CFRN Certification

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The Certified Flight Registered Nurse (CFRN) certification was developed by the Board of Certification for Emergency Nursing (BCEN) in the early 1990s in cooperation with the National Flight Nurses Association (NFNA).[1] The CFRN certification has been accredited by the Accreditation Board for Specialty Nursing Certification (ABSNC) since 2007.[1]

A revised version of the examination, the "upgraded CFRN," was deployed in 2011.[2] It was formulated in response to a role delineation study conducted in 2010 which surveyed over 800 nurses in the field of flight and transport nursing to determine the knowledge and competencies most crucial in the field.[3]

Function of the Test

CFRN Study Guide

The CFRN is a professional credential intended for flight nurses with at least two years of full-time experience in the field, though this level of experience is not required in order to attempt the examination.[4] In order to take the examination, candidates must hold a current, unrestricted nursing license if practicing in the United States or a nursing certificate equivalent to Registered Nurse if practicing abroad.[5]

Because candidates must already be licensed medical professionals, certification in Flight Nursing does not confer any additional licensure privileges. However, certification is beneficial as an exercise in professional development, motivating candidates to improve their skills and abilities and enhancing their future career prospects.[6]

The credential is accredited by the ABSNC, a national organization which investigates and reports on the validity of nursing specialty credentials.[1] The BCEN reports that more than 2,900 nurses hold current CFRN certification.[4]

Test Administration

CFRN Flashcards

Candidates must submit a registration application to the BCEN before scheduling a test date for the CFRN examination. The cost to take the CFRN exam varies depending on candidates' affiliation with professional organizations and current certification status. Members of the ENA or the ASTNA may take the initial exam for $230 or recertify for $210. Non-members must pay $370 for the initial exam or $350 to recertify.[7] Additional discounts are available for group registrations, military and veteran candidates,[7] or those who have failed the exam within the previous calendar year.[2]

The CFRN examination is offered year-round at AMP testing centers. The 180-question exam has a the time limit of three hours.[2]

Candidates receive a score report immediately upon completing the exam which indicates pass/fail status. Certificates and wallet cards are mailed to successful candidates within ten business days. Unsuccessful candidates who wish to take the examination again must wait 90 days before applying to retake the examination. Candidates who reapply within one year of the test date receive a discount on the exam fee.[2] Candidates may only take the exam twice during any six-month period, but there is no limit to the number of times a candidate may take the exam.[5]

Candidates with disabilities who require special testing accommodations should contact AMP directly to request accommodations.[2] AMP has a standardized accommodation request process which involves submitting a request form along with supporting documentation of disability-related needs.[8]

Test Format

Test Structure

The CFRN contains questions that focus on seven major categories: General Principles of Practice; Patient Care Principles; Trauma; Medical Problems; Environmental Emergencies and Toxicology; Obstetrical Patients; and Patient Care Issues and Management. Combined, there are a total of 150 questions. There are also an additional 30 pretest questions that will not count towards a candidate's final score.[9]

Test Environment

The CFRN is administered at AMP testing centers year around, and is also available with Pearson VUE. At both testing centers, at least one form of identification is required that is government issued, and contains a photo and signature. It is offered Monday through Friday twice a day, once 9:00 am and once at 1:30 pm. The test is computer based, and results will be reported before test-takers leave the testing center.[10]

Test Content

  • Sample CFRN Test Questions
  1. Which of the following conditions is an absolute contraindication to nasotracheal intubation?
    A. Cervical spine injury
    B. Facial trauma
    C. Skull fracture
    D. Apnea
  2. The primary purpose of using rapid sequence intubation is to:
    A. Reduce the risk of gastric aspiration
    B. Prevent esophageal trauma
    C. Speed intubation
    D. Reduce tracheal trauma
  3. A 17-year old man was bitten by a western diamondback rattlesnake on his right lower leg. The minimal indication for antivenin is:
    A. fang marks on the leg
    B. tenderness to palpation around the bite area
    C. patient insistence on receiving antivenin
    D. severe local pain and edema around the bite site
  4. A pregnant woman has an emergency delivery at term. When evaluating the infant, what heart rate should be expected in the first 30 minutes after birth (first period of reactivity)?
    A. 160 beats/min
    B. 130 beats/min
    C. 100 beats/min
    D. 80 beats/min
  5. Before insertion of an intra-arterial balloon pump, the ankle-brachial index (ABI) is used to assess circulation of the lower extremities. If the brachial systolic pressure is 120 and the ankle systolic pressure is 90, what is the ABI?
    A. 0.75
    B. 1.3
    C. 30
    D. 210
  6. An 18-kg child involved in a car accident has head and abdominal injuries and pediatric trauma score of 5, which indicates which of the following conditions?
    A. Normal status
    B. Mild injury, requiring outpatient care only
    C. Major injury requiring admission to the critical care unit
    D. Impending death


The CFRN comprises 150 scored multiple choice questions and 30 unmarked, unscored pretest questions which are being assessed for inclusion on future versions of the CFRN.[11] The breakdown of content on the CFRN is as follows:

Distribution of questions on the CFRN exam[11]
Content Area # of
General Principles of Practice 22
Patient Care Principles 25
Trauma 38
Medical Problems 39
Environmental Emergencies and Toxicology 8
Obstetrical Patients 8
Patient Care Issues and Management 10
Total 150

The passing score of the CFRN is approximately 75%;[3] however, the exact passing score varies depending on the exact form of the exam taken. The difficulty of each item on the exam is assessed by a panel of experts, who determine the percentage of minimally qualified candidates who would answer the question correctly. Slightly harder versions of the exam have lower passing scores than slightly easier versions of the exam do.[11]

Although the BCEN publishes pass rate statistics for some of its other certification exams such as the CEN and CPEN, it does not appear to publish any statistics for the CFRN.

Answers to Sample Questions

1;D 2;A 3;D 4;A 5;A 6;C


  1. ^ a b c BCEN - History March 25 2015
  2. ^ a b c d e BCEN - CFRN FAQ March 25 2015
  3. ^ a b BCEN - CFRN Test Content and Development March 25 2015
  4. ^ a b BCEN - CFRN Eligibility FAQ March 25 2015
  5. ^ a b BCEN - CFRN Exam Policies March 25 2015
  6. ^ BCEN - Why Certify? March 25 2015
  7. ^ a b BCEN - CFRN Fees March 25 2015
  8. ^ AMP - Request for Special Examination Accommodations March 15 2015
  9. ^ CFRN Content Outline 23 April 2015
  10. ^ About the CFRN Exam 23 April 2015
  11. ^ a b c BCEN - CFRN Candidate Handbook March 25 2015