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100+ Free CHPCN(C) Practice Questions

Pass your CNA Certification in Hospice Palliative Care Nursing [CHPCN(C)] exam on the first try — instant access, no signup required.

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2026 Statistics

Key Facts: CHPCN(C) Exam

165

Exam Questions

CNA

4 hours

Exam Time

CNA

$570

CNA Member Fee

CNA 2026

5 years

Credential Validity

CNA

3,900

Experience Hours Required

CNA Option A

100 hours

Continuous Learning for Renewal

CNA

The CHPCN(C) exam features 160-165 multiple-choice questions over a 4-hour session. Fees are $570 for CNA members and $756 for non-members. It is the premier credential for registered nurses in Canada specializing in hospice palliative care, requiring 3,900 practice hours or 1,950 hours plus post-basic education.

Sample CHPCN(C) Practice Questions

Try these sample questions to test your CHPCN(C) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A palliative nurse is assessing a patient with advanced COPD who is experiencing dyspnea. Using the Edmonton Symptom Assessment System (ESAS-r), the patient rates their shortness of breath as 7/10. What is the most appropriate first-line pharmacological intervention for this patient?
A.Administering a dose of subcutaneous or oral morphine
B.Initiating high-flow nasal cannula oxygen therapy
C.Administering subcutaneous haloperidol
D.Administering oral lorazepam
Explanation: Low-dose opioids, particularly morphine, are the gold standard and first-line pharmacological intervention for managing dyspnea in patients with advanced life-limiting illnesses like COPD. Opioids reduce the perception of breathlessness by altering the central response to hypoxia and hypercapnia. The route can be oral or subcutaneous depending on patient status.
2A patient with advanced heart failure has refractory dyspnea at rest. In addition to low-dose opioids, which non-pharmacological intervention has the strongest clinical evidence for reducing the sensation of breathlessness?
A.Directing a cool draft of air from a handheld fan toward the patient's face
B.Placing the patient in a flat, supine position to maximize diaphragmatic excursion
C.Applying warm compresses to the patient's chest wall
D.Keeping the patient in a closed room with minimal air circulation to prevent drafts
Explanation: Directed air flow from a fan toward the face stimulates the trigeminal nerve (specifically the V2 and V3 branches), which sends signals to the brain that help relieve the sensation of dyspnea. This is a highly effective, simple, and evidence-based non-pharmacological nursing intervention. Other helpful methods include upright positioning and relaxation techniques.
3A patient with advanced pancreatic cancer is experiencing persistent chemical-induced nausea due to chemotherapy. Which receptor pathway and corresponding antiemetic are most appropriate to target first-line for chemical-induced nausea?
A.Dopamine receptors in the Chemoreceptor Trigger Zone (CTZ) using haloperidol
B.Acetylcholine receptors in the vestibular system using dimenhydrinate
C.Histamine receptors in the gut using diphenhydramine
D.Serotonin receptors in the gastric mucosa using metoclopramide
Explanation: Chemical-induced nausea (caused by drugs, toxins, or metabolic abnormalities) is mediated by the Chemoreceptor Trigger Zone (CTZ), which is rich in dopamine receptors. Haloperidol is a potent dopamine antagonist that is highly effective for this pathway. Correctly matching the antiemetic to the underlying pathophysiology is a core palliative nursing competency.
4A palliative patient with advanced ovarian cancer reports early satiety, postprandial fullness, and chronic bloating. The nurse suspects 'squashed stomach syndrome' (gastric compression). Which antiemetic is the drug of choice to address this condition?
A.Metoclopramide
B.Dimenhydrinate
C.Ondansetron
D.Haloperidol
Explanation: Metoclopramide is a prokinetic agent that stimulates gastric emptying and upper gastrointestinal motility by blocking dopamine receptors and enhancing acetylcholine response. It is the treatment of choice for gastroparesis or external gastric compression ('squashed stomach syndrome') because it physically moves food through the stomach. It should be avoided if complete bowel obstruction is suspected.
5A patient with brain metastases presents with nausea accompanied by projectile vomiting and a severe headache that worsens when lying down. What is the most likely cause of this nausea, and what is the appropriate first-line treatment?
A.Increased intracranial pressure; treat with dexamethasone
B.Vestibular stimulation; treat with dimenhydrinate
C.Delayed gastric emptying; treat with metoclopramide
D.Toxin-induced CTZ activation; treat with haloperidol
Explanation: Nausea and projectile vomiting associated with a headache that worsens when supine are classic signs of increased intracranial pressure (ICP) from space-occupying lesions. Dexamethasone is the first-line treatment as it reduces peritumoral edema, thereby decreasing ICP and relieving the associated nausea. Supportive antiemetics can be added if necessary.
