The HESI A2, explained

Many US nursing and health professions programs ask applicants to sit the HESI A2. This guide explains what it involves and how to prepare. It's written from Elsevier's published descriptions and school admissions pages, and because programs choose their own sections, scores and rules, every specific is hedged: always check with your program for the current details.

What the HESI A2 is

The HESI Admission Assessment, usually called the HESI A2, is a proctored entrance exam from Elsevier (HESI stands for Health Education Systems, Inc.). Nursing programs (RN, BSN, PN and VN) use it, and so do many other health programs such as radiography, dental hygiene, respiratory therapy and paramedic programs. It checks the academic skills you need to start the coursework: reading, vocabulary, grammar, math and science.

The big difference from other entrance exams is that it's modular. Elsevier offers up to seven academic exams, and each program picks the ones its applicants take. You might sit four sections or all seven, depending on where you apply. You may also see two short unscored Learner Profile sections (learning style and personality) and, at some programs, a separate Critical Thinking exam with its own scale.

You can test at your school, at a Prometric test center, or online with a live remote proctor, depending on what your program accepts.

Sections and timing

English and Math sections have 55 questions and science sections have 30. In each section, 5 questions are unscored pilot items you can't identify. Elsevier gives a recommended time for each:

The common "Core 5" (Reading, Vocabulary, Grammar, Math, and Anatomy and Physiology) is 250 questions in about 3 hours 55 minutes. Your program sets the total time you get for the sitting. On Elsevier's current HESI platform you choose which section to start with and can move between sections, but the clock keeps running while you do. Some programs still use a 30-question Physics section, mostly for radiography, with about 50 minutes reported.

Which sections you'll take

Programs choose. In the school admissions pages we reviewed, Reading and Vocabulary were required everywhere, Math almost everywhere, Grammar and Anatomy and Physiology by most RN programs, and Biology and Chemistry mostly by BSN programs. Physics was rare. That's a small sample, so treat it as a guide.

What each section covers

Elsevier doesn't publish a detailed list of objectives, so these topic lists come from Elsevier's section descriptions and what schools and candidates consistently report. Vocabulary leans on health care words, and Math leans on the measures and conversions nurses use.

Question format and test day

• Mostly multiple choice: pick the one best answer. Some schools report a few typed-answer math questions.
• Reading in passage sets: each passage comes with several questions, and everything you need is in the passage.
• Calculator: schools report a basic on-screen calculator in Math. Personal calculators and phones aren't allowed.
• Scratch paper: remote testing allows one plain sheet; test centers vary, so check with yours.
• Going back: reports differ on whether you can return to an answered question, so practice answering each question in one pass.
• Results: section scores can show at the end of each section if your program allows it.

How scoring works

Each section gives you a percentage score. Your composite score is the average of the sections you complete. It's a plain average of the section percentages, so a 30-question science section counts as much as a 55-question English one. Reports also show subject-area composites, such as an English Language composite (Reading, Vocabulary and Grammar) that some programs use on its own.

Pilot questions don't count toward your score. Score reports also list the topics you missed in Reading, Vocabulary, Grammar and Math, which makes them useful for planning a retake.

Elsevier's score levels

Elsevier publishes interpretive levels to help programs read your scores. They're descriptions, not pass marks:

LearnHESI practice tests show the level for your score using these bands, labeled as a guide, alongside your section scores and composite.

What score do you need?

There is no Elsevier pass mark. Each program sets its own minimum: some on every section, some on the composite, some on both, and many rank applicants by score. As a rough guide, practical and vocational nursing programs often ask for 65% to 70%, most RN programs ask for 75%, and competitive BSN programs want 80% or more. Ranking formulas often reward 85% to 90% and above.

Retakes, fees and results

Elsevier has several versions of each exam, so you can retake it, but your program sets the rules. Programs we reviewed ranged from unlimited attempts to one attempt per admission cycle, with waits from a few weeks to three months between attempts. Some take your best score per section across attempts, some take a single sitting, and some let you retake only the sections you missed. Scores are typically valid for one to two years, again set by the program.

Elsevier doesn't publish one price. Schools have reported about $70 to $75 at a school test center and about $107 to $125 at a Prometric center, and a retake is usually charged again in full. Check with your program and testing site for current fees.

A study plan that works

1. 1

   Confirm your sections. List every HESI A2 section your programs require, and the score each one needs.

2. 2

   Get a baseline. Take a timed practice test before you study, so you know where your points are going.

3. 3

   Study weakest first. For many people that's Math (conversions, fractions and word problems) or Anatomy and Physiology.

4. 4

   Build vocabulary daily. Vocabulary rewards a little every day: learn word parts and health care terms, then test yourself.

5. 5

   Learn, then test, then fix. Learn each topic properly, answer exam-standard questions on it straight away, and relearn anything you miss a different way.

6. 6

   Finish with timed sections. In the last two weeks, sit full timed sections and mocks to build pacing, and review every mistake.

How LearnHESI helps

Most HESI prep is a question bank: you answer, you see the answer, you move on. LearnHESI teaches. Every one of its 147 lessons explains the idea with worked examples and diagrams, tests you on it at real exam difficulty, and if you miss something, reteaches it a different way and tests you again until it sticks.

• Guided learning across all 18 topics and every HESI A2 section. Your first topic is free.
• 1,700+ exam-standard questions with every answer explained, including whole reading passage sets.
• Full mocks and timed section tests on Elsevier's recommended times, scored as a composite against your own target.
• A free practice test with no sign-up, so you can see where you stand today.

LearnHESI is not affiliated with Elsevier. It is independent study material from Hamilton Technologies and is not endorsed by Elsevier or HESI. HESI and HESI A2 are trademarks of their owner. Exam details can change, so check with Elsevier and your program for current requirements.