CONTENT LIST
The CEN exam contains, but is not limited to, the following items and may include the following primary disease states. This list is not intended to be all encompassing and other disease states could be tested.

Cardiovascular Tasks (21 items)

A. Cardiovascular
Initiate monitoring and interpret ECG rhythm strips
Prepare for cardiac invasive procedures (e.g., stents, angiography, angioplasty)
Initiate external cardiac pacing
Assess pacemaker/implanted cardioverter defibrillator (ICD) functioning
Perform cardiac defibrillation
Perform automated external defibrillation
Obtain 12 lead ECG
Obtain right-sided ECG
Auscultate heart sounds
Perform cardioversion
Assess for neck vein distention
Identify patients who are candidates for fibrinolytic (thrombolytic) agents
Assist with insertion of arterial line
Monitor arterial line pressure
Assist with open thoracotomy
Administer fibrinolytic (thrombolytic) infusions
Interpret injury, infarction, or ischemia in the 12 lead ECG
Interpret 12 lead ECG for other abnormalities
Use length based resuscitation tape
Assess characteristics of chest pain
Assist with pericardiocentesis
Identify signs and symptoms related to cardiovascular emergencies
Apply physiologic principles when caring for patients with cardiovascular emergencies
Administer cardiovascular pharmacologic agents

Primary Disease States include: aneurysm (aortic), angina, arrest (e.g., cardiac/pulmonary arrest, medications via ET tube, SIDS, but not hypothermic arrest), CHF – congestive heart failure/pulmonary edema, contusion, dissection (aortic), including other injuries to great vessels, dysrhythmias (e.g., PEA), endocarditis, hypertension, infarction, pericarditis, PVD – peripheral vascular disease (e.g., arterial, venous), tamponade, and thromboembolic disease.

Gastrointestinal Tasks (9 items)

A. Gastrointestinal
Assist with focused abdominal sonogram for trauma (FAST)
Assess emesis for blood
Assess stool for blood
Assess abdomen for rigidity, tenderness, masses, and distention
Insert and irrigate gastric tubes
Identify signs and symptoms related to gastrointestinal emergencies
Apply physiologic principles when caring for patients with gastrointestinal emergencies
Administer gastrointestinal pharmacologic agents

Primary Disease States include: acute abdomen (e.g., peritonitis), appendicitis, bleeding, cholecystitis (e.g., cholecystectomy, cholelithiasis), cirrhosis, colon injuries, diverticulitis, esophagitis (e.g., gastroesophageal reflux disorder), gastritis, gastroenteritis, hernia (i.e., hiatal; e.g., inguinal, umbilical) , IBD - inflammatory bowel disease (e.g., Crohn's, colitis), intussusception, liver injuries, obstructions (e.g., ploric stenosis, bowel obstruction, constipation, fecal impaction, colic), pancreatitis, splenic injuries, trauma – other (e.g., perforations), ulcers (e.g., helicobacter)

Genitourinary, Gynecology, Obstetrical Tasks (10 items)

A. Genitourinary
Assess for urethral injury
Assess for flank tenderness and ecchymoses
Inspect genitals for inflammation, swelling, or injury
Manage urinary catheters
Identify signs and symptoms related to genitourinary emergencies
Apply physiologic principles when caring for patients with genitourinary emergencies
Administer genitourinary pharmacologic agents

B. Gynecology
Prepare vaginal or cervical specimens
Assess characteristics of vaginal discharge/bleeding
Interview victim of sexual assault
Collect forensic evidence from sexual assault victims
Identify signs and symptoms related to gynecological emergencies
Apply physiologic principles when caring for patients with gynecological emergencies
Administer gynecological pharmacologic agents

C. Obstetrical
Perform neonatal resuscitation following emergency delivery
Position a patient in labor with a prolapsed cord
Assist with emergency delivery of fetus
Assess for presence of fetal heart tones
Identify signs and symptoms related to obstetrical emergencies
Apply physiologic principles when caring for patients with obstetrical emergencies
Administer obstetrical pharmacologic agents

Primary Disease States include: abortion (i.e., vaginal bleeding in early pregnancy), assault (i.e., sexual; including evidence collection), bartholin's cyst, bleeding/dysfunction (vaginal), discharge (e.g., vaginal; monilia, gardnerella, yeast), ectopic pregnancy, emergency delivery, epididymitis, foreign bodies, genital trauma, hemorrhage (postpartum), hyperemesis gravidarum, kidney trauma, newborn resuscitation, other genitourinary (e.g., prostatitis, benign prostatic hypertrophy, orchiitis, urinary retention, phimosis), ovarian cyst, PID (Pelvic inflammatory disease), preeclampsia, eclampsia, HELLP syndrome , placenta previa and abruptio (i.e., vaginal bleeding in late pregnancy), preterm labor, pyelonephritis, renal calculi, ruptured bladder, testicular torsion, trauma in pregnancy, and UTI (urinary tract infection).

