by the International Association of Forensic Nurses (IAFN), the Sexual Assault
Nurse Examiner – Adult/Adolescent (SANE-A) exam certifies registered nurses so
they may treat adult and adolescent victims of sexual assault while using
forensics to gather information about the incident. The exam consists of five sections
or domains and has a four-hour time limit.


order to be eligible for the exam, the IAFN requires all interested individuals
to have:

  • completed
    an adult/adolescent sexual assault nurse examiner (SANE) nursing education
    comprised of at least 40 hours (in the form of coursework or contact hours)

    • OR 64 hours of an adult/adolescent/pediatric
      sexual assault nurse examiner education (in the form of coursework or contact
  • a
    license as either a registered nurse or a first-level general nurse depending
    on where you received your license
  • two
    years of practice as either a registered or first-level general nurse
  • completed
    a supervised position as a SANE
  • At
    least 300 hours of SANE-related work in the last three years      

You can register for the SANE-A exam on the IAFN website, or you can fill out and submit an application if you do not have internet access.

Should I Register for the Exam?

SANE-A Exam is offered each year in April and September. The exam can be taken
on any day of those months.

order to reserve your place, however, you will need to register several months
in advance. The deadline for the September exam is typically the first week in
July while April’s exam deadline is the first week in February.

your registration has been approved, you will receive a notification from the
testing vendor, Castle/Scranton, allowing you to select a specific date and testing
site for the SANE-A exam.

is on the Exam?

domain on the exam is weighted differently. The percentages below indicate the
amount of content per section.

Domain 1: Assessment and Documentation (32% of questions)

section evaluates your ability to initiate care for patients brought in after a
sexual assault. Topics covered include: obtaining the patient’s sexual assault
and health histories, evaluating if alcohol and/or drugs were involved in the
assault, and completing and recording comprehensive examination on the patient.

Domain 2: Evidence Collection (18% of questions)

the domain’s name suggests, this section focuses on collecting forensic
evidence. Topics include: how to properly preserve samples, how to identify
what should be considered evidence, and the proper procedures and tools for
collecting evidence.

Domain 3: Patient Management (28% of questions)

this section, your ability to care for and interact with patients will be
evaluated. Topics include: identifying necessary modes of communication (i.e.
having a sign language interpreter for a deaf patient), teaching the patient
about risks of pregnancy and/or sexually transmitted infections (STIs) and the
testing and preventative healthcare associated with treating them, as well as preparing
next steps, such as directing the patient to mental health services (i.e.
counseling) and/or putting together strategies that will ensure the patient’s
safety if the assailant was a significant other.

Domain 4: Legal Issues and the Judicial Process (10% of questions)

section assesses your knowledge of the legal elements associated with a SANE.
Topics include: Following any requirements associated with giving reports, as
well as appearing in court on either side of the argument as a witness and
giving testimony.

Domain 5: Professional Practice (12% of questions)

section covers professionalism that must be adhered to. This includes: safety
measures that must be enacted to ensure the SANE’s well-being throughout the examination,
utilizing informed consent and refusal so patients make informed decisions
regarding procedures, and incorporating principles such as autonomy or
beneficence to ensure the welfare of the patient.

What Does the Exam Cost?

You will need to pay one of the following application fees to register.


members: $275  Non-members: $425


IAFN members: $350  Non-members: $475

you register late (during the week after the deadline), you will have to pay a
fee of $150.

Do I
Need to Bring Anything to the Exam?

you arrive at the testing site, you will need to have the confirmation form
(also referred to as a notice) that Castle/Scranton will send after you
scheduled your exam. You will also need a form of identification with your
photo and signature, such as a passport or driver’s license. 

How is
the Exam Graded?

The exam uses a Pass/Fail system with a report detailing which domains to improve upon included with the score. Your results will arrive at least six weeks after you have taken the exam.

How Can I Prepare for the SANE-A Exam?

That’s a great question.  We’ve broken down the answer into three parts.

  1. Do yourself a favor and study.  Do not walk in unprepared. We have recommended prep materials below, but that only helps if you actually try.  Plus, studying is actually proven to be the best antidote to test anxiety.
  2. Take care of yourself.  Make sure you’re eating well, exercising, and sleeping.  All of these things are scientifically linked to brain performance.  If you take care of your body, you’ll be helping your grades.
  3. Get a study guide or set of flashcards.  Some people study better a certain way. Find your study strengths and make the most of them.  We’ve tried to make it easy for you by tracking down the best study guide and flashcard set for your exam. Below you’ll see links to both!

Study Guide



Last Updated: November 9, 2023