AP Safety, Clean Needle Technique & Ethics 3 — Questions and Answers
Question 1: Which antiseptic is MOST appropriate for preparing the skin before needle insertion according to clean needle technique (CNT)?
- Hydrogen peroxide 3%
- Isopropyl alcohol 70% (Correct answer)
- Iodine tincture 2%
- Chlorhexidine 0.5% in water
Correct answer: Isopropyl alcohol 70%
Isopropyl alcohol 70% is the standard antiseptic used for skin prep in CNT because it is effective, fast-drying, and well-tolerated.
Question 2: A patient in an acupuncture session becomes syncopal (faints). The FIRST action the practitioner should take is:
- Call 911 immediately
- Remove all inserted needles and position the patient safely (Correct answer)
- Administer smelling salts under the nose
- Document the event and continue treatment when the patient recovers
Correct answer: Remove all inserted needles and position the patient safely
Removing needles prevents injury during syncope and positioning the patient (e.g., supine with legs elevated) addresses the immediate safety need before further assessment.
Question 3: Which of the following patients presents the HIGHEST risk for pneumothorax during acupuncture?
- A 45-year-old with hypertension receiving LI-4 treatment
- A cachectic elderly patient receiving needling near GB-21 (Correct answer)
- A 30-year-old athlete receiving ST-36 treatment
- A patient with diabetes receiving KD-3 needling
Correct answer: A cachectic elderly patient receiving needling near GB-21
Cachectic (very thin) patients have minimal subcutaneous tissue over the chest and shoulder, making deep needling near GB-21 or the lung apex extremely high risk for pneumothorax.
Question 4: Under HIPAA, which of the following does NOT require patient authorization for disclosure?
- Sharing records with the patient's employer
- Disclosing records in response to a valid court subpoena (Correct answer)
- Releasing records to a marketing company
- Providing records to the patient's attorney
Correct answer: Disclosing records in response to a valid court subpoena
A valid court order or subpoena compels disclosure without patient authorization; sharing with employers, marketing companies, or attorneys generally requires authorization.
Question 5: How long must acupuncture patient records be retained under most U.S. state regulations for adult patients?
- 1 year after the last visit
- 3–7 years after the last visit (varies by state) (Correct answer)
- Until the patient requests destruction
- Indefinitely
Correct answer: 3–7 years after the last visit (varies by state)
Most states require retention of adult patient records for a minimum of 3–7 years after the last treatment date, though exact requirements vary by jurisdiction.
Question 6: The term 'dual relationship' in acupuncture ethics refers to:
- Treating two patients simultaneously in the same room
- A situation where the practitioner holds both a professional and personal role with a patient (Correct answer)
- Using two modalities (e.g., acupuncture and herbs) in one session
- Holding licenses in two different healthcare disciplines
Correct answer: A situation where the practitioner holds both a professional and personal role with a patient
A dual relationship exists when the practitioner has both a therapeutic and another significant relationship (familial, romantic, financial) with the patient, creating potential conflicts of interest.
Question 7: Which of the following is a contraindication for using an electrostimulation unit (e-stim) with acupuncture needles?
- Patient has a history of mild anxiety
- Patient has an implanted cardiac pacemaker (Correct answer)
- Patient is over 60 years of age
- Patient is currently taking herbal supplements
Correct answer: Patient has an implanted cardiac pacemaker
Electrical current from e-stim can interfere with pacemaker function and is an absolute contraindication in patients with implanted cardiac devices.
AP Safety, Clean Needle Technique & Ethics 3
Which antiseptic is MOST appropriate for preparing the skin before needle insertion according to clean needle technique (CNT)?