HESI A2 in 2026: The Score Your Nursing School Actually Requires
The HESI A2 (Health Education Systems, Inc. Admission Assessment) is a nursing school entrance exam used by hundreds of programs across the United States. But here's what creates the most confusion and anxiety for applicants: every nursing school sets its own score requirements, and the differences are significant.
Some programs accept 75%. Others won't look at you below 90%. Some require composite scores. Others require minimum scores in each individual section. This guide cuts through the confusion and tells you exactly what you need.
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HESI A2 Exam Format & Structure
| Component | Details |
|---|---|
| Sections | Up to 10 (your school selects which ones you take) |
| Questions per Section | 25–55 questions |
| Time Limit | Varies by school (typically 4–5.5 hours total) |
| Score Scale | 0–100% per section |
| Passing Score | Set by individual nursing program |
| Cost | $40–$100 (varies by testing site) |
| Provider | Elsevier (through nursing school testing centers) |
| Retake Policy | Set by individual school (typically 60–90 day wait) |
The 10 HESI A2 Sections
| Section | # Questions | Time | Tested By Most Schools? |
|---|---|---|---|
| Mathematics | 50 | 50 min | Yes — almost universal |
| Reading Comprehension | 47 | 60 min | Yes — almost universal |
| Vocabulary | 50 | 50 min | Yes — very common |
| Grammar | 50 | 50 min | Yes — very common |
| Anatomy & Physiology | 25 | 25 min | Yes — most BSN programs |
| Biology | 25 | 25 min | Common |
| Chemistry | 25 | 25 min | Some programs |
| Physics | 25 | 25 min | Rare (few programs require) |
| Critical Thinking | 30 | N/A | Uncommon |
| Learning Style | 14 | N/A | Not scored; informational only |
Important: Your nursing school will tell you which sections to take. Most programs require 4–6 sections. The "core four" (Math, Reading, Vocabulary, Grammar) are almost universal. Each section may include ~5 unscored pilot questions that you cannot identify.
Score Requirements by Nursing Program Type
Score requirements vary dramatically. Here's a general framework:
Community College / ADN Programs
| Score Level | What It Means |
|---|---|
| 75% composite | Minimum to apply at many ADN programs |
| 80% composite | Competitive for most community college programs |
| 85%+ composite | Strong application; likely admission |
University BSN Programs
| Score Level | What It Means |
|---|---|
| 78–80% composite | Minimum cutoff at many state universities |
| 82–85% composite | Competitive at most BSN programs |
| 88–92%+ composite | Required at highly competitive programs |
Accelerated BSN / Direct-Entry MSN Programs
| Score Level | What It Means |
|---|---|
| 85% composite | Minimum for many ABSN programs |
| 90%+ composite | Competitive at top accelerated programs |
| Individual section minimums | Many require 80%+ per section (no weak areas) |
Key Score Thresholds to Remember
- Below 75%: Very few programs will accept this score
- 75–79%: Meets minimum for many ADN programs; below threshold for most BSN programs
- 80–84%: Competitive for ADN and many BSN programs
- 85–89%: Strong for most BSN programs; competitive for accelerated programs
- 90%+: Competitive everywhere; opens doors to the most selective programs
HESI A2 Sections Ranked by Difficulty
Based on student performance data and failure rates, here's how the sections rank from hardest to easiest:
| Rank | Section | Avg. Score | Why It's Difficult |
|---|---|---|---|
| 1 (Hardest) | Anatomy & Physiology | 65–72% | Vast content, requires deep understanding of body systems |
| 2 | Chemistry | 68–75% | Math-heavy, requires understanding of chemical concepts |
| 3 | Biology | 70–76% | Broad range of topics from cellular to ecological |
| 4 | Mathematics | 75–80% | No calculator on some versions; ratios, fractions, conversions |
| 5 | Grammar | 78–83% | Tricky sentence structure and punctuation rules |
| 6 | Vocabulary | 80–85% | Medical terminology heavy; context clues help |
| 7 (Easiest) | Reading Comprehension | 82–88% | Passage-based; good readers score well naturally |
The A&P Problem
Anatomy & Physiology is where most HESI A2 scores fall apart. The section covers:
- All 11 body systems (cardiovascular, respiratory, nervous, endocrine, etc.)
- Cellular biology (cell structure, mitosis, meiosis)
- Tissue types (epithelial, connective, muscle, nervous)
- Organ functions and interactions
- Homeostasis mechanisms
With only 25 questions, each question covers a different system or concept. There's no room for weakness in any area.
