- The Credential at a Glance
- Exam Format Numbers to Memorize
- Domain Blueprint: Where the Scored Items Sit
- Eligibility and Practice Hours
- Fees, Windows, and Application Deadlines
- Scoring and Pass-Rate Facts
- Clinical Must-Knows by Domain
- Practice Resources: Know What You Are Using
- Renewal Through HPAR
- A Domain-Ordered Prep Sequence
- Frequently Asked Questions
- The exam has 150 multiple-choice questions, but only 135 are scored; 15 are unscored pretest items.
- Passing means a scaled score of 500 on a 200-800 scale, not a raw percentage.
- Pediatric Diagnoses & Symptom Management is the largest domain, with 34 scored items.
- Member pricing ($305 versus $445) requires HPNA membership before you submit the application.
The Credential at a Glance
The Certified Hospice and Palliative Pediatric Nurse (CHPPN) credential is awarded by the Hospice and Palliative Credentialing Center (HPCC). The Hospice and Palliative Nurses Association (HPNA) is the membership organization that supplies preparation resources and the member discount on exam fees. Keep those two bodies straight: HPCC certifies, HPNA supports. If you need a broader orientation before diving into numbers, start with What Is CHPPN Certification? and then return to this sheet.
This page is built as a one-sitting review. Everything below is drawn from the 2026 candidate handbook (dated December 2025) and the 2023 job analysis that underpins the exam content. If a number is not here, treat it as something to verify on the HPCC site rather than guess.
Exam Format Numbers to Memorize
Test-day mechanics are the easiest points to lock down, and they shape how you pace yourself. Here is the format in one table.
| Element | CHPPN Detail |
|---|---|
| Total questions | 150 multiple-choice |
| Scored items | 135 |
| Unscored pretest items | 15 |
| Time allowed | 3 hours |
| Answer options | 4 per question, one best answer |
| Format | Nonadaptive (fixed, not computer-adaptive) |
| Delivery | PSI test centers or live remote proctoring |
| Reference materials | Closed book; calculators prohibited |
| Conversion aid | Equianalgesic conversion table accompanies applicable questions |
What "one best answer" means in practice
Pediatric palliative scenarios rarely have a clean right-versus-wrong split. Two options may both be reasonable nursing actions; the exam wants the one that is safest, most family-centered, or first in the sequence. Read the stem for qualifiers such as "initial," "priority," or "most appropriate," and eliminate options that skip assessment or bypass the family.
Why you cannot identify the unscored items
The 15 pretest items are mixed in with scored ones and look identical. Do not spend extra minutes trying to guess which are unscored. Treat every question as if it counts. With 150 items in 3 hours, you have roughly 72 seconds per question on average, which is comfortable for most stems but tight if you linger on dosing scenarios.
Domain Blueprint: Where the Scored Items Sit
The official scored-item counts, in domain order, are 24, 24, 34, 31, and 22. Those add up to the 135 scored questions. The table below maps each count to its domain name.
| Domain | Scored Items |
|---|---|
| 1. Patient Care - Assessment and Planning | 24 |
| 2. Patient Care - Pain Management | 24 |
| 3. Patient Care - Pediatric Diagnoses & Symptom Management | 34 |
| 4. Family-Centered Support, Education, and Advocacy | 31 |
| 5. Professional Practice | 22 |
Two observations matter for strategy. First, Domain 3 is the single largest block at 34 items, so weak spots in pediatric diagnoses and symptom control cost the most. Second, Domain 4 at 31 items is nearly as large, which is a reminder that this exam weights family-centered care heavily rather than treating it as soft content. For a deeper walk through each area, see the complete guide to all 5 CHPPN content areas.
Key Takeaway
Domains 3 and 4 together account for 65 of 135 scored items. If your time is limited, those two areas deliver nearly half the exam.
Eligibility and Practice Hours
You must hold a current, unrestricted RN license in the United States or its territories, or the Canadian equivalent. On top of the license, you need pediatric hospice/palliative nursing practice hours in one of two forms:
- 500 hours in the preceding 12 months, or
- 1,000 hours in the preceding 24 months.
Both the license and the practice documentation may be audited, so keep records of your employer, unit, and hours rather than relying on memory. The hours must be pediatric hospice or palliative nursing practice specifically; general pediatric or adult palliative hours do not substitute. Our CHPPN requirements guide covers how to qualify if you are close to the threshold, and CHPPN training explains ways to build relevant experience.
Fees, Windows, and Application Deadlines
Exam fees
| Item | HPNA Member | Nonmember |
|---|---|---|
| Initial examination | $305 | $445 |
Membership must be in place before you submit the application to receive the member price. Joining afterward does not retroactively lower the fee. If you are comparing the full cost picture, the CHPPN certification cost breakdown lays out the pieces.
reTEST Assured
Eligible unsuccessful initial candidates may purchase reTEST Assured for $135 and use it in one of the next 3 testing windows. The word "eligible" matters: confirm your status in the handbook before assuming it applies to you.
Testing windows and matching application periods
| 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 the pattern: each application period closes on the 15th, roughly two weeks before the following window opens. Missing the close date pushes you to the next quarter. For scheduling advice, see CHPPN exam dates, testing windows, and deadlines.
Scoring and Pass-Rate Facts
The passing scaled score is 500 on a 200-800 scale. This is a scaled score, not a raw percentage, so you cannot convert it into "I need X of 135 correct." Scaling accounts for differences in form difficulty, which is why HPCC does not publish a fixed percent-correct cutoff. Details are in the CHPPN passing score guide.
