All About the CEN Exam and How to Pass

So you’re an ER nurse and you have been considering taking the Certified Emergency Nurse exam to become a board certified badass! Awesome! Or maybe you’re a nurse from some other specialty or area and you’ve decided that for whatever reason you want to take the exam and get certified. There are currently over 34,000 CENs! Whatever your reasoning may be, you have some work ahead on the road to becoming a CEN. I took the CEN exam twice and I’m going to give you some tips on what worked for me and some things that have worked for other people I know who took the exam and passed.

The Basics

To start, let’s learn more about the CEN exam. The Board of Certified Emergency Nursing (BCEN) is the organization who develops the certification exams or ER, trauma, and flight /transport nurses. They offer five exams that tailor to whatever emergency specialty you are the most skilled at. The cost is $370 for non-ENA members and $230 for ENA members. There are various benefits of an ENA membership and I highly recommend it. I got a huge discount at the time of the ENA National Conference for my CEN exam just for being a member ($195!). There is a small discount if you have to retake the exam, but let’s skip that because we know you will pass the first time!

The CEN exam is a 175 question exam with 150 scored questions and 25 questions unscored. It is not indicated during the test which items are scored versus unscored. You must answer 106 correctly to pass the exam. The test is 180 minutes long from start to finish. There is an option to mark questions you are wanting to revisit during the course of the test and a place at the end of the exam for you to see which questions were marked or unanswered, so don’t worry about hitting the back button 175 times at the end of the test. 😉

Before You Register

There are some pearls of wisdom that I wish I had heard or considered more prior to taking the CEN exam the first time. It is recommended by BCEN that test-takers have at least 2 years of experience in the area they will be sitting for. I wouldn’t recommend you ignore this. When I tested for the first time I had been an ER nurse for a year. I work in a high-traffic high-acuity ED and at 1 year of experience there, I thought I had seen a lot. After my failed attempt, I realized all the things that I had not seen much of. My ED is an adult only department and we are not a trauma center. With that being said, I had seen some traumatic injuries and a few trauma codes, but nothing to really hit it all home for me. I had also not taken the Trauma Nursing Core Course (TNCC). I realized that I definitely needed to gain more experience before taking the exam again, and when I retested after 2.5 years in the ED, I felt much more comfortable and knowledgeable as well as prepared.

For those who are deciding to take the CEN exam in order to reach a goal or prepare for time in the ED before actually working there, I would reconsider. Studying goes very far, but experience is essential to being successful during this exam as well as applying the knowledge into your own practice. It is also highly recommended that you take TNCC prior to embarking on the CEN exam as well as taking Pediatric Advanced Life Support (PALS) if you haven’t already. Get on the BCEN website I linked above and just really look it over good. There is tons of information there that would take us forever to cover here so trust me and just do it!

How to Study

Okay, with all that being said, you have registered and now have to study! My first recommendation would be to go here for the full exam content outline. This is your key to every topic that will be on the exam and to what extent you should study them. This is also helpful in identifying your weak areas before you get started. I recommend that you allot plenty of time to study. I thought going to one review course and a few hours of studying was enough the first time, and I attribute part of that to my failing the first time.

Next, I would consider how you learn best. Are you a lecture person? Do you like to read to learn information or do you prefer questions and rationales? I chose to do everything for a good mix. Below are some of the books/review programs/miscellaneous that my colleagues and I have used and found helpful:

Sheehy’s Manuel of Emergency Care, 7th Edition


This book has SO. MUCH. INFORMATION. Seriously. Just get it. Money well spent.

ENA CEN Review Manual, Plus 2 Online Exams, 5th Edition

ENPC_cover_6 2018

This edition just came out in September 2018 and it has 5 tests worth of questions and rationales in the book, as well as 2 full timed exams available online. All of the book content is also available online in test formats, with the ability to mark questions for review just like the actual exam. The only thing that sucks is that it is designed for you to take it as though you were taking the test, so you can’t see your results and rationales until you complete all 150 questions from each exam. You can stop and submit at any point, though, and take each test an unlimited number of times. There were many questions that were similar to actual exam questions and things that I otherwise may have had no clue about (hydrofluoric acid causes calcium depletion, what?).

Boswell Emergency Medical

Mark Boswell is an MSN, FNP-BC, CEN, CFRN, CTRN, CPEN, TCRN, SCRN, NREMT-P, EMT-T, W-EMT. He knows his stuff. This guy travels the country holding review courses and they’re incredibly informative and helpful. The class I went attended was two full days and included lectures on all of the major areas outlined on the BCEN exam outline. The price for each course is as high as $325 but he gives discounts to military, ENA members, as well as RNs who work for whatever organization is hosting his course (I got a discount for being an RN in my hospital system). Each course includes a book with fill in the blank  material accompanying the lectures as well as a practice test. All of his lectures are on his youtube channel here as well as tips and tricks.

Lecturio Medical Education, Youtube

Here you can find some other videos I found really helpful while studying. I listened to these, as well as Mark Boswell’s videos, in the car, while cooking, during a shower, basically any downtime I had and found them to be super educational but not overly complicated. Along with their emergency videos, they have a ton of others that I have found helpful during my FNP program.

The Day Of

So now that you’ve studied, freaked out if you’re like me, and done whatever you could do to get ready for the exam, it’s time. Get some sleep the night before, have a good breakfast/lunch/snack before you head in, and go inside with the knowledge that you know your stuff and you WILL pass. Breathe, take your time, and think things through. Read every question carefully and don’t let the wording trip you up. I found it helpful to write down the stuff I knew was strictly from memorization, like the 12-lead info and ABG numbers, on the white board that’s provided as soon as the exam began for my reference throughout.

You’re going to crush the test!


What study tips or tricks helped you pass the CEN? Let me know below!

Much love and luck,

Just Ask the Nurse, BSN, RN, CEN


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