The Certified Flight Registered Nurse (CFRN) exam is offered by the Board of Certification for Emergency Nursing (BCEN). It measures the specialized knowledge and clinical judgment needed to provide safe nursing care during air medical transport.
QUESTIONS
175
SCORED
150
TIME LIMIT
3 Hours
PASSING SCORE
102 / 150
BCEN introduced a revised CFRN content outline and passing standard on August 31, 2026. Make sure your study materials reflect the current exam rather than the previous blueprint.
What Is the CFRN Certification?
The CFRN credential is a specialty nursing certification for registered nurses who demonstrate knowledge related to flight transport nursing.
The examination covers the clinical care of critically ill and injured patients as well as the unique operational, physiological, safety, and environmental considerations involved in air medical transport.
BCEN’s CFRN certification program is accredited by the Accreditation Board for Specialty Nursing Certification (ABSNC).
Who Is Eligible for the CFRN Exam?
To take the CFRN exam, you must hold a current, unencumbered Registered Nurse license in the United States, a U.S. territory, Canada, or Australia.
A nursing credential from another country may also qualify if it is determined to be equivalent to a U.S. RN license through BCEN’s international credential-evaluation process.
BCEN recommends approximately two years of experience as a flight nurse before taking the CFRN exam, but this experience recommendation is not an eligibility requirement.
What’s on the CFRN Exam?
The current CFRN exam contains 175 questions. Of those, 150 are scored and 25 are unscored pretest questions being evaluated for possible use on future exams.
You will not know which questions are unscored, so answer every question as though it counts.
The 150 scored questions are divided among five content areas:
1. General Principles of Flight Transport Nursing Practice — 30 Questions
This domain focuses on the conditions and responsibilities unique to flight transport nursing.
- Transport physiology and physiologic stressors
- Scene safety
- Landing-zone operations
- Disaster management
- EMTALA
- Radio communication and patient handoff
- Air medical resource management
- Just Culture
- Navigation
- Survival principles
- Transport vehicle emergencies
- Pre-mission preparation
- Patient assessment and preparation for transport
2. Resuscitation Principles — 40 Questions
Resuscitation Principles is the largest individual domain on the current examination.
- Airway assessment
- Pre-intubation optimization
- Airway management and complications
- Pharmacologically assisted intubation
- Post-intubation management
- Invasive and noninvasive mechanical ventilation
- Fluid resuscitation
- Blood products
- Vasopressors
- Hypovolemic shock
- Obstructive shock
- Distributive shock
- Cardiogenic shock
3. Trauma — 30 Questions
Trauma questions cover assessment and management of a wide range of traumatic injuries.
- Mechanism of injury
- Hemostasis
- Traumatic brain injury
- Spinal cord injury
- Facial and neck trauma
- Thoracic trauma
- Abdominal trauma
- Pelvic and extremity injuries
- Crush injuries
- Chemical, electrical, and thermal burns
- Spinal motion restriction
4. Medical Emergencies — 35 Questions
This domain covers critical medical conditions that may require air transport.
- Seizures and neurologic emergencies
- Stroke
- Intracranial pressure management
- Acute coronary syndrome
- Heart failure
- Dysrhythmias
- Aortic emergencies
- Mechanical circulatory support
- Pulmonary emergencies
- Gastrointestinal emergencies
- Diabetic and endocrine emergencies
- Sepsis
- Hematologic disorders
- Renal emergencies
- Environmental emergencies
- Toxicology
5. Special Populations — 15 Questions
These questions address patient populations whose assessment, treatment, pharmacology, or transport needs may require additional considerations.
- Obstetric patients
- Neonatal and pediatric patients
- Geriatric patients
- Bariatric patients
The revised blueprint places the most questions in Resuscitation Principles, with 40 of the 150 scored items. Medical Emergencies is next with 35 questions.
How Is the CFRN Exam Scored?
Your score is based on the number of scored examination questions you answer correctly. Incorrect and unanswered questions do not subtract points from your score.
For exams administered on or after August 31, 2026, you must answer at least 102 of the 150 scored questions correctly to pass.
