most important thing to do if you suspect MRSA? - answer>>>Hand wash. Because MRSA is spread by skin to skin contact
How long should you wash your hands? - answer>>>10 seconds under running water. It is Best to use LIquid Soap
When washing hands is it ok to touch the handle of the sink as long as you do it fast? - answer>>>No, Use the elbow or have someone else do it for you. or turn it on and off with a paper towel
What are 4 choices to use if you do not have soap to wash with? - answer>>>Wipe with Alcohol,
Alcohol based hand rub,
antiseptic towel,
germicidal scrub
If you have touched your face or helped a patient pull off their socks , but have washed your hands, can you needle a point? - answer>>>No, you have to wash again either with antimicrobial soap or use the alcohol based hand cleanser.
What is the biggest risk for a patient and acupuncturist? - answer>>>Contaminated needles
If a patient has active TB what piece of equipment must you use? - answer>>>Wear a mask!
Patient refusal.
Wound at specific site of insertion (infection, bruise, rashes, etc.)
Precautions of needling - answer>>>Pregnant women.
Be aware if your patient is on blood thinners.
History of syncope/fainting.
Know if your patient has compromised the ability to sense pain, temp, pressure, etc.
Know anomolies and general health history of your patient.
Time considerations
True de Qi sensation - answer>>>Felt when the needle is seated in the muscle layer, not the skin layer. That is, in the channel, not the wei qi.
How should de qi feel? - answer>>>NOT excruciating pain. If it is excruciating, then something is wrong.
If there is no sensation when the needle has punctured, you'll have likely - answer>>>NOT contacted the qi.
Patient de qi sensation descriptors - answer>>>Dull ache, numbness, distention, heavy feeling, tight feeling, cold feeling, warm feeling, electric shock that doesn't last long, radiation to another location.
Practitioner De Qi sensation descriptors - answer>>>Heavy, tight pressure, perhaps slight muscle twitch (good visual cue), gentle reddening of the surrounding tissue, grasped or "fish tugging on the line" sensation.
Theraputic effects of TDP Lamps - answer>>>Dilating blood vessels and increasing blood flow and oxygen saturation.
Accelerating the decomp of dead or unstable cells
Enhancing white blood cell function, increasing immune response and stimulating the hypothalamus, which controls the production of neurochemicals, which control sleep, mood, pain, and bp.
TDP lamp head is usually how far away from body - answer>>>8 inches away
Mild stimulation with TDP lamps should be used... - answer>>>around the eyes.
if there are metals inside the irradiated part of the body
when treating chilblain and ulcer as well as infants.
Increased herb/drug absorption is seen with what? - answer>>>With the use of TDP lamps simultaneously with linaments.
Warning with TDP lamp - answer>>>Unplug when installing or dismantling the device.
The irradiation head will considerably hoe when operating. Make sure that you move the lamp head out of range of contact with your patients when they move to get off the table.
Never put fingers and other objects into the protective wire mesh of the head.
Make sure there are no covers over the head
Hot and cold pack warnings - answer>>>Be careful combing with liniments or herbs. Instruct patient on the amount of time to leave a pack on the skin.
OPIM - answer>>>1) Human body fluids.
Any unfixed tissue or organ.
HIV-containing cell or tissue cultures, organ cultures, and HIV or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.
What bodily substances are NOT on the OPIM list? - answer>>>tears, sputum, feces, urine, sweat, vomit, breast milk. Not on the list because they are not known to carry or support bloodborne pathogens of concern to us.
Direct transmission - answer>>>Person-to-person contact where pathogenic factor needs no contaminated intermediate object to facilitate the passage.
Indirect Transmission - answer>>>Requires a contaminated object to help make the connection between the source and the susceptible host (感受性宿主).
Droplet transmission - answer>>>Larger particles are expelled from the respiratory tract when a person talks, coughs, sneezes and tend to impact receptors within a yard of the mouth/nose from which they were ejected.
