Free CNA Emergency Nursing Certification Exam Practice Questions

About CNA Emergency Nursing Certification Exam

CNA Emergency Nursing Certification Exam · CA

Key exam facts

Provider

Canadian Nurses Association (CNA) owns the national specialty certification examination. Blueprint developed collaboratively with YAS and Canadian emergency nurses. Meazure Learning provides testing/scoring services; remote proctoring uses ProctorU, and selected Canadian test centres offer in-person delivery.

Format

Computer-based multiple-choice examination, delivered through online proctoring at home or in-person test centres. Official blueprint: 65–75% independent and 25–35% case-based questions. The specialty blueprint describes approximately 165 questions; CNA's current CBT instructions give the program-wide 160–165 range.

Exam questions

Total questions: 160–165.

Time limit

Four hours (240 minutes) for answering examination questions; the separate platform tutorial does not affect exam timing.

Passing score

The numerical pass mark is not published. Each specialty exam committee establishes a criterion-referenced pass mark using a modified Angoff method, with statistical review. Results are reported as pass or unsuccessful.

Exam fee

Canadian dollars: initial application $588 for CNA members or $780 for non-members, plus an appointment fee of $85 for remote ProctorU or $110 for an in-person test centre, plus applicable taxes. Application fees include a $130 non-refundable administrative fee. Eligible unsuccessful candidates pay reduced rewrite application fees of $378/member or $500/non-member, valid for the next two calendar years; appointment fees are additional.

Topics covered

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

• Triage — Official range: 5–9% (Practice allocation: 7%)

  • Facilitates a safe and welcoming environment
  • Interprets data related to triage:
  • Subjective assessment • Presenting complaint • History (e.g., history of presenting illness or mechanism of injury [MOI], past medical history, allergies, immunization, current medications, substance use, recent travel, parents’ perceptions, events surrounding the injury or illness, prior treatment, diet/diapers, last oral intake, last menses) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Airway, breathing, circulation, disability, exposure/environment (ABCDE) • General physical appearance (e.g., skin colour, fontanelles, diaphoresis, work of breathing, drainage, discharge, odours) • Verbal and non-verbal cues (e.g., distress) • Other physical assessments related to presenting illness or injury (e.g., first order modifiers [e.g., vital signs], second order modifiers [e.g., capillary blood glucose], inspection, palpation, auscultation, weight)
  • Prioritizes and reassesses clients based on the principles of the Canadian Emergency Department Triage and Acuity Scale (2016):
  • Level 1, Resuscitation
  • Level 2, Emergent
  • Level 3, Urgent
  • Level 4, Less Urgent
  • Level 5, Non-Urgent
  • Initiates time sensitive protocols (e.g., acute stroke, acute coronary syndrome [ACS]/ST elevation myocardial infarction [STEMI], sepsis)
  • Initiates risk screening (e.g., influenza-like illness [ILI], communicable diseases, systemic inflammatory response syndrome [SIRS]/sepsis, violence, suicidal ideation, falls)
  • Implements appropriate protocols (e.g., isolation/decontamination procedures)
  • Recognizes and manages aggressive behaviours
  • Directs the client to the appropriate treatment space based on triage assessment/factors

• Respiratory — Official range: 6–10% (Practice allocation: 8%)

  • Interprets the following data related to the respiratory system:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, past medical history) • Manifestations (e.g., shortness of breath, cough, fatigue, dyspnea) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., airway patency, respiratory rate, depth, rhythm, tracheal position, chest wall symmetry, work of breathing/accessory muscle use, skin colour, capillary refill, non-verbal cues related to pain, diaphoresis, singed facial/nasal hair) • Palpation (e.g., subcutaneous emphysema, tenderness, crepitus, deformities, chest wall integrity, skin temperature) • Percussion • Auscultation (e.g., heart sounds, breath sounds) • Other physical assessments related to presenting illness or injury (e.g., vital signs, weight, Broselow tape)
  • Diagnostic results (e.g., blood gases, peak flow measurements, ECG, cultures, hematology, chemistry, end tidal CO 2, D-dimers, point of care ultrasound [POCUS], diagnostic imaging)
  • Selects nursing interventions to appropriately manage the following alterations in respiratory function:
  • partial or complete airway obstruction (e.g., tongue, epiglottitis, foreign bodies, angioedema, mucous plugs, croup)
  • blunt and penetrating chest trauma (e.g., rib fractures, flail chest, pulmonary contusion, pneumothorax, tension pneumothorax, hemothorax, protruding foreign body, open chest wound)
  • pulmonary embolism
  • inhalation injuries (e.g., gases, chemical, smoke, thermal, vaping)
  • asthma, status asthmaticus
  • chronic obstructive pulmonary disease (COPD)
  • pneumonia
  • bronchiolitis, acute bronchitis, respiratory syncytial virus (RSV)
  • pulmonary edema
  • respiratory arrest
  • Selects nursing interventions related to pharmacological agents in the respiratory system (e.g., oxygen, bronchodilators, steroids, thrombolytic agents, analgesics, reversal agents, sedatives, neuromuscular blocking agents)

