Certified Emergency Nurse Exam

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The Certified Emergency Nurse (CEN) examination was originally developed between 1979 and 1980 by a committee established by the Emergency Nurses Association.[1] As the exam was under development, the Board of Certification for Emergency Nursing (BCEN) was formed as a not-for-profit corporation to be the administrator of the examination. It first administered the CEN in July 1980.[1]

The CEN certification first gained accreditation by the Accreditation Board for Specialty Nursing Certification (ABSNC) in 2002, and it was reaccredited again in 2007 and 2012.[1]

The CEN received a major revision in July 2011. The "upgraded CEN" substantially overhauled the content outline of the examination to deemphasize task-oriented questions and focus more on "disease processes and the critical thinking that goes along with the management and evaluation of disease processes."[2] The BCEN considers the upgraded CEN to be more difficult than previous task-oriented versions of the CEN.[2]

The CEN examination is under continual review and development. New item writers are appointed at least every two years, and once or twice a year, an Exam Construction Review Committee meets to revise and create new forms of the CEN.[3]

Function of the Test

CEN Study Guide

The CEN examination is administered to Registered Nurses (RNs) in the United States or its territories who wish to obtain certification in Emergency Nursing.[4] Because candidates must already be RNs, certification in Emergency 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.[5]

The only requirement for taking the examination is to have a current unrestricted RN license. However, the BCEN suggests that candidates wait until they have two years of experience in their institution's Emergency Department before attempting the examination.[4]

The BCEN reports that more than 28,000 nurses have received CEN certification.[4] They also report that "[t]he percentage of passing participants is in the 70th percentile," presumably meaning that about 70% of candidates pass the examination.[2]

Test Administration

CEN Flashcards

The fee for taking the CEN is $230 for members of the Emergency Nurses Association and $370 for non-members.[6] Candidates who register in groups of three or more receive a $20 discount each, and for military personnel, the certification fee is eligible for reimbursement through the Department of Veteran Affairs.[6]

The CEN is administered at Applied Meaurement Professionals, Inc. (AMP) testing sites across the United States.[7] It is primarily administered as a computer-based examination, but alternate test methods such as paper-and-pencil and mobile computer-based testing may be requested in advance.[7] The examination is offered every Monday through Friday, with seatings available at 9:00 AM and 1:30 PM. Saturday testing is available at least once per month at each AMP testing site.[7] The examination has a time limit of three hours.[8]

Candidates receive a score report upon completing the examination indicating whether the candidate has passed or failed the examination. Candidates who do not pass the examination must wait 90 days before submitting a retest application. A discounted price is available for retests.[8]

Candidates with disabilities who require special accommodations must submit their request for accommodation along with documentation of the disability at the time of application submission. The required forms are available on the BCEN Website.[9]


Sections of the CEN Test
CEN Test Subject Areas Percentage
Cardiovascular Emergencies 13%
Gastrointestinal Emergencies 7%
Genitourinary, Gynecology, and Obstetrical Emergencies 7%
Maxillofacial and Ocular Emergencies 6%
Neurological Emergencies 10%
Orthopedic and Wound Emergencies 9%
Psycho/Social Emergencies 5%
Respiratory Emergencies 12%
Environment and Toxicology Emergencies 7%
Shock 6%
Medical Emergencies and Communicable Diseases 11%
Professional Issues 7%
Total 100%

Test Environment

The CEN Exam takes place at AMP Assessment Center Network. After candidates arrive and are admitted into the testing area, there will be a brief tutorial on how to take the computerized exam. Once the exam is completed, or after the three hours allotted to take the exam is up, candidate's scores will be provided shortly after.[10]

Test Structure

The Certified Emergency Nurse Exam is made up of 175 questions, 25 of which are unscored, pretest, questions. All 175 questions deal with 12 major content areas: Cardiovascular Emergencies; Gastrointestinal Emergencies; Genitourinary, Gynecology, and Obstetrical Emergencies; Maxillofacial and Ocular Emergencies; Neurological Emergencies; Orthopedic and Wound Emergencies; Psycho/Social Emergencies; Respiratory Emergencies; Environment and Toxicology Emergencies; Shock; Medical Emergencies and Communicable Diseases; and Professional Issues. The time allotted to complete the exam is three hours.[2][11]

