HESI A2 Exam: Sections, Scores, and How to Pass (2026)

What Is the HESI A2 Exam?

The HESI A2 (Health Education Systems Incorporated Admission Assessment) is a standardized nursing school entrance exam used by hundreds of nursing programs across the United States to evaluate academic readiness before admission. It tests the knowledge and skills considered foundational for success in nursing coursework, covering math, reading comprehension, grammar, vocabulary, and basic sciences including biology, chemistry, and anatomy and physiology.

Unlike the NCLEX, which tests licensed nursing graduates, the HESI A2 is a pre-admission exam taken before nursing school begins. Programs use it alongside GPA and other application materials to make admissions decisions. Some schools require a minimum score in specific sections; others use a composite or weighted score. Because requirements vary significantly by program, the first step in HESI preparation is reviewing the exact score requirements at every school you are applying to.

The HESI A2 is administered through Elsevier, the company that owns and manages the exam. Testing typically occurs at the nursing school or a proctored testing center on campus. Some schools have moved to remote proctored testing, though in-person administration is more common. Registration and scheduling happen directly through the school's nursing admissions office rather than through a central registration system, which means test dates are tied to each program's admissions timeline.

Understanding what the HESI A2 tests, how it is scored, and which sections matter most for your target schools is the foundation of effective preparation. This guide covers all sections in detail, explains scoring, and provides a preparation strategy that applies to any timeline from two weeks to three months.

The HESI A2 scores are valid for a limited period, typically two years, though some programs require a more recent score (within the last 12 months) for admission consideration. If you are beginning the nursing school application process early, confirm how long your scores will remain valid for each target program. For students applying to multiple schools with different section requirements, studying all eight sections provides maximum flexibility even if not all are required by every school you apply to.

One logistical detail that surprises many first-time test-takers: the HESI A2 does not have a universal test center network like the SAT or ACT. You register and test at the school you are applying to or through a proctoring arrangement they specify. This means you may need to travel to each school and test separately if applying to programs in different locations — factoring travel and scheduling into your application timeline is part of practical preparation for the nursing admissions process.

HESI A2 Sections: What Each One Tests

The HESI A2 consists of up to ten sections, though individual nursing programs typically require only a subset. The most commonly required sections are Math, Reading Comprehension, Vocabulary and General Knowledge, and Grammar. Science sections (Biology, Chemistry, Anatomy and Physiology) are required by many programs, with Physics less commonly required. Check your target schools' requirements before deciding how many sections to prepare for.

Mathematics — Covers basic math operations, fractions, decimals, percentages, ratios and proportions, conversions (including medication dosage calculations), and basic algebra. No calculator is allowed on most administrations, so paper-and-pencil arithmetic proficiency matters. The math section is the most commonly cited weak point for test-takers who have been out of academic settings for several years, because basic arithmetic fluency fades without regular use. Focused practice with medication dosage conversion problems is particularly useful because dosage calculations appear on both the HESI A2 and in clinical nursing practice.

Reading Comprehension — Presents reading passages (roughly 300-600 words each) followed by multiple-choice questions testing main idea identification, detail recall, inference, vocabulary in context, and author's purpose. This section closely resembles the reading comprehension sections found on most standardized exams. Strategies include reading the questions before the passage to know what to look for, eliminating answers that go beyond what the passage states, and differentiating between stated facts and implied conclusions.

Vocabulary and General Knowledge — Tests health-related vocabulary and general academic vocabulary. Medical terminology, anatomy terms, and everyday words used in healthcare settings appear frequently. Preparation involves systematic vocabulary review using a HESI-specific word list — flash cards, spaced repetition apps, or the vocabulary section of any HESI A2 prep book. This is one of the sections most improved through focused study because vocabulary is purely a memorization task rather than a skill that requires extended development time.

Grammar — Tests knowledge of sentence structure, punctuation, verb tense, subject-verb agreement, pronoun usage, and commonly confused words. Unlike a writing test, the HESI Grammar section is entirely multiple choice. The most effective preparation is reviewing the specific grammar rules tested rather than broad grammar study — focus on subject-verb agreement with intervening phrases, comma splice identification, and correct pronoun reference.

Biology — Covers cell biology, genetics, evolution, ecology, and the scientific method. Biology is the most conceptual of the science sections and rewards students who understand how processes work rather than just memorizing facts. Key topics include cell respiration, photosynthesis, DNA replication, protein synthesis, and Mendelian genetics.

Chemistry — Covers the periodic table, atomic structure, chemical bonding, reactions, stoichiometry, and basic acid-base chemistry. Chemistry is often the most challenging section for students whose undergraduate chemistry was taken years ago. A focused 2-4 week review using a chemistry review guide is the standard approach for students who need science section remediation.

Anatomy and Physiology — Covers body systems, their structure, and their function. This section is highly relevant to nursing practice and often the section nursing program admissions offices weight most heavily in their scoring formulas. Key content areas include the cardiovascular, respiratory, nervous, musculoskeletal, and endocrine systems. A comprehensive A&P textbook or review guide is the most effective study resource because the breadth of content is too wide for flashcard study alone.

Physics, when required, covers mechanics (velocity, acceleration, Newton's laws), waves and sound, electricity and magnetism, and optics. Physics is the least commonly required section and is most often tested at BSN programs rather than ADN programs. If any of your target schools require Physics, verify this before excluding it from your study plan — a missing Physics score can disqualify an otherwise strong application. The HESI A2 Physics section tests conceptual understanding more than calculation, so reviewing the core principles without extensive mathematical problem solving is the most efficient preparation approach.

