CEN Exam Blueprint: Complete Content Outline
Master the CEN exam with our detailed breakdown of all content domains, their weightings, and key topics you need to know for emergency nursing certification.
Understanding the CEN Exam Structure
The CEN exam blueprint is carefully designed to reflect the knowledge and skills essential for competent emergency nursing practice. The exam covers emergency care across the lifespan, from pediatric to geriatric patients, with content organized into 10 major domains.
Exam Format
- Total Questions: 175 multiple-choice questions
- Scored Questions: 150 questions
- Pretest Questions: 25 unscored questions
- Time Limit: 3 hours (180 minutes)
Question Format: Single-answer multiple choice with 4 options. Pretest questions are randomly distributed throughout the exam and do not count toward your score.
Content Domain Breakdown
1. Cardiovascular Emergencies
18% (~27 questions)This is the largest content area on the CEN exam, reflecting the high prevalence of cardiac emergencies in emergency departments.
- • Acute coronary syndromes (STEMI, NSTEMI, unstable angina)
- • Heart failure and cardiogenic shock
- • Cardiac dysrhythmias and conduction disorders
- • Hypertensive emergencies
- • Pericarditis and cardiac tamponade
- • Aortic emergencies (dissection, aneurysm)
- • Peripheral vascular emergencies
- • ACLS protocols and post-resuscitation care
2. Respiratory Emergencies
16% (~24 questions)Respiratory emergencies are critical in emergency nursing, requiring rapid assessment and intervention.
- • Acute respiratory failure and ARDS
- • Asthma and COPD exacerbations
- • Pneumonia and pneumothorax
- • Pulmonary embolism
- • Airway management and mechanical ventilation
- • Pleural effusion and hemothorax
- • Upper airway obstruction
- • Tension pneumothorax recognition
3. Neurological Emergencies
14% (~21 questions)Neurological emergencies require rapid recognition and time-sensitive interventions.
- • Stroke (ischemic and hemorrhagic)
- • Seizure disorders and status epilepticus
- • Altered mental status and coma
- • Headache syndromes
- • Meningitis and encephalitis
- • Increased intracranial pressure
- • Spinal cord injuries
- • tPA protocols and stroke management
4. Gastrointestinal Emergencies
11% (~17 questions)GI emergencies often present with acute abdominal pain requiring careful assessment.
- • GI bleeding (upper and lower)
- • Acute abdomen and appendicitis
- • Bowel obstruction and perforation
- • Inflammatory bowel disease
- • Hepatitis and liver failure
- • Pancreatitis
- • Esophageal emergencies
- • Acute cholecystitis
5. Genitourinary and Gynecological Emergencies
9% (~14 questions)This domain covers both urological and gynecological emergency conditions.
- • Acute kidney injury and renal failure
- • Urinary tract infections and pyelonephritis
- • Kidney stones and urinary retention
- • Testicular torsion and epididymitis
- • Ectopic pregnancy and ovarian torsion
- • Pelvic inflammatory disease
- • Sexual assault examination
- • Pregnancy complications
6. Psychosocial & Medical
8%- • Suicidal and homicidal ideation
- • Substance abuse and withdrawal
- • Behavioral emergencies
- • Crisis intervention
7. Maxillofacial & Ocular
7%- • Facial fractures and trauma
- • Eye injuries and foreign bodies
- • Dental emergencies
- • Acute vision loss
8. Environmental & Toxicological
7%- • Poisoning and overdose management
- • Heat and cold-related illnesses
- • Drowning and electrical injuries
- • Bites and stings
9. Orthopedic & Wound
6%- • Fractures and dislocations
- • Compartment syndrome
- • Wound care and burns
- • Amputations
10. Communicable Diseases
4%- • Sepsis and septic shock
- • CNS infections
- • Tuberculosis and HIV complications
- • Infection control measures
Study Strategy by Domain Weight
High-Priority Domains
Focus 60% of study time
- • Cardiovascular (18%)
- • Respiratory (16%)
- • Neurological (14%)
Master ACLS, stroke protocols, airway management
Medium-Priority Domains
Focus 30% of study time
- • Gastrointestinal (11%)
- • Genitourinary/Gyn (9%)
- • Psychosocial/Medical (8%)
GI bleeding, renal emergencies, psychiatric crises
Lower-Priority Domains
Focus 10% of study time
- • Maxillofacial/Ocular (7%)
- • Environmental/Tox (7%)
- • Orthopedic/Wound (6%)
- • Communicable Diseases (4%)
Review key concepts, focus on high-yield topics
Key Concepts Across All Domains
Clinical Skills
- • Triage and prioritization (ESI levels)
- • Primary and secondary assessment
- • Critical vs. non-critical recognition
- • Emergency pharmacology
Professional Practice
- • Legal and ethical issues
- • EMTALA compliance
- • Therapeutic communication
- • Discharge planning and education
Ready to Master the CEN Blueprint?
Understanding this blueprint is crucial for effective exam preparation. Focus your study efforts proportionally to the domain weights, but ensure you have foundational knowledge in all areas.