- The Short Answer: What the Letters Spell Out
- Breaking Down Each Word in the Title
- Who Awards the Credential
- Who Can Sit for the Exam
- The Exam at a Glance
- The Five Content Domains
- Fees, Testing Windows, and Application Deadlines
- Keeping the Credential Active
- Where CHPPN-Certified Nurses Work
- Sequencing Your Prep Around the Domains
- Frequently Asked Questions
- CHPPN stands for Certified Hospice and Palliative Pediatric Nurse, awarded by the Hospice and Palliative Credentialing Center (HPCC).
- The exam has 150 multiple-choice questions, 135 scored and 15 unscored, with a 3-hour limit and a passing scaled score of 500.
- Eligibility needs an unrestricted RN license plus 500 pediatric hospice/palliative hours in 12 months or 1,000 in 24 months.
- Pediatric Diagnoses & Symptom Management is the largest domain, with 34 of the 135 scored items.
The Short Answer: What the Letters Spell Out
CHPPN stands for Certified Hospice and Palliative Pediatric Nurse. It is a specialty nursing credential for registered nurses who care for children with serious or life-limiting illness and who support those children's families through every stage of that illness, including end of life and bereavement.
The acronym is easy to confuse with similar-looking abbreviations in healthcare, so it helps to be precise. On this site, and throughout this article, CHPPN refers only to the pediatric hospice and palliative nursing certification awarded by HPCC. If you want a quick orientation from other angles, our companion pages cover what CHPPN is, the meaning of CHPPN, and what a CHPPN actually is as a professional.
Breaking Down Each Word in the Title
Certified
Certification differs from a course certificate. You are not receiving a document for attending a class; you are demonstrating, through a proctored exam, that you meet a national standard of knowledge. The credential is portable across employers and states, and it lasts four years before you must renew.
Hospice and Palliative
Palliative care in pediatrics often begins at diagnosis and runs alongside disease-directed treatment. Hospice care typically applies when the focus shifts toward comfort and quality of life. The exam expects you to understand both ends of that continuum, including how goals of care evolve and how a child's developmental stage shapes what comfort looks like.
Pediatric
This is the part that sets the credential apart. Pediatric symptom management, pain assessment in nonverbal or preverbal children, weight-based dosing considerations, and developmentally appropriate communication are all central. Adult-focused palliative knowledge will not carry you on its own.
Nurse
The credential is for registered nurses. You need a current, unrestricted RN license to apply, as covered in our CHPPN requirements guide.
Who Awards the Credential
The Hospice and Palliative Credentialing Center (HPCC) awards the CHPPN credential. The Hospice and Palliative Nurses Association (HPNA) is the related membership organization and provides preparation resources and member benefits. The distinction matters in practice: HPCC handles the certification itself, while HPNA membership affects your exam fee.
Exam delivery runs through PSI, either at a PSI test center or by live remote proctoring, so you can choose the setting where you perform best. For the bigger picture on what the credential involves from start to finish, see our overview of CHPPN certification.
Who Can Sit for the Exam
Eligibility has two parts, and both must be satisfied:
- Licensure: a current, unrestricted RN license in the United States or its territories, or the Canadian equivalent.
- Practice hours: either 500 hours of pediatric hospice/palliative nursing practice in the preceding 12 months, or 1,000 hours in the preceding 24 months.
Both your license and your practice documentation may be audited, so keep records that can support what you attest on the application. A nurse who floats occasionally to a pediatric palliative service may find the hour threshold the harder piece to meet. Our full requirements walkthrough explains how to think about qualifying hours before you apply.
The Exam at a Glance
| Feature | CHPPN Exam 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 |
| Passing score | 500 on a 200-800 scaled score |
| Reference materials | Closed book; calculators prohibited |
| Delivery | PSI test center or live remote proctoring |
What the format means for you
Because the exam is nonadaptive, every candidate works through a fixed set of questions rather than a test that changes difficulty based on your answers. You can pace yourself with a straightforward target: 150 questions in 180 minutes leaves roughly 72 seconds per item on average. The 15 unscored pretest items are mixed in and are indistinguishable from scored ones, so treat every question as if it counts.
The passing score is a scaled score of 500 on a 200-800 scale. It is not a raw percentage, so do not assume you need a particular number of correct answers expressed as a percent. Our passing score breakdown explains how to interpret this.
The Five Content Domains
The exam content is organized into five domains, based on the 2023 job analysis and described in the 2026 candidate handbook (dated December 2025). The official scored-item counts, in domain order, are 24, 24, 34, 31, and 22, totaling the 135 scored questions.
| 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 |
Domain 1: Patient Care - Assessment and Planning
Expect scenarios that ask what you assess first, how you identify a child's and family's needs, and how the plan of care should reflect goals of care.
- Developmentally appropriate assessment across age groups
- Recognizing disease trajectory and changing goals
- Interdisciplinary care planning
Domain 2: Patient Care - Pain Management
This domain pairs well with the equianalgesic table the exam provides. Questions reward judgment about the right drug, route, and next step rather than raw recall.
- Pain assessment tools suited to age and cognitive ability
- Opioid and adjuvant selection and conversion reasoning
- Pharmacologic and nonpharmacologic approaches
- Monitoring for and managing adverse effects
Domain 3: Patient Care - Pediatric Diagnoses & Symptom Management
The largest domain at 34 scored items, so it deserves the largest share of your preparation time. It combines disease knowledge with symptom-focused nursing action.
- Common life-limiting pediatric conditions and their courses
- Management of dyspnea, nausea, seizures, secretions, and other distressing symptoms
- Recognizing the imminently dying child and providing comfort
Domain 4: Family-Centered Support, Education, and Advocacy
At 31 scored items, this is the second-largest domain, and it is where pediatric palliative care differs most visibly from adult care. The family is the unit of care.
