- The exam has 175 questions (150 scored, 25 pretest) in 3 hours 30 minutes; passing score is 500 on a 200-800 scale.
- Assessment and Data Collection is the largest domain at 44 of 150 scored items - prioritize it.
- HPNA members pay $355 to sit; nonmembers pay $515.
- Eligibility needs 500 specialty hours in 12 months or 1,000 hours in 24 months, plus an active APRN license.
Quick Facts Snapshot
Before you memorize a single content point, get the mechanics of the ACHPN exam locked into memory. This is the one-page version - the numbers you should be able to recite without looking them up. For the full context behind each figure, see the ACHPN Study Guide 2026, which walks through how these facts translate into a study plan.
| Item | Detail |
|---|---|
| Administering body | Hospice and Palliative Credentialing Center (HPCC) |
| Test delivery | PSI - computer-based at test centers or live remote proctoring |
| Total questions | 175 (150 scored, 25 unscored pretest) |
| Time limit | 3 hours, 30 minutes |
| Passing score | 500 on a 200-800 scaled score |
| Fee (HPNA member) | $355 |
| Fee (nonmember) | $515 |
| Certification validity | 4 years |
Domain Breakdown at a Glance
The ACHPN blueprint is organized into four domains. Knowing the relative weight of each one tells you where to spend your limited study hours. This outline applies to the 2026 exam administration; HPCC has already published a separate outline for 2027, so don't study from outdated proportions.
Domain 1: Assessment and Data Collection
The largest domain at 44 of 150 scored questions. Covers comprehensive symptom assessment, disease trajectory recognition, functional status tools, and psychosocial/spiritual screening in seriously ill patients.
- Highest point value - treat as your top priority
Domain 2: Intervention and Management
Focuses on pharmacologic and non-pharmacologic symptom management, opioid conversions, and management of complications across hospice and palliative settings.
- Heavy overlap with pain and symptom titration scenarios
Domain 3: Education and Communication
Tests goals-of-care conversations, breaking bad news, advance care planning, and interdisciplinary team communication.
- Expect scenario-based items requiring you to choose the best next communication step
Domain 4: Professionalism and Practice
Covers ethical, legal, and regulatory considerations, self-care, and leadership within the interdisciplinary hospice/palliative team.
- Smaller point value but often decides borderline scores
For a granular walkthrough of every subtopic within each domain, read the ACHPN Exam Domains 2026 guide.
Exam Format & Scoring Mechanics
The ACHPN exam consists of 175 four-option multiple-choice questions. Of those, 150 are scored and 25 are unscored pretest items used to evaluate future exam content - you won't know which is which, so treat every question with equal seriousness. You have 3 hours and 30 minutes to finish, which averages to roughly 72 seconds per question if you pace evenly across all 175.
Your result is reported as a scaled score between 200 and 800, and you need at least 500 to pass. Scaled scoring means raw question counts don't map directly to a percentage - a candidate who answers a harder form of the exam correctly on fewer items could still pass, because item difficulty is factored into the scale. Don't try to reverse-engineer "how many I need to get right"; focus instead on mastering the content. For a deeper look at how the scaled score works, see ACHPN Passing Score 2026.
Key Takeaway
Because 25 of 175 questions are unscored pretest items, do not waste mental energy trying to identify and skip "weird" questions - answer everything as if it counts.
Registration, Fees, and Eligibility
Registration and testing run through PSI, which offers both traditional test-center appointments and live remote proctoring for candidates who prefer to test from home or office. Fee structure rewards HPNA membership:
- HPNA member: $355 for initial certification
- Nonmember: $515 for initial certification
Before you can even register, HPCC requires you to meet specific eligibility criteria:
- An active, unrestricted APRN license
- Graduate preparation as an NP or CNS from an accredited program including advanced pathophysiology, advanced health assessment, advanced pharmacology, and a 500-hour supervised practicum
- 500 hours of hospice/palliative specialty practice in the prior 12 months, or 1,000 hours in the prior 24 months
If you're unsure whether your clinical hours or coursework qualify, the ACHPN Requirements 2026 guide breaks down each eligibility pathway in detail, and ACHPN Certification Cost 2026 covers every fee scenario including retakes and renewals.
