BCEN (Board of Certification for Emergency Nursing)
CEN
Certified Emergency Nurse
The benchmark specialty certification for emergency department nurses. Validates expertise across the full span of emergency presentations and is favored by trauma centers for hiring and clinical-ladder advancement.
What's on the exam
CEN Exam Content Outline (effective July 6, 2026)
Cardiovascular Emergencies
18 of 150 items (12%)Acute coronary syndrome · Dysrhythmias and cardiopulmonary arrest · Heart failure · Aneurysm and dissection · Cardiogenic and obstructive shock · Pericardial tamponade
Respiratory Emergencies
17 of 150 items (11%)Airway obstruction · Asthma and COPD exacerbations · Pulmonary embolism · Pneumothorax and pleural effusion · Respiratory infections · Inhalation injuries
Neurological Emergencies
17 of 150 items (11%)Stroke and TIA · Seizure disorders · Head and spinal cord trauma · Increased intracranial pressure · Meningitis · Neurogenic shock
Gastrointestinal Emergencies
14 of 150 items (9%)GI bleeding and esophageal varices · Acute abdomen (appendicitis, peritonitis, perforation) · Bowel obstruction and intussusception · Pancreatitis and cholecystitis · GI trauma
Genitourinary, Gynecology, and Obstetrical Emergencies
10 of 150 items (7%)Renal calculi and urologic emergencies · Testicular torsion · Sexual assault · Ectopic pregnancy · Emergent delivery and OB complications · Preeclampsia, eclampsia, and HELLP
Mental Health Emergencies
13 of 150 items (9%)Aggressive and violent behavior · Homicidal and suicidal ideation · Intentional overdose and ingestions · Psychotic and bipolar disorders · Anxiety and depressive disorders
Medical Emergencies
15 of 150 items (10%)Allergic reactions and anaphylaxis · Sepsis · Electrolyte and fluid imbalance · Endocrine emergencies · Hypovolemic and distributive shock · Substance use and withdrawal syndromes
Musculoskeletal and Wound Emergencies
11 of 150 items (7%)Fractures and dislocations · Compartment syndrome · Amputation · Lacerations and penetrating injuries · Wound infections and management
Head, Eye, Ear, Nose, Throat Emergencies
10 of 150 items (7%)Maxillofacial trauma and infections · Ocular trauma, burns, and infections · Retinal detachment and artery occlusion · Epistaxis and foreign bodies · Epiglottitis and peritonsillar abscess
Environment and Toxicology Emergencies, and Communicable Diseases
13 of 150 items (9%)Burns, chemical exposure, and electrical injuries · Temperature-related emergencies and submersion injury · Carbon monoxide and cyanide poisoning · Acids and alkalis · Tuberculosis, respiratory viruses, and vaccine-preventable diseases
Professional Issues
12 of 150 items (8%)Triage and mass casualty · Patient throughput · End-of-life and palliative care · Forensic evidence collection and federal regulations · Abuse, neglect, and workplace violence
Frequently asked questions
How much does the CEN cost?
The CEN costs $380. $285 for ENA members / $380 for nonmembers.
How long is the CEN and how many questions does it have?
175 items (150 scored, 25 unscored) — 3 hours.
What do you need to pass the CEN?
Pass/fail — 99 of 150 scored items correct (outline effective July 2026).
Can you retake the CEN?
After 90 days; retest fee applies.
What is the best way to study for the CEN?
Study the official blueprint, not random material: the exam is weighted by domain (Cardiovascular Emergencies 18 of 150 items (12%), Respiratory Emergencies 17 of 150 items (11%), Neurological Emergencies 17 of 150 items (11%), Gastrointestinal Emergencies 14 of 150 items (9%), Genitourinary, Gynecology, and Obstetrical Emergencies 10 of 150 items (7%), Mental Health Emergencies 13 of 150 items (9%), Medical Emergencies 15 of 150 items (10%), Musculoskeletal and Wound Emergencies 11 of 150 items (7%), Head, Eye, Ear, Nose, Throat Emergencies 10 of 150 items (7%), Environment and Toxicology Emergencies, and Communicable Diseases 13 of 150 items (9%), Professional Issues 12 of 150 items (8%)). Spaced-repetition flashcards built domain-by-domain against that blueprint are the most time-efficient way to cover everything the exam tests.
Program in development
We're building a blueprint-complete program for this exam. Meanwhile, explore live programs across 66 exams.
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