CEN Practice Test: Free Certified Emergency Nurse Exam Questions, 2026 Outline

270 practice questions for the CEN (Certified Emergency Nurse) exam, built on the content outline that took effect July 6, 2026. They follow its 11 domains, weighted the way the real exam is, from Cardiovascular (18 of 150 questions) and Respiratory and Neurological (17 each) down to Head, Eye, Ear, Nose and Throat and the GU, gynecology and obstetric domain (10 each), and cover 149 of its 152 topics. Most are ED cases: a client, a few findings, and what the nurse should do FIRST, expect NEXT or question. Each is tagged to its outline code, so your score report shows exactly which topics you miss, and every answer explains why the best choice is best and names its public source.

The real test: 175 multiple-choice questions (150 scored, 25 unscored pretest) in 3 hours, at a PSI test center or by live remote proctoring, with a 90-day wait between attempts. Since July 6, 2026 you pass with 99 of the 150 scored questions right (66%), not curved, on a new 11-domain content outline. Our practice test is 75 scored questions plus 12 unscored, split by the 11 domains like the outline, passing at 50 of 75 (the same 66%).

Passing score: The CEN passing score (99 of 150), and the retest wait

Here: 270 questions. Our own practice questions, built on the CEN content outline that took effect July 6, 2026 and written from public sources (AHA and ACC/AHA guidelines, CDC, ATLS facts, the Surviving Sepsis Campaign, ACOG, FDA labels, NIH StatPearls, EMTALA and CMS rules), with every answer's source named. Topics are the 11 domains of the outline. Not BCEN's or ENA's test questions. Free.

What's on the test

"On the test" is the rough share of a 75-question test for each topic, following the exam's published weights.

10 sample questions

1. A 58-year-old man walks up to triage with 30 minutes of chest pressure and sweating. What is the priority within the first 10 minutes of his arrival?

   • A.A full set of vital signs and a pain score, then the waiting room
   • B.A 12-lead ECG read by a provider
   • C.A portable chest x-ray to look for a widened mediastinum
   • D.A troponin level first
   Show answer

   B. A 12-lead ECG read by a provider

   CEN-1 · 1. Cardiovascular

2. An adult with a recent stroke coughs during meals and now has fever and a new infiltrate. In which part of the lungs is aspiration MOST likely to show up when he is upright?

   • A.The left upper lobe
   • B.The left base, since the left mainstem bronchus is the straighter one
   • C.Both apices evenly
   • D.The right lower lobe
   Show answer

   D. The right lower lobe

   CEN-32 · 2. Respiratory

3. A client with Guillain-Barre syndrome has weakness that has climbed from her feet to her chest over 3 days. Which measurement BEST tells the nurse she may need intubation?

   • A.Forced vital capacity falling toward 20 mL/kg
   • B.A heart rate that changes from 60 to 110 through the day
   • C.SpO2 of 95% on room air
   • D.Deep tendon reflexes that are absent at the knees
   Show answer

   A. Forced vital capacity falling toward 20 mL/kg

   CEN-61 · 3. Neurological

4. A 19-year-old has pain that started around the navel and moved to the right lower quadrant, with nausea and a low fever. While waiting for imaging, he says the pain suddenly got much better. What should the nurse suspect?

   • A.The appendicitis is resolving on its own
   • B.The pain was gas and has passed
   • C.The pain medicine he got in triage has peaked
   • D.The appendix may have perforated
   Show answer

   D. The appendix may have perforated

   CEN-89 · 4. Gastrointestinal

5. A 14-year-old woke up with sudden severe left scrotal pain and vomiting. The left testicle rides high and the cremasteric reflex is absent. What is the priority?

   • A.Ice, pain medicine and a clinic visit within a week
   • B.Antibiotics for epididymitis and scrotal support
   • C.A urinalysis, then discharge if it is negative
   • D.An emergency urology consult for possible surgery
   Show answer

   D. An emergency urology consult for possible surgery

   CEN-115 · 5. Genitourinary, Gynecology and Obstetrical

6. A client is pacing, clenching his fists and shouting at the triage desk. What should the nurse try FIRST?

   • A.Telling him firmly that security will remove him if he keeps shouting
   • B.IM haloperidol and lorazepam before he can strike out
   • C.Four-point restraints before he can hurt anyone
   • D.Verbal de-escalation from a safe distance, with an exit for both of them
   Show answer

   D. Verbal de-escalation from a safe distance, with an exit for both of them

   CEN-138 · 6. Mental Health

7. A client stung by a bee has hives, throat tightness, wheezing and BP 82/50. What should the nurse give FIRST?

   • A.Epinephrine 0.5 mg IM in the outer thigh
   • B.Epinephrine 1 mg IV push, the cardiac arrest dose
   • C.Diphenhydramine 50 mg IV
   • D.Methylprednisolone 125 mg IV
   Show answer

   A. Epinephrine 0.5 mg IM in the outer thigh

   CEN-160 · 7. Medical

8. A carpenter cut off his thumb with a table saw. How should the nurse care for the amputated part?

   • A.Wrap it in dry gauze and keep it in the client's hand
   • B.Put it straight onto a bed of crushed ice so it stays as cold as possible on the way
   • C.Soak it in a cup of sterile saline at room temperature
   • D.Wrap it in moist sterile gauze, seal it in a bag and set the bag on ice water
   Show answer

   D. Wrap it in moist sterile gauze, seal it in a bag and set the bag on ice water

   CEN-185 · 8. Musculoskeletal and Wound

9. A client's right face droops, and she cannot wrinkle her right forehead or close her right eye. Her arms and legs are strong. Which finding points to Bell's palsy rather than a stroke?

   • A.Her speech is slurred and she cannot find words
   • B.She also has weakness in her right arm
   • C.The forehead is weak along with the lower face
   • D.The forehead moves normally while the mouth droops
   Show answer

   C. The forehead is weak along with the lower face

   CEN-204 · 9. Head, Eye, Ear, Nose, Throat

10. An adult with large deep burns is getting lactated Ringer's by a burn formula. What hourly urine output shows the fluid rate is about right?

    • A.Any urine output at all
    • B.About 0.5 mL/kg per hour, or 30 to 50 mL an hour
    • C.At least 200 mL an hour, to flush the kidneys
    • D.About 5 mL/kg per hour
    Show answer

    B. About 0.5 mL/kg per hour, or 30 to 50 mL an hour

    CEN-224 · 10. Environment, Toxicology and Communicable Diseases

What the study guide does

• Short study rounds and flip cards.
• A practice test built like the real one: 75 questions, 50 to pass.
• Pass Meter: your chance of passing if you sat the test today, worked out from your own answers.
• An explanation for every answer.