• Cardiovascular — Official range: 7–11% (Practice allocation: 9%)

  • Interprets the following data related to the cardiovascular system:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, past medical history) • Manifestations, considering variations of age and sex (i.e., associated symptoms including nausea, shortness of breath, diaphoresis, syncope, cough, fatigue, fever) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., skin colour, diaphoresis, capillary refill, jugular venous distension, pulsating masses, non-verbal cues related to pain and anxiety, level of consciousness) • Palpation (e.g., quality of peripheral/central pulses, skin temperature) • Auscultation (e.g., heart sounds, breath sounds) • Other physical assessments related to presenting illness or injury (e.g., vital signs including mean arterial pressure [MAP] , bilateral and/or postural blood pressure, weight, Broselow tape, fontanelles)
  • Diagnostic results (e.g., cardiac markers, hematology, coagulation studies, chemistry, toxicology, lactate, ECG, cultures, cardiac monitoring, blood type and screen, point of care ultrasound [POCUS], diagnostic imaging)
  • Selects nursing interventions to appropriately manage the following alterations in cardiovascular function:
  • acute coronary syndrome (e.g., angina, ischemia, infarction)
  • cardiac dysrhythmias
  • blunt cardiac injury (i.e., cardiac contusion)
  • cardiogenic shock
  • hypovolemic shock
  • obstructive shock (e.g., cardiac tamponade, tension pneumothorax)
  • distributive shock (e.g., anaphylactic, septic, neurogenic)
  • heart failure
  • hypertensive urgency/emergency
  • aortic aneurysm (e.g., abdominal and thoracic)
  • pericarditis, myocarditis and endocarditis
  • cardiomyopathy
  • cardiac arrest
  • Selects nursing interventions related to pharmacological agents in the cardiovascular system (e.g., antiplatelet agents, oxygen, analgesia, nitrates, anticoagulants, anticoagulant reversal agents, thrombolytic/fibrinolytic agents, inotropes, antihypertensives, antiarrhythmic agents)

• Neurological — Official range: 5–9% (Practice allocation: 7%)

  • Interprets the following data related to the neurological system:
  • Subjective assessment • Presenting complaint • History (e.g., onset, timing, last seen normal, risk factors, past medical history, preceding events, trauma, substance use) • Manifestations (e.g., headache, fatigue, altered level of consciousness, memory loss, syncope, vertigo, motor and sensory deficits, nausea and/or vomiting, seizures, cognition, orientation, changes in speech pattern, descriptors [i.e., worst headache of my life, thunderclap]) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Behaviour (i.e., chronic or acute change; e.g., co-operative, combative, agitated, confused) • Inspection (e.g., speech and language assessment, battle sign, raccoon eyes, posturing, pupils, extraocular movements, rhinorrhea, otorrhea, gait, skull symmetry) • Palpation (e.g., skin temperature, spinal column tenderness) • Auscultation (e.g., heart sounds, breath sounds) • Other physical assessments related to presenting illness or injury (e.g., Glasgow Coma Scale, stroke assessment tool, blood glucose, limb movement and sensation, neurovascular status, vital signs, weight, Broselow tape, fontanelles)
  • Diagnostic results (e.g., cerebral spinal fluid, hematology, chemistry, coagulation studies, ECG, cultures, toxicology, diagnostic imaging)
  • Selects nursing interventions to appropriately manage the following alterations in neurological function:
  • seizure activity, status epilepticus, febrile seizures
  • meningitis/encephalitis
  • transient ischemic attack (TIA)/acute ischemic/hemorrhagic stroke
  • spinal cord/vertebral injury or anomalies (e.g., cauda equina)
  • spinal shock/neurogenic shock
  • increased intracranial pressure (e.g., space-occupying lesions, epidural, subdural, subarachnoid hemorrhage, cerebral edema, hydrocephalus)
  • head injury (e.g., blunt and penetrating injury, contusion, traumatic brain injury [i.e., concussion], diffuse axonal injury, abusive head trauma [i.e., shaken baby syndrome])
  • headaches (e.g., migraine, tension, sinus)
  • organic brain syndrome (e.g., dementia, Alzheimer’s disease)
  • acute confusional state (e.g., delirium)
  • progressive neurological disorders (e.g., ALS, Guillain-Barré syndrome)
  • Selects nursing interventions related to pharmacological agents in the neurological system (e.g., oxygen, anticonvulsants, diuretics, barbiturates, thrombolytics/fibrinolytics, analgesics, sedatives, neuromuscular blocking agents, reversal agents)

