CEN Practice Test

What the CEN is and how it works

According to Board of Certification for Emergency Nursing, “To qualify for the exam, you must hold a current, unencumbered Registered Nurse license”^[6]

The CEN is the Certified Emergency Nurse credential awarded by the Board of Certification for Emergency Nursing (BCEN). It shows that a registered nurse has passed an exam on the knowledge used in emergency care.

Eligibility: you need a current, unencumbered RN license from the US, a US territory, Canada or Australia. BCEN also accepts an equivalent foreign license. BCEN decides what counts as equivalent, so check bcen.org/cen/eligibility if your license is from elsewhere.

Format and scoring: the exam has 150 questions and a total seat time of 180 minutes (3 hours). To pass, you need 99 of the 150 questions right. You take it on a computer, either at a PSI testing center or through Live Remote Proctoring. You see a pass or fail result as soon as you finish, and BCEN also emails your results.

Scheduling: once your application is approved, you must schedule and sit for the exam within a 90-day testing window.

Fees and retakes: the fee is $285 for ENA members, $380 for non-members and $195 for military candidates ($265 with BCEN Test Assurance). If you do not pass, you reapply, pay again and wait 90 days between attempts. BCEN offers a discounted retest fee up to 1 year after your initial exam date, and Test Assurance gives you a retest with no further fee. Passing certifies you for 4 years. Fees and policies can change, so confirm them in the current BCEN Candidate Handbook before you apply.

CEN Exam at a Glance

What changed for CEN in 2026

• Oct 25, 2026: Eligibility changed to Current, unencumbered RN license (US, US territory, Canada or Australia; equivalent foreign license accepted) (previously Current unencumbered RN license (US, territory, Canada, Australia or verified equivalent)).^[6]
• Oct 25, 2026: Number of questions changed to 150 questions (previously 150 items (content outline effective July 2026)).^[1]
• Oct 25, 2026: Passing score changed to 99 of 150 questions (previously Angoff-set raw cut score, equated per form).^[1]
• Oct 25, 2026: Score release changed to Immediately (score report at test center or on screen, plus email) (previously Immediately on screen and by email).^[2]
• Oct 25, 2026: Retake policy changed to Reapply and pay fees; 90-day wait between attempts (previously Reapply; 90-day wait between attempts).^[2]
• Oct 25, 2026: Testing window changed to 90 days after application approval (previously 90-day testing window after application approval).^[7]
• Oct 25, 2026: Retake fee changed to Discounted retest fee within 1 year of initial exam; no-fee second attempt with Test Assurance (previously $200 retest (within 1 year of initial exam)).^[4]

CEN content outline and where to practise each area

The content areas below are copied from the official CEN content outline published by Board of Certification for Emergency Nursing. The right-hand column shows which of our practice sets covers it.

Worked examples: how to reason through CEN questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: Magnesium toxicity in a preeclamptic patient on magnesium sulfate infusion is first evidenced by loss of which reflex?

1. Corneal reflex
2. Patellar (knee-jerk) reflex
3. Gag reflex
4. Pupillary reflex

Answer: B. Patellar (knee-jerk) reflex

Explanation:

Correct: B, patellar (knee-jerk) reflex. Deep tendon reflexes fade before the more dangerous effects of magnesium, such as respiratory depression and cardiac changes. That is why nurses check them routinely during a magnesium sulfate infusion.

Why the others are wrong: corneal, gag and pupillary reflexes are brainstem reflexes. They disappear only with much deeper central nervous system depression, so losing them is a late finding, not an early warning.

Rule to remember: during magnesium sulfate therapy, monitor deep tendon reflexes, respiratory rate and urine output. If the patellar reflex is weak or absent, stop the infusion, tell the provider and keep calcium gluconate ready as the antidote.

Example 2

Question: Which assessment finding in a burn patient indicates the need for immediate endotracheal intubation?

1. Burns covering 30% TBSA on the extremities
2. Singed nasal hairs with hoarse voice and stridor
3. Carbon monoxide level of 15%
4. Full-thickness burn to the right hand

Answer: B. Singed nasal hairs with hoarse voice and stridor

Explanation:

Correct: B, singed nasal hairs with hoarse voice and stridor. These signs point to inhalation injury with airway swelling that has already started. The swelling gets worse over the following hours, especially during fluid resuscitation, and a late intubation can become very difficult, so the airway is secured early.