HESI A2 Scores: What They Mean and What Schools Require

Each HESI A2 section is scored on a scale of 0 to 100, expressed as a percentage. Scores above 90% are considered excellent; 75-90% is proficient; below 75% may fall below the minimum threshold at many programs. Some schools report a composite score across all required sections; others evaluate each section individually with separate minimums.

Common minimum score requirements across nursing programs range from 75% to 85% per section, with many competitive programs setting minimums at 80% or higher in the science sections. Some programs use a weighted composite score that places higher weight on Anatomy and Physiology and Reading Comprehension, because these skills most directly predict success in nursing coursework. You can find each program's specific requirements in their admissions documentation or by contacting the nursing admissions office directly.

The HESI A2 can be retaken if you do not achieve the required score, though most programs impose a waiting period (typically 60-90 days) before retesting. Some programs limit total attempts to two or three. If you score below the minimum on your first attempt, the waiting period means you may miss an admissions cycle, which is a significant setback in a field where nursing school seats are competitive. This is why thorough preparation before the first attempt produces better outcomes than planning to rely on retakes.

Score reports are issued immediately after the test in most cases and include section scores, a composite score, and comparison data showing how you performed relative to other test-takers. The HESI A2 scoring system uses a learning profile that identifies specific content weaknesses by section, which is useful both for post-test review and for identifying preparation gaps before an exam retake. A detailed breakdown of scoring ranges and what they mean for admissions is in the HESI exam guide.

Some nursing programs use a weighted composite score rather than per-section minimums. In a weighted system, high-priority sections like Anatomy and Physiology and Math contribute more to the final composite than Grammar or Vocabulary. Understanding whether your target school uses weighted or unweighted scoring changes your preparation prioritization — in a weighted system, investing extra time in high-weight sections provides a larger composite score improvement than improving a low-weight section by the same amount. Contact each program's admissions office and ask whether they use per-section minimums or a composite score formula to evaluate applicants.

HESI A2 Preparation Strategy

Effective HESI A2 preparation centers on three activities: diagnostic assessment to find your weakest areas, targeted content review, and practice test simulation. The proportions of each depend on how much time you have and how your diagnostic results look.

Start with a diagnostic practice test to identify your current performance level across all sections. Most HESI A2 prep books include a diagnostic test, and full-length practice tests are available through the official Elsevier platform and third-party prep sites. Your diagnostic test results reveal which sections need the most work, allowing you to allocate study time toward the areas with the highest impact on your composite score.

For content review, section-specific study is more efficient than comprehensive review of all subjects equally. If you score 85% on Reading Comprehension and 62% on Chemistry, spend four times as much time on Chemistry as on Reading. HESI A2 prep books from Kaplan, McGraw-Hill, and Elsevier (the official publisher) are the standard resources. The Elsevier official prep materials are particularly aligned with the actual exam because they are produced by the same company that writes it. Practicing with an official HESI A2 practice test gives you the most accurate sense of question format and difficulty level.

Math preparation requires consistent daily practice rather than periodic cramming. Arithmetic and percentage fluency degrade without regular use, and the no-calculator constraint means you need paper-and-pencil speed. Practice 20-30 HESI A2 math problems daily for the two weeks before the exam, with emphasis on dosage calculation problems, fractions, and unit conversion. This daily practice approach is more effective than a single long math study session per week because it builds procedural fluency through repetition rather than just re-learning concepts.

Anatomy and Physiology preparation benefits from the same active learning techniques used in nursing school itself: concept maps connecting body systems, practice explaining physiological processes out loud, and clinical application questions that go beyond pure anatomy memorization.

The HESI A2 A&P section does not ask for obscure anatomical details — it focuses on function, homeostatic mechanisms, and system interactions that are foundational to clinical nursing assessment. Students who reviewed A&P with a nursing-specific lens (why does this matter at the bedside?) consistently report that the section felt more manageable than expected when they approached it with application-oriented study rather than pure memorization.

HESI A2 Exam Day: What to Expect

The HESI A2 is administered on a computer at your school's testing facility or a designated proctored location. Testing sessions typically run 3-5 hours depending on which sections are required, with breaks permitted between sections. Bring a government-issued photo ID and any registration confirmation your school provided. Most schools prohibit personal calculators, scratch paper from outside, phones, and study materials in the testing room — verify your school's specific rules when you schedule your appointment.

The exam interface presents one question at a time. You can flag questions for review and return to them within a section before submitting, but once a section is submitted you cannot return to it. The time allotment per section varies — math and science sections typically allow more time per question than vocabulary sections. Effective time management means answering each question within the time limit and using the flag feature for questions you want to reconsider rather than spending excessive time on any single item.

After completing the exam, scores are typically available immediately on screen and through the testing system. Your school's admissions office receives your scores directly, so you do not need to send a score report separately. Some programs send applicants a link to view their detailed learning profile, which breaks down performance by subtopic and identifies the specific content categories where your preparation was weakest. For practice sessions before exam day, the HESI practice test collection includes section-specific and full-exam simulations with the same format as the real exam.

Managing exam-day anxiety is a preparation component that many students overlook until test day. Familiarity with the exam format, having completed multiple timed practice sessions, and arriving prepared with required identification materials substantially reduces test-day anxiety compared to walking into an unfamiliar exam without practice under real conditions. The HESI exam guide covers specific logistics and what to expect during administration including computer interface features, section timing, and how scores are reported to your nursing program.

One logistical detail that surprises many first-time test-takers: the HESI A2 does not have a universal test center network like the SAT or ACT. You register and test at the school you are applying to or through a proctoring arrangement they specify. This means you may need to travel to each school and test separately if applying to programs in different locations — factoring travel and scheduling into your application timeline is part of practical preparation for the nursing admissions process.