• Multi-System Trauma — Official range: 5–9% (Practice allocation: 7%)

  • Interprets the following data related to multi-system trauma:
  • Subjective assessment • Presenting complaint • History (e.g., pre-hospital care, pre-hospital information, client-generated information, precipitating events, past medical history) • Mechanism of injury (e.g., mechanical energy, thermal energy, chemical energy, electrical energy, radiant energy, oxygen deprivation) • Manifestations (e.g., life- and/or limb-threatening injuries, blood loss, loss of consciousness, paresthesia) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Primary survey (i.e., control catastrophic hemorrhage, airway with c-spine precautions, breathing, circulation, disability and expose/environmental controls [C-ABCDE]) • Secondary survey (i.e., full set of vital signs, family presence, resuscitation adjuncts, comfort measures, history, head-to-toe assessment, inspect posterior surfaces) • Other physical assessments related to presenting illness or injury (e.g., weight, Broselow tape, burn percentage and degree)
  • Diagnostic results appropriate for involved systems (e.g., blood type and screen, crossmatch, blood gases, hematology, chemistry, urinalysis, coagulation studies, toxicology, carboxyhaemoglobin, myoglobin, point of care ultrasound [POCUS], diagnostic imaging)
  • Selects nursing interventions to appropriately manage multi-system trauma resulting from the following mechanisms of injury:
  • burn trauma (i.e., thermal, chemical, radiant, electrical)
  • blast injuries (e.g., explosions)
  • blunt trauma (e.g., vehicular impact, falls, assaults)
  • penetrating trauma (e.g., knife, gunshot, impaled)
  • Selects nursing interventions related to pharmacological agents utilized in multi-system trauma (e.g., oxygen, tranexamic acid [TXA], anesthetics, analgesics, sedatives, paralytics, inotropes, antibiotics, immunizations, cyanide poisoning kit)

• Maxillofacial, Eye, Ear, Nose and Throat (EENT) — Official range: 2–6% (Practice allocation: 4%)

  • Interprets the following data related to the maxillofacial, EENT:
  • Subjective assessment • Presenting complaint • History (e.g., onset and risk factors, past medical history) • Manifestations (e.g., sensory changes, motor changes, tinnitus, dysphagia, changes in phonation, swelling, bleeding/drainage) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., skin colour, symmetry, skin integrity, motor movement, malocclusion, trismus, bleeding/drainage, foreign bodies, visual acuity) • Palpation (e.g., crepitus, deformities) • Other physical assessments related to presenting illness or injury (e.g., vital signs, ocular pH, weight, Broselow tape)
  • Diagnostic results (e.g., hematology, chemistry, coagulation studies, diagnostic imaging)
  • Selects nursing interventions associated with the following alterations in maxillofacial, EENT function:
  • foreign body
  • chemical exposure (e.g., ocular, oral pharyngeal)
  • ocular injuries/disease (e.g., corneal abrasion, conjunctivitis, iritis, retinal detachment, ruptured globe injury, hyphema, subconjunctival hemorrhage, acute glaucoma)
  • ear injuries/disease (e.g., Ménière’s disease, otitis externa/media, mastoiditis, ruptured tympanic membrane)
  • epistaxis (i.e., anterior or posterior)
  • oropharyngeal injuries, abscesses or inflammation (e.g., epiglottitis, angioedema, peritonsillar abscesses, retropharyngeal abscesses, stomatitis, pharyngitis, tonsillitis, post-tonsillectomy bleed, pharyngeal trauma)
  • fractures (e.g., LeFort I, II, III, orbital, nasal, oral)
  • maxillofacial injuries/disease (e.g., dislocation/temporomandibular joint syndrome, trigeminal neuralgia, Bell’s palsy, dental avulsion)
  • Selects nursing interventions related to pharmacological agents utilized in maxillofacial and EENT conditions (e.g., oxygen, topical anesthetics, antibiotics, analgesics, antipyretics, immunizations)

• Gastrointestinal — Official range: 5–9% (Practice allocation: 7%)

