Nursing Program Entrance Exam: TEAS, HESI, Kaplan, & PAX Compared

The Nursing Program Entrance Exam: What It Is and Why Schools Use It

A nursing program entrance exam is the standardized test most U.S. nursing schools require before they will read your application. It is not a licensing exam. It does not let you practice nursing. It is a screening tool — the front door of a process that ends, much later, at the NCLEX. The exam exists because nursing programs receive far more applicants than they can train, and a four-hour multiple-choice test is the fastest, most defensible way to sort them.

There is no single national nursing entrance exam. Instead, four major tests compete for adoption: the ATI TEAS, the HESI A2, the Kaplan Nursing Entrance Exam, and the NLN PAX. Schools choose one — sometimes two — and applicants take whichever the school of their choice accepts. Each test has its own publisher, its own format, its own scoring, and its own quirks. They overlap heavily in content but differ enough that switching between them mid-prep is awkward.

The TEAS is by far the most widely used. As of the most recent rollouts, the ATI TEAS is required or accepted by the vast majority of ADN and BSN programs across the United States, and most candidates reading this guide will sit for it. HESI A2 is the next most common — heavily concentrated at university-based BSN programs and in southern states.

Kaplan is used by a smaller but loyal slice of programs, often at private institutions. The PAX, published by the National League for Nursing, has the longest history but is used by fewer schools each year, mostly in the Northeast.

This guide compares all four exams directly, shows you which schools require which, and walks through the content areas, scoring, retakes, and prep timelines so you can pick the right test, prep for it efficiently, and avoid wasting weeks on the wrong material.

Which Schools Require Which Exam

The single most important thing to do before opening a study guide is to check which exam your target programs actually accept. Sitting for the wrong one is one of the most common — and most expensive — mistakes in the nursing admissions process. Each test costs $70 to $115, and the prep materials for one exam will not transfer cleanly to another. The good news: every nursing program publishes its accepted exam on its admissions page, and the pattern across the country is fairly predictable.

TEAS-dominant programs include the bulk of community college ADN tracks and a large share of state-university BSN programs. If you are applying to a community college nursing program in California, Texas, Florida, the Midwest, or the Mountain West, the odds heavily favor TEAS. Many large state universities — Arizona State, Texas State, Indiana University, and similar — also require TEAS for their BSN tracks. The exam's ubiquity is why ATI has invested heavily in the format and why prep companies produce more TEAS materials than for any other nursing entrance exam.

HESI-dominant programs cluster at university-affiliated BSN tracks, particularly in the southern United States. Schools like the University of Texas system, the University of Alabama, the University of South Carolina, and many private universities use HESI A2 because the test integrates with the HESI Exit Exam used in their nursing curriculum. If you plan to apply to a southern university BSN program, check for HESI before assuming TEAS.

Kaplan-using programs are scattered but include several large private universities and select community colleges that have formal partnerships with Kaplan's prep arm. The list shifts year to year as programs renegotiate vendor contracts. Always check the current admissions page.

PAX-using programs have shrunk considerably over the last decade but remain present in the Northeast and at some Catholic-affiliated nursing programs. The NLN PAX is the oldest of the four exams and has a slightly different format that older programs sometimes prefer to keep using.

A small number of programs accept any of two or even three exams — this is the candidate-friendly scenario but is becoming less common. Most programs now standardize on one. The growing trend toward holistic admissions has not eliminated the entrance exam; if anything, it has hardened its role as the one quantitative filter applied uniformly to every applicant.

The Four Major Exams Compared

The differences between the four nursing entrance exams matter most for prep strategy and test-day expectations. Let's walk through what each exam contains, how it's scored, and what its quirks are. After this section you'll have a clear sense of which test fits your strengths and weaknesses, and you'll know what to look for when you compare specific prep books against each other.

The ATI TEAS (Test of Essential Academic Skills) is currently in its seventh edition, known as the TEAS 7. It contains 170 multiple-choice questions delivered in four sections: Reading (45 questions), Mathematics (38 questions), Science (50 questions), and English and Language Usage (37 questions). Test takers have 209 minutes — about three and a half hours — to complete the entire exam, with timed limits for each section. Scoring is reported as a composite percentage plus per-section percentages, and most programs use the composite score as their gate.

