How to Pass CEN Exam?

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The CEN Exam is often recognized as a fete of expertise. As a nurse working in the emergency department, it is the ideal certification you can obtain to demonstrate your skills. However, various elements come into play. The exam is not straightforward and requires quite a dedication.

Hence, throughout this article, details regarding the exam will be discussed. That includes things to expect and how to prepare for it. The certification will not only prove how qualified you are, but it’s a dedication to your career, patients, and organization.

What is the CEN Exam?What is the CEN Exam?

CEN stands for Certified Emergency Nurse. Hence its purpose is relatively straightforward. Only nurses who want to prove their performance and enhance their knowledge sit for this exam. It is designed and offered by the Board of Certification for Emergency Nursing (BCEN).

While the CEN Exam isn’t necessarily a requirement, it’s a bonus to whoever successfully passes it. It allows nurses to portray their professionalism. Moreover, nurses will have the ability to extend their knowledge and demonstrate to others how competent they are in their field.

The CEN Exam is generally observed as a commitment to your nursing career. While you would already have ample experience with the emergency room, it will provide you with much more education.

As for the CEN certification requirements, there are specific eligibility criteria. However, they aren’t strict rules, merely common sense ones. Below are the essentials you need to sit for the exam and the ones to receive the certificate:

  • Must have a valid, unrestricted nursing license that is valid.
  • Education requirements vary according to the state you’re living in, as nurses must obtain specific educational requirements in various parts of the country.
  • Two years of experience in the field is recommended but not mandatory.
  • Must receive the minimum passing score to pass (around 70% of the 150 questions answered).

Topics Covered in the CEN Test

The topics covered throughout the CEN Test are pretty extensive. CEN exam questions are composed of 150 total questions that will be scored. However, the total amount of questions is 175, where 25 counts as pretest items. There are 10 primary topics covered, which branch out into numerous others. Below are the subjects and the number of questions expected to ask about each:

  • Cardiovascular Emergencies (e.g., acute coronary syndrome, cardiovascular trauma, obstructive shock, diseases) – 19 questions
  • Respiratory Emergencies (e.g., aspiration, obstruction, pneumothorax, respiratory trauma) – 18 questions
  • Neurological Emergencies (e.g., neurological disorders, Meningitis, seizure disorders, headache, stroke, neurogenic shock) – 18 questions
  • Gastrointestinal, Genitourinary, Gynecology, & Obstetrical (e.g., appendicitis, Priapism, ovarian disorders, postpartum infection, neonatal resuscitation) – 18 questions
  • Mental Health Emergencies (e.g., anxiety disorders, mood disorders, thought disorders, situational crisis, aggressive behavior) – 11 questions
  • Medical Emergencies (e.g., allergic reactions, electrolyte imbalance, Sepsis, endocrine disorders, withdrawal syndrome) – 14 questions
  • Musculoskeletal & Wound Emergencies (e.g., amputation, dislocations, Osteomyelitis, lacerations, wound bleeding, avulsions) – 13 questions
  • Maxillofacial & Ocular Emergencies (e.g., abscess, facial nerve disorders, vestibular dysfunction, burns, foreign bodies, ocular trauma, retinal artery occlusion) – 11 questions
  • Environmental Emergencies, Toxicology Emergencies, & Communicable Diseases (e.g., submersion injury, animal bites, cyanide, acids, alkalis, Influenza, Tuberculosis) – 14 questions
  • Professional Issues (e.g., discharge planning, forensic evidence collection, pain management, patient safety, cultural considerations, abuse, neglect, mass casualty, risk management) – 14 questions

As for how much time you have for the CEN exam, it’s 180 minutes. As they’re all multiple-choice questions, one would expect them to be relatively easy with ample time to solve them. However, you must remember that the questions can be lengthy, which is why most students struggle.

Passing Score on the CEN Test

As there are 150 graded questions in each examination, the CEN passing score is generally 106 out of 150. As a percentage, that is approximately 70% of the questions present on the exam.

But how is the passing score decided for the CEN Test? Well, it might change over the years due to the revision’s procedure. Every few years, there is a job analysis that takes place. This is composed of numerous surveys that target nurses across each specialty area.

The surveys aim to establish how proficient and knowledgeable the nurses are in specific fields. The questions address the skills and knowledge those nurses possess, and it seeks to evaluate the judgment of nurses.

The procedure is a systemic one that addresses nurses across the country. Afterward, the BCEN Board of Directors evaluates whether the passing score should be shifted or not.

Cost to Take the CEN Exam

You’re not a certified emergency nurse until you receive your CEN certification. Hence, it’s an investment in yourself that aims to develop your skills and put you on a higher pedestal. Thus, while the examination might be expensive in hindsight, it’ll provide you with more beneficial effects later.

There are multiple different paths you can take to pay for the CEN program:

Self-Pay Plan

If you’re simply applying independently without any program or voucher, you’re expected to pay the full fee. However, while this is a plausible path, the intelligent approach is asking your supervisor or organization about plans they offer. If your supervisor isn’t aware of any plans, simply reach out to the BCEN Voucher Program organizations.

  • First time exam: $370
  • Resit exam: $340
  • Recertification by examination or attestation: $350

BCEN Voucher Program

The most cost-effective method is using the BCEN Voucher Program. Most often purchased by organizations who encourage their employees to sit for the exam, it allows apprentices to save up on money. The vouchers are non-refundable and are only valid for 12 months. For details on how to purchase the vouchers, use the Employer Program webpage.