  • Interprets the following data related to the gastrointestinal system:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, past medical history, recent travel) • Manifestations (e.g., nausea, vomiting, food/fluid tolerance, diarrhea, constipation, bleeding, melena, coffee-ground emesis) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (e.g., mild, moderate, severe) • Inspection (e.g., skin colour, diaphoresis, posturing, splinting abdomen, mucous membranes, production of tears, bruising [e.g., Cullen’s, Grey-Turner’s and seatbelt signs]) • Auscultation (e.g., bowel sounds, aortic bruits) • Percussion • Palpation (e.g., masses, guarding, skin turgor, pain, rebound tenderness, Murphy’s and McBurney’s signs) • Other physical assessments related to presenting illness or injury (e.g., vital signs, weight, Broselow tape, fontanelles)
  • Diagnostic results (e.g., hematology, chemistry, toxicology, coagulation studies, blood type and screen, crossmatch, ECG, pregnancy test, urinalysis, osmolality, cultures, occult blood, liver function tests, point of care ultrasound [POCUS], diagnostic imaging)
  • Selects nursing interventions associated with the following alterations in the gastrointestinal system:
  • hernia/ischemic/infarcted bowel or obstructed bowel (e.g., partial or complete, paralytic ileus)
  • peritonitis/non-traumatic perforation
  • GI bleed (e.g., esophageal varices, ulcer, upper/lower bleed)
  • pancreatitis, hepatic encephalopathy
  • foreign bodies
  • cholecystitis/cholelithiasis
  • appendicitis
  • pyloric stenosis, intussusception
  • ulcerative colitis, Crohn’s disease, gastroenteritis, diverticulitis, gastritis, esophagitis
  • abdominal injury (e.g., splenic rupture, liver laceration, perforated viscous, diaphragmatic rupture)
  • anorectal conditions (e.g., fistula, hemorrhoids, trauma, abscess/cysts, prolapse)
  • constipation/diarrhea
  • GI alterations including medical devices (e.g., ostomy, feeding tubes, drains)
  • Selects nursing interventions related to pharmacological agents in the gastrointestinal system (e.g., oxygen, antibiotics, analgesics, sedatives, antiemetics, enemas, laxatives, H2 antagonists, contrast medications)

• Genitourinary — Official range: 2–6% (Practice allocation: 4%)

  • Interprets the following data related to the genitourinary system:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, past medical history, sexual history, gender identity) • Manifestations (e.g., nausea, vomiting, hematuria, dysuria, discharge) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (e.g., mild, moderate, severe) • Inspection (e.g., skin colour, hematuria, perineal swelling, diaphoresis) • Palpation • Percussion (e.g., bladder, costovertebral angle) • Other physical assessments related to presenting illness or injury (e.g., vital signs, bladder scan, weight, Broselow tape, fontanelles)
  • Diagnostic results (e.g., urinalysis, hematology, chemistry, coagulation studies, urea, creatinine, cultures, sexually transmitted infection [STI] testing, diagnostic imaging)
  • Selects nursing interventions associated with the following alterations in genitourinary system:
  • infection (e.g., urinary tract infection [UTI], glomerulonephritis, pyelonephritis, prostatitis, cystitis, epididymitis, orchitis)
  • renal colic
  • renal failure (e.g., acute, chronic, dialysis dependant)
  • sexually transmitted infection (STI)
  • priapism, testicular torsion, phimosis, paraphimosis
  • urethral/genital injury
  • urinary retention or obstruction, foreign bodies
  • Selects nursing interventions related to pharmacological agents in the genitourinary system (e.g., diuretics, analgesics, antibiotics, topical agents, antipyretics, antivirals, antiemetics)

• Obstetrical Client and Female Reproductive System — Official range: 2–4% (Practice allocation: 3%)

