- CHPLN Exam Structure at a Glance
- Where the 2026 Content Outline Comes From
- The 7 CHPLN Content Domains, Explained
- Domain Weighting: Where the Points Actually Are
- Turning Domain Weights Into a Study Plan
- Registration, Fees, and Testing Windows
- Who Hires CHPLN-Certified LPNs/LVNs
- FAQ: CHPLN Exam Domains
- The CHPLN exam has 7 domains covering 135 scored items across 150 total questions.
- Patient Care: Symptom Management is the largest domain with 39 of 135 scored items.
- Treatments and Procedures (12 items) and Interdisciplinary Practice Issues (11 items) carry the least weight.
- The 2026 handbook uses the outline built from HPCC's 2019 job analysis - the same outline through 2026 administrations.
CHPLN Exam Structure at a Glance
Before drilling into content, it helps to understand the container that holds it. The Certified Hospice and Palliative Licensed Nurse (CHPLN) exam, awarded by the Hospice and Palliative Credentialing Center (HPCC) with preparation resources from HPNA, is a closed-book, computer-based test administered by PSI - either at a physical test center or via live remote proctoring.
The exam consists of 150 four-option multiple-choice questions: 135 are scored, and 15 are unscored pretest items being evaluated for future exams. You won't know which 15 are unscored, so every question deserves full attention. Candidates get three hours to complete the exam, and a passing result requires a scaled score of 500 on a 200-800 range - not a raw percentage. For a deeper look at how that scaled score works, see CHPLN Passing Score 2026: Exactly What You Need to Pass.
All 150 questions are distributed across seven content domains, and those domains are the actual blueprint for what you need to know walking into the testing room.
Where the 2026 Content Outline Comes From
HPCC periodically conducts a job analysis study - a large-scale survey of practicing hospice and palliative LPNs/LVNs - to determine what the exam should actually measure. The current content outline is based on the 2019 job analysis, and it remains the operative outline for 2026 administrations. The 2026 candidate handbook, dated December 2025, confirms this outline applies through the year's testing windows. HPCC has separately published a 2027 outline for later exam cycles, so if you're testing in 2026, the domain structure below is the one that governs your exam.
This matters because outline revisions can shift domain weights or terminology. If you're using a study guide or question bank, confirm it's aligned to the 2026 outline rather than an older or newer version. Our CHPLN Study Guide 2026 walks through how to verify your materials match the current outline before you invest study hours.
The 7 CHPLN Content Domains, Explained
Each domain below reflects the actual clinical and interpersonal skill set the exam is designed to verify. Understanding what each domain tests - not just its title - is the difference between recognizing a question's intent and guessing.
Domain 1: Patient Care - End-Stage Disease Process
Tests your understanding of how terminal illnesses progress physiologically across disease types, and how that trajectory informs nursing care decisions.
- Recognizing signs of disease progression and approaching end-of-life across common terminal diagnoses
- Anticipating complications tied to specific end-stage conditions
- Connecting disease trajectory to appropriate levels of hospice or palliative intervention
Domain 2: Patient Care - Pain and Comfort Management
Covers pain assessment, pharmacologic and non-pharmacologic comfort interventions, and monitoring for effectiveness and side effects.
- Pain assessment tools appropriate for verbal and non-verbal patients
- Titration principles and recognizing inadequate pain control
- Non-pharmacologic comfort measures alongside medication management
Domain 3: Patient Care - Symptom Management
The largest domain on the exam by a wide margin. It tests recognition and management of the full range of symptoms hospice and palliative patients experience beyond pain.
- Respiratory, gastrointestinal, neurological, and psychological symptom clusters
- Distinguishing expected symptoms from those requiring escalation to the RN or provider
- Symptom management strategies specific to actively dying patients
Domain 4: Patient Care - Treatments and Procedures
Focuses on the hands-on clinical skills and procedural knowledge LPNs/LVNs apply within their scope under RN supervision.
- Wound care, catheter management, and other routine hospice procedures
- Safe medication administration routes used in hospice settings
- Recognizing when a treatment or procedure falls outside LPN/LVN scope
Domain 5: Care of Patient, Family, and Other Caregivers
Tests your ability to support the entire care unit - not just the patient - through the emotional and practical demands of terminal illness.
- Recognizing caregiver burnout and burden
- Grief and bereavement support across the illness trajectory
- Cultural and spiritual considerations in family-centered care
Domain 6: Patient and Family Education and Advocacy
Assesses your ability to teach patients and families about disease process, care options, and self-advocacy within the healthcare system.
- Communicating prognosis and care planning information appropriately
- Advance directives, goals-of-care conversations, and patient rights
- Teaching families to safely manage symptoms and medications at home
Domain 7: Interdisciplinary and Collaborative Practice Issues
Covers how the LPN/LVN functions within the hospice interdisciplinary team, including scope-of-practice and supervisory relationships.
