CEN Practice Questions Study Guide: CEN Exam Review Questions with Rationale

Medically reviewed by

By

 

Read CEN Exam Prep Study Guide Online Free: CEN Practice Test Questions with Rationale

CEN Practice Test

CEN Study Guide

According to the National Specialty Nursing Certifying Organization, certification is the process by which a nongovernmental agency or association validates, on the basis of predetermined standards, a registered nurse’s qualifications and knowledge for practice in a defined functional or clinical area of nursing. To enhance your performance on the Certified Emergency Nurse (CEN) examination, review the answers to the following commonly asked questions.

Who sponsors the CEN examination?

The Board of Certification for Emergency Nurses (BCEN) sponsors the CEN examination. The BCEN evaluates and recognizes nurses who have attained a defined body of emergency nursing knowledge needed to function at a competent level. The website for this organization is important to the test taker. It is located at https://bcen.org.

Is the CEN examination as difficult as the National Council Licensure Examination (NCLEX)?

Healthcare professionals who take a certification examination for a specialty area of practice already have the knowledge required by the basic licensure examination. Because the knowledge measured by the CEN examination is specialized for emergency nursing, the CEN examination is at least as difficult as or more challenging than the NCLEX. This is also an individual viewpoint, with individual nurses varying in their ability to take the test and in how they view the questions. For some emergency nurses taking the test, it may seem easy, and for others, it will be very hard.

If I have been an emergency nurse for years, do I need to study?

As an emergency nurse, you have probably mastered complex technical skills related to the care of emergency patients as well as the theoretical knowledge that underlies these skills. You have also probably developed the ability to make sound nursing judgments in crises that often determine whether a patient lives or dies. Despite such advanced knowledge, skill mastery, and decisionmaking ability, many emergency nurses experience high levels of test-taking anxiety that may prevent them from seeking certification. These CEN Practice Questions can help alleviate test taking anxiety and provide a level of confidence to the reader by providing a thorough review of the material contained in the CEN examination. It is the hope of this author and contributors to provide the tools that will help you successfully pass this test. Included among the questions are helpful hints about emergency care issues that are coordinated with the question and the answer. This provides additional information that might not otherwise be dealt with in the test questions themselves.

Also, keep in mind that all nurses should study for the examination because it is impossible for every nurse to care for every kind of patient or to remember every nuance about disease processes and interventions. It is highly recommended that each nurse study for at least 1 month before sitting for the examination. Everyone has high spots and low spots in their knowledge base. Reminding yourself of some of the points of care of patient disease processes and injuries that you may not have cared for in the past is essential to the success of the emergency nurse taking this examination.

What are the eligibility requirements for CEN examination?

The BCEN establishes criteria for eligibility to take the CEN examination. Current criteria are listed here.

  • You must possess a current unrestricted license or nursing certificate as a registered nurse in the United States.
  • Nurses from other countries must possess licensure, registration, or certification to practice as a registered nurse in that country. An additional international testing fee will be assessed at the time of application.
  • Any restriction, suspension, or probation, or any order arising from a Nursing License Authority that limits your ability to function in an emergency nurse setting and perform those tasks normally associated with emergency nursing practice will disqualify you from sitting for the examination unless you are a qualified individual with a disability who can perform the essential functions of emergency nursing with or without reasonable accommodation.
  • Although not a requirement, the BCEN recommends that you have 2 years of experience in emergency nursing practice.
  • Membership in the Emergency Nurses Association (ENA) qualifies you for a reduced CEN examination application fee. This reduction is usually substantial.
  • To become a member, of the ENA, go to its website, www.ena.org.
  • A new voucher system that your hospital can take advantage of for employees is available. Contact the BCEN for information.

How many questions are on the CEN examination?

The CEN examination consists of 175 multiple-choice questions, of which 150 are scored. A candidate is allotted 3 hours to complete the examination. Twenty-five questions on the examination are present to test the question itself, not the test taker. This is the process by which a potential test item becomes an official test item because it is the only way to test that item for reliability and validity. The test taker will not know which questions are pretest questions. This will help gain the best information about each test item. These questions are embedded among the “real” questions to gain the best knowledge about their usefulness.

How is the CEN examination administered?

The CEN examination is administered by computer. Upon special request, a pencil-and-paper test may be available. When the emergency nurse requests to sit for the examination, she/he will be given a list of test sites in the area of choice. The nurse will be able to sign up at the time of the application for the time and location. One of the nice things now is that each nurse takes this examination individually, unlike in the beginning when everyone sat in the same room with paper and pencil. This means that the test taker is the only one who knows when that person is taking the test. No one needs to know about the day of your test except for those you choose to tell. At the time of application, the nurse has 90 days to take the examination. That gives ample time to start the studying process and gives the emergency nurse a deadline to work with.