  • Interprets the following data related to the obstetrical client and female reproductive system:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, last normal menstrual period, past medical history, gynecological surgeries, STIs, contraception, substance use history) Obstetrical (e.g., expected date of birth, gravida/para/abortions, frequency and duration of contractions, multiple gestation, meconium in fluid, recent drug ingestion, recent abdominal trauma, rupture of membranes, prenatal care, previous cesarean birth, Streptococcus B) • Manifestations (e.g., discharge, bleeding, nausea, vomiting, changes in fetal movement, headache, blurred vision) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (e.g., mild, moderate, severe) • Inspection (e.g., skin colour, diaphoresis, splinting of abdomen, vaginal bleeding, vaginal discharge) • Palpation (e.g., fundal height, fetal movement, contractions, breasts) • Auscultation (e.g., fetal heart rate) • Other physical assessments related to presenting illness or injury (e.g., vital signs, weight)
  • Diagnostic results (e.g., pregnancy test, urine protein and glucose, Rh factor, blood type and screen, hematology, chemistry, coagulation studies, STI testing, toxicology, liver function test, point of care ultrasound [POCUS], diagnostic imaging)
  • Selects nursing interventions associated with the following alterations in the obstetrical client and female reproductive system:
  • ectopic pregnancy, ovarian torsion, ovarian cyst
  • abortion (i.e., spontaneous, threatened, therapeutic, septic, missed)
  • pregnancy-induced hypertension, preeclampsia/eclampsia, hemolysis, elevated liver enzymes and low platelets (HELLP syndrome), hyperemesis gravidarum, gestational diabetes
  • abruptio placentae, placenta previa (e.g., amniotic fluid embolism, DIC), uterine rupture, delivery, retained products
  • foreign bodies, perineal trauma
  • infection (e.g., mastitis, perineum, STI, pelvic inflammatory disease, toxic shock syndrome)
  • postpartum hemorrhage
  • emergency childbirth (e.g., unexpected delivery, precipitous delivery, cord prolapse, meconium- stained amniotic fluid, breech birth)
  • postpartum mental health (e.g., psychosis, depression, blues)
  • Selects nursing intervention related to pharmacological agents in the obstetrical client and female reproductive system (e.g., magnesium sulfate, anticonvulsants, methotrexate, oxytocin, analgesics, antibiotics, antiemetics, Rh immune globulin, emergency contraception)

• Musculoskeletal/Integumentary — Official range: 4–8% (Practice allocation: 6%)

  • Interprets the following data related to the musculoskeletal/integumentary system:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, mechanism of injury, past medical history) • Manifestations (e.g., sensation, movement, skin temperature, swelling) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., skin colour, symmetry, skin integrity, rash, burns, bruising, contusion, deformity, neurovascular assessment, range of motion, inability to use limb/weight bear, blisters) • Palpation (e.g., temperature, pallor, pulses, paralysis, paresthesia) • Other physical assessments (e.g., vital signs, weight, Broselow tape)
  • Diagnostic results (e.g., myoglobin, uric acid, CK, hematology, chemistry, coagulation studies, sedimentation rate, C-reactive protein, point of care ultrasound [POCUS], diagnostic imaging)
  • Selects nursing interventions associated with the following alterations in the musculoskeletal/integumentary system:
  • compartment syndrome, neurovascular compromise
  • penetrating injury
  • soft tissue injuries (e.g., sprains and strains)
  • acute or exacerbated chronic inflammatory states (e.g., osteoarthritis, gout)
  • infectious processes (e.g., necrotizing fasciitis, septic joint, osteomyelitis, abscesses, cellulitis)
  • skin disorders (e.g., psoriasis, hives, erythema, rashes, ulcerations, eczema)
  • fractures, dislocations, amputations, crush injuries
  • degloving, avulsions, lacerations, bites, abrasions, foreign body
  • Selects nursing interventions related to pharmacological agents in the musculoskeletal/integumentary system (e.g., oxygen, antibiotics, analgesics, sedatives, local and topical anesthetic, antihistamines, steroids, immunizations, antiemetics, antivirals, antifungals)

• Environmental Emergencies — Official range: 2–4% (Practice allocation: 3%)

  • Interprets the following data related to environmental emergencies:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, type/length of exposure, past medical history, exposure source/route, interventions at scene) • Manifestations (e.g., shortness of breath, cramps, syncope, fatigue, dizziness, confusion, agitation, cough, fever) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., skin colour, capillary refill, rash, mucous membranes, skin integrity, diaphoresis, level of consciousness, work of breathing) • Palpation (e.g., pallor, pulses, paralysis, paresthesia, temperature, skin turgor) • Auscultation (e.g., heart sounds, breath sounds) • Other physical assessments related to presenting illness or injury (e.g., vital signs, Glasgow Coma Scale, weight, Broselow tape)
  • Diagnostic results (e.g., hematology, chemistry, coagulation, creatinine, urea, toxicology, myoglobin, blood gases, lactate, urinalysis, ECG, diagnostic imaging)
  • Selects nursing interventions associated with the following to appropriately manage environmental injuries:
  • heat syndromes (e.g., heat syncope, heat exhaustion, heat stroke)
  • cold syndromes (e.g., frostbite, hypothermia)
  • submersion injuries (i.e., near drowning)
  • high altitude illness, decompression illness
  • bites and stings from humans, animals, arthropods (e.g., insects, spiders, ticks)
  • noxious exposure (e.g., carbon monoxide)
  • Selects nursing interventions related to pharmacological agents for environmental injuries (e.g., oxygen, antivenom kits, antipyretics, analgesics, immunizations, rabies vaccine, antibiotics, diuretics, epinephrine, antihistamine)

