- What the CHPPN Credential Actually Is
- Who Qualifies to Sit for the Exam
- Exam Format: 150 Questions, 3 Hours, No Calculator
- The Five Domains and Where the Points Sit
- Fees, Testing Windows, and Application Deadlines
- Scoring, Pass Rates, and How to Read Them
- Practice Resources: What Each One Really Is
- A Domain-Weighted Study Sequence
- After You Pass: Four-Year Cycle and HPAR Renewal
- Frequently Asked Questions
- CHPPN is awarded by the Hospice and Palliative Credentialing Center (HPCC), and it stands for Certified Hospice and Palliative Pediatric Nurse.
- The exam has 150 multiple-choice questions, 135 scored and 15 unscored, over 3 hours with no calculator.
- Pediatric Diagnoses & Symptom Management is the largest domain, with 34 of the 135 scored items.
- Initial exam cost is US$305 for HPNA members and US$445 for nonmembers; join HPNA before applying to get member pricing.
What the CHPPN Credential Actually Is
The CHPPN is the specialty certification for registered nurses who care for children and families facing life-limiting illness. The Hospice and Palliative Credentialing Center (HPCC) awards it, while the Hospice and Palliative Nurses Association (HPNA) provides membership and preparation resources. The two organizations are related but distinct, and that distinction matters when you register: HPNA membership affects your fee, but the credential itself comes from HPCC.
If you are still orienting yourself to the acronym, our explainers on what CHPPN stands for and what CHPPN certification is cover the basics. This article focuses on the practical path: who qualifies, what the exam looks like, what it costs, and how to prepare for the content that is actually tested.
Pediatric palliative care is its own discipline. Adult hospice experience helps with symptom control and end-of-life communication, but the CHPPN exam is written around children: developmental stage, congenital and pediatric-onset diagnoses, weight-based dosing, sibling and parent needs, and the ethical landscape of decision-making when the patient is a minor. Nurses who work in pediatric hospice agencies, children's hospital palliative teams, pediatric home care, and perinatal or neonatal comfort-care programs are the typical candidates. For a view of where the credential is used, see CHPPN jobs.
Who Qualifies to Sit for the Exam
Eligibility has two components, and both must be documented:
- A current, unrestricted RN license in the United States or its territories, or the Canadian equivalent.
- Pediatric hospice and palliative nursing practice hours: either 500 hours in the preceding 12 months or 1,000 hours in the preceding 24 months.
The hours must be in the specialty itself. A nurse on a general pediatric floor who occasionally cares for a dying child should examine carefully whether those hours meet the standard. Our CHPPN requirements guide walks through eligibility scenarios in more detail, and it is worth reading before you commit to an application window.
Exam Format: 150 Questions, 3 Hours, No Calculator
Understanding the mechanics removes a layer of test-day anxiety. The CHPPN exam is delivered at PSI test centers or through live remote proctoring, so you can choose the setting that suits you.
| Feature | CHPPN Exam Detail |
|---|---|
| Total questions | 150 multiple-choice |
| Scored items | 135 |
| Unscored pretest items | 15 (indistinguishable from scored items) |
| Time allowed | 3 hours |
| Answer options | 4 per question, one best answer |
| Format | Nonadaptive (fixed form; difficulty does not change based on your answers) |
| Reference materials | Closed book; no calculators |
| Math support | Equianalgesic conversion table accompanies applicable questions |
| Delivery | PSI test center or live remote proctoring |
What "one best answer" means in this specialty
Many items present several options that are clinically defensible. Your task is to pick the best one for a child and family in a palliative context. A choice that is correct for an adult may be wrong here because of weight-based dosing, developmental appropriateness, or the need to include parents as partners in decisions. Read each stem for the child's age, diagnosis, setting, and goals of care before looking at the options.
The no-calculator rule and the conversion table
Calculators are prohibited, but the exam supplies an equianalgesic conversion table with applicable questions. That changes how you should practice opioid conversion: learn the logic of converting between agents and routes, practice reading a table accurately, and do the arithmetic by hand. Memorizing every conversion ratio is less valuable than being fast and careful with the supplied table. Because 15 items are unscored pretest questions you cannot identify, treat every question as if it counts.