Must-Know Clinical Topics by Domain
Generic multiple-choice test tactics won't move your score much on this exam - what moves it is deep familiarity with hospice and palliative clinical content mapped to each domain. Below is a condensed list of topics that repeatedly show up across ACHPN preparation resources.
Assessment and Data Collection Essentials
- Recognizing disease trajectories for cancer, heart failure, COPD, dementia, and renal failure
- Validated tools: Palliative Performance Scale, ESAS, PHQ-9, and delirium screening instruments
- Distinguishing total pain (physical, psychological, social, spiritual) from purely physiologic pain
- Identifying imminent-death signs versus reversible causes of decline
Intervention and Management Essentials
- Opioid equianalgesic conversions and rotation strategies
- Management of dyspnea, nausea, delirium, and terminal secretions
- Non-pharmacologic adjuncts alongside pharmacologic titration
- Recognizing and managing opioid-induced adverse effects
Education and Communication Essentials
- Structured frameworks for delivering serious news
- Facilitating goals-of-care and advance directive discussions
- Navigating family conflict and surrogate decision-making
- Interdisciplinary team communication and handoffs
Professionalism and Practice Essentials
- Legal/regulatory frameworks for hospice election and levels of care
- Ethical principles: autonomy, beneficence, nonmaleficence, justice in end-of-life decisions
- Self-care and prevention of compassion fatigue on the interdisciplinary team
- Scope-of-practice boundaries for APRNs in hospice and palliative settings
Employers hiring ACHPN-certified nurses - hospice agencies, inpatient palliative consult teams, oncology programs, and long-term care organizations - expect fluency in exactly these areas, which is part of why the credential carries weight beyond the exam itself. If you're weighing whether the certification pays off in your career, Is the ACHPN Certification Worth It? and the ACHPN Salary Guide 2026 lay out the practical return on investment, and ACHPN Jobs outlines where this credential opens doors.
Recertification and the SJE
ACHPN certification is valid for four years. Renewal isn't automatic - you must demonstrate ongoing competency through:
- HPAR (HPCC's professional development activity requirement)
- Continued current specialty practice in hospice/palliative care
- Successful completion of the Situational Judgment Exercise (SJE), a scenario-based assessment distinct from the initial certification exam
The SJE is worth flagging separately because it's not simply a shorter version of the original 175-question exam - it's a targeted judgment-based tool, so don't assume your initial exam prep materials will fully cover it when renewal time comes.
Key Takeaway
Mark your four-year certification expiration date now and start tracking HPAR-eligible activities well before renewal season - waiting until the final months creates unnecessary pressure.
Final-Week Review Schedule
In the last stretch before test day, structure your review around domain weight rather than generic study techniques. Because Assessment and Data Collection carries the most scored questions, it deserves the most review time, even in a short final push.
Assessment and Data Collection
- Drill disease-trajectory scenarios and assessment tools since this domain holds 44 of 150 scored points
Intervention and Management
- Rehearse opioid conversions and symptom-management algorithms until they're automatic
Education and Communication
- Practice scenario items on goals-of-care conversations and family communication
Professionalism and Practice
- Review ethical/legal frameworks and hospice regulatory structure
Full Timed Simulation
- Take a full-length practice run under the 3-hour, 30-minute limit to calibrate pacing across all 175 items
To simulate realistic exam conditions and pacing, run a full-length timed session on the ACHPN practice test platform before test day - it's the closest you'll get to the real 175-question, scaled-score experience outside the actual exam. If you want a structured week-by-week plan built around this same domain weighting, the ACHPN Study Guide 2026 extends this into a full multi-week schedule.
FAQ
The exam has 175 four-option multiple-choice questions - 150 scored and 25 unscored pretest items - with a total time limit of 3 hours and 30 minutes.
You need a scaled score of 500 on a 200-800 scale. This is not a raw percentage; scaling accounts for item difficulty.
Assessment and Data Collection, since it accounts for 44 of the 150 scored questions - the largest single domain on the exam.
$355 for HPNA members and $515 for nonmembers, covering initial certification through PSI-administered testing.
Certification is valid for four years. Renewal requires HPAR professional-development activities, continued specialty practice, and successful completion of the Situational Judgment Exercise (SJE).
For more foundational context on the credential itself, review What Is ACHPN?, ACHPN Meaning, or ACHPN Certification - and when you're ready to test your recall against exam-style items, head over to the practice test hub to get started.