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NC Chiropractic Assistant Level I Clinical exam
Questions and Correct Answers with
EXPLANATIONS LATEST THIS YEAR
Summarized Exam Coverage – NC Chiropractic Assistant Level I Clinical
The North Carolina Certified Chiropractic Assistant (CCA) Level I - Clinical exam is administered by
the North Carolina Board of Chiropractic Examiners (NCBOCE) . Certification is mandatory for any non-
licensed employee of a chiropractic physician who interacts directly with patients; certification must be
obtained within 180 days of beginning employment . Key requirements include: minimum age 18, high
school diploma (or equivalent), good moral character, completion of a 24-hour board-approved
education program (18 hours online + 6 hours in-person), and passing the state exam with a minimum
score of 75% .
The permitted duties of a CCA Level I Clinical are defined by statute: (i) collecting general health data
(oral history, vital signs), (ii) applying therapeutic procedures (thermal, sound, light, electrical modalities,
hydrotherapy), and (iii) monitoring prescribed rehabilitative activities . Prohibited duties include
chiropractic adjustments, manual therapy, nutritional instruction, counseling, or any therapeutic service
requiring individual licensure . Key exam topics include: basic anatomy, chiropractic philosophy and
terminology, therapeutic modalities (application, contraindications, safety), emergency response,
and jurisprudence/patient privacy (HIPAA) . Certification must be renewed every 2 years with 6 hours
of continuing education .
1. A new chiropractic assistant is hired and begins working with patients directly. Under North Carolina
General Statute 90-143.4, how many days does this person have to obtain Level I Clinical certification?
A) 30 days
B) 90 days
C) 180 days
D) 365 days
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*Answer: C — GS 90-143.4(b) requires any person employed as a chiropractic clinical assistant to obtain
certification within 180 days after beginning employment .*
2. A CCA Level I is asked by the chiropractor to perform a spinal adjustment on a patient with acute low
back pain. What is the most appropriate response by the CCA?
A) Perform the adjustment under direct supervision of the chiropractor
B) Politely decline, stating that adjustments are outside the scope of practice for a CCA Level I
C) Perform the adjustment if the patient gives written consent
D) Perform the adjustment only if the chiropractor is in the same room
*Answer: B — GS 90-143.4(a) explicitly states that nothing shall be construed to allow a chiropractic
clinical assistant to provide a chiropractic adjustment .*
3. A CCA Level I is preparing to apply electrical stimulation to a patient. The patient reports a history of a
cardiac pacemaker. What is the correct action by the CCA?
A) Proceed with the treatment at a low intensity setting
B) Apply the electrodes on the lower extremities only
C) Do not proceed and notify the chiropractor immediately of the contraindication
D) Place a grounding pad on the patient's chest
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Answer: C — Electrical stimulation is contraindicated for patients with cardiac pacemakers; the CCA must
recognize this as a contraindication and inform the supervising chiropractor .
4. The chiropractor instructs a CCA Level I to take an oral history from a new patient. Which of the
following is within the CCA's scope of practice when collecting general health data?
A) Diagnose the patient's condition based on the history
B) Prescribe over-the-counter pain medication for the patient
C) Record the patient's past medical history and current symptoms
D) Provide nutritional counseling based on the patient's symptoms
Answer: C — Collecting general health data, including taking an oral history, is explicitly permitted for a
CCA Level I .
5. A patient asks a CCA Level I about the side effects of a new medication prescribed by their medical
doctor. What should the CCA do?
A) Advise the patient to stop taking the medication immediately
B) Provide detailed information about potential side effects
C) Inform the patient that medication advice is outside the CCA's scope and recommend they consult
their prescribing physician or pharmacist
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D) Change the patient's medication dosage based on their symptoms
Answer: C — A CCA Level I cannot provide medication advice, nutritional instruction, or counseling; they
should refer such questions to an appropriate licensed professional .
6. Which of the following duties is explicitly permitted for a North Carolina Certified Chiropractic
Assistant Level I Clinical?
A) Providing a chiropractic adjustment
B) Nutritional instruction
C) Applying hydrotherapy
D) Manual therapy
*Answer: C — Hydrotherapy is one of the therapeutic procedures explicitly listed in GS 90-143.4(a) as
within the scope of a chiropractic clinical assistant .*
7. A CCA Level I is preparing to apply a therapeutic ultrasound to a patient. The patient reports feeling a
"deep heating sensation." What is the primary mechanism by which therapeutic ultrasound achieves its
therapeutic effects?
