Certified Emergency Nurse (CEN) Test Breakdown

In order to be eligible to take the Certified Emergency Nurse Exam, one must have a current, unrestricted nursing license or nursing certificate that is equivalent to a Registered Nurse in the United States. It is also recommended, though not required, to have at least two years of experience as an emergency room nurse in the United States.

To apply to take the CEN exam, an application must first be requested from the Board of Certification for Emergency Nursing (BCEN). This can be done by filling out an online form on their website. The application can then be filled out and mailed with the appropriate fees to BCEN. Currently, it is $220 for an Emergency Nurses Association (ENA) member to take the exam, and $360 for a non-member.

Once the application has been received by BCEN and approved, a handbook and an authorization letter will be sent to all qualified applicants. These materials will be sent within two weeks from when BCEN received the application in the mail. Once these materials are received, an exam may be scheduled with Applied Measurement Professionals by calling the phone number provided in the handbook.

The exam must be scheduled during the 90 day testing window, and it must be scheduled at least four days in advance of the desired exam date. Exams are given at Applied Measurement Professionals sites in major metropolitan areas in the United States Monday through Friday, twelve months a year. Details on specific site locations can be found on the Applied Measurement Professionals website.

It is recommended that one schedule their testing date and time as soon as possible after receiving the authorization letter in the mail. This can help in making sure that the desired test date and time are received.

The Certified Emergency Nurse exam is a computer-based examination. It consists of 175 multiple choice questions. 150 of these CEN test items are scored, and 25 items are pretest items. The pretest items are not scored. There is a maximum of three hours in which to complete the entire CEN examination.

Thirteen subject areas are covered on the CEN examination, and they are as follows:

  • Cardiovascular Emergencies (17 items)
  • Gastrointestinal Emergencies (9 items)
  • Obstetrical, Genitourinary, and Gynecological Emergencies (10 items)
  • Maxillofacial and Ocular Emergencies (9 items)
  • Neurological Emergencies (12 items)
  • Orthopedic Emergencies and Wound Management (15 items)
  • Psycho/Social (7 items), Respiratory Emergencies (18 items)
  • Patient Care Management (12 items)
  • Substance Abuse/Toxicological and Environmental Emergencies (13 items)
  • Shock/Multi-System Trauma Emergencies (8 items)
  • Medical Emergencies/Communicable Diseases (13 items)
  • Professional Issues (7 items).

Details about specific possible CEN test items in each of these thirteen subject areas can be found online on the BCEN website.


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The Certified Emergency Nurse Exam is scored based on how many answers out of the 150 scored CEN test items are answered correctly. A passing score is 109. This is approximately equal to answering 75% of the 150 scored test items correctly. A CEN test score report is given to each test taker upon completion of the CEN examination.

If a passing score is achieved, the CEN certification is good for four years. There are several ways to prepare for the CEN examination. Familiarization with the CEN test content is imperative. Studying this content using textbooks, study guides, or other materials can prove useful. In addition, taking CEN practice tests and practice problems is also useful.

Prior to the CEN examination, taking advantage of the computer orientation on exam day can be beneficial. This can help eliminate problems or confusion with the computer-based testing system during the CEN exam. In addition, since the score on the CEN exam is based on how many questions are answered correctly, it is imperative to answer all presented questions.

Even if the answer is not known, a best guess answer is better than no answer at all. Pacing oneself during the CEN exam is important, so that no questions are left blank.

The CEN exam is sponsored by the Emergency Nurses Association.