HESI Admission Assessment Exam (A2)

What Makes the HESI A2 Different

The HESI A2 is a modular exam. Your nursing program picks which sections you take and sets its own passing score—so no two programs give the same test. This flexibility is why schools love the HESI; it also means you cannot assume that every candidate takes the same exam you do.

The HESI is published by Elsevier and is used by roughly 40% of nursing programs nationwide (the other 60% use the TEAS). It covers more ground in science than the TEAS does—splitting it into separate sections for Chemistry, Biology, and Anatomy & Physiology rather than bundling them—and it includes dedicated Vocabulary and Grammar sections that test medical terminology and sentence mechanics the TEAS does not.

Most programs require four to six sections. The "core four" are Math, Reading, Vocabulary, and Grammar; many add Anatomy & Physiology. Chemistry and Physics are rarely required. Before you study a single page, confirm your program's required sections and minimum passing score.

Core Facts at a Glance

Your program will assign minimum scores section by section. Missing one section's minimum can disqualify you even if you excel everywhere else.

How HESI A2 Sections Break Down

The eight academic sections fall into three broad groups: English/language (Math, Reading, Vocabulary, Grammar), science (Biology, Chemistry, A&P, Physics), and behavioral (optional Learning Style and Personality assessments). Most students take four to six sections.

The exam includes approximately five unscored pilot questions per section; you cannot identify them during the test.

Anatomy & Physiology Is Where Candidates Get Stopped

A&P is the single most common reason people retake the HESI. It covers 11 body systems—cardiovascular, respiratory, nervous, endocrine, skeletal, muscular, digestive, urinary, reproductive, integumentary, and lymphatic—with 25 questions in 25 minutes. The material is too large to memorize three days before the test, yet many candidates try.

Effective A&P prep requires spaced repetition over at least two to three weeks. You need to know which organ systems are linked (cardiovascular and respiratory, for instance) and be able to explain what happens when one fails. Learn by system, then by mechanism (what do the kidneys do when blood pressure drops?), not by isolated facts.

Chemistry trips up the second group. Questions test concepts—why a solution's pH matters, how elements bond, what makes an acid different from a base—more than calculation speed. Long gaps since high school chemistry, or treating it as math, both trip students who would otherwise score higher.

Vocabulary and Grammar are improvable fast. They require targeted study of medical terms and grammar rules, not broad review. Many students waste time here because it feels easier than A&P, then underestimate how much time they actually have left.

Topics Candidates Consistently Get Wrong

Thinking each section's minimum is optional. Your school sets a minimum for every section you take. A 95% in Reading cannot compensate for a 68% in Math if your program requires 75% in Math.

Studying sections you don't have to take. If your program requires only Math, Reading, Vocabulary, Grammar, and A&P, spending weeks on Chemistry is wasted prep. Get your exact section list from your program's admissions page before you crack a book.

Using the on-screen calculator without practice. HESI provides a calculator during Math, but its interface is not like your phone's calculator. Many students lose time fumbling with it on test day. Practice with it during mock exams.

Treating A&P like other subjects. A&P needs 2–3× more study time than Grammar or Vocabulary. If you budget 50–70 total hours over six to eight weeks, A&P alone gets 15–25 of them. Spaced review beats cramming here.

Missing the "why" behind medical terms in Vocabulary. The HESI Vocabulary section tests medical terminology by testing word roots, prefixes, and suffixes. "What does 'tachycardia' mean?" is often easier if you know that 'tachy-' means fast and '-cardia' means heart. Learn roots, not just word lists.

Reading the question too fast in Math. HESI Math questions often hinge on whether you recognized the units, the number of doses, or the time period. Read twice, calculate once.

How to Use Practice Tests for HESI A2 Exam

Because the HESI is modular and each program scores differently, your practice strategy needs to be tailored.

Start by confirming which sections your program requires and what minimum score each one demands. Then, take a baseline practice test on only those sections—untimed—to see where you actually stand. Many candidates expect A&P and Chemistry to be easier than they are.

When you miss a question, identify why: you did not know the concept, you misread the scenario, or you knew the concept but made an error on test day. Each failure needs a different fix. A wrong vocabulary answer usually means you need to learn the term or the root. A wrong A&P answer often means you need to review the system, not just memorize the fact.

Use the calculator provided on HESI math questions. Time a few math sections to see whether pacing is a  issue for you or whether you have time to spare.

Take full-length practice tests (only the sections your program requires) under timed conditions after you have studied two to three weeks. Aim for at least two to three full-length tests before your  exam. You are testing stamina and decision-making under pressure, not just content knowledge.

Practice tests are not magic—they reveal gaps and train your pacing. They do not guarantee a pass.Get additional practice with our NREMT online practice test.

Common Mistakes That Lead to Retakes

Uneven prep. Spending 10 hours on Grammar because it feels manageable and 5 hours on A&P because it feels hard is backwards. Your score improves most where you have the biggest gap. A&P and Chemistry payoff more prep time.

Cramming A&P. You cannot absorb 11 body systems in three days. Start A&P at least three weeks before your test date.

Assuming your score on one section predicts your score on another. Strong readers sometimes freeze on Vocabulary because medical terminology is new. Good math students sometimes underestimate the conceptual reasoning Chemistry requires. Study each section's material.

Not asking your program which sections it requires. Some programs ask for six sections; others ask for four. Studying Chemistry when your program does not require it is lost time.

Ignoring the minimum-per-section rule. A 92% overall average that includes a 68% in A&P may not get you in if your program's minimum per section is 75%.

 Study Timelines

These are informed estimates. Adjust based on how many hours a week you can actually dedicate and your baseline scores on a mock exam.

What Changes on HESI A2 Exam

Elsevier updates the HESI content outline periodically. The eight-section structure described here has been stable for several years, but section weighting and specific topics do shift. Check with your program before you start studying to confirm they have not added or dropped a section for your admission cycle.

Vocabulary and Grammar on the HESI are also more stable than on some other exams; the topic pools do not turn over dramatically year to year. Biology, Chemistry, and A&P sometimes see updates to reflect current practice (e.g., new physiology findings or pharmacology).