CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

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A 10-year-old child is being treated by the emergency department staff. He or she has a normal systolic blood pressure, a rapid heartbeat, somewhat delayed capillary refill, and chilly, pale complexion. How much shock is the child most likely experiencing?

<label class="wq_answerTxtCtr">Compensated shock</label>
<label class="wq_answerTxtCtr">Decompensated shock</label>
<label class="wq_answerTxtCtr">Hypotensive shock</label>
<label class="wq_answerTxtCtr">None of the above</label>
Correct! Wrong!

The impact of shock on systolic blood pressure is frequently used to describe shock severity. The shock is referred to as ""compensated"" when the compensatory mechanisms are active and keep the systolic blood pressure constant. Shock is categorized as ""hypotensive"" (formerly called ""decompensated"") when the mechanisms can no longer support the blood pressure. Practice with the free CEN - Certified Emergency Nurse practice test on PracticeTestGeeks (7 questions with answer explanations).

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A 24-year-old guy with gunshot wounds to his abdomen and left groin area has been transported by emergency medical services to the emergency department. His heart rate is 120 beats per minute, and his blood pressure is 84/52. His skin is pale, cold, and diaphoretic. The procedure for which the nurse should get ready is:

<label class="wq_answerTxtCtr">Endotracheal intubation</label>
<label class="wq_answerTxtCtr">Administration of verapamil</label>
<label class="wq_answerTxtCtr">Rapid administration of a crystalloid solution</label>
<label class="wq_answerTxtCtr">Chest compressions</label>
Correct! Wrong!

The young man's symptoms and gunshot wounds suggest that he has suffered from hypovolemia as a result of severe blood loss. A quick intravenous infusion of a crystalloid solution is used to treat hypovolemia.

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The following are all indications of respiratory failure, WITH THE EXCEPTION

<label class="wq_answerTxtCtr">Decreased level of consciousness</label>
<label class="wq_answerTxtCtr">Nasal flaring and retractions</label>
<label class="wq_answerTxtCtr">Bradypnea</label>
<label class="wq_answerTxtCtr">Diminished air movement</label>
Correct! Wrong!

Not respiratory failure, although respiratory discomfort is indicated by nasal flaring and retractions. You can recognize respiratory failure by the following symptoms: diminished air movement, central and peripheral cyanosis, decreased level of consciousness, and decreased breathing effort with late bradypnea.

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All of the typical assessments listed below can be used to quickly assess a child's neurological condition, WITH THE EXCEPTION OF:

<label class="wq_answerTxtCtr">The Glasgow Coma Scale.</label>
<label class="wq_answerTxtCtr">Pupillary responses to light.</label>
<label class="wq_answerTxtCtr">The Epworth Scale.</label>
<label class="wq_answerTxtCtr">The AVPU scale.</label>
Correct! Wrong!

The Epworth Scale is a drowsiness test that is not typically evaluated as part of a child's neurological examination. The neural state of a child can be assessed using the AVPU and Glasgow Coma measures. It's important to assess the size and reaction of the pupil. (zolpidem)

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A patient who is experiencing respiratory distress is receiving positive pressure ventilation through an ET tube from you. Aside from: All of the following are signs that you are breathing too quickly.

<label class="wq_answerTxtCtr">Tension pneumothorax</label>
<label class="wq_answerTxtCtr">Aspiration</label>
<label class="wq_answerTxtCtr">Increasing waveform capnography readings</label>
<label class="wq_answerTxtCtr">Stomach insufflation</label>
Correct! Wrong!

Aspiration, stomach insufflation, and tension pneumothorax are latrogenic consequences of hyperventilation with an ET tube. Waveform capnography readings that are rising are a sign of effective CPR.

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A patient who is in cardiogenic shock is under your care. You are aware that one of this condition's likely causes is:

<label class="wq_answerTxtCtr">Spinal cord injury</label>
<label class="wq_answerTxtCtr">Congestive heart failure</label>
<label class="wq_answerTxtCtr">Infection</label>
<label class="wq_answerTxtCtr">Dehydration</label>
Correct! Wrong!

The most common cause of cardiogenic shock is congestive heart failure. Cardiogenic shock can also be brought on by acute myocardial infarction and other cardiac disorders. Hypovolemic shock can be brought on by dehydration. Injury to the spinal cord may result in neurogenic shock. Septic shock can result from infection.