Airborne transmission - answer>>>This route refers to the very small particles (fine mists and contaminated dust particles) that may remain airborne long enough for inhalation by another person.
Common Vehicle Transmission - answer>>>Contamination of everyday things that are shared by a larger community and normally assumed to be clean that are in fact, not clean. Diseases spread by contaminated food or water.
Parenteral Transmission - answer>>>Refers to the penetration into the skin by an object, such as a needle, knife, etc.
Autogenous (自己生成) Infections - answer>>>Occurs from pathogens that reside in or on a person's body.
Direct acquisition of cross infection - answer>>>Can occur when we come in direct contact with the blood or bodily fluid of a person who carries a particular virus or bacteria.
Indirect Acquisition of cross infection - answer>>>Can occur when we come in contact with a pathogen that has been deposited on an inanimate object, such as HBV tainted blood left on a guasha spoon.
What is our #1 defense against disease? - answer>>>Intact skin
Contamination - answer>>>The introduction of environmental contaminants or disease- causing microbes into or onto previously clean or sterile objects
With E-Stem, DON'T do what? - answer>>>-Don't interfere with implanted electrical stimulators.
-Do not cross the center line of the body.
-Never combine plated needles or solid needles made from soft metals
Incubation for Hepatitis A - answer>>>15-50 Days
Vaccine for Hepatitis C? - answer>>>No
Is Hepatitis C chronic? - answer>>>75 - 85%
Incubation for Hepatitis D - answer>>>Unknown
Transmission of Hepatitis D - answer>>>Percutaneous or mucosal contact with infectious blood
Onset of Hepatitis D - answer>>>Insidious
Vaccine for Hepatitis D? - answer>>>No
Is Hepatitis D chronic? - answer>>>Unknown
Incubation for Hepatitis E - answer>>>15-60 Days
Transmission of Hepatitis E - answer>>>Fecal-Oral Route
Onset of Hepatitis E - answer>>>Abrupt
Vaccine for Hepatitis E - answer>>>No
Is Hepatitis E chronic? - answer>>>No
Autogenous Infections - answer>>>Caused by an infectious agent that the patient is already carrying. An example would be peritonitis following a deep abdominal insertion that punctures the peritoneum and intestine.
Cross-Infections - answer>>>Caused by pathogens acquired from another person or by the environment. May be acquired directly or by transfer
Hepatitis A symptoms - answer>>>Abrupt onset with symptoms that include abdominal discomfort, loss of appetite, fatigue, nausea, dark urine, and jaundice. Symptoms usually last less than 2months. Individuals who have had HAV can NOT be reinfected.
HBV early symptoms - answer>>>Often begin with mild flu-like signs and symptoms such as a fever, general malaise, or insidious onset of anorexia and abdominal pain. Other symptoms include chills, nausea, joint pains, rash, and diarrhea.
What is the most common chronic bloodborne viral infection in the United States? - answer>>>Hepatitis C
Chronic Persistent Carrier of Hepatits - answer>>>Someone who is Asymptomatic or has minimal symptoms but can continue to infect others.
Chronic Active Carrier of Hepatitis - answer>>>Has the progressive symptomatic disease that continues to damage the liver.
In health care settings, what is the risk of infection from exposure to contaminated blood for HBV? - answer>>>30%
What are the signs and symptoms of puncture the liver or spleen? - answer>>>Abdominal pain, the rigidity of abdominal muscles, and/or rebound pain upon pressure.
What are the signs and symptoms of puncturing a Kidney? - answer>>>May cause pain in the lumbar region, tenderness and pain upon percussion around kidney region, and bloody urine. Coma may result if blood loss is great.
What points must you be worried about puncturing the spinal cord? - answer>>>DU 15 and DU 16. There may be bleeding and other severe consequences. Clinical manifestations are convulsions, paralysis, and coma.
