Lol, you should have said that. You can use an EGA resolution to do this. Generally when someone says "a CGA monitor" they mean its limited to that. If it can do CGA/EGA/VGA, that's called a tri-sync.
Take the original resolution of the game, take the larger dimension, and run it in a resolution of (the larger dimension * 4/3)x(the larger dimension). For example if MAME lists the game as "320x240," the larger dimension would be 320, so run it in (320 * 4/3)x(320), which is "427x320". Now, obviously that exact resolution may not be available, even if you try to create a custom res. Just use the next largest one that works. Don't use anything smaller.
Don't use waitvsync or triplebuffer, they cause lag. Run it in directdraw with sync to refresh, and tweak your refresh rate in Powerstrip to that of the original game. You can read that thread for more details on this, I'm not going to write it all out again here.