Choosing the CEN

What is a CEN in nursing?

The Certified Emergency Nurse (CEN) exam is developed by the Board of Certification for Emergency Nursing (BCEN) as part of its program for emergency room nurse certification. The exam measures the nursing skills necessary to excel as an emergency room nurse. The BCEN is the gold standard of ER nurse certifications.

Why should I become a CEN?

A BCEN certification can help you grow in your current position. In a survey of more than 1,000 nurse supervisors, the BCEN found that a BCEN certification is required or preferred for career advancement by 49 percent of employers. Of these supervisors, 40 percent say they pay emergency room nurses with CEN credentials more than their uncredentialed coworkers (an average of $1,397 per year).

An emergency room nurse certification will also make you more attractive to future employers. Forty-nine percent of nurse supervisors look for a CEN when hiring emergency room nurses.

Who is eligible to take the CEN exam?

To qualify for the exam, you must have a current Registered Nurse license in the United States or its territories. The BCEN also recommends that you have at least two years of nursing experience in an emergency department.

I have less than two years of experience as an emergency nurse. Should I take the test anyway?

Although there’s no level of experience that’s required for the exam, many emergency room nurses find that the practical knowledge they have acquired while working in the ER is vital to passing the exam. If you plan to take the CEN without significant ER experience, you may want to consider first taking the Trauma Nursing Core Course (TNCC) offered by the Emergency Nurses Association (ENA). The two-day course provides a hands-on approach to learning the basics of diagnosis and care in a trauma setting.

I’m interested in becoming a trauma nurse. Should I get a CEN or a CCRN?

The decision to get a CEN or a CCRN depends on your personal goals and career path. A CEN certification is specific to the work done in an emergency room or trauma center. ER nurses focus on short-term interventions meant to stabilize patients so they can be transferred for further treatment. If you like a bit of chaos and can make decisions quickly, working as a BCEN-certified emergency nurse is probably right for you.

A CCRN certification is for nurses who work in intensive care units, cardiac care units, or other critical care settings. They will respond to emergencies as needed, but the main role of the CCRN is to manage patients with complex care plans. The CCRN may work with the same patient for hours, days, or even weeks.

Some nurses choose to get both CEN and CCRN certifications. The path is usually followed by more senior nurses who have both ER and ICU experience. A CCRN certification requires 1,750 hours of direct critical care in the preceding 2 years, so many nurses plan to get their CEN first.

Taking the CEN Exam

When can I take the CEN exam?

The CEN exam is offered year-round.

How much does it cost to take the CEN exam?

  • ENA Members:

    • First Exam - $230

    • Retake - $200

    • Re-certification - $210

  • Individual Self-Pay:

    • First Exam - $370

    • Retake - $340

    • Re-certification - $350

Many employers offer vouchers that cover the cost of the CEN exam for qualified employees. Make sure to ask your supervisor about the continuing education options that may be available to you!

How many questions on are the CEN exam?

The CEN is 175 questions long. Only 150 of these questions are scored; 25 are unscored, or pretest questions. These questions are included by the BCEN to test their suitability for inclusion in future tests. You’ll have no way of knowing which questions are unscored, so treat every question like it counts.

How long is the CEN exam?

You will have three hours to complete the test. During this time you will also need to complete the BCEN Examination Rules and Regulations Agreement. You may take breaks at any point during the exam, but you will not be given extra time, and you cannot access personal items (other than medications).

What type of questions are on the CEN exam?

The questions on the CEN are multiple-choice with four answer choices. Some questions will include exhibits such as EKG strips or laboratory results. The CEN has no guess penalty. That is, if you answer a question incorrectly, no points are deducted from your score; you simply do not get credit for that question. Therefore, you should always guess if you do not know the answer to a question.

Will I need to know or calculate medication dosages for the CEN exam?

Yes, the CEN will include questions that require you to select or calculate the appropriate medication dosage for a specific patient.

