1
ABFM KSA Pain Management Actual
Exam Questions and Answers with
Rationales 2026/2027 | Family Medicine
Board Exam | Pass Guarantee
Q001: A 34-year-old man presents with acute low-back pain after lifting a box 2
days ago. Pain is 8/10, no leg numbness, no red-flag signs. Which first-line
pharmacologic recommendation aligns with 2026 CDC guidance?
Options:
A. Immediate oxycodone 5 mg q6h × 7 days
B. Ibuprofen 600 mg TID + acetaminophen 500 mg BID PRN
C. Cyclobenzaprine 10 mg TID for 2 weeks
D. Tramadol 50 mg q6h around-the-clock
ANSWER: B
Q002: A 28-year-old woman with fibromyalgia reports widespread pain 6/10
despite naproxen. Which adjuvant is FDA-approved for this condition?
Options:
A. Gabapentin 300 mg TID
B. Duloxetine 60 mg daily
C. Pregabalin 150 mg BID
D. Amitriptyline 25 mg at bedtime
ANSWER: B
, 2
Q003: A 55-year-old man on oxycodone 15 mg q6h for post-laminectomy pain
requests dose escalation after 4 weeks. His morphine milligram equivalent (MME)
is now 90/day. Per 2026 CDC guidelines, which action is most appropriate?
Options:
A. Increase to 20 mg q6h and reassess in 1 week
B. Rotate to morphine 30 mg q8h to reduce MME
C. Taper by 10 % weekly and initiate multimodal program
D. Add tramadol 100 mg BID for opioid-sparing
ANSWER: C
Q004: A 42-year-old woman with diabetic neuropathy describes burning feet pain
7/10. Gabapentin 600 mg TID provides partial relief. Which next agent has Level-
A evidence for neuropathic pain?
Options:
A. Start duloxetine 30 mg daily
B. Add oxycodone 5 mg BID
C. Increase gabapentin to 800 mg TID
D. Switch to carbamazepine 200 mg BID
ANSWER: A
Q005: A 19-year-old athlete twists an ankle; examination shows grade-II sprain.
Pain is 6/10. Which 2026 guideline-concordant initial analgesic regimen is best?
Options:
A. Naproxen 440 mg BID × 3 days + acetaminophen 650 mg PRN
B. Oxycodone 5 mg q6h × 5 days
C. Aspirin 650 mg TID
D. Tramadol 50 mg q6h PRN
ANSWER: A
, 3
Q006: A 60-year-old man with stage IV lung cancer has pain 9/10 from rib
metastases. He is opioid-naïve. Which opioid initiation plan aligns with 2026
palliative-care guidelines?
Options:
A. Morphine 5 mg PO q4h ATC with 5 mg q1h PRN
B. Fentanyl patch 25 mcg q72h
C. Oxycodone 15 mg PO q4h ATC
D. Hydromorphone 4 mg PO q4h
ANSWER: A
Q007: A 38-year-old woman has been taking oxycodone 5 mg BID for 3 weeks
after dental surgery and wants to stop. Which taper schedule is safest?
Options:
A. Stop immediately; no taper needed < 4 weeks
B. Reduce by 25 % every 3 days × 1 week
C. Switch to tramadol 50 mg BID × 1 week then stop
D. Continue current dose to prevent withdrawal
ANSWER: B
Q008: A 48-year-old man on chronic opioids reports constipation. Which first-line
laxative is recommended by 2026 guidelines?
Options:
A. Senna 2 tabs at bedtime
B. Polyethylene glycol 17 g daily
C. Docusate sodium 100 mg BID
D. Bisacodyl 5 mg daily
ANSWER: B
ABFM KSA Pain Management Actual
Exam Questions and Answers with
Rationales 2026/2027 | Family Medicine
Board Exam | Pass Guarantee
Q001: A 34-year-old man presents with acute low-back pain after lifting a box 2
days ago. Pain is 8/10, no leg numbness, no red-flag signs. Which first-line
pharmacologic recommendation aligns with 2026 CDC guidance?
Options:
A. Immediate oxycodone 5 mg q6h × 7 days
B. Ibuprofen 600 mg TID + acetaminophen 500 mg BID PRN
C. Cyclobenzaprine 10 mg TID for 2 weeks
D. Tramadol 50 mg q6h around-the-clock
ANSWER: B
Q002: A 28-year-old woman with fibromyalgia reports widespread pain 6/10
despite naproxen. Which adjuvant is FDA-approved for this condition?
Options:
A. Gabapentin 300 mg TID
B. Duloxetine 60 mg daily
C. Pregabalin 150 mg BID
D. Amitriptyline 25 mg at bedtime
ANSWER: B
, 2
Q003: A 55-year-old man on oxycodone 15 mg q6h for post-laminectomy pain
requests dose escalation after 4 weeks. His morphine milligram equivalent (MME)
is now 90/day. Per 2026 CDC guidelines, which action is most appropriate?
Options:
A. Increase to 20 mg q6h and reassess in 1 week
B. Rotate to morphine 30 mg q8h to reduce MME
C. Taper by 10 % weekly and initiate multimodal program
D. Add tramadol 100 mg BID for opioid-sparing
ANSWER: C
Q004: A 42-year-old woman with diabetic neuropathy describes burning feet pain
7/10. Gabapentin 600 mg TID provides partial relief. Which next agent has Level-
A evidence for neuropathic pain?
Options:
A. Start duloxetine 30 mg daily
B. Add oxycodone 5 mg BID
C. Increase gabapentin to 800 mg TID
D. Switch to carbamazepine 200 mg BID
ANSWER: A
Q005: A 19-year-old athlete twists an ankle; examination shows grade-II sprain.
Pain is 6/10. Which 2026 guideline-concordant initial analgesic regimen is best?
Options:
A. Naproxen 440 mg BID × 3 days + acetaminophen 650 mg PRN
B. Oxycodone 5 mg q6h × 5 days
C. Aspirin 650 mg TID
D. Tramadol 50 mg q6h PRN
ANSWER: A
, 3
Q006: A 60-year-old man with stage IV lung cancer has pain 9/10 from rib
metastases. He is opioid-naïve. Which opioid initiation plan aligns with 2026
palliative-care guidelines?
Options:
A. Morphine 5 mg PO q4h ATC with 5 mg q1h PRN
B. Fentanyl patch 25 mcg q72h
C. Oxycodone 15 mg PO q4h ATC
D. Hydromorphone 4 mg PO q4h
ANSWER: A
Q007: A 38-year-old woman has been taking oxycodone 5 mg BID for 3 weeks
after dental surgery and wants to stop. Which taper schedule is safest?
Options:
A. Stop immediately; no taper needed < 4 weeks
B. Reduce by 25 % every 3 days × 1 week
C. Switch to tramadol 50 mg BID × 1 week then stop
D. Continue current dose to prevent withdrawal
ANSWER: B
Q008: A 48-year-old man on chronic opioids reports constipation. Which first-line
laxative is recommended by 2026 guidelines?
Options:
A. Senna 2 tabs at bedtime
B. Polyethylene glycol 17 g daily
C. Docusate sodium 100 mg BID
D. Bisacodyl 5 mg daily
ANSWER: B
