If your nursing program requires the HESI A2 and you are staring at a list of eight subtests wondering how you are supposed to prepare for all of them — good news: you almost certainly will not take all eight. Your program picks the sections that count, and once you know which ones, the exam gets a lot more manageable.
The short version: the HESI A2 (Health Education Systems, Inc. Admission Assessment) is Elsevier's nursing school entrance exam, built from eight academic subtests — Reading Comprehension, Vocabulary, Grammar, Math, Biology, Chemistry, Anatomy & Physiology, and Physics — from which each program selects the four to six it requires.
This guide walks through every section — what is on it, how many questions to expect, and how to study for it — plus how scoring actually works and how much prep time to budget.
What is the HESI A2 and who requires it?
The HESI A2 is an admission assessment published by Elsevier and used by nursing and allied health programs across the country — ADN, BSN, and LPN/LVN programs especially — to screen applicants for academic readiness. It is a computerized, multiple-choice exam, taken either at a campus testing center or online with remote proctoring, depending on your school.
Two things make the HESI A2 different from a standardized test like the SAT:
- Your school configures it. The program decides which subtests you take, how much total time you get (commonly four to five hours — Tarrant County College allots five), whether you test on campus or remotely, and how often you can retake it.
- Your school scores it. Elsevier reports percentages; the program sets the cutoffs. There is no universal passing score.
Translation: before you study anything, pull up your program's admissions page and write down exactly which sections it requires and what minimum scores it wants. That single step will save you weeks.
All 8 HESI A2 sections at a glance
Here is the full academic battery. Question counts reflect common administrations (each section typically includes a handful of unscored pilot questions); because schools configure the exam, your counts and timing may vary slightly.
| Section | Typical questions | What it tests | How often required |
|---|---|---|---|
| Reading Comprehension | 55 | Main ideas, inference, tone, meaning in context — often with health-related passages | Almost always |
| Vocabulary & General Knowledge | 55 | Health care and general academic vocabulary, word meaning in context | Almost always |
| Grammar | 55 | Parts of speech, common grammatical errors, sentence structure | Almost always |
| Mathematics | 55 | Arithmetic, fractions, ratios, proportions, unit conversions — an on-screen calculator is provided | Almost always |
| Anatomy & Physiology | ~30 | Body systems, structures, and functions | Very common for RN programs |
| Biology | ~30 | Cells, cellular respiration, photosynthesis, genetics, biology basics | Program-dependent |
| Chemistry | ~30 | Atomic structure, the periodic table, bonding, reactions, acids and bases | Program-dependent |
| Physics | ~25 | Motion, forces, energy, waves — rotation, gravitation, and optics basics | Rare; mostly specific allied health programs |
Elsevier also offers non-academic companion assessments — a Personality Profile and Learning Style inventory — that some schools include. They are not scored like the academic sections, so do not spend study time on them.
The English sections: Reading, Vocabulary, and Grammar
These three sections are where careful, unglamorous practice pays off most, because nearly every program counts them.
Reading Comprehension
You will read short passages — frequently health-themed — and answer questions about main ideas, supporting details, inference, and word meaning in context. The skill being tested is exactly what nursing school demands: extracting precise meaning from dense text. Practice by always identifying the passage's main point in one sentence before touching the questions, and be suspicious of answer choices that are true statements but not what the passage actually said.
Vocabulary & General Knowledge
Expect a mix of everyday academic words and health care vocabulary — terms like "dilate," "distal," or "contraindication." The highest-leverage study strategy here is learning medical roots, prefixes, and suffixes: knowing that "brady-" means slow and "-cardia" refers to the heart lets you decode "bradycardia" and dozens of other words you have never seen. A root-based approach turns one memorized morpheme into ten answered questions.
Grammar
This section covers parts of speech, subject-verb agreement, pronoun use, and commonly confused words (their/there, affect/effect, lie/lay). It is the most learnable section on the exam — the rules are finite, and drilling the classic error patterns for a week moves scores fast.
The Math section: dosage-style arithmetic, not algebra
HESI A2 math is not a math-class test — it is a nursing-readiness test. The emphasis falls on fractions, decimals, percentages, ratios and proportions, and unit conversions (household to metric, pounds to kilograms, Roman numerals), because these are precisely the calculations behind medication dosages. Many questions are word problems dressed in clinical clothing: a ratio-and-proportion setup is the same skill you will later use for dose calculations.