Why the others are wrong: a 30% TBSA burn on the extremities needs fluid resuscitation but does not threaten the airway on its own. A carbon monoxide level of 15% calls for high-flow oxygen, not automatic intubation. A full-thickness hand burn needs specialist wound care, not airway control.

Rule to remember: when deciding on intubation, signs of airway involvement (stridor, hoarseness, facial or oral burns, soot in the airway) outrank burn size.

Example 3

Question: A patient has a zone II penetrating neck injury with active bleeding. Which is the priority intervention?

1. CT angiography of the neck
2. Immediate surgical exploration
3. Direct pressure and airway management
4. Diagnostic angiography and embolization

Answer: C. Direct pressure and airway management

Explanation:

Correct: C, direct pressure and airway management. Active bleeding from a zone II wound can kill within minutes, both through blood loss and through a growing hematoma that compresses the airway. Direct pressure controls the bleeding and early airway management prevents obstruction, so both come before any test or procedure.

Why the others are wrong: CT angiography suits stable patients, and an actively bleeding patient should not leave the bay for a scan. Surgical exploration may be needed to repair the injury, but the patient has to reach the operating room with bleeding controlled and the airway secured. Angiography with embolization is a planned procedure for stable patients.

Rule to remember: in penetrating neck trauma, airway and hemorrhage control come first. Do not probe the wound, and order imaging only once the patient is stable.

How to use these practice tests

Start with the official BCEN content outline and Candidate Handbook so you know the content areas and the test-day rules. Then take the CEN Certified Emergency Nurse and CEN Certified Emergency Nurse MCQ sets untimed to find your weak spots.

• Sort the questions you miss by content area using the table above, then work the matching topic sets, such as Neurological Emergencies or Respiratory Emergencies.
• Read every explanation, including for questions you got right, and write down the rule behind each answer in your own words.
• For areas with no matching set here (Head, Eye, Ear, Nose, Throat; Mental Health; Professional Issues), study from the official outline and your usual nursing references.
• Practise priority questions with an airway, breathing, circulation order in mind, since many items ask what to do first.

In the last weeks, take mixed sets in timed blocks to practise pacing for 150 questions in 180 minutes. Book your seat early in your 90-day testing window so you have room to reschedule, and remember that a retest means a 90-day wait.

Sources & last verified

1. Board of Certification for Emergency Nursing — number of questions, passing score (official source). “Updated CEN Passing Score: 99/150 questions” Verified Oct 25, 2026 · source checked Oct 21, 2026.
2. Board of Certification for Emergency Nursing — time limit, retake policy, validity, score release (official source). “Total seat time for the exam is 180 minutes (3 hours).” Verified Oct 25, 2026.
3. Board of Certification for Emergency Nursing — exam fee (official source). “Yes, the CEN exam fee is $285 for Emergency Nurses Association members and $380 for non-members.” Verified Oct 25, 2026 · source checked Oct 21, 2026.
4. Board of Certification for Emergency Nursing — exam fee, retake fee (official source). “We are proud to offer a reduced application fee of $195 (or $265 with BCEN Test Assurance)” Verified Oct 26, 2026 · source checked Oct 26, 2026.
5. Board of Certification for Emergency Nursing — delivery (official source). “Finally, examinations are delivered by computer at PSI testing centers and through Live Remote Proctoring (LRP).” Verified Oct 25, 2026 · source checked Oct 21, 2026.
6. Board of Certification for Emergency Nursing — eligibility (official source). “To qualify for the exam, you must hold a current, unencumbered Registered Nurse license” Verified Oct 25, 2026 · source checked Oct 21, 2026.
7. Board of Certification for Emergency Nursing — testing window (official source). “You must schedule and sit for your CEN exam within your 90-day testing window” Verified Oct 25, 2026 · source checked Oct 21, 2026.
8. Board of Certification for Emergency Nursing — other (official source). “cardiovascular emergencies” Verified Oct 28, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.