The CEN exam tests emergency nursing across body systems — cardiovascular, respiratory, neurological, GI, GU/OB/GYN, mental health, medical, musculoskeletal and wound, HEENT, environmental and toxicology emergencies and communicable diseases — plus professional issues like triage and legal and ethical care.
Exam format at a glance
| Format | 175 multiple-choice questions (150 scored, 25 unscored pretest) with 180 minutes of seat time. |
| Cost | BCEN lists exam fees on its website — check BCEN for current pricing. |
| Scoring | BCEN sets the passing score using the Angoff method with statistical equating, so it can vary slightly by exam form. Practice scores here use a 70% line as an estimate. |
| Validity | The CEN credential is valid for four years; recertify by exam or continuing education. |
Who this exam is for
- Registered nurses working in emergency departments
- Flight, transport and urgent care nurses
- ED nurses preparing for their first CEN or recertifying by exam
How to actually study for it
- Cardiovascular, respiratory and neurological emergencies make up about a third of the exam — master ACS, dysrhythmias, airway problems and stroke.
- Practice triage and prioritization: airway, breathing, circulation, then disability.
- Know classic presentations: epiglottitis, testicular torsion, ectopic pregnancy, compartment syndrome.
- Review toxicology antidotes and environmental emergencies like heat stroke and hypothermia.
Where to go next
Start with the free 10-question diagnostic to see where you actually stand, or go straight to the one-page CEN cheat sheet. The full CEN practice exam covers every domain at the real exam's weighting, with every answer explained.