The HESI A2 (Health Education Systems Inc. Admission Assessment) is more modular than TEAS. Schools choose which sections to require — typically Math, Reading, Vocabulary, Grammar, Anatomy and Physiology, Biology, and Chemistry, plus an optional Critical Thinking and a Personality Profile. A full HESI A2 can run five hours and contain 326 questions, but most programs require only three to six sections. Scoring is per-section, and schools set their own minimums, commonly 75 or 80 percent on each required section.

The Kaplan Nursing Entrance Exam contains 91 multiple-choice questions across four sections: Reading (22 questions), Math (28 questions), Writing (21 questions), and Science (20 questions). Test time is 165 minutes. Scores are reported as a composite percentage. Kaplan's signature feature is its emphasis on critical thinking — the reading and writing sections frequently require inference and rhetorical analysis that go beyond the surface-level comprehension on the other exams.

The NLN PAX contains 160 scored questions divided into Verbal Ability (60 questions), Mathematics (40 questions), and Science (60 questions). Test takers have three hours total. PAX scoring uses a composite score on a scale of 0 to 200 plus per-section percentile ranks. The verbal section is the most distinctive — it combines vocabulary and reading comprehension in a way the other three exams treat separately.

Content Areas Common to All Four Exams

Although the four exams differ in length, format, and scoring, they cover overlapping content. Roughly 80 percent of what you study for one exam will help on another. The big four content areas — Reading, Math, Science, and English/Grammar — appear in some form on every nursing entrance exam in active use. Knowing what each covers lets you build a prep plan that works regardless of which test you end up taking, and lets you switch exams later with minimal wasted effort.

Reading. Every exam tests reading comprehension. You'll see short and medium-length passages — usually 300 to 600 words — followed by questions about main idea, supporting details, author's purpose, tone, and inference. Some exams (Kaplan in particular) push harder on inference and rhetorical analysis. TEAS and PAX lean toward direct comprehension. Practice with passages drawn from health and science topics is most useful because that's what the exams use; literary fiction practice is mostly irrelevant.

Math. The math sections cover arithmetic, fractions, decimals, percentages, ratios, proportions, algebra basics, measurement conversions, and data interpretation. Calculator policies differ: TEAS provides an on-screen calculator, HESI provides one for some sections, PAX usually does not, and Kaplan policy varies by version. The math on every nursing entrance exam is solidly below college algebra level — there is no calculus, no trigonometry, no advanced statistics. Most students who struggle with math on these exams have weak fractions and proportions fundamentals, not weak algebra. That is where prep time pays off most.

Science. Science is the section that decides the most admissions outcomes, because nursing schools weight it heavily and because most candidates underprepare for it. TEAS covers human anatomy and physiology, life science, physical science, and scientific reasoning. HESI breaks science into separate Anatomy & Physiology, Biology, and Chemistry sections, each treated as its own scored area. PAX covers biology, chemistry, physics, and health. Kaplan keeps science to a single section but covers a similar range. The reading-and-recall demands here are real; the science sections feel more like high school biology and chemistry quizzes than reading-comprehension exercises.

English and Grammar. Every exam includes language usage. TEAS calls it English and Language Usage. HESI splits it into Grammar and Vocabulary. PAX calls it Verbal Ability. Kaplan calls it Writing. The shared content is grammar (subject-verb agreement, pronoun usage, parallel structure, punctuation), word choice, and sentence-level mechanics. Vocabulary questions appear most heavily on HESI and PAX and least on TEAS. This is the section most native English speakers neglect and where the easiest score gains live for anyone who has not studied grammar in years.

Retake Policies and What They Mean for Your Strategy

Every major nursing entrance exam allows retakes, but each one has different rules — and most importantly, each individual nursing program has its own retake policy that sits on top of the exam publisher's rules. Understanding both layers helps you plan attempts strategically and avoid wasting a try.

