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PMGT-BC Practice Questions (2026) — Free Sample Questions with Answers

6 free PMGT-BC questions from our 25-question bank, grouped by content domain. Each answer explains why the right option is right — and why every wrong option is wrong.

Fundamentals of Pain (3)Interventions (2)Professional Practice (1)
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Fundamentals of Pain

Question 1

A postoperative patient on IV hydromorphone PRN rates pain 6/10 and asks for a dose, but falls asleep twice mid-sentence while talking with the nurse. Respirations are 12 and regular. What is the appropriate action?

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Answer: D

Give the dose, since her pain score is still 6/10: Sedation level, not the pain score alone, determines whether an opioid is safe; giving it risks respiratory depression.

Give half the dose and recheck her in 2 hours: A reduced dose is still unsafe at this sedation level, and a 2-hour recheck is too long.

Wake her fully, then give the full dose with supplemental oxygen: Supplemental oxygen can mask hypoventilation on pulse oximetry and does not make an opioid dose safe.

Hold the opioid, keep her awake and use non-opioid options: Correct. Falling asleep mid-conversation is Pasero Opioid-Induced Sedation Scale level 3 (unacceptable): hold opioids, monitor closely and use non-opioid methods.

POSS 3 or 4 = hold opioids and monitor closely; sedation precedes opioid-induced respiratory depression.

Question 2

Six weeks after a distal radius fracture, a patient has burning pain out of proportion to the injury, swelling, shiny reddened skin, increased sweating of the hand and pain when touched lightly. Which syndrome is most likely?

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Answer: C

Carpal tunnel syndrome: Carpal tunnel causes numbness in the median nerve distribution without color, temperature and sweating changes.

Acute compartment syndrome: Compartment syndrome develops within hours to days of injury with pain on passive stretch, not weeks later with sudomotor changes.

Complex regional pain syndrome: Correct. Disproportionate pain with sensory, vasomotor, sudomotor/edema and trophic changes after trauma meets Budapest criteria for CRPS.

Myofascial pain syndrome: Myofascial pain features trigger points with referred pain, not autonomic skin changes.

CRPS: disproportionate pain + sensory, vasomotor, sudomotor/edema, motor/trophic changes (Budapest criteria); early mobilization is key.

Question 3

A patient with long-standing type 2 diabetes describes burning pain in both feet with episodes of electric-shock sensations, worse at night. Light bedsheets touching his feet are painful. How should the nurse classify this pain?

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Answer: A

Neuropathic pain: Correct. Burning, shooting, electric descriptors and allodynia from a lesion of the somatosensory nervous system (diabetic polyneuropathy) define neuropathic pain.

Somatic nociceptive pain: Somatic pain from tissue injury is usually well localized, aching or throbbing, not burning with allodynia.

Visceral nociceptive pain: Visceral pain arises from organs and is poorly localized, cramping or pressure-like.

Nociplastic pain: Nociplastic pain occurs without evidence of tissue or nerve lesion; here a clear nerve disease is present.

Neuropathic = nerve lesion or disease (burning, shooting, allodynia); nociceptive = tissue damage; nociplastic = altered nociception without a lesion.

Interventions

Question 4

A patient with a continuous ropivacaine peripheral nerve catheter after shoulder surgery reports a metallic taste, ringing in the ears and numbness around the mouth, then becomes agitated. After stopping the infusion and calling for help, which treatment should the nurse anticipate?

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Answer: B

Naloxone IV to reverse the toxic reaction: Naloxone reverses opioids; it has no effect on local anesthetic toxicity.

20% lipid emulsion IV with airway support: Correct. These are early signs of local anesthetic systemic toxicity; airway management, seizure control and 20% lipid emulsion therapy are the recommended treatment.

Flumazenil IV to reverse CNS depression: Flumazenil reverses benzodiazepines and could provoke seizures; it does not treat LAST.

Increase the infusion rate to treat pain: Continuing or increasing the local anesthetic would worsen toxicity.

LAST: perioral numbness, metallic taste, tinnitus → seizures → cardiac arrest. Stop the drug, support airway, give 20% lipid emulsion.

Question 5

A patient taking oral morphine 180 mg/day with good pain control is switched to extended-release oral oxycodone every 12 hours. Using equianalgesic doses of oral morphine 30 mg = oral oxycodone 20 mg and a 25% reduction for incomplete cross-tolerance, what dose is appropriate?

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Answer: B

30 mg every 12 hours: This applies a 50% reduction (120 → 60 mg/day) rather than the 25% specified.

45 mg every 12 hours: Correct. 180 × (20/30) = 120 mg oxycodone/day; 120 × 0.75 = 90 mg/day; divided every 12 hours = 45 mg.

60 mg every 12 hours: This converts correctly (120 mg/day) but omits the 25% reduction for incomplete cross-tolerance.

67.5 mg every 12 hours: This reduces the morphine dose by 25% but skips the morphine-to-oxycodone conversion (180 × 0.75 = 135 mg/day).

Opioid rotation: total 24-h dose → equianalgesic ratio → reduce 25–50% for incomplete cross-tolerance → divide by dosing interval.

Professional Practice

Question 6

A patient is being discharged with a 5-day supply of oxycodone after surgery. He lives with teenage children. Which teaching is most important for household safety?

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Answer: B

Keep the tablets in a kitchen cabinet so they are easy to find: Unlocked, accessible storage is a leading source of diverted opioids for adolescents.

Store them locked and dispose of extra tablets at a take-back: Correct. Locked storage and prompt disposal through take-back programs reduce diversion and accidental ingestion; naloxone education is also recommended.

Keep leftover tablets for any future injuries in the family: Saving opioids for later or for others encourages misuse and unsafe self-treatment.

Share any unused tablets only with adults who are in pain: Sharing prescription opioids is illegal and unsafe.

Opioid safety teaching: lock it up, don't share, dispose of leftovers (take-back), and keep naloxone available.

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