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The optimum method to confirm and maintain tracheal tube position, when available, is described by the American Heart Association ACLS guidelines as:

<label class="wq_answerTxtCtr">Clinical examination and quantitative waveform capnography.</label>
<label class="wq_answerTxtCtr">Clinical examination only.</label>
<label class="wq_answerTxtCtr">Quantitative waveform capnography.</label>
<label class="wq_answerTxtCtr">Clinical examination and Pulse oximetry.</label>
Correct! Wrong!

To establish and maintain ET tube position, the AHA advises using clinical evaluation and continuous waveform capnography.

Advanced nursing candidates can reinforce their specialty knowledge and critical reasoning with our TCRN trauma nurse exam 2026, aligned to national certification standards.

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CEN: upcoming dates and official changes
  • Jul 6, 2026: An updated CEN exam content outline, based on BCEN's 2025 emergency nursing job analysis, took effect on July 6, 2026, together with a new passing score set by the 2026 CEN Passing Point Study. (Board of Certification for Emergency Nursing)

Facts verified Oct 20, 2026 against Board of Certification for Emergency Nursing. Dates that have passed are removed automatically.

Facts verified Oct 20, 2026 against Board of Certification for Emergency Nursing. Dates that have passed are removed automatically.

CEN Exam at a Glance

ItemDetailOfficial source
Number of questions150 items (content outline effective July 2026)Board of Certification for Emergency Nursing
Time limit180 minutes (3 hours)Board of Certification for Emergency Nursing
Passing scoreAngoff-set raw cut score, equated per formBoard of Certification for Emergency Nursing
Exam fee$380 ($285 for ENA members, $195 military)Board of Certification for Emergency Nursing
Retake policyReapply; 90-day wait between attemptsBoard of Certification for Emergency Nursing
Validity4 yearsBoard of Certification for Emergency Nursing
DeliveryComputer-based at PSI test centers or Live Remote ProctoringBoard of Certification for Emergency Nursing
EligibilityCurrent unencumbered RN license (US, territory, Canada, Australia or verified equivalent)Board of Certification for Emergency Nursing
Score releaseImmediately on screen and by emailBoard of Certification for Emergency Nursing
Testing window90-day testing window after application approvalBoard of Certification for Emergency Nursing

Facts verified Oct 20, 2026 against Board of Certification for Emergency Nursing. Dates that have passed are removed automatically.

Free CEN - Certified Emergency Nurse Study Tools

Interactive CEN - Certified Emergency Nurse resources on PracticeTestGeeks, free to start:

Review the official CEN exam content outline
Take a diagnostic practice test to identify weak areas
Create a study schedule (4-8 weeks recommended)
Focus on your weakest domains first
Complete at least 3 full-length practice exams
Review all incorrect answers with explanations
Take a final practice test 1 week before exam day
📝 📝 How many questions are on the CEN exam?
The CEN exam has 175 multiple-choice items. Only 150 are scored; the other 25 are unscored pretest items that BCEN is trialing for future exams, and they are not marked, so treat every question as if it counts.
🎯 🎯 What score do you need to pass the CEN exam?
You must answer 106 of the 150 scored items correctly, which is about 71%. BCEN states the passing score is not curved; it depends only on your own performance on the exam.
⏱️ ⏱️ How long is the CEN exam?
Total seat time is 180 minutes (3 hours) for 175 items, roughly one minute per question. Five practice questions at the start familiarize you with the testing software before the exam timer begins.
🔁 🔁 How soon can you retake the CEN exam if you fail?
BCEN requires a 90-day waiting period before you retake the CEN exam. A discounted retest fee applies if you reapply within one year of your first attempt, and Test Assurance buyers get a no-fee second attempt.
❤️ ❤️ ST elevation in leads II, III and aVF means which artery is blocked?
ST elevation in leads II, III and aVF indicates an inferior wall MI. The right coronary artery is the most common culprit, so watch for bradycardia and heart blocks, and obtain right-sided leads to check for right ventricular involvement.
🫀 🫀 What is Beck's triad on the CEN exam?
Beck's triad is hypotension, jugular venous distension and muffled heart sounds. It points to cardiac tamponade, a common CEN trauma scenario after penetrating chest injury, treated by relieving the fluid around the heart (pericardiocentesis or surgery).
🧠 🧠 What is Cushing's triad and what does it signal?
Cushing's triad is hypertension with a widening pulse pressure, bradycardia and irregular respirations. It is a late sign of rising intracranial pressure and impending brain herniation, so it calls for immediate escalation of care.
🔥 🔥 How do you calculate burn fluids with the Parkland formula?
Parkland formula: 4 mL x body weight (kg) x %TBSA burned of lactated Ringer's over 24 hours. Give half in the first 8 hours from the time of the burn, not from arrival, and the rest over the next 16 hours.
🫁 🫁 What is the priority for a suspected tension pneumothorax?
Tension pneumothorax is a clinical diagnosis: absent breath sounds on one side, hypotension, distended neck veins and late tracheal deviation. Do not wait for a chest X-ray; perform immediate needle decompression, followed by chest tube placement.
🚑 🚑 What is ESI triage and what does ESI level 1 mean?
The Emergency Severity Index (ESI) is a five-level ED triage system. ESI level 1 means the patient needs an immediate life-saving intervention, such as for cardiac arrest, while levels 4 and 5 need one or no resources.