The Five Domains and Where the Points Sit
The exam content is based on the 2026 candidate handbook (dated December 2025) and the 2023 job analysis. Official scored-item counts in domain order are 24, 24, 34, 31, and 22, totaling the 135 scored items.
| Domain | Scored Items |
|---|---|
| Domain 1: Patient Care - Assessment and Planning | 24 |
| Domain 2: Patient Care - Pain Management | 24 |
| Domain 3: Patient Care - Pediatric Diagnoses & Symptom Management | 34 |
| Domain 4: Family-Centered Support, Education, and Advocacy | 31 |
| Domain 5: Professional Practice | 22 |
Domains 3 and 4 together account for 65 of the 135 scored items, which is nearly half the exam. That is where preparation time pays off most. For a deeper breakdown, see the complete guide to all five CHPPN content areas.
Domain 1: Patient Care - Assessment and Planning
Expect questions about assessing children across developmental stages and building plans of care that reflect the child's condition and the family's goals.
- Developmentally appropriate assessment of pain, distress, and understanding of illness
- Recognizing prognostic indicators and transitions in the illness trajectory
- Coordinating the interdisciplinary plan, including school, community, and home resources
Domain 2: Patient Care - Pain Management
This is the domain where the no-calculator rule and the equianalgesic table matter most.
- Selecting pharmacologic and nonpharmacologic approaches for children of different ages
- Opioid conversion using the supplied table, with attention to route and weight-based considerations
- Recognizing and managing adverse effects, tolerance, and the difference between physical dependence and addiction
- Choosing the right pain assessment tool for a preverbal or cognitively impaired child
Domain 3: Patient Care - Pediatric Diagnoses & Symptom Management
The largest domain at 34 scored items. It rewards breadth across pediatric life-limiting conditions and fluency in symptom control.
- Common life-limiting pediatric diagnoses and how each typically progresses
- Management of dyspnea, seizures, secretions, nausea, constipation, agitation, and feeding difficulties
- Comfort-focused care for children with complex medical technology at home
- Recognizing the active dying process in children and responding to it
Domain 4: Family-Centered Support, Education, and Advocacy
At 31 scored items, this domain is far larger than many candidates expect. Children's palliative care is delivered to the whole family.
- Supporting parents, siblings, and extended family through anticipatory grief and bereavement
- Communicating with children about illness and death in developmentally appropriate language
- Advocating for the child's and family's wishes across care settings
- Cultural, spiritual, and values-based considerations in decision-making
Domain 5: Professional Practice
The smallest domain at 22 scored items, but it is often where well-prepared clinicians drop easy points.
- Ethical and legal considerations specific to minors, including consent, assent, and surrogate decision-making
- Scope of practice, interdisciplinary collaboration, and quality improvement
- Self-care and moral distress among clinicians who care for dying children
Fees, Testing Windows, and Application Deadlines
The initial examination costs US$305 for HPNA members and US$445 for nonmembers. Membership must precede the application to obtain member pricing, so join HPNA first and apply second. If you join after submitting, the nonmember fee stands. A full cost breakdown, including renewal, is in our CHPPN certification cost guide.
If your first attempt is unsuccessful, eligible candidates may purchase reTEST Assured for US$135 and use it in one of the next 3 testing windows.
| Testing Window | Application Period |
|---|---|
| March 1-31 | December 1-February 15 |
| June 1-30 | March 1-May 15 |
| September 1-30 | June 1-August 15 |
| December 1-31 | September 1-November 15 |
Notice that each application period closes about two weeks before the testing window opens, and the next application period begins the day the previous window ends in some cases. Work backward from your target window: confirm your hours, join HPNA, gather documentation, and submit well before the deadline. Our CHPPN exam dates guide covers scheduling in detail.
Scoring, Pass Rates, and How to Read Them
The passing scaled score is 500 on a 200-800 scale. This is not a raw percentage, and you should not assume that 500 equals answering a particular fraction of questions correctly. Scaled scoring adjusts for differences in form difficulty so that a passing score represents the same level of competence across exam versions. Details are in the CHPPN passing score guide.
Official 2025 pass rates were:
- Overall: 89.2% (33 of 37 attempts)
- First-time: 94.3% (33 of 35)
- Repeat: 0% (0 of 2)
Candidates are generally experienced pediatric palliative nurses who passed the eligibility screen, which likely contributes to the high first-time rate. That is an inference, not an official explanation. For more on interpreting the data and on perceived difficulty, see what the pass rate data shows and how hard the CHPPN exam is.