A) Chemical reaction with skin oils
B) High-frequency sound waves producing deep tissue heat
NC Chiropractic Assistant Level I Clinical exam
Questions and Correct Answers with
EXPLANATIONS LATEST THIS YEAR
Summarized Exam Coverage – NC Chiropractic Assistant Level I Clinical
The North Carolina Certified Chiropractic Assistant (CCA) Level I - Clinical exam is administered by
the North Carolina Board of Chiropractic Examiners (NCBOCE) . Certification is mandatory for any non-
licensed employee of a chiropractic physician who interacts directly with patients; certification must be
obtained within 180 days of beginning employment . Key requirements include: minimum age 18, high
school diploma (or equivalent), good moral character, completion of a 24-hour board-approved
education program (18 hours online + 6 hours in-person), and passing the state exam with a minimum
score of 75% .
The permitted duties of a CCA Level I Clinical are defined by statute: (i) collecting general health data
(oral history, vital signs), (ii) applying therapeutic procedures (thermal, sound, light, electrical modalities,
hydrotherapy), and (iii) monitoring prescribed rehabilitative activities . Prohibited duties include
chiropractic adjustments, manual therapy, nutritional instruction, counseling, or any therapeutic service
requiring individual licensure . Key exam topics include: basic anatomy, chiropractic philosophy and
terminology, therapeutic modalities (application, contraindications, safety), emergency response,
and jurisprudence/patient privacy (HIPAA) . Certification must be renewed every 2 years with 6 hours
of continuing education .
1. A new chiropractic assistant is hired and begins working with patients directly. Under North Carolina
General Statute 90-143.4, how many days does this person have to obtain Level I Clinical certification?
A) 30 days
B) 90 days
C) 180 days
D) 365 days
, Page 2 of 129
*Answer: C — GS 90-143.4(b) requires any person employed as a chiropractic clinical assistant to obtain
certification within 180 days after beginning employment .*
2. A CCA Level I is asked by the chiropractor to perform a spinal adjustment on a patient with acute low
back pain. What is the most appropriate response by the CCA?
A) Perform the adjustment under direct supervision of the chiropractor
B) Politely decline, stating that adjustments are outside the scope of practice for a CCA Level I
C) Perform the adjustment if the patient gives written consent
D) Perform the adjustment only if the chiropractor is in the same room
*Answer: B — GS 90-143.4(a) explicitly states that nothing shall be construed to allow a chiropractic
clinical assistant to provide a chiropractic adjustment .*
3. A CCA Level I is preparing to apply electrical stimulation to a patient. The patient reports a history of a
cardiac pacemaker. What is the correct action by the CCA?
A) Proceed with the treatment at a low intensity setting
B) Apply the electrodes on the lower extremities only
C) Do not proceed and notify the chiropractor immediately of the contraindication
D) Place a grounding pad on the patient's chest
, Page 3 of 129
Answer: C — Electrical stimulation is contraindicated for patients with cardiac pacemakers; the CCA must
recognize this as a contraindication and inform the supervising chiropractor .
4. The chiropractor instructs a CCA Level I to take an oral history from a new patient. Which of the
following is within the CCA's scope of practice when collecting general health data?
A) Diagnose the patient's condition based on the history
B) Prescribe over-the-counter pain medication for the patient
C) Record the patient's past medical history and current symptoms
D) Provide nutritional counseling based on the patient's symptoms
Answer: C — Collecting general health data, including taking an oral history, is explicitly permitted for a
CCA Level I .
5. A patient asks a CCA Level I about the side effects of a new medication prescribed by their medical
doctor. What should the CCA do?
A) Advise the patient to stop taking the medication immediately
B) Provide detailed information about potential side effects
C) Inform the patient that medication advice is outside the CCA's scope and recommend they consult
their prescribing physician or pharmacist
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D) Change the patient's medication dosage based on their symptoms
Answer: C — A CCA Level I cannot provide medication advice, nutritional instruction, or counseling; they
should refer such questions to an appropriate licensed professional .
6. Which of the following duties is explicitly permitted for a North Carolina Certified Chiropractic
Assistant Level I Clinical?
A) Providing a chiropractic adjustment
B) Nutritional instruction
C) Applying hydrotherapy
D) Manual therapy
*Answer: C — Hydrotherapy is one of the therapeutic procedures explicitly listed in GS 90-143.4(a) as
within the scope of a chiropractic clinical assistant .*
7. A CCA Level I is preparing to apply a therapeutic ultrasound to a patient. The patient reports feeling a
"deep heating sensation." What is the primary mechanism by which therapeutic ultrasound achieves its
therapeutic effects?
A) Chemical reaction with skin oils
B) High-frequency sound waves producing deep tissue heat
