2020 Edition

CEN Practice Exam

Try our free CEN Practice Exam below written by CEN experts. Your results will be scored automatically and will display your strengths and weaknesses.

A nurse who wishes to obtain the Certified Emergency Nurse (CEN) credential must take and pass the CEN exam which is administered by the Board of Certification of Emergency Nursing (BCEN). The CEN exam is composed of 175 multiple choice questions and you are given three hours to complete the exam.There are twelve areas tested on the CEN exam: Cardiovascular - Respiratory - Medical Emergencies and Infections - Neurological - Orthopedics and Wounds - Gastrointestinal - Genitourinary, Gynecological and Obstetrical - Environment and Toxicology - Professional issues - Shock - Maxillofacial and Ocular – Psychosocial.The CEN exam tests your ability to use the Nursing Process within the context of Emergency nursing.  Throughout the test, you can expect to see questions that will test your assessment, analysis, intervention and evaluation knowledge.

For complete practice, check out the CEN Practice Exam Kit with 750 questions and fully explained answers.


Cardiovascular Emergencies

1. The patient is brought to the ED with an anterior ST-elevation myocardial infarction (STEMI). You are assessing him for possible administration of fibrinolytics. An absolute contraindication for this treatment is:
2. Preload refers to:
3. The team is performing CPR on a patient. The rhythm that will respond to an electrical shock is:
4. When suctioning during a cardiac arrest, suctioning should be limited to which of the following?
5. Possible causes of cardiac arrest include all of the following EXCEPT:

Respiratory Emergencies

6. You are providing ventilations using a Bag-mask device. Suddenly, you do not see the patient's chest rise with the ventilation. You reposition the patient to ensure an open airway. When you attempt to ventilate, you do not see his chest rise. The most likely cause of this is:
7. According to American Heart Association ACLS guidelines, cricoid pressure during intubation:
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8. You are providing positive pressure ventilation through an ET tube to a patient in respiratory distress. Indications that you are ventilating too fast include all of the following EXCEPT:
9. According to American Heart Association ACLS guidelines, when available, the best way to confirm and maintain tracheal tube position is by:
10. Signs of respiratory failure include all of the following EXCEPT:

Shock Emergencies

11. Emergency Medical Service has brought a 24-year-old man to the ED with gunshot wounds to his abdomen and left groin area. His blood pressure is 84/52 and heart rate is 120 per minute. His skin is diaphoretic, cool, and pale. The treatment the nurse should prepare for is:
12. You are on the ED team caring for a 10-year-old child with a normal systolic blood pressure, increased heart rate, slightly delayed capillary refill and cool, pale skin. What severity of shock is the child likely in?
13. You are caring for a patient in cardiogenic shock. You know that a probable cause of this condition is:
14. You are caring for a 10-year-old child with normal blood pressure, increased heart rate, and cool pale skin. The child is reported to have had vomitting and diarrhea the past two days. As you perform your primary assessment, you note that respirations are clear and not labored. What is the probable first intervention for this child?

Neurological Emergencies

15. You assume care for the patient in the ED. During the time she has been in the ED, she has consistently complained of photophobia, a stiff neck, increasing confusion, and nausea. Her history shows a motor vehicle accident several days ago. She states the pain is the worst headache she has ever had. You suspect she might have a:
16. To quickly evaluate a child's neurological status, all of the following standard evaluations can be used EXCEPT:
17. According to the American Heart Association stroke recommendations, the critical goal time from arrival to the Emergency Department to CT brain scan is:
18. The National Institute of Neurological Disorders and Stokes (NINDS) has set the goal for immediate general assessment by a stroke team or emergency physician as:

Genitourinary, Gynecological and Obstetrical Emergencies

19. A 16-year-old boy is brought to the ED by his parents. They state that he awoke from sleep with nausea, vomiting, and pain in his scrotum. The nurse notes that the boy's scrotum is swollen and he has a low-grade fever. His urinalysis is normal. The physician suspects a testicular torsion. The definitive treatment for this boy is:
20. A 24-year-old woman is seen in the emergency department complaining of urinary frequency, pain with urination and urgency. Vital signs are stable and within normal limits. When you obtain a urine specimen, you note that it is cloudy and foul smelling. You should prepare the patient for:
21. A woman is admitted to the ED with complaints of lower abdominal pain, smelly vaginal discharge, pain with intercourse, and burning with urination. Her vital signs are stable, and she has no other symptoms. Treatment for this patient will likely include:
22. When evaluating a patient for Acute Renal Failure, it is helpful to use the RIFLE criteria for classification. This acronym refers to:
23. The nurse has assisted in an emergent delivery of an infant in the Emergency Department. The infant was born 2 weeks before the due date and is small for gestational age. The nurse documents a thin upper lip, small eye openings, and a smooth philtrum above the upper lip. This child may be diagnosed with:

Medical and Infectious Disease Emergencies

24. A young man is brought to the Emergency Department after receiving multiple fire ant bites while working in his yard. Although initially alert and oriented, he begins to develop wheezing and an itchy throat. He complains of nausea and severe anxiety. The ED nurse should prepare to administer all of the following for initial treatment EXCEPT:
25. An eight-year-old child is brought to the emergency department by his parents after receiving multiple fire ant bites at his home. His lips are swollen, and he is complaining of itching. During your assessment, you note that he is wheezing. The most appropriate immediate treatment for this child is:
26. The Emergency Department nurse knows that the best way to prevent transmission of nosocomial infections is:
27. Patient placement in the emergency department should be based on:

