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Exam Overview
The CPEN exam is a computer-based test delivered by PSI, either at a testing center or by live remote proctoring. Every question is multiple choice with four answer choices, and there is no essay or simulation section.
Key Facts About the CPEN Exam
| Feature | Details |
|---|---|
| Full name | Certified Pediatric Emergency Nurse (CPEN) |
| Certifying body | Board of Certification for Emergency Nursing (BCEN) |
| Questions | 175 multiple-choice questions |
| Scored questions | 150 (the other 25 are unscored pretest questions) |
| Answer choices | Four per question |
| Time | 3 hours (180 minutes) |
| Passing point | 110 of the 150 scored questions correct |
| Delivery | PSI testing center or live remote proctoring |
| Certification period | 4 years |
What the Test Covers
Test Design by Domain
| Domain | Title | Scored Items | Approximate Share |
|---|---|---|---|
| 1 | Triage Process | 20 | 13% |
| 2 | Assessment | 25 | 17% |
| 3 | System-Focused Emergencies | 56 | 37% |
| 4 | Special Considerations | 25 | 17% |
| 5 | Multi-System Considerations | 12 | 8% |
| 6 | Professional Issues | 12 | 8% |
System-Focused Emergencies, which covers ten body systems including trauma to each, is the largest domain by far. Triage and assessment together make up nearly a third of the scored questions, so the skills you use in the first minutes with every child carry a lot of weight.
What Each Domain Includes
| Domain | Main Topics |
|---|---|
| 1 Triage Process | Pediatric Assessment Triangle, acuity and resource-based triage, immunization and isolation screening, behavioral risk, gender identity, culture and language; decontamination and mass casualty incidents |
| 2 Assessment | Primary and secondary survey, developmental milestones, children with special health care needs, caregiver perception and family dynamics; developmentally appropriate pain assessment and treatment |
| 3 System-Focused Emergencies | Respiratory, cardiovascular, neurological, gastrointestinal, genitourinary and obstetric, maxillofacial, ocular and ENT, musculoskeletal, integumentary, hematologic and oncologic, and endocrine and metabolic emergencies, including trauma |
| 4 Special Considerations | Neonatal emergencies, behavioral health, maltreatment and human trafficking, environmental emergencies, toxicology and communicable diseases |
| 5 Multi-System Considerations | Submersion, sepsis, anaphylaxis, post-resuscitation care and procedural sedation |
| 6 Professional Issues | Consent, forensic evidence, EMTALA, HIPAA and mandatory reporting, risk management, workplace violence, culture of safety, delegation, discharge, palliative care, injury prevention and transfers |
How the Test Is Scored
The CPEN is a pass/fail exam. To pass, you must answer at least 110 of the 150 scored questions correctly, which is about 73% of the scored items. The passing point is not set on a curve; it was established by pediatric emergency nursing experts working with the testing company and approved by the BCEN Board. The 25 pretest questions are mixed in with the scored questions and cannot be identified, so give every question your best effort. Only correct answers count, with no penalty for a wrong answer, so never leave a question blank.
What Kinds of Questions to Expect
- Triage scenarios that ask which child should be seen first or which acuity level fits
- Scenarios that ask for the highest-priority or first nursing action
- Vital signs, weights, laboratory values and assessment findings to interpret by age
- Questions about the most likely cause of a child's presentation, or what the child is at highest risk for
- Findings that require intervention, and the best way to evaluate whether a treatment worked
- Pain assessment tool selection and developmentally appropriate care
- Legal, safety and family-centered care questions such as consent, mandatory reporting and discharge teaching
- Calculations such as weight-based drug doses, fluid boluses and burn fluids
Score Reports
- BCEN reports a pass or fail result, along with feedback on your performance in each domain; the Candidate Handbook explains when and how you receive it.
- If you do not pass, use the domain feedback to decide where to focus before you retest.
- You may retest after a 90-day waiting period, at a reduced fee within one year of your first attempt; check the current policy in the Candidate Handbook before you reapply.
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