Maxillofacial/Ocular Tasks (6 items)

A. Maxillofacial
Palpate face and neck for pain, edema, or crepitus
Assess facial symmetry and sensation
Evaluate balance/gait instability
Inspect posterior oropharynx
Irrigate ear canals
Assess for dental abnormalities
Assist with management of epistaxis
Assess gag reflex
Assess drainage from ears and nose for blood and cerebrospinal fluid
Prepare avulsed tooth for replantation (re-implantation)
Identify signs and symptoms related to maxillofacial emergencies
Apply physiologic principles when caring for patients with maxillofacial emergencies
Administer maxillofacial pharmacologic agents

B. Ocular
Perform visual acuity examination
Perform eye irrigation
Distinguish between minor and more serious ocular emergencies
Apply eye patch
Remove contact lenses
Identify signs and symptoms related to ocular emergencies
Apply physiologic principles when caring for patients with ocular emergencies
Administer ocular pharmacologic agents

Primary Disease States include: abrasion, ocular (i.e., corneal, snow blindness, flash burns), abscess (i.e., peritonsillar), burns (i.e., chemical), conjunctivitis, epiglottitis/croup Epistaxis, facial nerve disorders (e.g., Bell's palsy, trigeminal neuralgia, temporal arteritis), foreign body – ocular, ear, nose or throat, glaucoma, globe rupture, hyphema, intraoral/dental (e.g., tooth fracture, avulsion, Ludwig's angina), iritis, labyrinthitis, laceration (i.e., of the eyelid) , larynx fracture, mandibular fracture, maxillary fracture, Ménière's disease, nasal fracture, orbit fracture, otitis, retinal artery occlusion, retinal detachment, ruptured membrane (i.e., tympanic), sinusitis, soft tissue injury to the neck, TMJ (temporomandibular joint) dislocation, ulcerations/keratitis, upper throat conditions (e.g., pharyngitis, tonsillitis, laryngitis, diphtheria), and zygomatic fractures.

Neurological Tasks (15 items)

A. Neurological
Perform neurological assessment
Perform spinal stabilization/immobilization
Manage ventilation for a patient with suspected head injury
Assess and monitor Glasgow Coma Scale
Assess for symptoms of stroke
Administer stroke scale (e.g., NIHSS)
Assess seizure activity
Assess pronator drift
Assess for nuchal rigidity
Identify signs and symptoms related to neurological emergencies (e.g., spinal cord
assessment)
Apply physiologic principles when caring for patients with neurological emergencies
Administer neurologic pharmacologic agents
Administer high-dose steroids to patients with acute spinal cord injuries
Administer intravenous tissue plasminogen activator (t-PA) for ischemic stroke

Primary Disease States include: Alzheimer's disease/dementia, chronic neurological disorders (e.g., ALS, MS, Myasthenia Gravis, Parkinson’s), epidural hematoma, Guillain-Barré syndrome, head injury (e.g., concussion, diffuse axonal injury), headache, increased ICP (intracranial pressure), seizure disorders, shunt dysfunctions, skull fractures (e.g., linear, depressed, basilar), spinal cord injuries (e.g., autonomic dysreflexia), stroke/transient ischemic attack, subarachnoid hemorrhage/aneurysm rupture, subdural hematoma

Orthopedic/Wound Tasks (13 items)

A. Orthopedic/Wound
Assess orthopedic injuries
Teach crutch-walking techniques
Assess peripheral neurovascular status
Prepare and manage patients undergoing joint aspiration
Apply or assist with application of wound adhesive
Immobilize injured extremities
Irrigate wounds
Assess complications associated with casting or splinting
Assess soft tissue injury
Assist with reduction of orthopedic injury
Evaluate joint discomfort and range of motion
Apply local hot/cold therapy
Apply a traction splint
Preserve amputated extremity or digit for replantation
Identify signs and symptoms related to orthopedic emergencies
Apply physiologic principles when caring for patients with orthopedic emergencies
Administer pharmacologic agents for wounds and orthopedic emergencies

Primary Disease States include: abrasions, amputation, avulsions, bites/stings (localized reactions, e.g., aquatic organisms, bees, wasps, ticks, stinger removal), carpal tunnel syndrome, compartment syndrome, contusions, costochondritis, foreign bodies, fractures/dislocations, infections (e.g., related to wound, such as tattoos), inflammatory conditions (e.g., bursitis, tendinitis, arthritis, gout), joint effusion, lacerations, low back pain, missile injuries (e.g., paint gun; nail gun; shrapnel gun; gun weapons), Osteomyelitis, peripheral vascular trauma, puncture wounds (e.g., body piercing), strains/sprains (i.e., ligament and musculotendinous injuries).