If you have punctured a vein, for how long must you apply pressure? - answer>>> seconds up to a minute
If you have punctured an artery, for how long must you apply pressure? - answer>>>Up to 5 minutes
When might a broken needle occur? - answer>>>1) there are cracks or erosions on the shaft of the needle.
the quality of the needle is poor.
the patient has change position to too great of an extent.
there is a strong spasm of the muscle.
Excessive force is used in manipulating.
the needle has been struck by an external force.
A bend needle has been rigidly withdrawn.
Should pressure be applied before and during needle removal? - answer>>>No.
Because applying pressure next to a needle that is being removed increases the risk for inadvertent needlestick injuries, best practice techniques would be to apply pressure to an acupuncture point only after the needle has been completely removed from the site.
Does strong thrusting, twisting, inserting and lifting cause an increase in bleeding and bruising? - answer>>>Unknown/untested.
While it makes sense that the more a needle is manipulated the more bruising and bleeding will take place, there have been no studies to support this theory.
Does the size or width of the needle make for a stronger or less strong needle sensation?
- answer>>>Unknown/untested.
Generally, practitioner expertise has more to do with the amount of needle sensation than does the size or width of an acupuncture needle.
In making sure there are no needles left in a patient at the end of a treatment, does the palpating the site where a needle was inserted follow best practices? - answer>>>Palpating areas looking for forgotten needles may increase the risk of needlestick injuries. Use counting and proper documentation to check for missing needles. However, if needle counts do not match, palpation may be necessary but should be done with extreme caution.
Should warm water or water with sugar be given to patients who have fainted during acupuncture? - answer>>>Variable.
If the patient just feels faint, some water, tea or other liquids may be helpful. If the patient has fainted, then do not force liquids into the mouth until the patient regains consciousness and clarity of thought.
Can practitioners' hands be sterilized? - answer>>>No.
Sterilization is defined as "the complete destruction of all living tissue." Since practitioners are living, breathing individuals, their hands can be clean but not sterile.
Must a different guide tube be used for different areas on the patient's body? - answer>>>No.
Guide tubes must be sterile at the start of a treatment but a guide tube may be used for multiple needle insertions at various areas of the patient's body.
Is the best way to clean skin prior to needle or lancet insertion to use 70% alcohol? - answer>>>Unclear.
The literature is clear about the skin being clean but there have been no comparison studies of soap and water vs. alcohol vs. other products, such as those containing chlorhexidine.
How do I use an alcohol swab to clean the skin - one direction only or back and forth "cleaning"? - answer>>>Unclear.
The alcohol is being used to be sure the skin is clean. Since the needles do not enter the vascular tree, the specific directionality of swabbing has not been studied.
When doing wet cupping should the cup be left in place for approximately 30 seconds after "breaking the seal" so as to avoid an aerosol effect of the drawn blood? - answer>>>No.
Some blood will be released during the loss of suction no matter how long the cup is retained. Use of proper PPE is needed to protect the practitioner from blood and OPIM.
Should a new alcohol swab be used for different body regions? - answer>>>No.
Alcohol swabs can be used for multiple points in multiple parts of the body as long as the swab remains moist and is not visibly dirty. New swabs are needed when cleaning areas that are covered with make-up or other products or for areas with high bacteria counts such as the groin or axilla.
Can I use reusable needles for treatments? - answer>>>No.
The standard of care for U.S. CCAOM CNT course graduates is to use single use sterile disposable needles only. Reusing needles are not permitted legally in many states. The cost saved by autoclaving needles is negligible when compared to the cost of even one patient contracting a disease from needle reuse.
When cleaning a cup or gua sha device, do I disinfect first, then clean the cup or device? - answer>>>No.
You must remove all biological material for the disinfectant to work properly. Clean the device with soap and water first, then disinfect, then rinse the device (if it is desired to remove any remaining disinfectant) before using on the next patient.