The passing standard is not determined by comparing your performance with other candidates, so the examination is not graded on a curve.
Older CFRN resources may list passing standards of 108 or 109 correct answers. Those figures do not reflect the current exam administered under the revised 2026 content outline.
How Much Does the CFRN Exam Cost?
STANDARD FEE
$380
ASTNA MEMBER
$285
MILITARY
$195
BCEN also offers optional Test Assurance for an additional fee. Test Assurance provides an included second attempt if an eligible first-time candidate does not pass the initial examination.
A discounted retest application is available for qualifying candidates who retest within one year of their initial examination date.
How Do You Register?
CFRN applications are submitted through your BCEN account. Once your application is processed and payment is complete, you can schedule your examination through PSI.
- Confirm your eligibility. Make sure your RN license satisfies current BCEN requirements.
- Create or sign in to your BCEN account.
- Submit the CFRN examination application and payment.
- Receive your exam eligibility information.
- Schedule your exam with PSI within your 90-day testing window.
Where Can You Take the CFRN Exam?
BCEN currently offers the CFRN exam through PSI testing centers worldwide and through Live Remote Proctoring.
Remote testing allows eligible candidates to take the exam from an approved location using a computer that meets PSI’s technical and testing-environment requirements.
Whether you test remotely or at a testing center, the first and last name on your examination registration must match your valid identification.
What Happens on Test Day?
You have three hours to complete the examination.
If you test at a PSI testing center, plan to arrive approximately 30 minutes before your scheduled appointment. Live remote candidates should also begin the check-in process according to the instructions provided with their appointment.
Your score report is available immediately after completing the examination. Testing-center candidates receive their results from the test administrator, while remote candidates see the result on screen. BCEN also sends the score report by email.
Can You Retake the CFRN Exam?
Yes. If you do not pass, you must wait 90 days before testing again.
BCEN does not impose an overall limit on the number of times an unsuccessful candidate may take the examination. Each new attempt requires another application and applicable examination fee unless an eligible attempt is covered through Test Assurance.
How to Prepare for the CFRN Exam
Begin with the current BCEN examination content outline. Because the blueprint changed in August 2026, older CFRN study materials may devote the wrong amount of attention to individual content areas.
CFRN Study Checklist
- Use the current 2026 BCEN CFRN content outline.
- Give substantial study time to airway management, ventilation, perfusion, and shock.
- Review trauma assessment and management across all major body systems.
- Review neurologic, cardiac, pulmonary, endocrine, renal, environmental, and toxicologic emergencies.
- Know transport physiology and the effects of the flight environment on patients and crew.
- Review scene safety, landing-zone operations, navigation, survival, and vehicle emergencies.
- Review obstetric, neonatal, pediatric, geriatric, and bariatric transport considerations.
- Practice applying knowledge to patient-care scenarios rather than relying only on memorization.
- Complete timed practice so you are comfortable answering 175 questions within three hours.
CFRN Practice Questions
Practice questions can help you identify weaknesses in both transport-specific knowledge and critical-care concepts.
When reviewing a missed question, determine whether the problem was a knowledge gap, difficulty interpreting the clinical scenario, or a failure to select the safest and most appropriate intervention.
How Long Is CFRN Certification Valid?
CFRN certification is valid for four years.
BCEN currently provides two primary recertification options:
- Recertification by continuing education: Complete 100 qualifying contact hours during the four-year certification period. At least 75 hours must be clinical content relevant to the specialty.
- Recertification by exam: Retake and pass the current CFRN certification examination.
For CE recertification applications submitted before January 1, 2027, at least 50 of the 100 contact hours must come from an accredited source. BCEN has announced that this requirement increases to 75 accredited hours for applications submitted on or after January 1, 2027.
CFRN Exam Resources
Free CFRN Practice Test — Practice CFRN material and review detailed answer explanations.
CFRN Study Guide — Find additional content review and practice questions for the CFRN examination.
BCEN CFRN Study and Preparation Resources — Access the current content outline, official sample questions, reference list, and preparation checklist.
BCEN Candidate Handbook — Review current eligibility, scheduling, exam-day, scoring, and certification policies.