Test Content

  • Sample CEN Practice Questions:
  1. A forty-year-old female presents to the emergency department (ED) complaining of chest pain. After triaging the client, obtaining vital signs including a blood pressure of 90/46, and establishing an adequate airway, what is the next most important intervention for this client?
    A. registering the patient into the system
    B. ordering serum blood laboratory tests
    C. placing the client on a cardiac monitor, administering oxygen, and obtaining an electrocardiogram (EKG)
    D. giving a sublingual nitroglycerin tablet for the immediate relief of pain
  2. Which nursing diagnosis would be appropriate for a client with a cardiac history and shortness of breath?
    A. ineffective tissue perfusion
    B. low fluid volume
    C. ineffective breathing pattern
    D. none of the above
  3. While assessing a trauma patient, the nurse finds the client complaining of flank pain where there is also bruising noted. What intervention should the nurse be ready to perform because of these signs of injury?
    A. a CT scan of the client's head
    B. a urinalysis and a complete blood count (CBC)
    C. offer oral fluid to promote hydration
    D. administer oxygen
  4. What symptoms may occur in late eclampsia that can be life threatening?
    A. proteinuria
    B. seizures
    C. hemolysis
    D. headache
  5. All of the following are appropriate ways to establish an initial airway on a nonresponsive client EXCEPT?
    A. nasal trumpet
    B. endotracheal tube
    C. esophageal-tracheal Combitube
    D. a Replogle tube
  6. Which of the following is effective in the management of posterior epistaxis?
    A. pinching the nose to stop the blood flow
    B. topical vasoconstrictors such as phenylephrine
    C. silver nitrate or electric cautery
    D. insert a Merocel nasal sponge or Nasostat epistaxis nasal balloon
  7. All of the following are appropriate measures in stabilizing a patient with a suspected cervical spine injury EXCEPT:
    A. a four-person team is optimal
    B. strap the patient to the blackboard at the shoulders, hips, and proximal to the knees
    C. do not attempt to remove a helmet
    D. a rigid cervical collar is applied by one person while the leader maintains in-line head position
  8. The best method of limiting absorption in an adult who has ingested an unknown toxic substance is:
    A. induced emesis with syrup of ipecac
    B. gastric lavage
    C. administer activated charcoal
    D. administer activated charcoal plus a cathartic
  9. Which of the following coagulation factors is NOT vitamin K dependent?
    A. prothrombin (factor II)
    B. prothrombin conversion accelerator (factor VII)
    C. antihemophilic factor A (factor VIII)
    D. antihemophilic factor B (factor IX)

More free CEN practice test questions.


The CEN consists of 175 questions, of which 150 are scored. The remaining 25 unscored questions, which are scattered randomly throughout the examination, are pretest items being assessed for inclusion on future versions of the CEN examination.[12]

There is no penalty for guessing on the CEN. The pass/fail status is determined by the candidate's raw score, meaning that an incorrect answer and an omitted answer count the same.[13] The passing score is approximately 70%.[13]

Recent Developments

Effective May 18, 2014, the fee for CEN certification and recertification was increased to match the fees of the CFRN and CTRN examinations. It was the first CEN fee increase since 2002.[8]

Answers to Sample Questions

1:C; 2:C; 3:B; 4:B; 5:D; 6:D; 7:C; 8:D; 9:C;


  1. ^ a b c BCEN and the CEN Certification May 17 2014
  2. ^ a b c d Test Content and Development May 17 2014
  3. ^ Exam Development and Updates May 17 2014
  4. ^ a b c CEN® Eligibility FAQ May 17 2014
  5. ^ Why Certify? May 17 2014
  6. ^ a b Fees and Ways to Save May 17 2014
  7. ^ a b c Testing Agency and Sites May 17 2014
  8. ^ a b c CEN® Exam FAQ May 17 2014
  9. ^ Test Accomadation Form 2 July 2018
  10. ^ Testing Agency Sites 14 July 2014
  11. ^ Prometric CEN Content Outline 14 July 2014
  12. ^ Exam Scoring 2 July 2018
  13. ^ a b Exam Scoring FAQs 2 July 2018

External Links