How many questions are on the CEN exam and how many are scored?

The Certified Emergency Nurse (CEN) exam contains 175 multiple-choice items, according to BCEN. Of these, 150 are scored and 25 are unscored pretest items being evaluated for future exams. Pretest items are mixed in with scored ones and are not identified, so you should answer every question carefully. Your result is based on the number of scored items you answer correctly (raw score).

What is the passing score for the CEN exam?

To pass the CEN exam you must answer 106 of the 150 scored items correctly, which is roughly 71%. BCEN states that the passing score is not based on a curve; it depends only on your individual performance, not on how other candidates score. The 25 unscored pretest items do not count toward this total, so there is no percentage target across all 175 questions.

How long do you have to take the CEN exam?

BCEN allows a total seat time of 180 minutes (3 hours) for the CEN exam. Before the timed exam starts, you get five practice questions to get used to the testing software. With 175 items, that works out to about one minute per question, so practicing full-length timed tests helps you build the pacing you need on exam day.

How much does the CEN exam cost?

BCEN lists the initial CEN exam fee as $380, or $285 for Emergency Nurses Association (ENA) members. Active-duty service members, reservists and veterans pay $195. A retest within one year of the first attempt costs $200. Optional BCEN Test Assurance raises the initial fee by $70 and covers a free second attempt if you do not pass the first time.

Who is eligible to take the CEN exam?

You need a current, unrestricted Registered Nurse license in the United States, a U.S. territory, Canada or Australia, or an equivalent foreign nursing credential verified through TruMerit. BCEN recommends at least two years of emergency nursing experience before testing, but experience is not required. Nurses who no longer work in a clinical setting can still sit for the exam with an unrestricted license.

Can you take the CEN exam online from home?

Yes. BCEN delivers the CEN exam through its testing provider PSI, either in person at a PSI testing center or online via Live Remote Proctoring (LRP). After your application and payment are processed, you receive an eligibility email and have a 90-day window to schedule and sit for the exam. Remote testing requires a personal computer that passes PSI compatibility checks.

What happens if you fail the CEN exam?

If you do not pass the CEN exam, you can apply to retake it after a 90-day waiting period; your retest eligibility date appears on your BCEN account dashboard. BCEN offers a discounted $200 retest fee for applications within one year of your initial exam. If you bought Test Assurance with your first attempt, the second attempt carries no additional fee.

How long is CEN certification valid?

CEN certification is valid for four years. To keep the credential, you recertify before it expires either by retaking the CEN exam or by completing the required continuing education (CE) hours through BCEN. Passing the exam itself does not earn CE credit. The CEN is an ABSNC-accredited board certification, which distinguishes it from course-completion certificates such as ACLS or TNCC.

Sample CEN - Certified Emergency Nurse Practice Questions

Try these questions from our free CEN - Certified Emergency Nurse practice tests. The correct answer and an explanation follow each question.

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

    • A. CT angiography of the neck
    • B. Immediate surgical exploration
    • C. Direct pressure and airway management
    • D. Diagnostic angiography and embolization

    Answer: C. Direct pressure and airway management

    For any penetrating neck injury with active hemorrhage, direct pressure to control bleeding combined with airway management is the immediate priority before any imaging or surgical planning.