- Role clarity between LPN/LVN, RN, social worker, chaplain, and physician
- Reporting and documentation responsibilities within the care team
- Ethical and regulatory considerations in interdisciplinary decision-making
Domain Weighting: Where the Points Actually Are
Not all domains carry equal weight. Here is the official scored-item allocation across the 135 scored questions:
| Domain | Scored Items | Share of 135 Scored Items |
|---|---|---|
| 1. End-Stage Disease Process | 18 | ~13% |
| 2. Pain and Comfort Management | 27 | ~20% |
| 3. Symptom Management | 39 | ~29% |
| 4. Treatments and Procedures | 12 | ~9% |
| 5. Care of Patient, Family, and Other Caregivers | 15 | ~11% |
| 6. Patient and Family Education and Advocacy | 13 | ~10% |
| 7. Interdisciplinary and Collaborative Practice Issues | 11 | ~8% |
Domains 2 and 3 combined - Pain and Comfort Management plus Symptom Management - account for nearly half of all scored questions. That single fact should shape how you allocate study time far more than a generic "study everything equally" approach.
Key Takeaway
If you only have time to deeply master two domains, choose Symptom Management (39 items) and Pain and Comfort Management (27 items) - together they're worth nearly 49% of the scored exam.
Turning Domain Weights Into a Study Plan
Domain weighting should drive sequencing, not just topic selection. A practical approach is to front-load the heaviest domains early in your study timeline, when you have the most energy and time for depth, and reserve the lighter domains for later review passes.
Symptom Management (39 items) + Pain and Comfort Management (27 items)
- Build symptom-recognition flashcards by body system
- Practice distinguishing escalation-worthy symptoms from expected decline
End-Stage Disease Process (18) + Care of Patient, Family, and Other Caregivers (15)
- Review disease trajectories for the most common terminal diagnoses
- Study grief, bereavement, and caregiver-burden indicators
Education and Advocacy (13) + Treatments and Procedures (12) + Interdisciplinary Issues (11)
- Review scope-of-practice boundaries for LPN/LVN vs. RN roles
- Take full-length practice sets to simulate the three-hour, 150-item format
This is where generic methodology can support - not replace - content review: spaced repetition works well for symptom-cluster flashcards, and timed practice blocks help you build stamina for the three-hour testing window. For a full walkthrough of pacing and question-review strategy, see CHPLN Study Guide 2026: How to Pass on Your First Attempt, and for a realistic read on exam difficulty given this domain spread, check How Hard Is the CHPLN Exam? Complete Difficulty Guide 2026.
Registration, Fees, and Testing Windows
Domain content is only half the equation - you also need to register correctly and on time. The CHPLN exam is offered during four testing windows each year: March, June, September, and December. Online applications are due by February 15, May 15, August 15, and November 15, respectively, for those windows.
Initial examination fees are $260 for HPNA members and $365 for nonmembers. If you don't pass on your first attempt, the one-time reTEST Assured option costs $135 and allows a retake in one of the next three testing windows - not the same window you just tested in.
To sit for the exam, you need a current unrestricted U.S. or territorial LPN/LVN license, along with hospice or palliative nursing practice under RN supervision totaling either 500 hours in the preceding 12 months or 1,000 hours in the preceding 24 months. Full eligibility details, including how practice hours are documented, are covered in CHPLN Requirements 2026: Eligibility, Prerequisites & How to Qualify. For a complete cost breakdown including recertification fees, see CHPLN Certification Cost 2026: Complete Pricing Breakdown, and for exact deadlines by window, see CHPLN Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Who Hires CHPLN-Certified LPNs/LVNs
Employers value the CHPLN credential specifically because the seven domains map directly to real hospice and palliative nursing responsibilities - not generic med-surg competencies. Hospice agencies, palliative care consult teams, long-term care facilities with end-of-life units, and home health organizations with hospice service lines commonly seek CHPLN-certified LPNs/LVNs to staff symptom management, comfort care, and family support roles.
Because Domain 5 (Care of Patient, Family, and Other Caregivers) and Domain 7 (Interdisciplinary and Collaborative Practice Issues) are explicitly tested, employers also treat the credential as evidence a nurse can function effectively within an interdisciplinary team - a distinguishing factor in hospice hiring compared to a general nursing license alone. If you're evaluating whether certification is worth pursuing given your career goals, Is the CHPLN Certification Worth It? Complete ROI Analysis 2026 and CHPLN Salary Guide 2026: Complete Earnings Analysis go deeper on that decision, and CHPLN Jobs covers where these openings tend to appear.
Once you understand which domains carry the most weight, running full-length timed practice questions through our CHPLN practice test platform is the fastest way to see which of the seven areas need more attention before exam day. Reviewing your practice test results by domain - not just overall score - mirrors exactly how PSI scores the real exam.
FAQ: CHPLN Exam Domains
Patient Care: Symptom Management is the largest domain, with 39 of the 135 scored items - nearly 29% of the scored exam.
There are seven content domains, covering everything from end-stage disease process and pain management to interdisciplinary collaboration.
No. The 2026 candidate handbook, dated December 2025, uses the same content outline built from HPCC's 2019 job analysis. A separate 2027 outline applies only to later exam cycles.
No. Of the 150 total questions, 135 are scored and 15 are unscored pretest items used to evaluate future exam questions. You won't know which ones are unscored.
No. Because Symptom Management (39 items) and Pain and Comfort Management (27 items) together make up nearly half the scored exam, allocating proportionally more study time to those two domains is more efficient than equal coverage across all seven.