What is on the CEN exam?

The BCEN develops its exams based on feedback from emergency nursing professionals about the nursing concepts and skills that are most important to their work. This feedback has been used to develop an exam framework that emphasizes the assessment, diagnosis, and treatment of conditions emergency nurses are likely to encounter in the ER.

The framework is broken down into seven sections loosely based on human body systems and one section devoted to professional issues. The table below gives the breakdown of the questions on the exam.

Quick Summary of CEN Test Sections

  • Cardiovascular Emergencies: 23 questions

  • Respiratory Emergencies: 19 questions

  • Neurological Emergencies: 19 questions

  • Gastrointestinal, Genitourinary, Gynecology, and Obstetrical Emergencies: 24 questions

  • Psychosocial and Medical Emergencies: 29 questions

  • Maxillofacial, Ocular, Orthopedic, and Wound Emergencies: 24 questions

  • Environment and Toxicology Emergencies, and Communicable Diseases: 18 questions

  • Professional Issues: 19 questions

Total: 175 questions

 Click here to see the full content outline for the CEN exam.

How do I register for the CEN exam?

To register for the exam, you must first apply through the BCEN website. After your application is accepted, you will receive an exam eligibility email with instructions on how to register for the exam. Once you have received your eligibility email, you will have 90 days to take the exam. If you do not take the exam within the 90-day window, you will have to reapply.

Can I reschedule my CEN exam?

You can reschedule your exam, but it must be at least two business days prior to the exam date.

 Where can I take the CEN exam?

The CEN is administered at Pearson VUE at testing centers around the nation. You can find a testing center when you schedule your exam through the Pearson VUE scheduling portal.

 What happens when I arrive for the CEN exam?

The CEN is administered at Pearson VUE at testing centers around the nation. Plan to arrive at least 30 minutes before the exam; if you arrive more than 15 minutes after the test starts, you will not be admitted. Bring two forms of ID and be prepared to be photographed and have a palm vein scan. Your primary ID must be government issued, include a recent photograph and signature, and match the name under which you registered to take the test. You secondary ID must include your name and signature or name and photograph. If you do not have proper ID, you will not be allowed to take the test.

You will not be allowed to bring any personal items into the testing room, such as calculators or phones. You may not bring pens, pencils, or scratch paper. Other prohibited items include hats, scarves, and coats. You may wear religious garments, however. Most testing centers provide lockers for valuables.

How do I get testing accommodations for the CEN exam?

The exam application includes a Test Accommodation form. You will need to provide documentation showing that you have a disability that affects your ability to take the exam. The type of documentation required will depend on your disability and the accommodations you are requesting. For more information, you can contact a BCEN Candidate Experience Specialist at bcen@bcen.org. All Pearson VUE testing centers meet ADA accessibility guidelines.

CEN Scores

When will I get my CEN score?

Once you have completed your test, the staff at the Pearson VUE testing center will give you a score report; you can also request to receive the report via email.

How is the CEN exam scored?

Your score report will include your raw score (the number of questions you answered correctly) for the whole test and for each content area. The report will also include a pass/fail designation.

What is a passing score on the CEN exam?

The number of correct answers needed to pass the exam will vary slightly depending on the questions included in your version of the test (i.e., if you took a version of the test with harder questions, the passing score will be lower). For most test takers, a passing score will be 106 questions answered correctly. However, this can range from 105 to 110 questions.

Can I retake the CEN exam if I don’t pass?

If you do not pass the exam, you will be able to reapply and retake the test after 90 days.

How many people pass the CEN exam?

Every year around 60 percent of the people who take the CEN exam pass and become certified.


How often do I need to recertify my CEN credentials?

You will need to recertify every four years.

Do I have to take the CEN exam again to get recertified?

You can earn your recertification by taking continuing education courses or by retaking the exam. If you are taking the exam for recertification, you must submit your application 91 days before your certification lapses. You must then pass the exam within the 90-day testing window.