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The PMGT-BC exam has 150 questions and runs 3 hours.
These 10 free PMGT-BC questions are organized by exam domain, so you can see how each part of the Pain Management Nursing Certification (PMGT-BC) blueprint is tested. Reveal the answer and explanation under each question.
A patient with a pelvic bone metastasis describes a deep ache that increases with weight bearing and electric pain extending down the leg. Examination shows reduced pinprick sensation in the painful leg, and imaging confirms tumor involvement of a sacral nerve root. Which description best accounts for the entire pain pattern?
Correct answer: C - Mixed nociceptive and neuropathic pain
At the start of treatment, a patient's past-week PEG ratings were 6 for average pain, 8 for interference with enjoyment of life, and 7 for interference with general activity. Six weeks later, the respective ratings are 6, 3, and 3. The patient has resumed cooking and walking to nearby shops without troublesome treatment effects. What do these results demonstrate?
Correct answer: D - Interference has decreased and function has improved, despite an unchanged pain-intensity rating.
During a fibromyalgia consultation, a patient asks why ordinary pressure hurts across many body regions even though no inflammatory disease or somatosensory lesion has been identified. The patient also reports unrefreshing sleep and fatigue. Which mechanism is most consistent with this presentation?
Correct answer: D - Altered nociceptive processing that amplifies sensitivity to sensory input
Six weeks after a wrist sprain, a patient has continuing disproportionate pain and reports touch sensitivity, episodes of redness and swelling, and intermittent loss of wrist motion. Today, examination shows brush allodynia and pinprick hyperalgesia. Skin color, temperature, sweating, strength, range of motion, and trophic findings are normal, and no edema is present. No better explanation has been identified. How do the Budapest clinical criteria apply at this visit?
Correct answer: A - Only one category has examination signs; the clinical criteria are not met.
A 7-year-old with a splinted forearm fracture demonstrates understanding of the Faces Pain Scale-Revised and selects the fifth face in its six-face sequence, counting from the no-pain end. The parent suggests 2/10 because the child is smiling at a video. Which pain rating belongs in the record?
Correct answer: D - 8/10, from the child's selection on the faces scale
A postoperative patient receiving IV hydromorphone is barely responsive to physical stimulation and has six shallow breaths per minute. A pulse is present, and oxygen saturation is 98% on supplemental oxygen. The opioid infusion has been stopped, and a colleague is activating the rapid-response team. What should the bedside nurse do while help is arriving?
Correct answer: A - Start assisted ventilation with a bag-mask device and administer naloxone per protocol.
"On a good day I do all the housework, then I spend the next two days in bed," says a patient with chronic low back pain. A recent assessment found no new neurologic findings or other red flags, and the rehabilitation team has cleared gradual activity. Which plan most directly interrupts this cycle?
Correct answer: B - Set manageable daily activity targets with planned breaks and gradual increases.
The nurse is checking an ordered rotation from oral morphine to oral immediate-release oxycodone because of persistent pruritus. During the preceding 24 hours, the patient received morphine 15 mg every 4 hours around the clock, plus two 15-mg rescue doses from an order allowing a dose every 2 hours as needed. No other opioids were given. The pain service uses the oral equivalence of 30 mg morphine to 20 mg oxycodone. The prescriber specifies a 50% reduction for incomplete cross-tolerance, followed by four equal scheduled doses per day. Which oxycodone order matches that plan?
Correct answer: C - 10 mg orally every 6 hours
A 79-year-old taking scheduled morphine develops confusion, visual hallucinations, and brief involuntary muscle jerks after several days of poor fluid intake. Kidney function has deteriorated markedly. The morphine schedule has not changed, no doses were missed, and no other medications were added. Which treatment-related complication best explains these findings?
Correct answer: B - Opioid-induced neurotoxicity
An adult with sickle cell disease reports the usual vaso-occlusive pain at 9/10. The patient is alert, has stable vital signs, and has no chest symptoms or new neurologic findings. Individualized analgesic orders and the time of the last opioid dose have been verified. A colleague suggests delaying the IV opioid because the patient is quietly using a phone. Which response best supports appropriate care?
Correct answer: B - "Use the individualized orders; reassess pain and sedation promptly."
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