An on-screen calculator is available, which changes how you should prepare: your enemy is not arithmetic speed but setup errors. Practice writing the proportion or conversion factor cleanly before computing. If you can reliably convert between milligrams and grams, cups and milliliters, and pounds and kilograms without hesitation, you are most of the way there.
The Science sections: A&P, Biology, Chemistry, and Physics
The sciences are where preparation time varies most from student to student, and where your program's section list matters most — study only the sciences your program requires.
Anatomy & Physiology — the section students rank hardest
Ask students who have taken the HESI A2 which section hurt, and A&P is the most common answer. The question pool is broad — every body system, from cardiovascular to endocrine to renal — while the section itself is short, so any given administration samples unpredictably from a large territory. You cannot cram it; you have to actually know structures and functions. Visual study helps enormously here, which is why our HESI A2 lessons use real labeled anatomy diagrams rather than text-only review. Prioritize the systems you are weakest in, and drill structure-function pairs: not just "the nephron exists" but "the nephron filters blood and forms urine."
Biology
Covers the fundamentals of a first biology course: cell structure and organelles, cellular respiration, photosynthesis, biological molecules, and basic genetics. If your general biology course is recent, this section mostly needs a refresh; if it is years old, budget real review time for cellular processes, which are the most heavily tested ideas.
Chemistry
Expect atomic structure, the periodic table, chemical bonding, balancing reactions, and acids, bases, and pH. The section rewards conceptual fluency over calculation — knowing what an ionic bond is and how pH scales behave matters more than solving multi-step stoichiometry.
Physics
Physics is the least commonly required subtest — it appears mostly in specific allied health tracks (some radiologic technology and similar programs). It covers motion, forces, energy, waves, and basic optics. Do not touch it unless your program explicitly lists it.
How is the HESI A2 scored?
Each section is scored as a percentage from 0 to 100%, and schools also see a composite across your required sections; there is no official pass/fail line from Elsevier — every program sets its own. Many programs look for roughly 75% or higher in each required section, and competitive programs often want more: the University of Arizona College of Nursing, for example, publishes its own HESI requirements, and cutoffs genuinely differ from school to school.
Three practical implications:
- Check your program's cutoff — per section, not just composite. Some programs require a minimum in every section, so one weak section can sink an otherwise strong exam.
- Competitive admissions treat the HESI A2 as a ranking tool. If admission is score-ranked, "above the minimum" is not the goal; "as high as you can reasonably get" is.
- Retake policies are school-specific too. Some schools allow one attempt per application period with a mandatory wait between attempts (TCC requires 60 days); others differ. Know the rule before you sit, because a rushed first attempt can cost you a cycle.
Which HESI A2 sections will I actually take?
Whichever ones your program says — most commonly four to six of the eight. A typical RN program battery is Reading, Vocabulary, Grammar, Math, and A&P; some add Biology or Chemistry; LPN/LVN programs sometimes skip the sciences entirely; Physics is rare. Some testing centers administer a fixed battery and simply disregard sections your program does not use, so even the same campus can weight sections differently across programs.
This is worth repeating because it is the single most common HESI A2 prep mistake: students spend weeks grinding chemistry for a program that never looks at a chemistry score. Confirm your section list in writing from your program's admissions page or advisor, then build your plan around only those sections.
How long should I study for the HESI A2?
For most students, four to eight weeks of consistent study — about an hour a day — is a realistic runway, with the wide range driven almost entirely by your science background. Strong recent A&P coursework can shrink prep to a few weeks of English and math polish; a long gap since your last science class means starting closer to eight weeks, with A&P getting the largest share.
Whatever your timeline, sequence it the same way:
- Diagnose first. Take a diagnostic across your required sections so you know your actual gaps instead of your suspected ones.
- Train weakest-first, one skill at a time. Closing your worst section from 60% to 80% is worth far more than nudging your best from 88% to 92% — especially under per-section minimums.
- Re-attack every miss. When you get a question wrong, do not just read the explanation — re-answer a fresh variation of it days later. If you cannot get the variation right, you learned the answer, not the concept.
- Simulate before you sit. At least one full-length, timed practice run across all your sections, in one sitting. A four-to-five-hour exam is partly an endurance event, and the first time you feel that should not be test day.
The HESI A2 rewards exactly the kind of student nursing school rewards: steady, honest preparation over cramming. Figure out your sections, find your gaps, and close them one at a time — it is a very beatable exam when you stop preparing for all eight sections and start preparing for yours.