• Immunology/Hematology/Endocrinology — Official range: 4–8% (Practice allocation: 6%)

  • Interprets the following data related to the immunologic/hematological/endocrine systems:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, past medical history) • Manifestations (e.g., diaphoretic, nausea, vomiting, fatigue, mental status changes, altered level of consciousness, swelling, weight loss/gain, shortness of breath, increased thirst, fever) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., diaphoresis, respiratory rate, work of breathing, mucous membranes) • Palpation (e.g., skin turgor, capillary refill) • Auscultation (e.g., heart sounds, breath sounds) • Other physical assessments (e.g., vital signs, odour, weight, Broselow tape)
  • Diagnostic results (e.g., urine/serum ketones, blood glucose, serum calcium/magnesium/phosphate, blood gases, hematology, chemistry, coagulation studies, blood type and screen, crossmatch, thyroid studies, osmolality, anion gap, diagnostic imaging)
  • Selects nursing interventions associated with the following alterations in immunologic/hematological/endocrine functions:
  • hyperglycemic emergencies (e.g., diabetic ketoacidosis [DKA], hyperglycemic hyperosmolar nonketotic state [HHNS])
  • hypoglycemia
  • thyroid emergencies (e.g., thyroid storm, myxedema coma)
  • adrenal gland emergencies (e.g., Addisonian crisis, Cushing’s syndrome, syndrome of inappropriate antidiuretic hormone [SIADH], diabetes insipidus [DI])
  • blood dyscrasias (e.g., DIC, sickle cell crisis, hemophilia)
  • oncological emergencies (e.g., spinal cord compression syndrome, malignant effusions [pleural, pericardial, peritoneal], hypercalcemia)
  • immunocompromised client (e.g., HIV/AIDS, febrile neutropenia, asplenia)
  • Selects nursing interventions related to pharmacological agents for the immunologic/hematological/endocrine systems (e.g., oxygen, hypoglycemic agent, insulin, electrolytes, dextrose, anticoagulants, analgesics, glucocorticoids, diuretics, thyroid therapy, hormones, anticoagulant reversal agents)

• Relationship Violence/Sexual Assault — Official range: 2–6% (Practice allocation: 4%)

  • Interprets the following data related to relationship violence/sexual assault:
  • Subjective assessment • Presenting complaint • History (e.g., onset, type [physical, verbal, financial, emotional, sexual], past medical history, mechanism of injury, safety of self and children, suicidal ideation, history of depression, substance use, post-traumatic stress) • Manifestations (e.g., non-specific complaints of pain, delays in presentations, partner answering for client, frequency of injuries, flat affect, poor eye contact) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., lacerations, bruises in multiple stages of healing, injuries inconsistent with history or stages of development, bite marks, burns) • Palpation • Auscultation (e.g., heart sounds, breath sounds) • Other physical assessments related to presenting illness or injury (e.g., vital signs, Glasgow Coma Scale, weight, Broselow tape)
  • Diagnostic results (e.g., hematology, chemistry, toxicology, coagulation studies, pregnancy test, diagnostic imaging)
  • Selects nursing interventions associated with the following:
  • child abuse (e.g., neglect, physical, verbal, emotional, sexual)
  • intimate partner violence (e.g., physical, verbal, financial, emotional, sexual)
  • older/dependant adult abuse (e.g., neglect, physical, verbal, financial, emotional, sexual)
  • human trafficking
  • bullying/workplace violence
  • sexual assault
  • Selects nursing interventions related to pharmacological agents for relationship violence and sexual assault clients (e.g., antibiotics, emergency contraception, HIV/hepatitis prophylaxis, immunizations, antiemetics, analgesics, anxiolytics)

• Toxicology/Substance Use — Official range: 3–5% (Practice allocation: 4%)

