Certified Pain Management Pharmacist
(CPMP) Practice Exam Verified Questions,
Correct Answers, and Detailed Explanations
for Science Students||Already Graded A+
1. Which neurotransmitter is most directly involved in central sensitization in
chronic pain?
A. Dopamine
B. Acetylcholine
C. Glutamate
D. GABA
Answer: C
Glutamate activates NMDA receptors, leading to central sensitization and
amplification of pain signals.
2. Which opioid receptor is primarily responsible for analgesia?
A. Delta
B. Kappa
C. Mu
D. Sigma
Answer: C
Mu receptors mediate supraspinal and spinal analgesia as well as respiratory
depression and euphoria.
3. A patient on long-term opioid therapy develops worsening pain despite
dose escalation. This is best described as:
A. Tolerance
B. Dependence
C. Addiction
D. Opioid-induced hyperalgesia
,Answer: D
Opioid-induced hyperalgesia is paradoxical increased pain sensitivity due to
chronic opioid exposure.
4. Which medication is first-line for diabetic peripheral neuropathy?
A. Morphine
B. Duloxetine
C. Acetaminophen
D. Ibuprofen
Answer: B
SNRIs like duloxetine have strong evidence for neuropathic pain management.
5. Which adverse effect is most associated with methadone?
A. Nephrotoxicity
B. Hepatotoxicity
C. QTc prolongation
D. Hypertension
Answer: C
Methadone blocks cardiac potassium channels, increasing risk of torsades de
pointes.
6. Which pain scale is most appropriate for a nonverbal ICU patient?
A. Numeric Rating Scale
B. Visual Analog Scale
C. Wong-Baker Faces
D. Behavioral Pain Scale
Answer: D
Behavioral tools assess facial expression, movement, and compliance in
nonverbal patients.
7. Which NSAID has the highest COX-2 selectivity?
, A. Naproxen
B. Ibuprofen
C. Diclofenac
D. Celecoxib
Answer: D
Celecoxib selectively inhibits COX-2, reducing GI toxicity compared to
nonselective NSAIDs.
8. Which condition is most appropriate for topical lidocaine?
A. Fibromyalgia
B. Migraine
C. Postherpetic neuralgia
D. Rheumatoid arthritis
Answer: C
Topical lidocaine is FDA-approved for postherpetic neuralgia.
9. Which opioid is safest in severe renal impairment?
A. Morphine
B. Codeine
C. Fentanyl
D. Meperidine
Answer: C
Fentanyl lacks active renally cleared metabolites, making it safer in renal
dysfunction.
10. Which enzyme primarily metabolizes tramadol to its active metabolite?
A. CYP3A4
B. CYP1A2
C. CYP2D6
D. CYP2C9
Answer: C
The active metabolite (M1) provides much of tramadol’s opioid activity.
(CPMP) Practice Exam Verified Questions,
Correct Answers, and Detailed Explanations
for Science Students||Already Graded A+
1. Which neurotransmitter is most directly involved in central sensitization in
chronic pain?
A. Dopamine
B. Acetylcholine
C. Glutamate
D. GABA
Answer: C
Glutamate activates NMDA receptors, leading to central sensitization and
amplification of pain signals.
2. Which opioid receptor is primarily responsible for analgesia?
A. Delta
B. Kappa
C. Mu
D. Sigma
Answer: C
Mu receptors mediate supraspinal and spinal analgesia as well as respiratory
depression and euphoria.
3. A patient on long-term opioid therapy develops worsening pain despite
dose escalation. This is best described as:
A. Tolerance
B. Dependence
C. Addiction
D. Opioid-induced hyperalgesia
,Answer: D
Opioid-induced hyperalgesia is paradoxical increased pain sensitivity due to
chronic opioid exposure.
4. Which medication is first-line for diabetic peripheral neuropathy?
A. Morphine
B. Duloxetine
C. Acetaminophen
D. Ibuprofen
Answer: B
SNRIs like duloxetine have strong evidence for neuropathic pain management.
5. Which adverse effect is most associated with methadone?
A. Nephrotoxicity
B. Hepatotoxicity
C. QTc prolongation
D. Hypertension
Answer: C
Methadone blocks cardiac potassium channels, increasing risk of torsades de
pointes.
6. Which pain scale is most appropriate for a nonverbal ICU patient?
A. Numeric Rating Scale
B. Visual Analog Scale
C. Wong-Baker Faces
D. Behavioral Pain Scale
Answer: D
Behavioral tools assess facial expression, movement, and compliance in
nonverbal patients.
7. Which NSAID has the highest COX-2 selectivity?
, A. Naproxen
B. Ibuprofen
C. Diclofenac
D. Celecoxib
Answer: D
Celecoxib selectively inhibits COX-2, reducing GI toxicity compared to
nonselective NSAIDs.
8. Which condition is most appropriate for topical lidocaine?
A. Fibromyalgia
B. Migraine
C. Postherpetic neuralgia
D. Rheumatoid arthritis
Answer: C
Topical lidocaine is FDA-approved for postherpetic neuralgia.
9. Which opioid is safest in severe renal impairment?
A. Morphine
B. Codeine
C. Fentanyl
D. Meperidine
Answer: C
Fentanyl lacks active renally cleared metabolites, making it safer in renal
dysfunction.
10. Which enzyme primarily metabolizes tramadol to its active metabolite?
A. CYP3A4
B. CYP1A2
C. CYP2D6
D. CYP2C9
Answer: C
The active metabolite (M1) provides much of tramadol’s opioid activity.
