Free CEN Practice Questions (With Rationales)

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See where you stand before you buy. These sample questions match the BCEN CEN
style — scenario-based, single best answer, with a rationale that explains the reasoning. Work
each one before reading the answer.

Unlock 2,100+ CEN practice questions across 14 full-length simulators — $19.99 lifetime →

How close are these to the real CEN?

The CEN is 175 questions (150 scored) over 3 hours, spanning every emergency presentation —
cardiovascular, respiratory, neurologic, trauma, medical, and more. The samples below reflect that.

Sample CEN questions

  1. A trauma patient has absent breath sounds on the right, tracheal deviation to the left,
    and hypotension. The priority intervention is:

    • A. Chest X-ray, then treat
    • B. Needle decompression of the right chest
    • C. Intubation
    • D. A fluid bolus only

    Answer: B. That’s a tension pneumothorax — a clinical diagnosis requiring
    immediate needle decompression (second intercostal space, midclavicular line), not waiting for imaging.

  2. A patient presents with stroke symptoms. The single most important piece of information
    for treatment decisions is:

    • A. The patient’s age
    • B. The time the patient was last known well
    • C. The blood pressure
    • D. The medication list

    Answer: B. “Last known well” drives eligibility for thrombolytics (generally within
    4.5 hours) and thrombectomy windows. Establishing it early is the priority in suspected stroke.

  3. A patient with a suspected STEMI is in the emergency department. The key time-based goal is:
    • A. Door-to-balloon within 90 minutes
    • B. Door-to-balloon within 4 hours
    • C. No time goal
    • D. Admit and monitor for 24 hours first

    Answer: A. The goal for primary PCI in STEMI is a door-to-balloon time of 90
    minutes or less. Rapid recognition and activation of the cath lab are central emergency-nursing skills.

  4. The antidote for a significant acetaminophen overdose is:
    • A. Naloxone
    • B. N-acetylcysteine (NAC)
    • C. Flumazenil
    • D. Activated charcoal only

    Answer: B. N-acetylcysteine is the antidote for acetaminophen toxicity, most
    effective when started early and guided by the Rumack-Matthew nomogram.

  5. Using the Emergency Severity Index (ESI), a patient who requires immediate life-saving
    intervention is triaged as:

    • A. ESI level 1
    • B. ESI level 3
    • C. ESI level 5
    • D. ESI level 4

    Answer: A. ESI level 1 is the highest acuity — a patient needing immediate
    life-saving intervention. Accurate triage is foundational emergency-nursing practice.

How did you do?

The CEN is known for a tough pass rate, so realistic practice matters. Our bank has 2,100+ CEN
questions across 14 timed simulators with rationales like these, plus a free sample test.

Unlock 2,100+ CEN practice questions across 14 full-length simulators — $19.99 lifetime →

Sources & references

The exam facts on this page are drawn from official certifying-body materials, reviewed 2026-06-18 by the DrCertifications exam-prep team (10+ years in exam preparation and publishing).