CNA Emergency Nursing (ENC(C)) study guide
CNA Emergency Nursing (ENC(C)) · Work through your exam, one topic at a time.
The CNA Emergency Nursing Certification - commonly written ENC(C) - is a specialty credential for registered nurses who work in emergency departments, urgent care, trauma bays, and prehospital-adjacent settings. It signals that a nurse has moved beyond general practice and can reason through undifferentiated, time-critical presentations: the patient who arrives without a diagnosis and may deteriorate within minutes. The CNA Emergency Nursing (ENC(C)) study guide has 9 sections and about 3,211 words.
01Assessment, Triage, and Clinical Decision-Making
Triage is a sorting decision, not a diagnosis. The candidate must know the difference between acuity scales (five-level systems such as ESI or CTAS, three-level military-style systems) and the principle behind all of them: physiologic instability and resource need outrank the chief complaint as stated by the patient.
398 words, about 2 min02Resuscitation and Cardiovascular Emergencies
The candidate must know current basic and advanced life support sequence: recognition, activation, early compressions, defibrillation for shockable rhythms, and advanced airway and drug administration without interrupting compressions. Key numbers to internalize: compression rate 100–120 per minute, depth at least 5 cm in adults, full recoil, minimal interruptions, and a compression-to-ventilation ratio of 30:2 for one- or two-rescuer adult BLS without an advanced airway.
352 words, about 2 min03Respiratory and Thoracic Emergencies
Candidates must separate oxygenation failure (hypoxemia) from ventilation failure (hypercapnia) and recognize when each needs escalation. Know the signs of impending airway loss: stridor, drooling, muffled voice, tripod positioning, and silent chest in severe asthma.
354 words, about 2 min04Neurological and Neurosurgical Emergencies
The candidate must know the stroke chain: recognition with a validated screen, last-known-well time, glucose check, noncontrast imaging, and reperfusion decision within the window. Know that thrombolysis eligibility depends on time, imaging, blood pressure, anticoagulation, and bleeding risk, and that blood glucose and seizure are the great mimics.
353 words, about 2 min05Trauma and Musculoskeletal Injuries
Candidates must connect mechanism of injury to expected injuries and recognize that exsanguinating hemorrhage is the leading early cause of preventable trauma death. Control external bleeding with direct pressure and tourniquets when indicated, and remember that a tourniquet is not a last resort for life-threatening extremity bleeding.
345 words, about 2 min06Medical, Gastrointestinal, and Genitourinary Emergencies
Candidates must recognize the presentations of diabetic ketoacidosis, hyperosmolar hyperglycemic state, hypoglycemia, thyroid storm, myxedema coma, and adrenal crisis. DKA management priorities are fluids, insulin after confirming potassium is not critically low, and potassium replacement; total body potassium is depleted even when serum potassium looks normal or high.
357 words, about 2 min07Obstetric, Gynecologic, and Pediatric Emergencies
Candidates must know that in a pregnant patient beyond about 20 weeks, the uterus compresses the inferior vena cava when supine; displace the uterus leftward and treat the mother first, because maternal resuscitation is fetal resuscitation. Recognize pregnancy-induced hypertension and preeclampsia with severe features (headache, visual changes, right upper quadrant pain, rising blood pressure) and eclampsia (seizures), treated with magnesium sulfate and blood pressure control.
373 words, about 2 min08Toxicological, Environmental, and Psychiatric Emergencies
Candidates must recognize the classic toxidromes: anticholinergic (dry, flushed, hot, dilated pupils, delirium, urinary retention), cholinergic (salivation, lacrimation, urination, diarrhea, bronchospasm, bradycardia), sympathomimetic (tachycardia, hypertension, agitation, dilated pupils, sweating), opioid (pinpoint pupils, respiratory depression, decreased consciousness), and sedative-hypnotic (decreased consciousness with normal pupils and respirations). Know key antidotes: naloxone for opioids, acetylcysteine for acetaminophen, sodium bicarbonate for salicylates and tricyclic cardiotoxicity, calcium for hydrofluoric acid and calcium channel blocker overdose, glucagon and high-dose insulin for beta blocker overdose, and hydroxocobalamin for cyanide.
350 words, about 2 min09Emergency Department Operations, Safety, and Professional Practice
Candidates must understand the operational levers of an emergency department: triage design, fast-track and vertical flow models, bed management, boarding of admitted patients, and ambulance diversion. Crowding is measured by input, throughput, and output; the most effective intervention is usually moving admitted patients out of the department, not speeding up triage.
329 words, about 2 min