What is normalization of deviance?

A change that passed a full review

What does shared governance bring to process improvement?

Frontline staff share decisions

Vendors set the department's policy

A leader learns AI tools are being marketed for instrument identification. What is the right first step?

Evaluate evidence and fit first

Buy it before other hospitals do

Replace all inspection staff with it

Free CHL Healthcare Leader Practice Test 2026

200 original questions on the HSPA CHL exam content outline: quality systems, safety, staffing, budgets, leadership, communication, inventory and infection prevention. Four 50-question practice tests. Tuned for mobile. Free to start, no account needed.

Start practicing

Try one now

Pick an answer

Under OSHA's PPE standard, what must an employer do before choosing PPE for a task?

Tigertest CHL practice test training mode on mobile

Train on mobile

Test on desktop

The CHL (HSPA) exam at a glance

The Certified Healthcare Leader (CHL) exam is the Healthcare Sterile Processing Association's (HSPA) certification exam for sterile processing managers and supervisors. HSPA's handbook gives it 150 multiple-choice questions, 125 scored and 25 unscored pretest items, taken on a computer at a Prometric test center in 3 hours. Pass or fail depends on the number of scored questions answered correctly against a passing point HSPA sets by the Angoff method and does not publish as a percentage. The content outline revised August 2025 and updated January 2026 has four sections: Planning and Decision Making 25%, Organizing 23%, Leading 29%, and Governing and Compliance 23%. A current CRCST is required, and from October 2026 HSPA also asks for 12 months of sterile processing or leadership experience or an associate degree.

Tigertest has 200 CHL (HSPA) practice questions with explanations, free to start with no account required.

Questions: 150 multiple choice (125 scored, 25 pretest)
Time: 3 hours
Pass mark: Set number of scored questions correct (Angoff method); no percentage published
Content: Leading 29%, Planning 25%, Organizing 23%, Governing and Compliance 23%
Eligibility: Current CRCST, plus (from Oct 2026) 12 months of SP or leadership experience or an associate degree
Where: Computer based at Prometric test centers
Renewal: Every year, with continuing education; CRCST must stay current
Run by: Healthcare Sterile Processing Association (HSPA)

Updated November 2026 by the Tigertest team. Practice questions follow HSPA's CHL Exam Content Outline (revised August 2025, updated January 2026), CHL eligibility update page and Certification Handbook (revised January 2026), checked November 2026. Exam rules change, so confirm current details with HSPA: Certified Healthcare Leader (CHL).

How It Works

Train by Outline Section

Four training sets follow the HSPA CHL outline: planning and decision making; organizing; leading; and governing and compliance. Questions you miss come back until you have mastered them.

Weighted Practice Tests

Four practice tests of 50 questions, each weighted like the four sections of the real exam. Aim for 70% or better. No question appears in more than one test, and every one comes with an explanation.

Built on the HSPA CHL Content Outline

HSPA publishes the weight of each of the four sections, and every practice test here keeps that balance, scaled to 50 questions: 15 on leading, 13 on planning and decision making, and 11 each on organizing and on governing and compliance. Sterile processing leadership course instructors can set Tigertest as CHL review at tigertest.io/teach and see which topics the class misses most.

Leading29%

Planning and Decision Making25%

Organizing23%

Governing and Compliance23%

Help Make Tigertest Better

Have an idea, a topic you'd like covered, or a question that could be clearer? We read every message and use it to improve every test.

Share Feedback

How to Pass the CHL Exam

1. Lead people first

Leading is 29% of the exam. Know onboarding and precepting, competency assessment, engagement, conflict management, SBAR and other team communication tools, HIPAA basics and how to build buy-in for change.

2. Practice the numbers

Work FTEs, cost per tray, budget variance, payback, straight-line depreciation, ROI and par levels on paper until the setup is automatic, and know the difference between capital and operating budgets.

3. Know the quality and safety tools

Learn when to use FMEA and when to use root cause analysis, the PDSA cycle, Lean and Six Sigma ideas, near misses and sentinel events, MAUDE reporting and OSHA's PPE and bloodborne pathogens duties.