- Supporting parents, siblings, and caregivers
- Communication, decision-making, and advocacy
- Anticipatory guidance, grief, and bereavement support
Domain 5: Professional Practice
The smallest domain at 22 scored items, but not one to skip. It covers the standards, ethics, and collaborative responsibilities that frame the role.
- Ethical and legal considerations in pediatric end-of-life care
- Scope of practice, collaboration, and quality of care
- Self-care and professional development
For a deeper treatment of each content area, read our complete guide to the five CHPPN exam domains.
Fees, Testing Windows, and Application Deadlines
Initial exam fee
The initial examination costs US$305 for HPNA members or US$445 for nonmembers. One mechanical detail trips people up: membership must precede the application to receive member pricing. Joining after you submit does not retroactively lower the fee. If you are weighing the cost of membership against the savings, our CHPPN certification cost breakdown lays out the full picture.
If you are an eligible unsuccessful initial candidate, reTEST Assured is available for US$135 and may be used in one of the next 3 testing windows.
Testing windows and when to apply
The exam is offered in four windows each year, and each window has its own application period:
| 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 |
Plan backward from the window you want. Missing an application deadline pushes you to the next window, a three-month delay. For scheduling strategy, see our CHPPN exam dates guide.
Keeping the Credential Active
CHPPN 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. HPAR practice eligibility mirrors the initial standard: 500 hours in the preceding 12 months or 1,000 hours in the preceding 24 months.
| Renewal Fee Tier | HPNA Member | Nonmember |
|---|---|---|
| Early | US$270 | US$410 |
| Standard | US$380 | US$520 |
| Reactivation | US$540 | US$680 |
Key Takeaway
Renewing early is meaningfully cheaper than renewing at the standard rate, and reactivation after a lapse is the most expensive path. Track your practice hours and professional development throughout the four years rather than reconstructing them at the deadline.
Where CHPPN-Certified Nurses Work
Pediatric hospice and palliative nurses practice wherever seriously ill children and their families need support. Typical settings include:
- Children's hospitals with dedicated pediatric palliative care teams
- Community hospice agencies with pediatric programs
- Home health and home-based palliative services
- Pediatric oncology, cardiology, neurology, and critical care units that consult with palliative teams
- Dedicated pediatric hospice residences and respite programs
Employers value the credential as evidence of specialized, verified competence in a niche where family communication and symptom control are high-stakes. For openings and role types, see our page on CHPPN jobs, and for earnings context see the CHPPN salary guide. If you are deciding whether the investment makes sense, our ROI analysis weighs the costs against the benefits.
Sequencing Your Prep Around the Domains
Rather than studying the domains in numerical order, weight your time to match the exam. Domain 3 carries 34 scored items and Domain 4 carries 31, so together they account for 65 of the 135 scored questions. A sensible sequence builds the clinical foundation first, then layers on the family and professional material.
Assessment, Planning, and Pain
- Review Domain 1 assessment approaches across developmental stages
- Work through Domain 2 pain scenarios, practicing with an equianalgesic table in hand
- Practice manual arithmetic since calculators are not allowed
Diagnoses and Symptom Management
- Spend the most time here: it is the largest domain
- Pair each common pediatric condition with its typical symptom burden and nursing response
- Rehearse recognition of the imminently dying child
Family-Centered Support and Professional Practice
- Study communication, anticipatory guidance, and bereavement support for Domain 4
- Cover ethics, scope, and collaboration for Domain 5
Timed Practice and Review
- Complete full-length timed sets of 150 questions in 3 hours
- Review missed items by domain to find patterns
For a fuller plan, read our CHPPN study guide, and keep the one-page CHPPN cheat sheet nearby for last-week review.
A note on practice resources
HPNA's official practice product contains 50 questions, which is a sample rather than a rehearsal of the real exam's length. The certification exam itself has 150 questions. Independently written practice simulations, such as those on our CHPPN practice test site, can fill the gap by letting you build stamina across a full-length set. Treat any practice resource as a way to find weak domains, not as a prediction of your result.
Setting realistic expectations
The official 2025 pass rates were 89.2% overall (33 of 37 attempts), 94.3% for first-time candidates (33 of 35), and 0% for repeat candidates (0 of 2). These are exam-attempt statistics from a small cohort, so they should be read cautiously rather than as a guarantee. Our pass rate analysis and difficulty guide discuss how to interpret numbers like these. The reassuring takeaway is that candidates who met the eligibility requirements and prepared deliberately did well, but a small cohort limits how much weight any single percentage deserves.
When you are ready to test your readiness against realistic questions, you can start with the CHPPN Exam Prep practice tests.
Frequently Asked Questions
CHPPN stands for Certified Hospice and Palliative Pediatric Nurse. It is a specialty certification for registered nurses who provide hospice and palliative care to children and support their families, awarded by the Hospice and Palliative Credentialing Center (HPCC).
HPCC awards the credential. The Hospice and Palliative Nurses Association (HPNA) is the related membership organization that provides preparation resources, and HPNA membership qualifies you for lower exam and renewal fees.
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.
The exam has 150 multiple-choice questions, of which 135 are scored and 15 are unscored pretest items, with 3 hours allowed. The passing score is a scaled score of 500 on a 200-800 scale, not a raw percentage.
Certification lasts 4 years. Renewal is completed through the Hospice and Palliative Accrual for Recertification (HPAR) process in LearningBuilder, which requires documentation of practice hours and professional development. Early renewal costs less than standard renewal or reactivation.