Section-by-Section Study Strategy
Mathematics (50 Questions)
What's Tested:
- Fractions, decimals, percentages, ratios
- Dosage calculations and unit conversions
- Roman numerals and military time
- Basic algebra and word problems
- Measurement conversions (metric ↔ household)
High-Yield Study Tips:
- Master dosage calculations: "Desired over Have" method
- Memorize conversions: 1 kg = 2.2 lbs, 1 oz = 30 mL, 1 tsp = 5 mL
- An on-screen calculator is provided in the testing software (personal calculators are not allowed)
- Focus on ratio/proportion — it's the most common question type
Reading Comprehension (47 Questions)
What's Tested:
- Main idea identification
- Supporting details and evidence
- Inference and conclusion drawing
- Author's purpose and tone
- Fact vs. opinion
High-Yield Study Tips:
- Read the questions first, then the passage — know what to look for
- Answers are always in the passage — don't use outside knowledge
- Eliminate extreme language ("always," "never") in answer choices
- Practice with healthcare-themed passages (HESI uses medical topics)
Vocabulary (50 Questions)
What's Tested:
- Medical terminology (prefixes, suffixes, roots)
- Context clue usage
- Synonym and antonym identification
- Words commonly used in healthcare settings
High-Yield Study Tips:
- Learn word parts: hyper- (above), hypo- (below), -itis (inflammation), -ectomy (removal)
- Study the HESI A2 vocabulary list (Elsevier publishes one)
- Use context clues in the sentence to determine meaning
- Focus on healthcare vocabulary over general vocabulary
Grammar (50 Questions)
What's Tested:
- Subject-verb agreement
- Pronoun usage
- Commonly confused words (their/there/they're, affect/effect)
- Sentence structure and punctuation
- Active vs. passive voice
High-Yield Study Tips:
- Most common errors tested: subject-verb agreement, comma splices, run-on sentences
- Learn the commonly confused word pairs — guaranteed to appear
- Read the complete sentence before choosing; look for what "sounds right"
- Independent vs. dependent clauses — know when to use semicolons vs. commas
Anatomy & Physiology (25 Questions)
What's Tested:
- All 11 organ systems and their functions
- Cellular structure and processes
- Tissue types and locations
- Electrolyte balance and homeostasis
- Anatomical terminology and body planes
High-Yield Study Tips:
- Focus on cardiovascular and respiratory first — most commonly tested
- Know the path of blood through the heart (right atrium → right ventricle → pulmonary artery → lungs → pulmonary veins → left atrium → left ventricle → aorta)
- Understand hormones and their glands (insulin/pancreas, thyroxine/thyroid, cortisol/adrenal)
- Study nerve impulse transmission and neurotransmitters
- Use diagrams and labeling exercises — visual learning sticks for A&P
Free HESI A2 Practice Questions
Our question bank covers all HESI A2 sections with detailed explanations for every answer choice.
4-Week HESI A2 Study Plan
This schedule is weighted toward the hardest sections:
| Week | Focus | Daily Study (90 min) | Activities |
|---|---|---|---|
| Week 1 | A&P + Biology | 90 min | Body systems (2 per day), cellular biology, diagrams |
| Week 2 | Math + Chemistry | 90 min | Dosage calculations, conversions, ratio/proportion, basic chem |
| Week 3 | Vocabulary + Grammar | 90 min | Medical terminology word parts, grammar rules, practice drills |
| Week 4 | Reading + Full Practice Tests | 90 min | Timed passage reading, full practice tests, review weak areas |
Total study time: 40–50 hours over 4 weeks
Study Priority Breakdown
| Section | Study Time Allocation | Why |
|---|---|---|
| A&P | 30% | Hardest section, lowest average scores |
| Math | 20% | Requires practice, no shortcuts |
| Vocabulary | 15% | Medical terminology takes repetition |
| Grammar | 15% | Rule-based, quick to improve |
| Reading | 10% | Most intuitive; practice improves speed |
| Biology/Chemistry | 10% | If required by your program |
HESI A2 Retake Policies
Retake policies are set by individual schools, but common patterns:
| Policy | Typical Rule |
|---|---|
| Wait period | 60–90 days between attempts |
| Maximum attempts | 2–3 per year |
| Score validity | 1–2 years (varies by school) |
| Best score used? | Some schools use highest, others use most recent |
| Cost per retake | $40–$100 |
Important: Some schools will only accept your FIRST attempt score. Check with your specific program before relying on a retake strategy.
Exam Day Tips
Before the Exam
- Check which sections your school requires — don't study for Physics if it's not required
- Get the testing location details from your nursing program (usually on-campus)
- Bring a government-issued photo ID
- Get a full night's sleep — A&P recall is heavily impacted by fatigue
During the Exam
- Section timing varies — keep an eye on the clock for each section
- You can't go back to previous sections once you submit
- Use process of elimination — cross off obviously wrong answers first
- Don't overthink vocabulary questions — your first instinct on word meaning is often correct
- For math: Use the on-screen calculator provided, write down your work, check units
Score Results
- Unofficial scores may be available immediately after testing
- Official scores are sent to your nursing program within 24–48 hours
- You receive a score for each section — check which sections matter for your application
HESI A2 vs. TEAS: Quick Comparison
Many nursing schools accept either the HESI A2 or the TEAS. Key differences:
| Feature | HESI A2 | TEAS |
|---|---|---|
| Provider | Elsevier | ATI |
| Sections | Up to 10 (school selects) | 4 fixed sections |
| Total Questions | Varies (typically 200–350) | 170 |
| Time | 4–5.5 hours | 3.5 hours |
| Scoring | Percentage per section | Composite + section scores |
| Harder Section | A&P | Science |
| Cost | $40–$100 | $70–$100 |
If your school accepts both, check which exam aligns better with your strengths. Students strong in A&P often prefer the HESI.
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- All sections covered — Math, Reading, Vocabulary, Grammar, A&P, Biology, Chemistry
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- Updated for 2026 content and question styles
No credit card required. Your nursing school acceptance starts with a strong HESI score.
Official Resources
- Elsevier HESI A2 Information — Official exam provider
- NLN (National League for Nursing) — Nursing education standards
- AACN (American Association of Colleges of Nursing) — BSN program information
- BLS Registered Nurses Career Outlook — Nursing career data
- Your nursing school's admissions page — For specific HESI requirements