The ATI TEAS allows unlimited attempts at the publisher level, but ATI imposes a mandatory waiting period between attempts (usually 30 days). Programs typically cap retakes at three attempts per academic year and accept your highest attempt. Some programs require a 30-day wait between attempts even if ATI doesn't enforce one for your particular test version. Always check the program rule, not just the publisher rule.

The HESI A2 has no publisher-imposed waiting period in most cases — you can retake as soon as the testing center has availability — but again, programs almost always impose limits. Two to three attempts per cycle is common, with 30 to 60 day waits between attempts. Because HESI is modular, some programs only require you to retake the sections you scored low on, while others require a full retake of all required sections.

The Kaplan Nursing Entrance Exam generally limits applicants to two or three attempts per year, with mandatory waiting periods between attempts. Score reporting on retakes is most-recent rather than highest at some Kaplan-using schools, so plan attempts knowing the most recent score may be the one that counts.

The NLN PAX allows retakes with a six-month waiting period between attempts at most testing sites. Programs accepting PAX typically use the highest score across attempts, similar to TEAS.

The strategic implication is significant: if a program uses your highest attempt, take the test early in your application cycle even if you're unsure of your readiness, treat the first attempt as a diagnostic, then prep targeted weaknesses and retake. If a program uses your most recent attempt, only take the test when you're confident you'll hit your target score. Read each program's retake policy in writing before scheduling any attempt.

Interpreting Your Score: What Numbers Actually Mean

The raw number on your score report is only the starting point. Understanding what a given score actually means at the programs you're applying to — and how that score compares to other applicants — determines whether you should accept the score, retake the exam, or shift your school list.

On the TEAS 7, scores are reported as a percentage. ATI also publishes proficiency-level interpretations: Basic, Proficient, Advanced, and Exemplary. Most programs require at least Proficient (around 58.7% on TEAS 7) but competitive applicants score Advanced or Exemplary. A 70% on TEAS 7 puts you in the Proficient range; an 80% lands in Advanced; a 90% puts you in Exemplary territory. Programs publish their own minimums, often in the 60–75% range, but the actual admission threshold is typically 10–15 points above the minimum because applicants outscore the minimum.

On HESI A2, scores are reported per section as percentages plus a composite. Programs commonly require 75% or 80% on each required section. Because HESI is modular, a single weak section can disqualify you even with strong other sections — there is no averaging. If your program requires 80% on Math, Reading, A&P, Biology, and Chemistry, you need 80% on all five, not 80% on average.

On the Kaplan Nursing Entrance Exam, scores are reported as a composite percentage. Programs typically require 65% to 75% composite to remain competitive, though some private universities set higher bars. Because Kaplan emphasizes critical thinking, scores tend to cluster lower than on TEAS for the same level of preparation — a 70 on Kaplan often reflects similar readiness to a 78 on TEAS.

On PAX, the composite is reported on a 0–200 scale alongside per-section percentile ranks. A composite around 95–100 is typical for accepted applicants at most PAX-using schools, with competitive programs requiring 110+. The percentile rank tells you how you scored relative to other test takers in the same window, which is useful when programs use cohort-relative ranking instead of fixed thresholds.

One more layer matters: programs often weight sections differently from the composite. A strong overall score with a weak math section can still get you rejected if the program weights math heavily. Read the program's published rubric or call the admissions office and ask how they weight the score.

Switching Between Exams: When It Makes Sense and When It Doesn't

Candidates sometimes find themselves wanting to switch exams mid-prep. This usually happens for one of three reasons: a target program changes its accepted exam, the candidate adds a new target school that requires a different exam, or the candidate scores poorly on one and hopes another will be easier. Each scenario calls for a different decision.

If a target program changes its accepted exam (this does happen — programs renegotiate vendor contracts every few years), switching is mandatory. Pivot fast. Identify which content already transfers (most reading, math, and grammar prep transfers cleanly) and which doesn't (HESI's deeper A&P and chemistry require additional study if you started on TEAS). Order the new exam's official prep materials immediately; the publisher-produced prep is closer to actual exam questions than third-party books.