Psychological/Social Tasks (6 items)

A. Psychological/Social
Provide a therapeutic environment for psychiatric patients
Assess for signs of maltreatment
Provide support to family after patient death
Assess the need for crisis intervention
Assess potential for suicide
Assess potential for and manage violent behavior
Identify signs and symptoms related to psychological and social emergencies
Apply physiologic principles when caring for patients with psychological and social
emergencies
Administer psychological pharmacologic agents

Primary Disease States include: adult abuse, anxiety/panic, bereavement, Bipolar disorder, child abuse, depression, eating disorders (e.g., anorexia, bulemia), elder abuse, end of life issues (e.g., DNR, family presence, withdrawal of support), homicidal/violent, pharmacology unique to psycho/social conditions, psychosis, SIDS (sudden infant death syndrome), situational crisis (e.g., job loss, divorce) and suicide.

Respiratory Tasks (18 items)

A. Respiratory
Assist with tracheal intubation
Suction airway
Ventilate patient using esophageal-tracheal combitube or laryngeal mask airway (LMA)
Evaluate the patient’s response to oxygen therapy
Interpret end-tidal CO2 results via capnography
Manage patients with surgical airway (e.g., cricothyrotomy, tracheostomy)
Perform a respiratory assessment
Measure peak expiratory flow rate
Assess endotracheal/tracheal tube placement
Initiate oxygen therapy
Care for patient on a mechanical ventilator
Assess need for needle thoracostomy
Perform arterial puncture for arterial blood gas sample
Use BiPAP or CPAP
Manage chest tube and drainage system
Interpret results of arterial blood gas studies
Assist with and/or administer a nebulizer treatment
Assess for pulsus paradoxus
Identify signs and symptoms related to respiratory emergencies
Apply physiologic principles when caring for patients with respiratory emergencies
Administer respiratory pharmacologic agents

Primary Disease States include: aspiration, asthma, bronchiolitis (e.g., RSV), bronchitis/upper respiratory infections, contusion (pulmonary), COPD (chronic obstructive pulmonary disease), flail chest, hemothorax, hyperventilation, inhalation injuries, obstruction (i.e., of airway), pleural effusion, pneumonia, pneumothorax (e.g., chest tubes), pulmonary edema, noncardiac, pulmonary embolus, respiratory distress syndrome, rib fractures, ruptured diaphragm, ruptured large airway, and tension pneumothorax (e.g., needle decompression)

Patient Care Management Tasks (9 items)

A. Patient Care Management
Teach family, patient, and/or significant other about care and follow-up
Assess knowledge of illness or injury severity
Teach pain management techniques
Perform primary and secondary surveys
Assess urgency of patient’s status to determine priority of care (triage)
Calculate and titrate intravenous drip medications
Assist with rapid sequence intubation
Care for patients receiving procedural sedation
Implement steps of a disaster plan
Assess and manage pain
Administer immunizations
Identify patients who are potential organ/tissue donors
Apply patient restraints
Provide community education
Ensure continuity of care for patients being transferred
Implement discharge planning
Provide care to patients admitted but held in the emergency department
Collect specimens for laboratory analysis
Identify population-specific patient needs (e.g., cultural, age-specific)
Prepare for a disaster response
Interpret laboratory results
Communicate with EMS personnel (e.g., pre-hospital)
Accompany patients during transport within the facility
Evaluate patient’s response to medications
Provide a safe environment
Accompany patient during transport between facilities
Manage cooling for neurologic preservation (e.g., following arrest or stroke)
Administer pharmacologic agents to patients with multisystem illness or injury

Primary Disease States include: discharge planning, organ donation, patient safety, pharmacology (i.e., related to more than one disease process or system), transfers and stabilization, and Triage and priority setting.