When cleaning a cup or gua sha device, does it need to be sterilized? - answer>>>A cup or gua sha device needs to be cleaned of any biological material and then disinfected using an EPA-‐approved disinfecting solution or autoclaved. If the cup has or will be used for wet cupping, there will be a break in the skin. In this case, you must follow the CDC directives for cleaning, disinfecting, storing and using semi-‐critical devices.PPE is also required. If the cup or gua sha device has or will be used on intact skin, you must follow CDC directives for cleaning, disinfecting, storing and using noncritical devices. The CNT Manual advises when these tools are used over intact skin, you must use at least intermediate-‐level disinfectants.Because you cannot always anticipate that the skin will remain intact during cupping or gua sha, taking the extra precaution to consider all cups and gua sha tools as semicritical devices that require high-‐leveldisinfectants or autoclaving is strongly recommended.
Specifically, what fluids are considered potentially infectious? - answer>>>Blood and OPIM (Other Potentially Infectious Materials). OPIM include; synovial fluid, amniotic fluid, cerebrospinal fluid, pleural fluid, semen and vaginal secretions, peritoneal fluid, pericardial fluid, saliva (in dental procedures only), any fluids visibly contaminated with blood, stool, and all body fluids where it may be difficult to differentiate between contaminated and non-contaminated fluids.
What bodily fluids are known to be a source for HIV infections? - answer>>>Blood, any body fluid contaminated with blood, semen, vaginal secretions, synovial fluid, amniotic fluid, cerebrospinal fluid, and breast milk. Sweat and urine are not sources for HIV infections.
What are the standard procedures to follow after an exposure incident such as a needlestick? - answer>>>1. Treat the exposure site as soon as possible after the exposure incident.
- Use soap and water to wash and clean areas exposed to blood or OPIM as soon as possible after exposure occurs. DO NOT "milk"a puncture site to draw out some blood first.
- Flush exposed mucus membranes with water.
- Flush eyes with running water or saline solution.
- Do not inject antiseptics or disinfectants into the wound.
- Report the incident to your supervisor.
- Note the incident in the incident log.
- Utilize follow-‐up procedures as specified in the clinic's BBP manual.
If I can reach into the clean field to pick up needles, why has it been taught that I cannot reach across the clean field when disposing of unclean items? - answer>>>Unclear.
It is important to avoid contaminating the clean field with dirty items by dropping them on the clean field, brushing clothing across the clean field, or dripping unclean liquids on the clean field. Reaching across the clean field may not be a problem as long as practitioners remember not to contaminate the clean items. The historical avoidance of reaching across the clean field helps remind practitioners of the importance of maintaining cleanliness.
What procedures require consent? Does consent for acupuncture treatment cover cupping, bleeding,moxa, and gua sha as well as needle insertion? - answer>>>Informed consent requires that all patients should understand and agree to the potential consequences of the entirety of their care. Consent must include a number of features, including the nature and purpose of a proposed treatment or procedure and the risks and benefits of proposed treatment or procedures. If your acupuncture consent includes this for ALL procedures you perform, then that probably covers you. But if your consent form only discusses acupuncture, then you probably need to obtain additional or separate consent for all planned procedures. See http://www.templehealth.org/ICTOOLKIT/html/ictoolkitpage5.html
Why does this edition of the manual offer opposing views for some traditionally restricted procedures, such as electrical stim on someone with a pacemaker, or points that require special skill? - answer>>>Practitioners are encouraged to read the manual with a critical eye, reviewing the evidence provided and using their personal knowledge and practitioner judgment to minimize risks for their specific practice. This manual is a teaching tool. Information about risks and benefits of specific procedures continues to grow. Practitioners are encouraged to compare their standard of care with the evidence from research studies and case studies to create their own best practices.
Why are the techniques described in the manual called "clean technique" rather than "sterile techniques?" - answer>>>While the needles and lancets used as described in this manual are sterile before use, other devices are clean but not sterile and the entire field being prepared for patient treatments is clean, not sterile. Clean technique is a better