  • Interprets the following data related to toxicological emergencies:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, exposure, time, amount, route, intentional versus unintentional, past medical history, substance use) • Manifestations (e.g., altered levels of consciousness, shortness of breath, cough, fatigue, vomiting, fever, seizures) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Behaviours (i.e., chronic or acute change; e.g., agitation, bizarre behaviour) • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., toxidrome indicators [e.g., pupils, skin diaphoresis, skin temperature], work of breathing, skin colour, evidence of poisoning, capillary refill) • Palpation (e.g., skin temperature) • Auscultation (e.g., heart sounds, breath sounds) • Other physical assessments related to presenting illness or injury (e.g., vital signs, Glasgow Coma Scale, weight, Broselow tape)
  • Diagnostic results (e.g., serum and urine toxicology screens, ECG, cardiac monitoring, blood glucose, blood gases, osmolality, anion gap, chemistry, hematology, coagulation studies, liver function tests [LFTs], renal function, carboxyhaemoglobin, methemoglobin, diagnostic imaging)
  • Selects nursing interventions associated with the following toxicological emergencies:
  • toxic exposure (e.g., environmental, chemical)
  • poisonings and substance use (e.g., alcohol, tobacco, cannabinoids, recreational drugs, prescription drugs, predatorial drugs [e.g., Rohypnol, GHB], inhalants [e.g., glue, cleaners, hairspray])
  • substance withdrawal (e.g., alcohol, opioids, benzodiazepines)
  • Selects nursing interventions related to pharmacological agents for toxicological emergencies (e.g., charcoal, antidotes [e.g., naloxone, vitamin K], sodium bicarbonate, thiamine, N-acetylcysteine, dextrose, antiemetics, sedatives, anticonvulsants, osmotic diuretic, paralytics)

• Mental Health — Official range: 4–8% (Practice allocation: 6%)

  • Interprets the following data related to mental health issues including:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, suicidal ideation, homicidal ideation, past medical history, substance use, medication history and compliance) • Manifestations (e.g., mood, affect, agitation, behaviour, cognition and thought processes, changes in speech pattern, changes in gait) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., hygiene/personal appearance, skin colour, motor restlessness) • Mental status (e.g., orientation, changes in behaviour or thought process, hallucinations, delusions, changes in perception, judgment) • Other physical assessments related to presenting illness or injury (e.g., vital signs, Glasgow Coma Scale, weight)
  • Diagnostic results (e.g., chemistry, hematology, toxicology, urinalysis, osmolality, therapeutic drug levels, thyroid function, blood glucose, diagnostic imaging)
  • Selects nursing interventions associated with the following alterations in mental health:
  • mood, anxiety and stress disorders (e.g., depression, bipolar, panic attacks, anxiety states, post- traumatic stress, situational crisis)
  • psychotic disorders (e.g., schizophrenia, postpartum psychosis)
  • eating disorders (e.g., anorexia, bulimia)
  • pediatric behavioural emergencies
  • personality disorders (e.g., borderline, antisocial)
  • Selects nursing interventions related to pharmacological agents for mental health (e.g., sedatives, antipsychotics, anxiolytics, antidepressants, benztropine)

• Infectious Disease — Official range: 3–7% (Practice allocation: 5%)

  • Interprets the following data related to infectious diseases:
  • Subjective assessment • Presenting complaint • History (e.g., onset, risk factors, exposure, recent travel, past medical history, immunization status) • Manifestations (e.g., rash, altered level of consciousness, shortness of breath, cough, fatigue, vomiting, agitation, seizures, fever, diarrhea) • Pain (e.g., provoking factors, quality, region and radiation, symptoms and severity, timing and treatment [PQRST], age- and language-appropriate scale)
  • Objective assessment • Degree of distress (i.e., mild, moderate, severe) • Inspection (e.g., rash, petechiae, purpura, work of breathing, skin colour, diaphoresis, capillary refill) • Palpation (e.g., skin temperature) • Auscultation (e.g., heart sounds, breath sounds) • Other physical assessments related to presenting illness or injury (e.g., vital signs, Glasgow Coma Scale, weight, Broselow tape)
  • Diagnostic results (e.g., cerebral spinal fluid, blood glucose, blood gases, chemistry, hematology, coagulation studies, liver function tests [LFTs], creatinine, cultures, parasitology, virology, diagnostic imaging)
  • Selects nursing interventions associated with the following infectious diseases and processes:
  • emerging infectious diseases (e.g., Ebola, vaccine-preventable diseases
  • antibiotic-resistant organisms (e.g., MRSA, VRE)
  • communicable infections (e.g., influenza-like illness [ILI], TB)
  • non-communicable infections (e.g., Lyme disease, malaria)
  • Selects nursing interventions related to pharmacological agents for infectious diseases (e.g., antibiotics, antivirals, antifungals, antimalarials, antipyretics, immunizations)

• Psychosocial — Official range: 1–3% (Practice allocation: 2%)