Keep in mind that these vouchers apply for all the various testing reasons. These include the cost of the initial examination, retesting, and even recertification.

  • Cost per voucher: $190 (if the number of vouchers bought is between 11-20)
  • Cost per voucher: $180 (if the amount of vouchers purchased exceeds 20)

ENA Member Discount

ENA stands for Emergency Nurses Association. One can become one through the membership page. This is another situation where you invest in your future by getting various benefits. This includes connecting with people worldwide, accessing free education, the ability to read through publications, and discounted prices at multiple conferences.

  • The initial take of the exam: $230
  • Reset of the exam: $200
  • Recertification: $210

Military and Retired Cost

There is a reduction in price for any active-duty service members. Military personnel would only have to pay $195, which applies to retests and recertifications.

As for the retired person, the fees are only $75.

How Long to Study for the CEN Exam?

How Long to Study for the CEN Exam?

As the CEN exam pass rate throughout 2021 was approximately 50% (3,480 exams out of 6,890 administered ones were successful), you should prepare yourself for a long study session. Hence, you should study for at least 3 months for the CEN exam.

Keep in mind that one usually works alongside studying to keep everything in balance. Not only does that make it more difficult, but it leads test takers to neglect the fact that they have to learn. You must have a dedicated amount of time each day solely for studying your resources. Moreover, practice is critical in such situations.

Since the CEN exam duration is 180 minutes (3 hours), go through many practice exams that aim to familiarize you with concepts. Moreover, the questions themselves could be lengthy, which is why the passing rate is often low.

How to Prepare for the Exam: 5 Tips for Passing the Exam

How to Prepare for the Exam: 5 Tips for Passing the Exam

There are a few steps you can follow to ensure you pass the CEN exam. While the list isn’t limited to the following, these are the very basics you should follow:

Dedicate Time

When looking for methods for how to study for the CEN exam, you’ll start fumbling around for resources. Don’t get us wrong, as books and videos will be your best friends here, but they’re all void without proper dedicated time.

Hence, the very first step is mapping out what your day will look like. Set aside at least two hours daily you are solely dedicated to preparing for the CEN exam. That one hour requires your full attention, in which you’ll often be going through modules, past exams, and sample questions.

Familiarize Yourself with the Exam

While every applicant wonders how to pass the CEN exam, most fail to get familiar with the fundamentals. BCEN offers various resources, including the exam outline, a list of study sources, and general sample questions. All of those could be accessed through their preparation page.


Invest in yourself by accessing the optimal study sources out there. While you might hesitate to spend some money on a podcast, online videos, book, or sample questions, it’ll pan out once you take the examination.

More often than not, students skimp out on the exam material, which results in poor results. No wonder 50% of students didn’t manage to pass the examination without ample preparation. Hence, while it might be tempting to find the free resources online, they won’t do you justice.

However, use any free online samples as a general guide and a starting point. Once you start getting into the rigor of preparation, ensure that you have various resources around you. These will often include the ones you have to purchase.

Find a Study Guide

There are limitless resources you’ll find online. However, a fantastic CEN study guide is one offered by MED-ED. While you must purchase the course to be able to access it, it provides you with a wide variety of resources to access.

The MED-ED course offers access for one full year, an extensive study guide, and a variety of sample questions. This specific guide contains 11 modules that add up to 19 hours of material and videos. While that might not seem like a lengthy period, you’re expected to take study breaks, pause to take notes, and review on your own.

Practice Everyday

The first time you go through a CEN practice test, cover up the answers and try doing them without preparation or studying. Whenever you cannot answer a question, check the answer and read through the explanation. It’s essential that you fully comprehend the reasoning behind each answer.

The best CEN practice test is the one offered by BCEN, which you can access here through registration. Once you register and purchase the module, you will have limitless access to the examination for 90 days. You also have the option of choosing a timed or non-timed exam.

How Long is the CEN Exam Good For?

How Long is the CEN Exam Good For?

No matter which path you choose to take, you must renew your CEN certification every 4 years. However, you have two methods by which you can restore it.

The first way to validate your CEN certification is by retaking the exam. While that might sound like a hassle, you’ll probably be more proficient and educated in your field by that time. However, there is an alternative route if you’re someone who enjoys enhancing your education and learning all the time.

The second method involves using continuing education (CE) courses to validate your certification. This can be done through an ample variety of classes, but make sure you contact the Board of Certification for Emergency Nursing if you choose this route.

Wrapping Things Up: How to Pass CEN Exam?

All things wrapped up, the CEN exam requires your full attention and dedication. Students sitting for the exam often neglect to dedicate enough time to prepare as people often assume they have ample knowledge to pass.

While that might be true, as most will apply for the exam with prior experience in the emergency room, it doesn’t necessarily mean you’ll pass the exam with flying colors.

Hence, while it might be nerve-wracking and quite stress-inducing, the exam simply needs time for you to sort through some information and basics. An hour or two every day for 3 months will be more than enough time for you to feel confident about your skills and pass.

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Professor Conquer

Professor Conquer started Conquer Your Exam in 2018 to help students feel more confident and better prepared for their tough tests. Prof excelled in high school, graduating top of his class and receiving admissions into several Ivy League and top 15 schools. He has helped many students through the years tutoring and mentoring K-12, consulting seniors through the college admissions process, and writing extensive how-to guides for school.

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