- 2025 HPCC data shows a 69.3% first-time pass rate and 66.8% total candidate pass rate.
- Passing requires a scaled score of 500 on a 200-800 scale, not a fixed raw percentage.
- Symptom Management, Support/Education/Advocacy, and Practice Issues each make up about 20.7% of scored items.
- Failing costs $135 for reTEST Assured plus lost time before the next PSI testing window.
The Numbers: What HPCC Actually Reports
Anyone researching the Certified Hospice and Palliative Nurse (CHPN) exam eventually asks the same question: what are my actual odds of passing? The Hospice and Palliative Credentialing Center (HPCC), which governs the CHPN credential in affiliation with the Hospice and Palliative Nurses Association (HPNA), publishes official pass rate data periodically. The most recent figures show a 2025 first-time pass rate of 69.3% and a total candidate pass rate of 66.8%.
That gap between first-time and total candidates is small but meaningful. It tells you that repeat test-takers don't dramatically outperform first-timers as a group - which suggests the exam rewards focused, domain-specific preparation more than it rewards simply having "another attempt" under your belt. If you want the fuller context behind these numbers, our companion piece on CHPN Pass Rate 2026: What the Data Shows tracks how these figures are reported and updated by HPCC over time.
Why First-Time and Total Pass Rates Differ
The distinction between "first-time" and "total" pass rate matters for how you plan your own attempt. First-time pass rate counts only candidates sitting for the CHPN for the very first time. Total pass rate blends those first-timers with candidates who are retesting after a prior failure. Because CHPN scoring uses a scaled score of 500 on a 200-800 scale rather than a raw percentage cutoff, HPCC can adjust for slight differences in item difficulty across different test forms - which means the passing bar stays statistically consistent even though the exact number of questions you need correct can vary slightly by form.
This scaled scoring approach is one reason candidates should not obsess over "how many questions can I miss." Instead, the more useful framing is: which domains are you weakest in, and are those weaknesses concentrated in the highest-weighted content areas? Our CHPN Exam Domains 2026: Complete Guide to All 5 Content Areas breaks down exactly how the content outline maps to the exam blueprint.
Key Takeaway
Because passing is based on a scaled score rather than a fixed percent-correct threshold, your prep should target consistent competency across all five domains rather than trying to "guess" a pass/fail cutoff.
How the Five Domains Drive the Pass Rate
The CHPN exam draws its 135 scored questions from five content domains defined in the HPCC detailed content outline. Understanding the weight of each domain is the single most actionable thing you can do to interpret - and improve upon - the published pass rate.
| Domain | Weight | Why It Affects the Pass Rate |
|---|---|---|
| Patient Care - Assessment and Planning | 18.5% | Foundational clinical reasoning; weak assessment skills cascade into later domain errors |
| Patient Care - Pain Management | 19.3% | Dense pharmacology and titration content; frequently underestimated by candidates |
| Patient Care - Symptom Management | 20.7% | Largest single domain; broad scope beyond pain alone |
| Support, Education, and Advocacy | 20.7% | Tests communication, family dynamics, and ethical scenarios - not just facts |
| Practice Issues | 20.7% | Covers regulatory, interdisciplinary, and end-of-life policy knowledge |
Notice that three domains - Symptom Management, Support/Education/Advocacy, and Practice Issues - each sit at roughly 20.7%, meaning together they account for over 62% of scored content. Candidates who focus their study time disproportionately on Pain Management (still a high-yield, clinically dense domain) sometimes shortchange these larger domains, which can quietly erode a score even when pain management knowledge is strong.
Patient Care - Symptom Management (20.7%)
This domain extends well beyond pain into dyspnea, nausea, delirium, fatigue, and terminal secretions. Candidates must recognize symptom clusters typical of specific disease trajectories.
- Differentiate opioid-induced versus disease-related symptoms
- Know non-pharmacologic interventions alongside pharmacologic ones
- Understand symptom management differences across cancer, cardiac, pulmonary, and neurologic terminal diagnoses
Support, Education, and Advocacy (20.7%)
This domain tests soft-skill application in hard clinical scenarios - grief support, cultural competence, and interdisciplinary communication.
- Apply advocacy principles when patient and family wishes conflict
- Recognize anticipatory grief versus complicated grief
- Know when and how to escalate ethical concerns to the interdisciplinary team
For a domain-by-domain study breakdown, see CHPN Domain 3: Patient Care - Symptom Management (20.7%) - Complete Study Guide 2026 and CHPN Domain 4: Support, Education, and Advocacy (20.7%) - Complete Study Guide 2026.
Exam Mechanics That Shape Your Odds
Pass rates aren't just a function of knowledge - they're also shaped by exam mechanics that candidates sometimes overlook. The CHPN exam consists of 150 multiple-choice questions, of which 135 are scored and 15 are unscored pretest items used by PSI and HPCC to evaluate future exam content. You won't know which 15 are unscored, so every question deserves full attention. The exam allows 3 hours, which averages to about 1.2 minutes per question - tight enough that time management is a real factor in whether prepared candidates finish confidently or rush the final domain.