Gastrointestinal Emergencies

28. You are caring for a patient who has just been diagnosed with hepatitis A. The discharge instructions for this patient will likely include all of the following EXCEPT:
29. A 12-year-old patient is brought to the emergency department by his parents after accidentally swallowing a disk battery while changing the battery in his watch. A chest x-ray reveals that the battery is in the patient's esophagus. He is able to swallow and breathe without difficulty. The most appropriate intervention for this patient is to:
30. A nurse is caring for a patient with pancreatitis. Which of the following symptoms would indicate a possible life-threatening complication?
31. An alcoholic patient well known to the emergency department staff presents to the department with complaints of generalized weakness, low-grade fever off and on for the last month, new onset ankle edema, anorexia, right upper quadrant abdominal pain and vomiting. He denies any bloody or coffee ground emesis. This patient should be evaluated for esophageal varices.

Maxillofacial and Ocular Emergencies

32. A patient has been admitted to the Emergency Department with persistent epistaxis. Vital signs are stable. The correct position for this patient is:
33. A patient presents to the ED with complaint of ear and jaw pain. Upon assessment, you note that his tympanic membranes are non-bulging, pearly gray. You look in his mouth and see this: The primary diagnosis for this patient will be:
34. A young woman is brought to the ED by her roommates. The nurse notes that a knitting needle is sticking out of her right eye. All of the following are appropriate initial interventions EXCEPT:
35. A baseball coach calls the emergency department after a 15-year-old boy had a tooth knocked out during a baseball game. The baseball coach found the intact tooth on the ground and has rinsed off the dirt. What should the coach be advised to do?

Orthopedic and Wound Emergencies

36. The child pictured on the right is seen in the ED for a left forearm fracture. The orthopedic surgeon reduces the fracture in the ED and applies the cast. The discharge instructions have not been understood because:
37. A seventeen-year-old is brought to the emergency department complaining of leg pain after a motor vehicle crash. X-rays show a fracture of the femur with several bone fragments at the fracture site. You note that the skin above the fracture site is intact but bruised. This type of fracture is called:

Environment and Toxicological Emergencies

38. A nurse is caring for a farmer who was bitten by a rattlesnake while working in his field. He killed the snake and brought it to the ED for positive identification. The triage nurse notes two puncture marks on his right hand. The proper interventions for this patient may include all of the following EXCEPT:
39. A 36-year-old African American man presented to the emergency department with burns to his hands that were suffered when his car radiator boiled over onto his hands. He has run cool water over his hands but he is still experiencing what he describes as "horrible" pain. He does not have burns on any other area of his body. How should this burn be classified according to the American Burn Association's guidelines?
40. The medication indicated for a suspected opioid overdose is:
41. A patient in the ED is diagnosed with West Nile virus. Which of the following is the mode of transmission for this disease?

Psychosocial Emergencies

42. The pediatric Emergency Department nurse is required to report:
43. You are working in the pediatric emergency department. Parents bring their 6-year-old child in with what is diagnosed as a fracture of the left ulna. The mother states that the child fell off his bike. The child appears withdrawn and states "I fell" when you ask how his arm was broken. Which of the following would be an improper intervention with this family at this point?
44. The nurse in the Emergency Department is discharging a patient who has been evaluated by the psychiatric team for suicidal ideations. Discharge instructions should include all of the following EXCEPT:
45. As an emergency department nurse, you must report suspected child abuse or neglect.
46. You are the nurse in the Emergency Department caring for a patient with a known history of alcoholism. He is loud, verbally abusive and argumentative to the staff, and uncooperative with requests from the staff. His blood pressure is 158/84. Heart rate is 104, respiratory rate 22, and a blood alcohol level of 0.30%. The first action by the staff should be to:

Professional Issues

47. The ENA Code of Ethics expects the emergency nurse to do all of the following EXCEPT:
48. Emergency nurses are encouraged to use evidence based practices (EBP) in the practice of emergency nursing. Which of the following practices is not recommended by the Emergency Nurse's Association?
49. The nurse in a small rural hospital is caring for a pregnant woman who is at 34-weeks gestation in her first pregnancy. She is complaining of intermittent lower abdominal pain. The hospital does not have a labor and delivery unit, but the on-call physician has determined that her cervix is dilated to 3 cm. The fetal heart sounds are strong at a rate of 150 beats per minute. The woman is accompanied by her husband. The nearest hospital with a labor and delivery unit is 30 minutes away. The correct action in this situation is to:
50. A nurse has inserted a nasogastric (NG) tube for the relief of nausea and vomiting. The technician working with the nurse does not have any special training or certification. The nurse asks the technician to "take care of the patient while I go to lunch". While the nurse is out of the department, the technician working with the patient can:

CEN Practice Exam

The CEN test is a certification exam for emergency room nurses. The CEN credential demonstrates that a nurse has knowledge and skills specific to the nursing needs of an emergency room. The exam includes 13 sections covering everything from cardiovascular emergencies to patient care to wound management. For more on the CEN exam, please see our CEN Test Guide.