The CFRN exam from the Board of Certification for Emergency Nursing (BCEN) is for registered nurses with a current, unrestricted RN license who work in flight transport or plan to. This page puts the key exam facts together and gives you free practice sets for each official content area, worked explanations of sample questions, a study plan and answers to common questions. We write our questions with AI tools, and they are not real exam items.
The CFRN has 175 questions, takes about 3 hours and costs $380[1][2] (Board of Certification for Emergency Nursing, verified Oct 25, 2026).
Numbers in brackets link to the official sources listed under Sources & last verified. Dates that have passed are removed automatically.
| Item | Detail | Source · Verified |
|---|---|---|
| Number of questions | 175 items (150 scored + 25 unscored)[1] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
| Time limit | 180 minutes (3 hours)[1] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
| Exam fee | $380 ($285 ASTNA members)[2] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
| Retake policy | 90-day wait after a failed attempt[1] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
| Validity | 4 years[2] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
| Renewal | Re-take the exam or CE attestation[3] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
| Delivery | Computer-based at PSI Testing Centers or Live Remote Proctoring[1] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
| Eligibility | Current, unrestricted RN license (US, US territory, Canada, Australia or equivalent)[4] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
| Score release | Immediately after the exam[4] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
| Testing window | 90-day testing window after approval[1] | Board of Certification for Emergency Nursing · Oct 25, 2026 |
According to Board of Certification for Emergency Nursing, “The CFRN exam consists of 175 items (150 scored and 25 unscored pretest items).”[1]
The CFRN credential from BCEN is for registered nurses who care for patients during flight transport. To be eligible, you must hold a current, unrestricted Registered Nurse license from the United States, a US territory, Canada or Australia, or an equivalent RN license.
You take the exam on a computer, either at a PSI Testing Center or at home through Live Remote Proctoring. It has 175 items. 150 of them are scored and 25 are unscored pretest items. Total seat time is 180 minutes. Your score appears on screen as soon as you finish.
Once you are approved, you must schedule and sit the exam within a 90-day test window. If you do not pass, you have to wait 90 days before you can test again. The fee is $380, or $285 for members of the Air & Surface Transport Nurses Association (ASTNA).
The certification is valid for 4 years. To renew, you either re-take the exam or use CE attestation. BCEN sets the passing standard, the CE requirements for renewal and all current policies, and these can change. Check the details at bcen.org before you apply, schedule or renew.
The content areas below are copied from the official CFRN content outline published by Board of Certification for Emergency Nursing. The right-hand column shows which of our practice sets covers it.
| Official content area | Practice on this site |
|---|---|
| General Principles of Flight Transport Nursing Practice[5] | CFRN Physiology and Gas Laws Practise applying the gas laws, hypoxia types, effects of altitude on patients and equipment, and the safety rules around aircraft operations. |
| Medical Emergencies[5] | CFRN Cardiovascular Emergencies Practise recognising and treating cardiac, respiratory, neurological, environmental and toxicological emergencies when the transport cabin limits your resources. |
| Resuscitation Principles[5] | CFRN Advanced Airway Management Practise rapid sequence intubation drug choices, ventilator management, shock states and dosing of resuscitation medications. |
| Special Populations[5] | CFRN Pediatric and Neonatal Patients Practise how assessment, drug dosing and equipment change for pediatric, neonatal and obstetrical patients. |
| Trauma[5] | CFRN Specialized Trauma Care Practise prioritising head, chest, abdominal, burn and multisystem injuries, including how altitude affects trapped gas and bleeding. |
Prepare for the CFRN - Certified Flight Registered Nurse exam with our free practice test modules. Each quiz covers key topics to help you pass on your first try.
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.
Question: What is the significance of 'density altitude' for helicopter flight nurses?
Answer: B. It affects aircraft performance by reducing lift capacity in hot, high, or humid conditions
Explanation:
B is correct. Density altitude is the altitude the aircraft performs as if it were at, once temperature, elevation and humidity are taken into account. Hot, high or humid air is thinner, so the rotor makes less lift and the engine makes less power. That reduces how much weight the aircraft can carry and how well it hovers and climbs. This is why a pilot may limit crew, equipment or patient weight on some flights.