Practice Resources: What Each One Really Is
It helps to be precise about what you are practicing with. Three different things get called "practice tests," and they are not interchangeable:
| Resource | What It Is | How to Use It |
|---|---|---|
| HPNA official practice product | 50 questions, published through HPNA's certification prep offerings | Diagnostic check of your readiness and familiarity with item style |
| The certification exam | 150 questions, 135 scored, 3 hours | The real thing; your only attempt per application unless you retest |
| Independently written practice simulations | Question banks written by third parties, including our CHPPN practice tests | Volume practice and stamina building; not official exam content |
A 50-question official product cannot replicate a 150-question, 3-hour sitting, so build endurance with longer independent simulations as well. Equally, no third-party bank is the real exam, so use these tools to find weak areas rather than to predict your score. If you want a compact review sheet near exam day, our CHPPN cheat sheet condenses the must-know facts.
A Domain-Weighted Study Sequence
Because the domains are unevenly weighted, schedule your time to match. The sequence below assumes you are already working in pediatric hospice or palliative care and are filling gaps rather than learning from scratch. For a broader plan, see the CHPPN study guide.
Pain Management (Domain 2)
- Start here because opioid conversion is a hand-calculation skill that needs repetition
- Practice reading the equianalgesic table without a calculator
- Review pain assessment tools by developmental stage
Diagnoses and Symptom Management (Domain 3)
- Give this the most time; it carries 34 scored items
- Build a one-page summary per major pediatric life-limiting condition
- Drill dyspnea, seizures, secretions, and end-of-life symptom protocols
Family-Centered Support (Domain 4)
- Review anticipatory grief, sibling support, and communication across developmental stages
- Work through advocacy and culturally responsive care scenarios
Assessment, Planning, and Professional Practice (Domains 1 and 5)
- Review ethics and legal topics specific to minors, including assent versus consent
- Take a full-length timed simulation and review every miss by domain
One note on method: after each practice set, tag every missed question by domain and by reason (knowledge gap, misread stem, or second-guessing). Patterns in the reasons tell you more than the raw score does.
After You Pass: Four-Year Cycle and HPAR Renewal
Certification lasts 4 years. Renewal runs through the Hospice and Palliative Accrual for Recertification (HPAR) process in LearningBuilder, where you document practice hours and professional development rather than retaking the exam. HPAR practice eligibility mirrors the initial requirement: 500 hours in the preceding 12 months or 1,000 hours in the preceding 24 months.
| Renewal Timing | HPNA Member | Nonmember |
|---|---|---|
| Early | US$270 | US$410 |
| Standard | US$380 | US$520 |
| Reactivation | US$540 | US$680 |
The pattern is clear: renewing early is meaningfully cheaper than renewing late, and reactivating a lapsed credential costs the most. Start documenting practice hours and professional development from the day you pass so the HPAR submission is a matter of organizing records, not reconstructing four years of work.
For the career side of the equation, including earnings and whether the credential pays off, see the CHPPN salary guide and the analysis of whether CHPPN certification is worth it.
Frequently Asked Questions
The exam has 150 multiple-choice questions, of which 135 are scored and 15 are unscored pretest items. You have 3 hours, each question has 4 options with one best answer, and the format is nonadaptive.
The passing scaled score is 500 on a 200-800 scale. It is a scaled score, not a raw percentage, so it does not translate directly into a fixed number of correct answers.
The initial exam is US$305 for HPNA members and US$445 for nonmembers. You must be a member before you apply to receive member pricing. Eligible unsuccessful candidates can buy reTEST Assured for US$135 and use it in one of the next 3 testing windows.
You need a current unrestricted RN license in the United States or its territories, or the Canadian equivalent, plus either 500 hours of pediatric hospice/palliative nursing practice in the preceding 12 months or 1,000 hours in the preceding 24 months. License and practice documentation may be audited.
Testing windows run March 1-31, June 1-30, September 1-30, and December 1-31. Applications for those windows are open December 1-February 15, March 1-May 15, June 1-August 15, and September 1-November 15, respectively.
Certification lasts 4 years and is renewed through the Hospice and Palliative Accrual for Recertification (HPAR) process in LearningBuilder, using practice-hour and professional-development documentation. Early renewal costs US$270 for HPNA members and US$410 for nonmembers, and fees rise if you renew late or reactivate.
Ready to test your readiness against CHPPN-style questions? Try the practice simulations on the main CHPPN Exam Prep site, and revisit the CHPPN certification overview whenever you need a quick refresher on the credential's fundamentals.