  2. A patient arrives after a motor vehicle accident. He is hypotensive with a distended abdomen and a seatbelt sign. What is the most appropriate rapid assessment?

    • A. CT abdomen/pelvis with contrast
    • B. Diagnostic peritoneal lavage (DPL)
    • C. Focused Assessment with Sonography for Trauma (FAST)
    • D. Plain abdominal X-ray

    Answer: C. Focused Assessment with Sonography for Trauma (FAST)

    FAST exam rapidly detects free intra-abdominal fluid (blood) at the bedside and can immediately guide surgical decision-making in a hemodynamically unstable patient.

  3. A patient presents with crushing chest pain, diaphoresis, and ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?

    • A. Left anterior descending
    • B. Right coronary artery
    • C. Left circumflex artery
    • D. Left main coronary artery

    Answer: B. Right coronary artery

    ST elevation in leads II, III, and aVF indicates an inferior MI, which is most commonly caused by occlusion of the right coronary artery.

  4. A patient with carbon monoxide poisoning has a carboxyhemoglobin level of 30% and is confused. Which oxygen delivery is the treatment priority?

    • A. Nasal cannula at 4 L/min
    • B. 100% oxygen via non-rebreather mask
    • C. Hyperbaric oxygen therapy
    • D. Intubation with 40% FiO2

    Answer: B. 100% oxygen via non-rebreather mask

    100% oxygen via non-rebreather mask is the immediate treatment for CO poisoning; it reduces CO half-life from ~5 hours on room air to ~60–90 minutes.

Take the full CEN - Certified Emergency Nurse practice test

CEN Practice Test Questions

Prepare for the CEN - Certified Emergency Nurse exam with our free practice test modules. Each quiz covers key topics to help you pass on your first try.

CEN Cardiovascular Emergencies
CEN Exam Questions covering Cardiovascular Emergencies. Master CEN Test concepts for certification prep.
CEN Neurological Emergencies
Free CEN Practice Test featuring Neurological Emergencies. Improve your CEN Exam score with mock test prep.
CEN Obstetric and Gynecologic Emergencies
CEN Mock Exam on Obstetric and Gynecologic Emergencies. CEN Study Guide questions to pass on your first try.
CEN Pediatric and Obstetric Emergencies
CEN Test Prep for Pediatric and Obstetric Emergencies. Practice CEN Quiz questions and boost your score.
CEN Pediatric Emergencies
CEN Questions and Answers on Pediatric Emergencies. Free CEN practice for exam readiness.
CEN Respiratory Emergencies
CEN Mock Test covering Respiratory Emergencies. Online CEN Test practice with instant feedback.
CEN Toxicology and Environmental Emergencies
Free CEN Quiz on Toxicology and Environmental Emergencies. CEN Exam prep questions with detailed explanations.
CEN Trauma Emergencies
CEN Practice Questions for Trauma Emergencies. Build confidence for your CEN certification exam.
CEN Trauma Nursing
CEN Test Online for Trauma Nursing. Free practice with instant results and feedback.
CEN Certified Emergency Nurse MCQ
CEN Study Material on Certified Emergency Nurse MCQ. Prepare effectively with real exam-style questions.
CEN Certified Emergency Nurse
Free CEN Test covering Certified Emergency Nurse. Practice and track your CEN exam readiness.

CEN: Pros and Cons

Pros

  • CEN credential is recognized by employers and industry professionals
  • Higher earning potential compared to non-credentialed peers
  • Expanded career opportunities and professional advancement
  • Structured learning path builds comprehensive knowledge
  • Professional development that stays current with industry standards

Cons

  • Preparation requires significant time and study commitment
  • Associated costs for exams, materials, and renewal fees
  • Continuing education needed to maintain credentials
  • Competition for advanced positions can be challenging
  • Requirements and standards may vary by state or region

Pros and Cons at a Glance

ProsCons
CEN credential is recognized by employers and industry professionalsPreparation requires significant time and study commitment
Higher earning potential compared to non-credentialed peersAssociated costs for exams, materials, and renewal fees
Expanded career opportunities and professional advancementContinuing education needed to maintain credentials
Structured learning path builds comprehensive knowledgeCompetition for advanced positions can be challenging
Professional development that stays current with industry standardsRequirements and standards may vary by state or region

Official Resources

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