6A nurse is assessing a palliative patient using the Confusion Assessment Method (CAM). The patient presents with an acute onset of fluctuating mental status, inattention, and disorganized thinking. Which syndrome is characterized by these findings?
A.Delirium
B.Dementia
C.Depression
D.Anticipatory grief
Explanation: Delirium is characterized by an acute onset, a fluctuating course, inattention, and either disorganized thinking or an altered level of consciousness. The CAM is a standardized tool designed to detect these specific features. Delirium is often reversible in palliative care and must be actively assessed to identify underlying causes.
7A patient in the last days of life is experiencing hyperactive delirium with severe agitation, hallucinations, and safety risks. The non-pharmacological interventions have been exhausted. According to Canadian palliative care guidelines, which medication is considered the first-line pharmacological treatment for terminal delirium?
A.Haloperidol
B.Lorazepam
C.Propranolol
D.Donepezil
Explanation: Haloperidol is the first-line antipsychotic recommended for managing hyperactive delirium and distressing hallucinations in palliative care. It helps restore cognitive clarity and reduces agitation without excessive sedation. Benzodiazepines like lorazepam should generally be avoided as monotherapy because they can cause paradoxical excitation and worsen delirium, unless used in terminal sedation or alcohol withdrawal.
8In the final hours of life, a patient develops noisy, rattling respirations (often referred to as the 'death rattle'). Which explanation should the nurse provide to the family, and what is the appropriate first-line nursing intervention?
A.Explain that the noise is due to pooled secretions in the hypopharynx that the patient cannot clear; reposition the patient on their side.
B.Explain that the patient is choking and requires immediate deep endotracheal suctioning.
C.Explain that the patient has developed acute pneumonia and needs urgent intravenous antibiotics.
D.Explain that this is a sign of fluid overload; immediately administer a rapid bolus of intravenous normal saline.
Explanation: Noisy breathing or 'death rattle' occurs because the patient is too weak or semi-comatose to swallow or cough up normal salivary secretions, leading to pooling in the hypopharynx. The first-line nursing intervention is to reposition the patient (e.g., side-lying or semi-prone) to allow gravity to drain the secretions. Deep suctioning is invasive, distressing, and ineffective, as it does not reach the pooled secretions and can cause trauma.
9A palliative nurse is caring for a patient who has been prescribed glycopyrrolate to manage refractory terminal secretions (death rattle). What pharmacological advantage does glycopyrrolate have over atropine or scopolamine?
A.It is a quaternary ammonium compound that does not cross the blood-brain barrier, reducing the risk of central side effects like delirium.
B.It has a rapid onset of action of less than 30 seconds and is given intravenously only.
C.It actively sedates the patient and relieves terminal dyspnea simultaneously.
D.It stimulates the salivary glands to liquefy secretions for easier swallowing.
Explanation: Glycopyrrolate is a quaternary anticholinergic agent. Because of its polar structure, it does not cross the blood-brain barrier, which minimizes central anticholinergic side effects such as drowsiness, confusion, and delirium. In contrast, atropine and scopolamine cross the blood-brain barrier and can exacerbate cognitive impairment or terminal agitation.
10A patient with advanced lung cancer is receiving round-the-clock hydromorphone. The patient has not had a bowel movement in four days and reports abdominal discomfort. Which bowel regimen is most appropriate for opioid-induced constipation?
A.A combination of a stimulant laxative (e.g., senna) and an osmotic agent (e.g., PEG 3350) daily
B.A high-dose bulk-forming laxative (e.g., psyllium) with fluid restriction
C.PRN (as-needed) administration of docusate sodium monotherapy
D.Daily administration of an enema to avoid oral medication burden
Explanation: Opioids cause constipation by reducing peristalsis and increasing water absorption in the bowel. A prophylactic regimen combining a stimulant laxative (to increase motility) and an osmotic or softening agent (to draw water into the stool) is the standard of care. Daily senna and PEG 3350 are effective and well-tolerated. Bulk-forming laxatives are contraindicated due to the risk of bowel obstruction in patients with low fluid intake.

About the CHPCN(C) Exam

The Hospice Palliative Care Nursing certification [CHPCN(C)] is a national specialty credential offered by the Canadian Nurses Association. It validates advanced nursing knowledge, clinical skills, and professional judgment in providing high-quality palliative and end-of-life care in Canada. The certification covers 9 competency domains including symptom and pain management, care of the person and family, last hours, grief support, collaboration, education, ethics, and professional advocacy.

