Journal of Emergency Nursing
Volume 32, Issue 3 , Pages 209-211, June 2006

Who's afraid of the CEN exam?

Staff Nurse, WellStar Kennestone Hospital, Marietta, Ga

Article Outline

 

Dear Editor:

Many experienced ED nurses haven't taken the Certified Emergency Nurse (CEN) exam because they believe they won't pass. Most of them are wrong. I have taken and passed the exam 3 times. The first time was within a year of my graduation from college. Although the Board of Certification for Emergency Nursing (BCEN) recommends 2 years of ED experience before taking the exam, I wanted to take it and needed the $2 per hour additional pay that my hospital provided for specialty certification.

I prepared for that first exam by reviewing ACLS and by reading an emergency nursing textbook. The exam was given on paper, so I had to fill in the “bubbles” on my answer sheet. Despite the horror stories I had heard from nurses who had taken the CCRN exam, I found the CEN exam to be easier than expected! After waiting weeks for my results to arrive in the mail, I was happy to find a passing score.

Four years later I took the exam again to renew my certification. I was working in a pediatric emergency department at that time, so I reviewed emergency adult care from a textbook. I found the exam more challenging than before, but still not unreasonable or difficult, and I did pass.

The year after that exam, I had my first child and decided to stay home for a while. Later, when my second child had started school, I was ready to return to the emergency department. Because I had been out of nursing for more than 5 years, I had to complete an “RN Re-entry” program to regain my nursing license.

Once I was back to work in a new emergency department, I started to look around for some CENs to ask about the current exam and was disappointed to find very, very few. Even though this hospital offers a $1000-per-year bonus for certification, the “dreaded exam” scared off most who were considering taking it. When I asked some emergency nurses why they hadn't taken the exam, they looked at me as if I was crazy, while others made excuses such as, “I'm not a good test taker.” Most, however, echoed one who said, “I've heard horror stories about the CEN!”

I thought to myself, “Wow, they've made it more difficult now. I'll really have to study. Maybe I should work a while before I try it.” About a year later, having spent little to no time studying, I decided to register to take the exam and then study. My plan worked: Having a deadline motivated me!

I reviewed ACLS, a CEN review video I had purchased, a tiny booklet on traumatic brain injury, a CEN practice test on floppy disc from the ENA, and my notes from my hospital's ED orientation classes. I went to a nearby testing center and took the computerized CEN exam for the first time. What a nice way to test and in a relaxing atmosphere! I found the exam to be very straightforward—nothing tricky, obscure, or complicated. I had no idea at all about 3 questions and felt uncertain about 5 to 10 others. Upon completing the test, I notified the attendant and she printed out my results: 139 out of 150 correct! That is the best part about the computerized testing—no waiting for results!

If you are not computer literate, you still can complete this exam easily. The attendant will demonstrate how to operate the computer and will provide sample questions (if you need them) for practice. A person who has never used any computer at all can learn how to take the computerized CEN exam in 5 to 10 minutes.

The ENA includes test-taking skills in their CEN Review classes. Here are a few tips.

1.Read the question and then STOP! Do not look at the answer choices. Think of the answer first, and then look for it among the choices. If your answer isn't one of the choices, re-read the question (and scenario if there is one) to make sure you read it correctly, and then choose an answer. This method eliminates any confusion that can come from looking at similar answers and builds your confidence while taking the test.

2.Most people who claim to be “terrible test takers” will add that they “read too much into the question.” First of all, anyone who made it through nursing school and passed a state board exam cannot truly be a poor test taker!

3.Considering the context, especially with scenario questions, is key to providing the correct answer. Be sure to answer for that patient at that phase of his or her care. For example, as you read a scenario, tell yourself: “Okay, the ABCs have been taken care of, now they're assessing her pain level.” Remember, “assessment, planning, implementation and evaluation,” as well as the “A, B, C, D, E, F's” of trauma assessment. Some texts also refer to “primary survey” (ABCs) and “secondary survey.”

4.If you are somewhat baffled by a question, ask yourself, “What are they making sure that I know?” For example:
•ABCs always come first

•Maintain C-spine immobilization while caring for the ABCs of a trauma patient

•Consider ectopic pregnancy for any woman of child-bearing age with abdominal pain

•Signs and symptoms of acute myocardial infarction can be subtle and atypical in women and diabetics

•A worst-case scenario in middle-aged and older patients with severe abdominal pain is aortic dissection

•Consider equipment failure if a patient appears to be declining and the physical examination doesn't indicate a problem

•Know the signs and symptoms of such conditions as increased intercranial pressure, tension pneumothorax, and sepsis

•Be able to recognize injuries or patterns suggesting abuse


5.If a question really stumps you, jot down the number so that you can go back to it if the answer comes to you later. Alternatively, the computerized version of the exam offers you the ability to “bookmark” a question at the bottom of the screen for later review. There also is a hand key tool on the bottom left corner of the screen that will take you to the next unanswered question or bookmarked question.Make sure that you are well rested before the exam. If you think you will have trouble sleeping, schedule your exam for 1:00 in the afternoon and set your alarm for 11:00 am. That way, if you don't fall asleep until 3:00 am, you will still be rested. Scheduling your own exam time truly is a luxury!

7.Go very easy on the caffeine before the exam. If your mind is racing through the questions, you are more likely to miss crucial details and differences in answers.

8.The ENA provides some references to help you prepare for the CEN exam (www.ena.org/bcen/cen/). I would highly recommend the online practice tests. It's inexpensive and can demonstrate your areas of strengths and weaknesses. As long as you do not score your practice exam, you can take the exam as many times as you like during a 90-day period. You do have the opportunity to score individual questions, for which you receive a rationale and feedback on the correct answers.

Be sure to review ACLS and keep up with current trends in emergency nursing. If you read the Journal of Emergency Nursing, you will know what they are. Recent issues are mass-casualty incidents, EMTALA, HIPPA, family presence during resuscitation, and domestic abuse screening.

I find it sad that smart, savvy, tenured nurses aren't being recognized and rewarded for their mastery of emergency nursing because they believe certification is out of their reach. I feel certain that quite a few of my coworkers could take the test tomorrow and pass it because they use this body of knowledge every day.

The CEN exam isn't easy, but it is fair, direct, and relevant, and that's what makes a good certification exam.

 Submit all Letters to the Editor online at http://ees.elsevier.com/jen/

PII: S0099-1767(06)00130-9

doi:10.1016/j.jen.2006.03.006

Journal of Emergency Nursing
Volume 32, Issue 3 , Pages 209-211, June 2006

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