  • Interprets data related to the client’s psychosocial needs including experience with the health crisis, coping skills, perceived vulnerability, response to the health-care system, current and past experiences (e.g., intergenerational trauma, adverse childhood experiences), support systems, and cultural, religious and spiritual values and beliefs
  • Selects nursing interventions related to the psychosocial management of grief/loss, pain, anxiety, stress, distress and uncertainty (e.g., therapeutic communication, complementary therapies, family support/involvement, relaxation techniques, spiritual and cultural needs)

• Discharge Planning/Client Education — Official range: 1–3% (Practice allocation: 2%)

  • Identifies priorities for discharge planning and client education considering the following: • time • resources • environment • referrals
  • Selects nursing interventions for discharge planning and client education considering: • community resources • cognitive functioning (age/growth and development appropriate) • support systems • socioeconomic status • physical limitations, safety • cultural/spiritual beliefs • coping strategies • health promotion and injury prevention • language and literacy levels • available resources (e.g., verbal and written instructions, demonstrations) • readiness for change (e.g., substance use)

• Professional Practice Issues/Legal and Ethical Issues — Official range: 1–3% (Practice allocation: 2%)

  • Follows legislation, standards of practice, code of ethics, policies and procedures as related to the practice of nursing: • Mental Health Act • informed consent, capacity assessment • advance directives (e.g., power of attorney, living will, substitute decision maker, goals of care/code status) • medical assistance in dying • medical examiner/coroner • police requests, preservation and collection of evidence • mandatory reporting (e.g., gunshot wounds, notifiable diseases, abuse) • organ/tissue donation • family presence during resuscitation/invasive procedures • unidentified client • self-identifies any ethical and moral biases

• Psychological Safety — Official range: 1–3% (Practice allocation: 2%)

  • Recognizes that work stress, workload and work–life issues (e.g., violence, traumatic events, overcapacity, compassion fatigue, shift work) can have a negative impact on their physical and mental health (e.g., musculoskeletal injuries, substance use, depression, anxiety, PTSD, decreased job satisfaction)
  • Participates in activities to mitigate harm, such as: • building resilience (e.g., self-care, mindfulness, self-compassion) • health and wellness activities (e.g., physical activity, sleep hygiene) • reflective practice • critical incident stress management/debriefing • respectful collaboration/supportive environment • reporting unsafe working situations • education on management of aggressive/violent behaviours

• Disaster/Emergency Preparedness — Official range: 1–3% (Practice allocation: 2%)

  • Recognizes situations when the number of incoming clients exceeds the resources of the Emergency Department during the following: • mass casualty incident • chemical, biological, radiological, nuclear and explosive (CBRNE) exposure • natural disaster (e.g., flood, fire, earthquake, tornado, hurricane, blizzard) • pandemic • emergency codes (e.g., bomb threat, active shooter, hostage situation)
  • Selects nursing interventions associated with disaster preparedness:
  • communicates and collaborates with the team to activate the emergency plan (e.g., code orange, pandemic response)
  • ensures safety of the environment (e.g., chemical, biological, radiological, nuclear and explosive [CBRNE] exposure)
  • triages multiple casualties according to disaster triage principles (i.e., greatest good for the greatest number)

How to prepare

Work through the topics, read the explanation after each answer, and revisit the areas where you miss questions. Use the official outline and reference materials below to guide your study.

These independent practice questions are not actual exam items and do not guarantee a passing result.

Frequently asked questions

Official sources and references

• CNA blueprints

  Exam Competencies & Blueprints

• CNA Emergency Nursing Exam Blueprint and Specialty Competencies

  pp. 4–5, Table 1: Competency Sampling

• CNA Emergency Nursing Exam Blueprint and Specialty Competencies

  p. 6, Table 2

• CNA Emergency Nursing Exam Blueprint and Specialty Competencies

  p. 9, Summary chart, Client Age

• CNA Emergency Nursing Exam Blueprint and Specialty Competencies

  p. 5, Question Presentation

• Canadian Nurses Association — general

  General Competencies

• CNA Medical Assistance in Dying Core Competencies

  p. 1, Assumptions

• CNA Cultural Competence and Safety Competencies

  p. 1, Assumptions

• CNA Substance Use Competencies

  p. 1, Assumptions

• CNA Emergency Nursing Exam Blueprint and Specialty Competencies

  p. 5, Structural Variables

• CNA cbt

  CBT exam tips

• Canadian Nurses Association — results

  Exam Results and Retesting

• Canadian Nurses Association — fees

  Initial Exam Fees, complete fee table and footnotes

• Canadian Nurses Association — emergency

  p. 7, Conclusions

• Canadian Nurses Association — cbt

  Before exam day

• Canadian Nurses Association — delivery

  Platform Tutorial

Confirm current exam arrangements with the exam provider.