Where do these CEN Exam Questions come from?

Each question on the test has gone through a rigorous system to become an actual test item. To begin with, nurses from all over the country are invited to become item writers. Each year, this group of nurses is chosen according to their perceived ability to write questions, their geographic location, and the size of the hospital in which they work. The BCEN makes sure that all nurses are represented—throughout the country—and that all sizes of hospitals are included. After these nurses attend classes on item writing, they are given their assignments. When these assigned questions are completed, they are then reviewed by another group of nurses called the Examination Construction and Review Committee (ECRC). These nurses, who were prior item writers, reviewed these questions and started the rewrite process. The final process is from the testing company which then edits the questions and places them on your test. So, in the end, the test items are written by nurses, for nurses.

What topics does the CEN examination cover?

The content of the CEN examination, based on recognized standards and practices for emergency nursing, is divided into two major areas: clinical practice and professional issues.

Clinical practice
The CEN sample tests reflect the blueprint of the actual examination. This blueprint can be found on the BCEN website and includes the breakdown according to the number of questions for each area and also provides some insight into possible topics that may be on the test.

In 2017, after the last Role Delineation Study (RDS), a survey sent out to thousands of emergency nurses that helps keep the test up to date with current nursing practice, the blueprint was changed a great deal. These surveys help drive the major changes that occur in the test itself over the years. The content is usually changed in minor ways, that is, removing content; however, the test may see other major changes happening. For instance, in 2011, the focus of the test items moved from task oriented to disease process oriented, which made the test a bit harder. This was complemented by reducing the number of correct answers that were required for successful completion. The test taker had to answer 105 questions correctly. In 2017, the blueprint of the test was changed and the categories were restructured with several of them combined. The blueprint went from 13 categories to 8 categories. All body systems and emergencies were maintained, they were just redistributed. You might notice that there is not a category for shock. All of the shock states have been incorporated into the other appropriate categories, that is, cardiogenic shock is included in the cardiovascular section. The test taker now must answer 106 questions correctly to be successful.

This Best CEN Study Guide has maintained separate chapters for each body system, including a separate chapter for shock because we believe it is easier to study for the potential questions in this way. The content did not change, it was simply moved around. Also, on the test, sections are not presented; instead, all questions are mixed throughout the test.
Once the categories are established with the correct number of questions on the test, these questions are further divided by the nursing process. These are as follows; Assessment, Analysis, Intervention, and Evaluation. So, on the test there will be 32 assessment, 34 analysis, 43 intervention, and 25 evaluation questions. Regarding the professional issues category, these questions are further divided by cognitive level—Recall (3), Application (10), and Analysis (3). Another item of interest is that nursing diagnoses have been removed from test items.

Assessment questions
These questions test your ability to collect data. They focus on such nursing behaviors as:
assessing the patient’s physiologic and psychosocial health as well as safety needs.
collecting information from the patient, family, friends, hospital records, and health team members.
recognizing symptoms and findings.
challenging orders and decisions by health team members, as appropriate.

Analysis questions
These questions test your ability to understand disease processes and their related testing modalities. They focus on such nursing behaviors as:

  • organizing, interpreting, and validating assessment data.
  • gathering additional data when necessary.
  • understanding the pathophysiology of the process.
  • relating laboratory and radiographic results to the problem.

Intervention
These questions test your ability to initiate and complete actions that provide nursing care for the patient. They focus on such nursing behaviors as:

  • selecting the best nursing measures to deliver effective care.
  • prioritizing interventions to ensure optimal outcomes.
  • identifying community resources to assist the patient and family.
  • coordinating the patient’s care with other health care providers.
  • delegating care responsibilities to other health care providers.
  • supervising and validating the activities of other health team members.
  • formulating outcomes of nursing interventions.

Evaluation
These questions test your ability to measure goal achievement. They focus on such nursing behaviors as:

  • comparing actual outcomes with expected outcomes.
  • evaluating the patient’s compliance with the prescribed plan of care.
  • documenting the patient’s response to care.
  • revising the plan of care and reordering priorities as needed.
  • making sure the patient understood the discharge information.

What is the best way to study for the CEN examination?

Although individual study is highly recommended, the “best” way to study is a matter of personal preference. Remember that some people are visual learners and some are auditory learners. Figure out how you learn best and make sure you utilize that! Some test candidates prefer to study alone, whereas others opt for group study, and still others enjoy a combination of the two.

