Exam guide

CEN Exam Guide

BCEN Certified Emergency Nurse: format, the July 2026 outline, eligibility and an 8-week plan

Reviewed by Alex G, BSN, RN, CEN, CCRN, CMC, NREMT-P · Checked against current sources October 2026

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The exam at a glance

Feature	CEN
Questions	175: 150 scored, 25 unscored pretest
Time	3 hours of seat time; 5 practice items to learn the software
Item type	Multiple choice, 4 options, one best answer
Format	Fixed length, not adaptive
Passing standard	99 of 150 scored items correct
Cost	$380; ENA member $285; military $195
Retest	Unlimited, 90 days apart; $200 within 1 year
Test Assurance	$450 ($355 ENA, $265 military); covers a second attempt
Where	PSI test center or Live Remote Proctoring, within your 90-day window
Results	Pass/fail at once, scores by domain
Credential	Valid 4 years

Outline effective July 6, 2026.

Item counts are BCEN's; shares are rounded from 150.
Domain	Items	Share
Cardiovascular	18	12%
Respiratory	17	11%
Neurological	17	11%
Gastrointestinal	14	9%
GU, gynecology, obstetrics	10	7%
Mental health	13	9%
Medical	15	10%
Musculoskeletal and wound	11	7%
Head, eye, ear, nose, throat	10	7%
Environment, toxicology, communicable disease	13	9%
Professional issues	12	8%
Total	150	100%

Shock: cardiogenic and obstructive (Cardiovascular), hypovolemic and distributive, plus sepsis (Medical), neurogenic (Neurological)
Overdose: intentional (Mental Health), substance use and withdrawal (Medical), CO, cyanide, acids and alkalis (Toxicology)
Pediatrics has no domain: croup, intussusception and neonatal resuscitation sit in the systems
Easy to miss: forensic evidence, drug diversion, workplace violence, cultural humility

Changed from the 2022 outline:

Gastrointestinal is its own domain; GI plus GU/GYN/OB rose from 18 to 24 items
HEENT replaces Maxillofacial and Ocular
Professional Issues: Prioritization (triage, mass casualty, throughput) plus Legal and ethical
No longer listed: envenomation, pain management, procedural sedation

Current, unencumbered RN license in the US, a US territory, Canada or Australia
RN-equivalent license from another country: accepted once verified through TruMerit
Two years of emergency experience recommended, not required
No current clinical job needed
Any active restriction, suspension or probation disqualifies you
English only, in every country

Week 1: read BCEN's outline and 10 sample questions (they show format, not difficulty), then take a full Mock Exam as a baseline.
Weeks 1-2: Cardiovascular, Respiratory, Neurological; Rhythm Gallery and ACLS Algorithms in Brief One-Pagers.
Weeks 3-4: Medical, GI, GU/GYN/OB, Mental Health; Sepsis Bundle, Shock Types and Electrolyte One-Pagers.
Weeks 5-6: Musculoskeletal and Wound, HEENT, Environment/Toxicology, Professional Issues.
Every day: clear Daily Review first; spaced repetition brings back questions you missed or were unsure of.
Every week: one Weakest Subject session and a pass through Trouble Questions.
Weeks 7-8: two timed Mock Exams (BCEN's practice exam is optional), read every rationale, rest the last 2 days.

Arrive (test center) or log in (remote) 30 minutes early; expect a photo, and wanding at test centers
Remote: personal computer only (employer laptops often fail); run PSI's system check and tutorial 3+ days ahead
ID: unexpired government photo ID with signature, such as a passport, driver's license or state ID (not a military ID)
Testing outside your home country: bring your passport
Your first and last name must match your registration exactly
Up to 2 breaks of 10 minutes or less; the clock keeps running
Scratch paper: 2 sheets (given at test centers, your own blank sheets remotely), destroyed at the end

Candidate Handbook, Content Outline (July 2026), Resource List and Preparation Checklist (2026)
BCEN Learn CEN Practice Exam: timed, untimed and Quick 10 modes
CEN Sample Questions (10) and Review Course ($250, 21 CE)

Selected titles; BCEN endorses no resource. Newer editions exist: AHA ACLS and PALS manuals (2025) and ATLS 11th edition.
Title (BCEN 2026 list)	Edition
Emergency Nursing Core Curriculum (ENA)	8th (2026)
Emergency Severity Index Handbook	5th (2023)
TNCC Provider Manual	9th (2023)
ENPC Provider Manual	6th (2023)
ACLS and PALS Provider Manuals (AHA)	2020
ATLS Student Course Manual (ACS)	10th (2018)

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BCEN. Certified Emergency Nurse (CEN) Examination Content Outline, effective July 2026 (PDF). Link
BCEN. Certified Emergency Nurse (CEN) Examination Content Outline, effective January 2022 (PDF). Link
BCEN. Evolving Excellence: Updating the CEN Exam (blog). Link
BCEN. Frequently Asked Questions About the CEN. Link
BCEN. CEN Exam Fees & Discounts. Link
BCEN. CEN Eligibility. Link
BCEN. How to Take the CEN Exam (exam delivery options). Link
BCEN. Apply For & Schedule Your CEN Exam. Link
BCEN. The CEN Certification Process. Link
BCEN. Candidate Handbook (PDF, file dated 2024, footer Rev. 01/21). Link
BCEN. How to Study for the CEN Exam (Study and Prepare). Link
BCEN. Certified Emergency Nurse (CEN) Certification Exam Resource List (2026) (PDF). Link
BCEN. CEN Sample Questions (PDF). Link
BCEN. CEN Review Course: Essentials of Emergency Nursing. Link
BCEN Learn. CEN Practice Exam. Link
BCEN. Exam Preparation Checklist 2026 (PDF). Link
BCEN. CEN certification page. Link
BCEN. Trademark Policy. Link
Elsevier. Emergency Nursing Core Curriculum, 8th Edition (ENA). Link
American Heart Association. 2025 ACLS Provider Manual eBook (25-3100). Link
American Heart Association. 2025 PALS Provider Manual eBook (25-3120). Link
American College of Surgeons. Advanced Trauma Life Support (ATLS). Link