The Health Education Systems Incorporated Admissions Assessment (HESI A2) is a critical exam for aspiring nursing students. Designed by Elsevier, this standardized test evaluates your academic knowledge and readiness for rigorous nursing school coursework. Whether you're applying to an LPN, ADN, or BSN program, a strong HESI A2 score can significantly strengthen your application.
Key Fact: Unlike the TEAS which has a fixed set of sections, schools choose which HESI A2 sections they require. Most require Anatomy & Physiology, Biology, Chemistry, Math, Reading Comprehension, Vocabulary, and Grammar. Always confirm with your school.
HESI A2 Exam Format & Sections
The HESI A2 is not a single fixed test — nursing programs select which sections they require from the full bank of available subtests. However, the most commonly required sections are:
| Section | Questions | Time Limit |
|---|---|---|
| Reading Comprehension | 47 | 60 min |
| Vocabulary & General Knowledge | 50 | 50 min |
| Grammar | 50 | 50 min |
| Basic Math Skills | 55 | 50 min |
| Biology | 25 | 25 min |
| Chemistry | 25 | 25 min |
| Anatomy & Physiology | 25 | 25 min |
| Physics (less common) | 25 | 25 min |
Scores are reported as a percentage (0–100%). Most nursing programs require a composite score of 75–80%+, with some competitive programs expecting 85%+.
Reading Comprehension Section
The HESI Reading Comprehension section features passages on healthcare-related topics. Questions assess your ability to identify the main idea, locate details, make inferences, and understand vocabulary in context.
Study Tips for Reading
- Read healthcare and medical articles regularly — try websites like WebMD, MedlinePlus, and nursing journals.
- Practice identifying the main idea vs. supporting details in passages.
- Focus on inference questions — these ask what the passage implies, not what it directly states.
- Practice with a timer: you have roughly 76 seconds per question.
- Learn common signal words: "however," "therefore," "in contrast" signal important transitions.
Vocabulary & General Knowledge
This section tests general English vocabulary AND medical terminology. Many questions are healthcare-focused, asking you to know what clinical terms mean.
Essential Medical Terms to Know
- Prefixes: brady- (slow), tachy- (fast), hyper- (over), hypo- (under), anti- (against), peri- (around)
- Suffixes: -itis (inflammation), -ectomy (removal), -ology (study of), -plasty (repair), -scopy (visual exam), -emia (blood condition)
- Root words: cardi (heart), pulm/pneum (lung), derm (skin), hepat (liver), nephr (kidney), neur (nerve)
Build a vocabulary list of at least 200 medical terms and review them daily using flashcards.
Grammar Section
The Grammar section tests standard English grammar rules. This includes subject-verb agreement, correct pronoun use, punctuation, sentence structure, and identifying grammatical errors.
Top Grammar Topics
- Subject-verb agreement (especially with collective nouns and indefinite pronouns)
- Pronoun-antecedent agreement
- Correct comma usage (compound sentences, introductory clauses, series)
- Identifying run-on sentences and fragments
- Correct use of apostrophes (possessives vs. contractions)
- Commonly confused words: affect/effect, than/then, its/it's, lay/lie
Basic Math Skills
The HESI Math section covers arithmetic, fractions, decimals, percentages, ratios, proportions, and basic algebra. Medical math is heavily emphasized because nurses perform dosage calculations regularly.
Key Math Topics
- Fraction operations: adding, subtracting, multiplying, dividing
- Decimal conversions and rounding
- Percentage calculations (including % increase/decrease)
- Ratio and proportion problems
- Roman numerals (used in medication orders)
- Military time conversion
- Basic dosage calculation: D/H × V = amount to administer
Science Sections (Biology, Chemistry, A&P)
Biology
Biology covers cell biology, genetics, microbiology, and basic life science concepts. Focus areas include:
- Cell structure and function (organelles, cell membrane, mitosis vs. meiosis)
- DNA, RNA, and protein synthesis
- Mendelian genetics and Punnett squares
- Photosynthesis and cellular respiration
- Classification of organisms
Chemistry
Chemistry on the HESI focuses on basic concepts relevant to healthcare:
- Atomic structure (protons, neutrons, electrons)
- Chemical bonds (ionic vs. covalent)
- pH scale and acid-base chemistry
- Chemical reactions and equations
- Water properties and solutions (molarity, concentration)
Anatomy & Physiology
A&P is often the most heavily weighted science section. You must know all major body systems:
- Skeletal system: bones, joints, and bone tissue
- Muscular system: muscle types and contraction mechanisms
- Cardiovascular: heart anatomy, blood flow, cardiac cycle, blood vessels
- Respiratory: lungs, gas exchange, breathing mechanics
- Nervous system: central vs. peripheral, neurons, neurotransmitters
- Endocrine: major glands and hormones (insulin, cortisol, thyroid hormone)
- Digestive, urinary, reproductive, lymphatic, and immune systems
6-Week HESI Study Plan
Week 1–2: Foundation
- Take a diagnostic practice test to identify weak sections.
- Begin Anatomy & Physiology study — one system per day (starting with cardiovascular).
- Start medical vocabulary flashcard deck (20 new terms per day).
Week 3–4: Deep Study
- Intensive biology and chemistry review.
- Daily math practice: 30 dosage calculation problems per day.
- Grammar: review all major rules and do 20 practice questions daily.
Week 5–6: Practice & Polish
- Two full-length practice tests under timed conditions.
- Focus remaining study on weakest sections.
- Final review of all medical vocabulary and A&P systems.
Struggling with Your HESI A2? Get Expert Help 🏥
Our HESI specialists can help you target your weakest sections and achieve the score you need for nursing school admission.
Top Test-Day Strategies
- Get a full 8 hours of sleep the night before — fatigue dramatically reduces test performance.
- Eat a protein-rich breakfast before your exam.
- Answer every question — there's no penalty for guessing on the HESI.
- Use the process of elimination on difficult questions.
- Manage your time carefully — flag difficult questions and return to them.
- Don't second-guess yourself repeatedly — change answers only if you have a clear reason.
HESI A2 FAQs
What score do I need on the HESI?
Most nursing programs require a composite score of 75–80%. Highly competitive BSN programs may require 85%+ on specific sections like A&P and Reading. Always verify with your target school.
How long does it take to prepare for the HESI?
Most students need 4–8 weeks of consistent preparation. If your science background is weak, budget 8–10 weeks for thorough preparation.
Can I retake the HESI A2?
Yes, but policies vary by institution. Some schools require a 60-day waiting period and limit total attempts to 3. Know your school's specific policy.