Assessment

160-165 multiple-choice questions (4 options, single best answer)

Time Limit

4 hours

Passing Score

Scaled passing score based on psychometric benchmarking

Exam Fee

$588 CAD (CNA member) / $780 CAD (non-member) application fee, plus $85 online (ProctorU) or $110 in-person writing appointment fee; rewrite $378 (member) / $500 (non-member). Applicable taxes extra. (Canadian Nurses Association (CNA))

CHPCN(C) Exam Content Outline

20–27%

Symptom Assessment and Management

Pharmacological and non-pharmacological interventions for dyspnea, nausea, delirium, secretions, bowel issues, and oncological emergencies.

15–22%

Pain Assessment and Management

Opioid initiation, titration, rotation, breakthrough calculations, neuropathic pain adjuvants, and opioid toxicity.

15–20%

Last Days/Hours/Imminent Death Care

Physiological signs of active dying, death rattle, terminal restlessness, eye/mouth care, palliative sedation, and post-mortem care.

12–15%

Care of the Person and Family

Family-centered care, caregiver burden, spiritual assessments (HOPE), Dignity Therapy, cultural safety, and child communication.

7–10%

Interprofessional/Collaborative Practice

Interdisciplinary collaboration, family conferences, specialist consults, rural home care, and discharge planning.

7–10%

Education

Teaching family members about medications, explaining trajectories, health literacy, and mentoring nursing peers.

5–8%

Loss, Grief and Bereavement Support

Anticipatory vs conventional grief, Prolonged Grief Disorder, bereavement programs, tasks of mourning, and staff compassion fatigue.

5–8%

Ethics and Legal Issues

Advance directives, substitute decision makers (SDM), treatment refusal, and Canadian MAID regulations.

5–8%

Professional Development and Advocacy

Early integration of palliative care, staff self-care, maintaining competence, and CNA renewal processes.

How to Pass the CHPCN(C) Exam

What You Need to Know

  • Passing score: Scaled passing score based on psychometric benchmarking
  • Assessment: 160-165 multiple-choice questions (4 options, single best answer)
  • Time limit: 4 hours
  • Exam fee: $588 CAD (CNA member) / $780 CAD (non-member) application fee, plus $85 online (ProctorU) or $110 in-person writing appointment fee; rewrite $378 (member) / $500 (non-member). Applicable taxes extra.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

CHPCN(C) Study Tips from Top Performers

1Master the Edmonton Symptom Assessment System (ESAS-r) and how to interpret scores to guide clinical interventions.
2Understand opioid equianalgesic rotation and breakthrough calculation rules (10% of total 24-hour dose).
3Be clear on the clinical and ethical differences between Palliative Sedation Therapy (PST) and Medical Assistance in Dying (MAID) in Canada.
4Study pharmacological choices for non-pain symptoms: haloperidol for delirium/chemical nausea, glycopyrrolate for secretions, metoclopramide for gastric stasis.
5Review the legal substitute decision-maker (SDM) hierarchies and advance care planning rules in Canadian provinces.
6Understand the physiological signs of imminent death (mottling, Cheyne-Stokes breathing) and how to support families through education.

Frequently Asked Questions

What is the CHPCN(C) certification?

The CHPCN(C) (Certified in Hospice Palliative Care Nursing - Canada) is a nationally recognized specialty credential offered by the Canadian Nurses Association (CNA). It validates that a registered nurse or nurse practitioner has achieved advanced competence and specialized knowledge in providing palliative and end-of-life care.

What are the eligibility requirements for the CHPCN(C) exam?

Candidates must have an active registered nurse (RN) or nurse practitioner (NP) license in Canada and meet one of two practice pathways: (1) Option A: 3,900 hours of nursing experience in hospice palliative care within the last 5 years; or (2) Option B: 1,950 hours of experience plus a formal post-basic palliative care education course of at least 300 hours.

How much does the CHPCN(C) certification cost?

The CNA certification application fee is $570 CAD for CNA members and $756 CAD for non-members. In addition, there is a writing appointment fee (typically around $105-110) paid directly to the testing center or remote proctoring service (Meazure Learning) at booking.

How many questions are on the CHPCN(C) exam?

The exam consists of 160 to 165 multiple-choice questions, which are answered over a 4-hour computer-based testing session. The session can be booked at a local testing center or taken via remote online proctoring.

How do I maintain my CHPCN(C) certification?

CNA certifications are valid for a 5-year term. To renew, certified nurses must either: (1) accumulate a minimum of 100 continuous learning hours in the specialty during the 5-year period; or (2) successfully rewrite the CHPCN(C) certification exam at the end of the term.