If you're adding a new target school with a different exam, the question is whether to prep for both or to drop one school list. Prepping for two exams simultaneously is hard. The content overlaps, but the question style and timing differ enough that you'll lose efficiency.

The honest math: prepping for two exams takes about 130 to 150 percent of the time needed to prep for one, and your scores on each will be slightly lower than if you'd focused. If the second school is a top-choice program, the trade-off is worth it. If it's a backup, consider whether you really need it.

The third scenario — switching because you scored poorly and hope another exam will be easier — is usually a mistake. The exams cover similar content, and a poor score on TEAS rarely reflects exam-specific weakness; it reflects content-specific weakness that will show up on HESI, Kaplan, or PAX too. Spend the time you'd spend switching exams on targeted weakness review instead. The exception: if your weakness was test format (timing, on-screen calculator policies, question density) rather than content, a different exam with a different format might genuinely fit you better. Honest self-assessment is everything here.

Programs That Don't Require an Entrance Exam

A growing minority of nursing programs have moved away from requiring a standardized entrance exam, replacing it with holistic admissions based on GPA, prerequisite coursework, healthcare experience, essays, and interviews. If your circumstances make an entrance exam impractical — for instance, you're a non-traditional applicant with a strong professional record but weak standardized test history — these programs are worth identifying early.

No-exam BSN programs tend to fall into three categories. The first is selective private universities that have built their admissions around a holistic file review. They reason that a 4.0 prerequisite GPA, hospital volunteer experience, and a strong interview tell them more about an applicant's likelihood of success than a 90% on TEAS. These programs are typically expensive and competitive; the absence of an exam doesn't make admission easier, just different.

The second is direct-admit BSN programs at universities that admit students from high school into a guaranteed nursing track. These programs use high school GPA, SAT/ACT, and sometimes an interview rather than a nursing-specific entrance exam. The catch: you have to apply during senior year of high school. Transfer admission to these programs almost always reintroduces the entrance exam requirement.

The third is some accelerated BSN programs for second-degree students. The reasoning is that a bachelor's degree already demonstrates academic readiness, so a separate entrance exam adds little. Coursework prerequisites — A&P, microbiology, statistics — and prior degree GPA take the entrance exam's place.

If you're considering no-exam programs as your primary path, build the application around what these programs actually weight: prerequisite GPA (especially in A&P and chemistry), healthcare experience (CNA, EMT, hospital tech, scribe), and interview readiness. The pre-nursing GPA expectation at no-exam programs is usually higher than at exam-requiring programs because GPA is doing the work the exam would otherwise do.

Putting It Together: Your Decision Tree

The nursing program entrance exam landscape has four major players, and the right one for you is determined by your target programs, not by your preferences. Start by listing every program you want to apply to, then write the exam each one accepts next to its name. The exam that appears most often on your list is the one to prep for. If two appear equally, prep for the harder one — usually HESI over TEAS, or Kaplan over either — because the harder exam's prep covers easier exams adequately, but not vice versa.

Build a 10 to 14 week prep timeline working backward from your target test date. The first two weeks are diagnostic and content review of weak areas. The middle six to eight weeks are focused content study plus weekly mixed practice. The last two to four weeks are full-length timed practice tests under realistic conditions, with each test followed by targeted review of missed questions. Skip none of these phases. The full-length practice tests are not optional; they're where most score gains in the final stretch come from.

Sit for the exam early enough in your application cycle that you have time to retake if needed. For most cycles that means testing 3 to 6 months before the application deadline. Programs with rolling admissions reward applicants who submit complete files early, so don't slow your application waiting for a perfect score.

After the exam, focus entirely on the rest of your application: prerequisites in progress, letters of recommendation, healthcare experience, and a focused personal statement. Your entrance exam score gets you into the consideration pile; the rest of the application gets you into the program.

The nursing program entrance exam is a serious test, but it's a knowable one. The content is finite, the formats are well-documented, and millions of candidates have prepped successfully. Pick the right exam, prep deliberately, and treat your first attempt as the floor of what you'll score — not the ceiling.