The CHPN (Certified Hospice and Palliative Nurse) credential is awarded by the National Board for Certification of Hospice and Palliative Nurses (NBCHPN) and represents a high standard of competency in end-of-life care. Registered nurses who work with patients facing life-limiting illness use this certification to demonstrate their knowledge of pain management, symptom control, family support, and interdisciplinary collaboration. Preparing for the exam requires deep familiarity with both the clinical and psychosocial dimensions of palliative and hospice nursing practice.
This free CHPN practice test PDF gives you a printable set of exam-style questions covering the major content areas tested by NBCHPN. Whether you study at home, during a break at work, or away from a screen, having a physical copy of practice questions helps reinforce concepts through repetition and active recall. Use this PDF alongside your primary study materials to identify knowledge gaps before exam day.
Pain control is the cornerstone of hospice and palliative nursing, and it accounts for the largest share of CHPN exam questions. You need to understand opioid pharmacology in detail — including equianalgesic dosing, around-the-clock scheduling versus as-needed (PRN) dosing, and rotation between opioids when side effects become unmanageable. Morphine, oxycodone, hydromorphone, and fentanyl each have distinct pharmacokinetic profiles that affect how you titrate doses and anticipate adverse effects.
Beyond opioids, the exam tests your knowledge of adjuvant analgesics such as corticosteroids for bone pain, gabapentinoids for neuropathic pain, and tricyclic antidepressants used off-label in palliative settings. Recognizing the difference between nociceptive, neuropathic, and total pain — the latter including physical, psychological, social, and spiritual components — is fundamental. You should also know the WHO analgesic ladder and when to escalate from non-opioid to opioid therapy.
Non-pain symptoms also receive significant attention. Dyspnea management in terminal patients, including low-dose opioids and benzodiazepines for air hunger, is frequently tested. Nausea etiology (opioid-induced, constipation-related, bowel obstruction, metabolic) shapes antiemetic selection — haloperidol, metoclopramide, ondansetron, and dexamethasone each serve different mechanisms. Terminal secretions, delirium, and constipation from opioids are high-yield topics that appear regularly on the CHPN.
Hospice philosophy centers on comfort-focused care and honoring patient goals rather than curative treatment. The CHPN exam expects you to understand Medicare Hospice Benefit eligibility criteria — prognosis of six months or less if the disease follows its expected course, patient or surrogate consent to forego curative treatment — and the levels of care: routine home care, continuous home care, general inpatient care, and respite care.
Advance care planning documentation is tested extensively. Nurses must know the difference between a living will, durable power of attorney for healthcare, and a POLST (Physician Orders for Life-Sustaining Treatment) or MOLST form. These documents have different legal statuses and operational roles at the bedside. Understanding when a DNR order is active, how to communicate it to emergency responders, and how to support families when they question it is an applied skill that the exam probes through scenario questions.
The active dying process — mottling, Cheyne-Stokes respirations, decreased urine output, cooling extremities, withdrawal from interaction — must be recognized and explained to families clearly and compassionately. The nurse’s role includes preparing the family for what death looks like, managing the patient’s comfort during the final hours, and supporting the family immediately after the death occurs.
The CHPN credential places heavy emphasis on holistic, person-centered care that extends beyond physical symptom management. Psychosocial support involves assessing and addressing anxiety, depression, existential distress, and anticipatory grief in both patients and families. Screening tools such as the PHQ-9 for depression or the GAD-7 for anxiety are referenced in practice guidelines, and nurses should understand when pharmacological intervention is appropriate versus when counseling or chaplaincy referrals are the priority.
Spiritual care is integrated into the palliative nursing role even when a chaplain is part of the team. The nurse performs spiritual screening using tools like FICA (Faith, Importance, Community, Address in Care) or HOPE (sources of Hope, Organized religion, Personal spirituality, Effects on care). Understanding that spirituality is broader than religious practice — patients may find meaning through nature, relationships, creative work, or personal philosophy — helps nurses avoid assumptions and engage in genuine therapeutic communication.
Grief and bereavement care extend into the post-death period. NBCHPN expects CHPN candidates to know the difference between normal grief, complicated grief (now termed prolonged grief disorder in DSM-5), and anticipatory grief. Bereavement follow-up by the hospice team for at least 13 months after the patient’s death is a Medicare requirement, and you may be tested on how to identify and refer bereaved family members who are at high risk for complicated grief.
Hospice care is delivered by an interdisciplinary team (IDT) that typically includes physicians, nurses, social workers, chaplains, home health aides, and volunteers. The CHPN exam tests how nurses function within and contribute to the IDT — presenting clinical summaries at team meetings, coordinating medication changes with the attending physician, and communicating patient status changes to the medical director. Understanding scope-of-practice boundaries and knowing when to escalate versus manage independently is a recurring theme.
Communication skills are not peripheral — they are a core clinical competency in palliative nursing. Delivering bad news using frameworks like SPIKES (Setting, Perception, Invitation, Knowledge, Empathy, Summary) or conducting goals-of-care conversations using structured approaches helps nurses navigate high-stakes discussions with families. The exam may present scenarios where a family is pushing for aggressive intervention against the patient’s stated wishes, and you must demonstrate understanding of patient autonomy, surrogate decision-making hierarchy, and when to involve an ethics consultant.
Care transitions — from hospital to home hospice, from home to inpatient facility, or between levels of hospice care — require meticulous handoff communication. Medication reconciliation, updated care plans, and ensuring the family understands the new setting’s role are all within the nurse’s coordination responsibilities. Documenting these transitions accurately protects both the patient and the organization during regulatory review.
Consistent practice with exam-style questions is one of the most effective strategies for CHPN preparation. After working through this PDF, continue building your confidence with full-length timed sessions — the chpn practice test on this site offers additional questions across all NBCHPN content domains, complete with detailed answer explanations to help you understand the reasoning behind each correct response.