4. Fix your misses, then retest

Tigertest tracks your accuracy by category. Aim for 70% or better on every practice test before your exam date. After each test, drill the questions you missed and retrain the weakest category.

CHL Exam Frequently Asked Questions

What is the HSPA CHL exam?

It is the certification exam for the Certified Healthcare Leader credential from the Healthcare Sterile Processing Association (HSPA), a secondary certification for people who manage the daily operations of a sterile processing department. A current CRCST is required. From October 2026 HSPA also asks for one of 12 months of sterile processing experience, 12 months in a leadership role, or an associate degree or higher.

How many questions are on the CHL exam?

HSPA's certification handbook gives the CHL exam 150 multiple-choice questions: 125 scored and 25 unscored pretest questions mixed in so they cannot be told apart. It is taken on a computer at a Prometric test center, there is no paper version, and candidates have 3 hours. Questions can be marked for review and changed later in the exam.

What score do you need to pass the CHL exam?

HSPA does not publish a percentage. Pass or fail is decided by the number of scored questions answered correctly, against a passing point set by the Angoff procedure with the Beuk compromise and approved by the Certification Council. Result reports show each section as At or Above, Below or Well Below, and HSPA does not give percentage scores. The 70 percent line on these practice tests is a readiness target, not HSPA's standard.

What is on the CHL exam?

HSPA's content outline, revised August 2025 and updated January 2026, has four sections. Leading is the largest at 29 percent, covering staff support, mentoring and training, communication and leadership skills. Planning and decision making is 25 percent, covering quality control processes, equipment, workplace safety, workforce and financial planning. Organizing and governing and compliance are 23 percent each. Each practice test here keeps that balance.

Are these the real CHL exam questions?

No. Every question is original, written by Tigertest from HSPA's published content outline and from public sources such as OSHA standards and AHRQ patient safety guidance. Tigertest is not affiliated with the Healthcare Sterile Processing Association.

I teach a sterile processing leadership course. Can my students use Tigertest?

Yes, for free. Make a class at tigertest.io/teach, post one link, and students join with just their name. You see who practiced, their test scores and the topics your class misses most.

CHL (HSPA) sample questions and answers

6 of the 200 practice questions, one from each topic, with the answer explained.

1. Which professional language habit helps in emails to other departments?
- A.Long and full of blame
- B.Clear, courteous and brief
- C.Written in all capital letters
- D.Full of slang and jokes
Answer: B. Professional written communication is clear, respectful and to the point, which helps the reader act on it.
2. Which organization publishes the Guidelines for Perioperative Practice used in the OR?
- A.OSHA
- B.FDA
- C.CMS
- D.AORN
Answer: D. The Association of periOperative Registered Nurses publishes the Guidelines for Perioperative Practice.
3. When deciding between reusable and single-use products, what should be weighed?
- A.Total cost, safety and waste
- B.Only the unit price
- C.Only what staff prefer
- D.Only the package color
Answer: A. A full comparison covers purchase, reprocessing labor and supplies, safety, storage and disposal costs.
4. What is normalization of deviance?
- A.A rule written into policy
- B.A change that passed a full review
- C.Shortcuts come to seem normal
- D.A single careless mistake
Answer: C. PSNet describes normalization of deviance as the gradual shift in what is regarded as normal after repeated exposure to behavior that strays from safe procedure.
5. What does shared governance bring to process improvement?
- A.Vendors set the department's policy
- B.Patients write the procedures
- C.Frontline staff share decisions
- D.Only executives make choices
Answer: C. Shared governance involves staff in decisions about practice, which builds buy-in and uses their knowledge of the work.
6. A leader learns AI tools are being marketed for instrument identification. What is the right first step?
- A.Evaluate evidence and fit first
- B.Buy it before other hospitals do
- C.Replace all inspection staff with it
- D.Ignore all new technology
Answer: A. New technology is assessed for proven benefit, compatibility with workflows and standards, and cost before adoption.

Every test on Tigertest is free to start, with no account needed.

See all 390 practice tests

Ready to Pass the CHL Exam?

Start for free. No account required. 200 questions across every section of the HSPA CHL content outline.