Individual study
No matter what other study strategies you use, individual preparation for the CEN examination is highly recommended. This preparation can take several forms.

  • Read review books such as this one to help you pinpoint areas that need improvement. You can then concentrate on reviewing materials in those areas.
  • Consult emergency nursing textbooks and study guides. As you read the material, ask yourself multiple-choice questions about the information. Consider how the CEN examination might test your knowledge of this material.
  • Answer practice questions similar to those on the test. Spend about 30 minutes each day answering 10 to 20 questions (do not try to answer 100 questions on your day off). After you answer the questions, compare your answers with the correct answers listed in the review book; also review the rationales provided. In this book, we have included the rationale for the correct answer and the incorrect answers as well. If you answer some questions incorrectly and are not sure why, return to the textbook or review book to find the rationale. By doing this, you will become more familiar and comfortable with the examination’s format while reinforcing the information you have studied.
  • If you have not attended an Advanced Cardiac Life Support (ACLS) course, Pediatric Advanced Life Support (PALS) course, Trauma Nursing Care Course (TNCC), or an Emergency Nursing Pediatric Course, consider attending these courses or review the course provider manuals for these courses. Content covered in these courses is often found in the CEN examination. These manuals are often used as reference material. Expect to have a few rhythm strips and emergency medication questions on the test.

Group study
Studying with others can effectively prepare you for the CEN examination. To get the most from your sessions, follow these guidelines:

  • Be choosy about whom to include in your study group. Limit the number of people (the recommended size is four to six people); larger groups can disrupt the study.
  • Ask each member to prepare one section of the study topic before the group meets. For example, have one person discuss anatomy and physiology, another review the drugs used for treatments, and a third to cover key elements of emergency nursing care.
  • Meet regularly (once or twice weekly) to maintain a studious atmosphere.
  • Limit each study session to 2 hours. Longer sessions invite participants to wander off the topic and promote a negative attitude toward the examination.
  • Avoid turning study sessions into a party. Although snacks and refreshments can help maintain the group’s energy, a party atmosphere will render the session ineffective.

How can I master a multiple-choice test of CEN examination?

Multiple-choice questions are one of the most commonly used test formats for such standardized tests as the CEN examination. After you have mastered these test-taking strategies, you will be able to score better on multiple-choice tests.

  • Read the question and all options carefully and completely. This is really important. Take your time and read every word. Missing one word can make a big difference in how you answer the question.
  • Treat each question individually. Use only the information provided for that question, and avoid reading into a question any information that is not provided.
  • Monitor your time. You will have approximately 60 seconds per question; because most test takers average 45 seconds per question, you may finish well before the time limit. You are given 3 hours to complete the test. Before the test, you will be given 10 minutes to “practice.” Take this time to get settled in and start answering questions. The 3-hour period does not start until the actual test is opened.
  • Narrow your choices using the process of elimination. If you can identify even one option as incorrect, you can focus your attention on the more plausible answers (and improve your chances of answering correctly). If something in any of the options seems to not match with the stem of the question, toss that one out. Usually, the test taker (myself included) can eliminate two of the answers, which now gives you an advantage of a 50/50 chance!
  • Do not change your answers. Studies show that test takers who change an answer on a multiple-choice examination usually change it from a correct answer to an incorrect one or from one incorrect answer to another incorrect answer. Rarely do they change to a correct answer. This is super important!
  • Look for qualifying words in the question (such as first, best, most, better, and highest) that ask you to judge the priority of the options; then select the answer that has the highest priority. Be careful with questions that give you the first intervention and ask you to choose the “next” intervention!
  • Look for negative words in the question (such as not, least, unlikely, inappropriate, unrealistic, lowest, contraindicated, except, inconsistent, all but, atypical, and incorrect). In general, when you are asked a negative question, three of the choices are appropriate actions, and one is inappropriate. You are being asked to select
  • the inappropriate choice as your answer. These can be tricky! On the test, these negative words will be capitalized, bolded, and underlined. Be on the lookout for them!
  • Avoid selecting answers that contain absolute words (including always, every, only, all, never, and none); these options usually are incorrect.
  • Never choose an option that refers the patient to a physician/provider. Because the CEN examination is for nurses and includes conditions and problems that nurses should be able to solve independently, an answer that refers a patient to the physician/provider usually is incorrect and can be eliminated from consideration.
  • Do not look for a pattern (such as C, C, A, B, C, C, A, B) when selecting answers. The questions and answers on the examination are randomly arranged.
  • Do not panic if you read a question that you do not understand. Some questions may refer to diseases, drugs, or laboratory tests that you are unfamiliar with. In such cases, remember that nursing care is similar in many situations, even when disease processes differ markedly. Just select the answer that seems logical and involves general nursing care. Also, utilize your understanding of pathophysiology and normal anatomy and physiology. When you get to these questions, stop and take a deep breath. You can probably work your way through it.
  • If necessary, skip a question and come back to it later. Sometimes something will jog your memory or otherwise help you with the question. Just be sure to go back and answer it! Blank answers are wrong answers!
  • Remember that there are no zebras on the test! Every situation is classic textbook picture. Thousands of emergency nurses across the country are taking this test. The questions have to be uniform!
  • Be careful about how “things are done in my ER.” Again, this test is universal. Understand the importance of knowing the “book way” just in case there is a question about a procedure.
  • Another good point is to cover up the answers, and when the stem is read, figure out what answer you are looking for. Then reveal the options and see if the answer is there.
  • If something seems bizarre, it is! If an answer just does not make sense, consider it as wrong and move on.
  • Questions now are much “cleaner” and there are not as many scenarios that include things like, “A 55-year-old male was involved....” If there is an actual age or gender in the question, it is there for a reason.
  • When taking practice examinations, please remember that you do not have to be getting 100% or even close
  • to that to be prepared! On the test, you have to answer 106 questions out of 150 correctly! That is not even 80%! Do not be so hard on yourself and think you have to be making extremely high scores on all of the practice examinations!
  • Remember that things that you might have learned to help you “take a test” will not be on this test! There are no answers on the test that use the words, “All of the above” or “None of the above.” There will be four distinct answers for you to choose from. Also, words that are used in the stem of the question are not repeated in the one correct answer. And the best one of all! All answers are the same length! You will not be able to choose the correct answer depending on the length of the option. This is a test of your emergency nursing ability, not your test-taking ability!
  • Think positively about the examination. People who have a positive attitude score higher than those who do not.