Official 2025 statistics are shown below.
| Group | Pass Rate | Attempts |
|---|---|---|
| Overall | 89.2% | 33 of 37 |
| First-time | 94.3% | 33 of 35 |
| Repeat | 0% | 0 of 2 |
Clinical Must-Knows by Domain
The blueprint names five domains. The points below are the kinds of competencies a pediatric hospice and palliative nurse is expected to demonstrate within each. Use them as a recall checklist, and confirm depth against the handbook content outline.
Domain 1: Patient Care - Assessment and Planning (24 items)
Comprehensive assessment of a child within the context of family, development, and illness trajectory.
- Developmentally appropriate assessment tools and communication by age
- Goals-of-care discussions and how they evolve as illness progresses
- Interdisciplinary care planning, including school, child life, and community services
- Recognizing changes in condition and adjusting the plan of care
Domain 2: Patient Care - Pain Management (24 items)
Pain assessment and pharmacologic and nonpharmacologic management in children.
- Choosing validated pain scales suited to age and cognitive ability, including nonverbal children
- Opioid selection, titration, route changes, and use of the equianalgesic table
- Managing opioid adverse effects proactively, such as constipation
- Adjuvant medications and integrative approaches
- Weight-based reasoning and safe dosing principles
Domain 3: Pediatric Diagnoses & Symptom Management (34 items)
The largest domain. It tests whether you can recognize pediatric life-limiting conditions and manage the symptoms that accompany them.
- Common life-limiting diagnoses in children and their typical trajectories
- Symptom control: dyspnea, nausea, seizures, agitation, secretions, and feeding concerns
- Neonatal and perinatal palliative considerations
- Recognizing signs of approaching death and managing the final hours
- Distinguishing symptoms that are expected from those needing urgent intervention
Domain 4: Family-Centered Support, Education, and Advocacy (31 items)
The family, including siblings, is part of the unit of care.
- Anticipatory guidance for parents and caregivers
- Sibling support and age-appropriate explanations of illness and death
- Grief and bereavement support before and after the death
- Cultural, spiritual, and family-values considerations in decision making
- Advocating for the child's and family's wishes across the care team
Domain 5: Professional Practice (22 items)
Ethics, legal considerations, and sustaining your own practice.
- Ethical reasoning, including assent versus consent in minors
- Advance care planning documentation in pediatric settings
- Scope of practice, collaboration, and quality improvement
- Self-care and moral distress, which this specialty makes unavoidable
Practice Resources: Know What You Are Using
Candidates often blur three different things, and that confusion can distort how ready you feel.
- The certification examination: 150 questions, 3 hours, 135 scored.
- HPNA's official practice product: contains 50 questions. It is a sampler, not a full-length rehearsal.
- Independently written practice simulations: produced by third parties, including our own CHPPN practice test. These are useful for stamina and exposure to question styles, but they are not official exam items.
Finishing a 50-question official product tells you something about your baseline but does not test whether you can hold focus across 150 questions. Plan at least some full-length sessions to build that endurance. For a complete preparation plan, the CHPPN study guide is the companion to this cheat sheet.
Renewal Through HPAR
Certification lasts 4 years. Renewal runs through the Hospice and Palliative Accrual for Recertification (HPAR) process, completed in LearningBuilder, with documentation of practice hours and professional development.
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 | $270 | $410 |
| Standard | $380 | $520 |
| Reactivation | $540 | $680 |
The cost ladder rewards planning: renewing early saves $110 over standard for members and $110 for nonmembers, and avoiding reactivation saves substantially more. Put your renewal window on a calendar the day you pass.
A Domain-Ordered Prep Sequence
Rather than a generic calendar, sequence your study by domain weight and by how much each area depends on the others. The plan below assumes about five weeks; stretch or compress it to fit your application deadline.
Domain 2: Pain Management
- Start here because dosing logic is the most mechanical and benefits from repetition
- Practice reading the equianalgesic table without a calculator
- Review pediatric pain scales by age group
Domain 3: Diagnoses & Symptom Management
- Give this two weeks; it is 34 scored items
- Work condition by condition, then symptom by symptom
- Revisit actively dying signs and final-hours care
Domains 1 and 4: Assessment and Family Support
- Pair assessment and planning with family-centered scenarios, since they overlap
- Rehearse anticipatory guidance, sibling support, and bereavement
Domain 5 plus full-length practice
- Review ethics, assent and consent, and advance care planning
- Complete at least one timed 150-question simulation
- Return to your weakest domain based on results
The reasoning: mechanical, high-repetition content goes first so it can be revisited; the heaviest domain gets the most time; the overlapping domains are paired; and the final week is for integration under timed conditions.
Frequently Asked Questions
The exam has 150 multiple-choice questions, of which 135 are scored and 15 are unscored pretest items. You are given 3 hours, each question has four options, and the format is nonadaptive.
A scaled score of 500 on a 200-800 scale. It is not a raw percentage, so there is no fixed number of correct answers that guarantees a pass. See the passing score guide for how to interpret it.
The initial exam is $305 for HPNA members and $445 for nonmembers. You must join HPNA before submitting the application to get the member price. Full details are in the cost breakdown.
A current unrestricted RN license in the U.S. or its territories (or the Canadian equivalent), plus 500 hours of pediatric hospice/palliative nursing practice in the past 12 months or 1,000 hours in the past 24 months. Documentation may be audited.
Certification lasts 4 years. You renew through the HPAR process in LearningBuilder, submitting practice-hour and professional-development documentation. Early renewal costs less than standard renewal or reactivation.
If you are weighing whether the investment makes sense for your career, read whether the CHPPN is worth it and explore CHPPN jobs to see where the credential is valued.