All questions use a four-option multiple-choice format, tested via computer at PSI test centers or through live remote proctoring. Candidates who haven't taken a proctored, timed computer-based exam recently sometimes lose points not to knowledge gaps but to unfamiliarity with the interface and pacing. Practicing under realistic timed conditions - ideally with a full-length simulation - closes that gap. You can build that familiarity using full-length timed simulations on our CHPN practice test platform before exam day.
Who Tends to Struggle - and Why
Eligibility for the CHPN requires a current, unrestricted, active RN license in the United States or its territories (or the Canadian equivalent), plus either 500 hours of hospice and palliative nursing practice in the most recent 12 months or 1,000 hours in the most recent 24 months. This means every candidate already has meaningful clinical exposure - the exam isn't testing whether you've worked in hospice, it's testing whether your clinical experience has been paired with structured knowledge of the content outline.
Nurses coming from inpatient hospice units sometimes have strong Symptom Management and Pain Management instincts but less structured exposure to the Practice Issues domain, which covers regulatory frameworks, interdisciplinary team roles, and the broader policy environment. Conversely, nurses in case management or home hospice roles may have strong Support, Education, and Advocacy skills but less hands-on exposure to acute symptom crisis management. Recognizing your own clinical background's blind spots - and using the content outline to map them against domain weights - is a more precise strategy than generic exam prep advice.
Employers hiring for hospice, palliative care, home health, and inpatient consult teams increasingly list the CHPN as a preferred or required credential. If you're weighing whether the credential fits your career trajectory, Is the CHPN Certification Worth It? Complete ROI Analysis 2026 and CHPN Jobs cover the employer landscape in more depth.
Closing the Gap: A CHPN-Specific Prep Sequence
Generic study techniques like spaced repetition or timed practice blocks only help when they're mapped to the actual CHPN blueprint. Rather than a generic weekly template, sequence your review around domain weight and personal weak spots.
Assessment and Planning + Pain Management
- Review assessment frameworks and pain pharmacology together, since accurate pain assessment underlies correct pain management decisions
- Drill opioid conversion and titration scenarios using timed question sets
Symptom Management
- Work through non-pain symptom clusters by disease trajectory
- Spend extra time here given its 20.7% weight and broad scope
Support, Education, and Advocacy + Practice Issues
- Focus on scenario-based questions involving family communication, ethics, and regulatory knowledge
- Review interdisciplinary team roles and end-of-life policy topics
Full-Length Timed Simulation
- Take a complete 150-question, 3-hour practice exam under realistic conditions
- Review missed items by domain to catch any late-stage gaps
This sequencing front-loads the clinically dense domains (Assessment/Planning and Pain Management) while your recall is freshest, then dedicates real time to the three large domains that together carry the most scoring weight. For a more detailed walkthrough of this kind of structured plan, see the CHPN Study Guide 2026: How to Pass on Your First Attempt.
The Cost of Not Passing the First Time
Beyond the emotional toll, a failed attempt has a real financial cost. Between the $305-$445 initial fee, the $135 reTEST Assured fee, and potentially a $110 transfer fee if your schedule shifts, retesting adds up quickly - not to mention the delay in earning a credential that's valid for four years before renewal through HPCC's HPAR process, Situational Judgment Exercise, and practice-hour requirements. This is one more reason candidates benefit from realistically gauging exam difficulty before scheduling. If you're unsure how demanding the CHPN really is relative to other nursing certifications, How Hard Is the CHPN Exam? Complete Difficulty Guide 2026 walks through the comparison in detail.
Using a realistic practice environment before you commit to a testing date is one of the most effective ways to convert a marginal first attempt into a confident pass. You can start building that readiness with timed CHPN practice questions that mirror the domain weighting and four-option format of the real exam.
Frequently Asked Questions
According to HPCC's most recent published statistics, the 2025 first-time pass rate was 69.3%, and the total candidate pass rate (including retests) was 66.8%.
No. The CHPN uses a scaled score, and you need a scaled score of 500 on a 200-800 scale to pass. This accounts for slight difficulty variations between different exam forms.
There are 150 total multiple-choice questions, but only 135 are scored. The remaining 15 are unscored pretest items used to evaluate future exam content, and you won't know which ones they are.
Symptom Management, Support/Education/Advocacy, and Practice Issues each represent about 20.7% of scored content, making them collectively the largest share of the exam. Pain Management (19.3%) and Assessment/Planning (18.5%) remain essential clinical foundations even though their individual weights are slightly lower.
You can retest using HPCC's reTEST Assured option for $135. If you need to reschedule your testing window, a $110 transfer fee may apply. Reviewing your domain-level performance before rescheduling helps target the retest more effectively.