Are there any other tips I should know on the CEN examination?

Proper planning can go a long way toward ensuring your success on the CEN examination. Try these suggestions.

Before examination day

  • A week or so before the examination, drive to the test site to familiarize yourself with parking facilities and to locate the test room. Knowing where to go will greatly reduce your anxiety on the day of the examination.
  • Follow as normal a schedule as possible on the day before the examination. If you need to travel to the test site and stay away from home overnight, try to follow your usual nightly routine; avoid the urge to do something different.
  • The night before the test, avoid drinking alcoholic beverages. Alcohol, a central nervous system (CNS) depressant, interferes with your ability to concentrate. Avoid eating foods you have never eaten before, which may cause adverse GI effects the next day.
  • Avoid taking sleep medications you have never taken before. Like alcohol, most sleep aids are CNS depressants; some have a hangover effect, while others produce drowsiness for an extended period.
  • Do not stay up late to study; this will make you tired during the test, which will decrease your ability to concentrate. Besides, you are probably as prepared as you can be. Review formulas, charts, and lists for no more than 1 hour. Then relax, perhaps by watching- television or reading a magazine or book. These activities will help decrease your anxiety. In reality, try not to study the night before!
  • Go to bed at your usual time.

Examination day

  • On the morning of the examination, do not attempt a major review of the material. The likelihood of learning something new is slim, and intensive study may only increase your anxiety.
  • Do not drink excessive amounts of coffee, tea, or caffeine-containing beverages. Caffeine will increase your nervousness and stimulate your renal system.
  • Eat breakfast, even if you usually do not, and include foods high in glucose and protein to maintain your energy level and help you think! Shun greasy, heavy foods, which tend to form an uncomfortable knot in your stomach and may decrease your ability to concentrate.
  • Dress in comfortable, layered clothing. Jogging suits are popular. Many rooms are air-conditioned in the summer and maybe cool even if it is hot outside. Be prepared by taking a sweater or sweatshirt.
  • Arrive at the test site 30 to 45 minutes early, and make sure you have the required papers and documents
  • for admittance to the test room. Latecomers are not admitted to the examination. They are now requiring two photo IDs. The paperwork you are provided with will let you know which to bring.
  • Do not bring pencils, pens, note paper, calculators, calipers, or other resources. Nothing is permitted to be taken into the testing room.
  • At the testing center, you will be given a pencil and a blank piece of paper for notes and calculations. You will be asked to turn in that paper after the test.
  • Think positively about how you will do it. Taking the CEN examination shows confidence in your knowledge of emergency nursing. When you receive your passing results, plan to celebrate your success, a significant achievement in your professional life that deserves to be rewarded.
  • RELAX! Try not to get too stressed! It is normal to have some anxiety, but make sure it stays in the mild stage which will help keep you on your toes and not become a liability!

Book an appointment