Substance Abuse/Toxicological/Environmental Tasks (10 items)

A. Substance Abuse/Toxicological/Environmental
Measure/normalize core body temperature
Manage the patient with a cold injury
Obtain history and implement nursing measures for treating hazardous materials exposure
Estimate severity of burn injury
Consult information resources about management of poisoning
Manage the patient with a burn injury
Manage the patient with drug abuse and/or overdose
Perform gastric emptying for toxic substance ingestion
Assess patient for signs of envenomation
Identify clusters of infectious patients (e.g., bioterrorism)
Identify signs and symptoms related to substance abuse, toxicological, and environmental
emergencies
Apply physiologic principles when caring for patients with substance abuse, toxicological, and
environmental emergencies
Administer pharmacologic agents for substance abuse, toxicological, and environmental
emergencies

Primary Disease States include: acetaminophen, acids and alkalis, amphetamines, benzodiazapines (e.g., Rohypnol), burns (e.g., thermal; electrical, chemical), carbon monoxide, cocaine, cold-related systemic emergencies, cyanide, delirium tremens (i.e., alcohol), detoxification (i.e., alcohol), drug abuse (e.g., cocaine abuse - peforated septum), drug toxicity (e.g., therapeutic, OTC, alternative therapies), envenomation emergencies (i.e., systemic, e.g., black widow, snakes, aquatic organisms), food poisoning (e.g., botulism, hemolytic uremic syndrome, e-coli, shigella, salmonella), frostbite, hallucinogens (e.g., GHB), heat-related systemic emergencies, heavy metal, infectious conditions from environment (i.e., systemic, e.g., rabies, Lyme disease, plague, cat scratch fever, Rocky Mountain Spotted fever, Hantavirus), iron, opiates, organophosphates, insecticides, petroleum distillates, plants, radiation/hazardous material exposure, salicylates, sedatives/hypnotics/barbiturates, submersion injury (e.g., fresh, saltwater, decompression), tricyclics, Withdrawal syndrome (e.g., from alcohol; Wernicke Korsakoff Syndrome)

Shock/Multi-System Tasks (11 items)

A. Shock/Multi-System
Administer banked blood products
Determine mechanism of injury
Perform rapid fluid resuscitation
Manage the patient in shock
Institute measures to control hemorrhage
Assess patients using the trauma score
Assess for signs of shock
Initiate/Manage intraosseous infusions
Perform autotransfusion
Identify signs and symptoms related to shock and multi-system emergencies
Apply physiologic principles when caring for patients with shock and multi-system emergencies
Administer pharmacologic agents for shock

Primary Disease States include: anaphylactic shock, cardiogenic shock, distributive shock, general characteristics of shock, hypovolemia (e.g., nondisease specific transfusions), multiple trauma, neurogenic/spinal shock, and septic shock.

Medical Emergency Tasks (15 items)

A. Medical Emergency
Identify and manage endocrine disorders
Assess risk of communicable disease transmission/exposure
Identify and manage immunologic/hematological disorders
Assist with lumbar puncture
Assess orthostatic vital signs
Initiate isolation precautions
Assess and manage fluid and electrolyte emergencies
Determine severity of allergic reactions
Assess patency of dialysis arteriovenous fistula
Administer pharmacologic agents for medical emergencies

Primary Disease States include: allergic reaction (e.g., diaper rash; poison ivy; latex sensitivity; dermatologic allergic response), blood dyscrasia (e.g., anemia, idiopathic thrombocytopenia purpura, polcythemia), childhood diseases (e.g., measles, mumps, pertussis, chicken pox), DIC (disseminated intravascular coagulation), electrolyte/fluid imbalance (e.g., non-shock dehydration, hypo-electrolytes, hyper-electrolytes) Endocrine (other, e.g., SIADH, Addisons), fever (e.g., febrile seizures), fibromyalgia, glucose abnormalities, hemophilia (e.g., Von Willebrands), hepatitis, HIV/AIDS, hyperglycemia (including diabetes mellitus, HHNK, DKA), hypoglycemia, immunocompromise/oncological (e.g., Hodgkins, chemotherapy, leukemia), Meningitis, Mononucleosis (i.e., infectious), parasite and fungal infestations (e.g., giardia, ringworm, tineas, tape worms, pin worms, lice, maggots, scabies), renal failure, Reye's Syndrome, sickle cell crisis, STD, TB (tuberculosis), and thyroid disorders (e.g., Graves, thyroid storm, myxedema coma).

Professional Issue Tasks (7 items)

A. Professional Issue
Delegate tasks to unlicensed assistive personnel
Participate in critical incident stress management
Ensure preservation of evidence for legal/forensic situations
Participate in ethical decision making
Evaluate patient’s capacity to refuse treatment
Verify that informed consent is obtained for invasive procedures
Protect patient confidentiality
Participate in quality improvement activities
Evaluate applicability of published research to practice
Notify authorities of reportable situations (e.g., abuse, communicable disease)
Document assessment, intervention, and evaluation of patient care
Participate in continuing education/inservice program