A is wrong because medical helicopters are usually unpressurized, and pressurization has nothing to do with air density for lift. C is wrong because density altitude does not affect drug dosing. D is wrong because oxygen decisions follow cabin altitude and the patient's condition, not aircraft performance.
Rule to remember: density altitude is about how the aircraft performs. Gas laws and hypoxia are about the patient's physiology.
Question: Rocuronium is selected instead of succinylcholine for RSI. What reversal agent is available for rocuronium?
Answer: B. Sugammadex
Explanation:
B is correct. Sugammadex is a modified cyclodextrin. It binds rocuronium (and vecuronium) directly in the plasma and pulls it away from the neuromuscular junction. It can reverse even deep blockade quickly, which matters in a cannot-intubate, cannot-ventilate situation.
A is wrong. Neostigmine is a cholinesterase inhibitor. It can help reverse non-depolarizing blockade, but only after some recovery has started. It also works more slowly and needs an anticholinergic given with it. C is wrong because flumazenil reverses benzodiazepines. D is wrong because physostigmine treats anticholinergic toxicity.
Rule to remember: sugammadex works only on the aminosteroid blockers, rocuronium and vecuronium. Succinylcholine has no reversal agent. Have your airway plan and backup ready before you push either drug.
Question: What is the correct IV loading dose of amiodarone for a hemodynamically stable patient with ventricular tachycardia?
Answer: B. 150 mg over 10 minutes
Explanation:
B is correct. For a stable patient in ventricular tachycardia with a pulse, the amiodarone load is 150 mg IV over 10 minutes, followed by a maintenance infusion. The bolus can be repeated if VT comes back. Giving it slowly lowers the risk of hypotension and bradycardia.
A is wrong because 75 mg is below the standard adult loading dose. C is wrong because 300 mg IV push is the first dose for pulseless VT or ventricular fibrillation during cardiac arrest, not for a patient with a pulse. D is wrong because 600 mg over 30 minutes is not a standard loading regimen and makes hypotension more likely.
Rule to remember: if there is a pulse and the patient is stable, give 150 mg slowly. If there is no pulse, give 300 mg push. Confirm the pulse and blood pressure before you choose the dose, and follow your program's protocols.
Start with the official content outline and candidate information on bcen.org so you know what the exam covers and the rules for test day. Then do the CFRN General set without notes to find your weak areas.
Next, work through the topic sets that match those gaps. For transport practice, use Physiology and Gas Laws and Aviation Safety and Survival. For resuscitation, use Advanced Airway Management and Shock and Hemodynamic Monitoring. For special populations, use Obstetrical Patient Management. After each set, read every explanation, including the ones for questions you got right, and write down the rule behind each miss.
Closer to test day, do the CFRN MCQ set under a timer. The real exam gives you 180 minutes for 175 items, so practise keeping a steady pace and flagging hard questions instead of getting stuck. Book your exam early in your 90-day window so you have room to reschedule. Decide whether you will test at a PSI center or by Live Remote Proctoring, then prepare your route or your room.
The CFRN exam has 175 items. 150 are scored and 25 are unscored pretest items. Total seat time is 180 minutes (3 hours). You cannot tell which items are pretest items, so answer every question as if it counts. The exact wording of these rules is in BCEN's CFRN FAQs at bcen.org.
The fee is $380 for non-members and $285 for members of the Air & Surface Transport Nurses Association (ASTNA). Fees can change, so check the current amount on bcen.org before you apply. If you are an ASTNA member, make sure your membership is active when you register so the member price applies.
Yes. You can take the exam by computer at a PSI Testing Center or at home through Live Remote Proctoring (LRP). Remote testing has its own rules for your room, computer and ID, so read BCEN's and PSI's requirements before you choose it. Test your setup well before exam day.
You have to wait 90 days after a failed attempt before you can test again. Your score appears on screen as soon as you finish, so you will know your result right away. Use the waiting period to focus on your weakest content areas, and check bcen.org for the steps to reapply.
CFRN certification is valid for 4 years. To renew, you either re-take the certification exam or complete CE attestation. BCEN sets the continuing education requirements and deadlines for attestation, so check the recertification page on bcen.org well before your expiration date to choose the route that suits you.
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