HESI A2 Practice Test: Every Section, and Why Your School Only Wants Some of Them
The HESI A2 is modular — your programme chooses which sections you sit and what each must score. Here is what every section contains, how the scoring differs from the TEAS, and where applicants most often fall short.
Key point: strong nursing writing makes every clinical conclusion traceable to assessment data, relevant evidence, and a defined outcome.
The HESI is modular, and that changes everything
The most important thing to understand about the HESI A2 is that it is not one fixed exam. It is a set of sections, and each nursing programme chooses which of them you must sit. Two applicants to two different schools may take entirely different HESI exams.
The available academic sections are Mathematics, Reading Comprehension, Vocabulary and General Knowledge, Grammar, Biology, Chemistry, Anatomy and Physiology, and Physics. Many programmes also include a Learning Style and a Personality Profile, which are not scored in the pass-or-fail sense.
Your first task is therefore not studying. It is finding out precisely which sections your programme requires and what minimum each carries. Preparing for Physics when your school does not test it is a common and entirely avoidable waste of several weeks.
The best academic structure does not decorate the clinical reasoning—it makes that reasoning visible.
Section scores, not a single composite
Unlike the TEAS, which produces one headline composite, the HESI reports a percentage score for each section you sit plus a cumulative average across them. Programmes typically set a minimum on each required section, and often on the cumulative score as well.
This matters strategically. On a composite exam, a strong section can carry a weak one. On the HESI, if your programme sets a floor of 75 percent per section, a 95 in Reading does not rescue a 70 in Anatomy and Physiology. Your weakest required section effectively determines your result.
Typical minimums sit around 75 to 80 percent per section, with competitive and accelerated programmes asking for 80 to 90. Because the HESI is scored per section, applicants underestimate how exposed a single weak area leaves them.
Anatomy and Physiology is the decisive section
Where it is required, Anatomy and Physiology is the section that most often decides an application. It is more demanding than the equivalent TEAS content and expects genuine familiarity with structure, function and the relationships between systems.
Expect questions across the skeletal, muscular, nervous, cardiovascular, respiratory, digestive, renal, endocrine, reproductive and integumentary systems. Anatomical terminology matters: directional terms, planes and body cavities appear reliably, and they are cheap marks if you have learned them.
The most productive study approach is to trace processes rather than memorise lists. Follow a red blood cell through pulmonary and systemic circulation. Follow a bolus from mouth to elimination. Follow an impulse from stimulus to muscle contraction. Questions are usually built on those pathways.
Mathematics, Biology and Chemistry
HESI Mathematics is deliberately weighted toward the arithmetic nurses actually use: fractions, decimals, ratios, proportions, percentages, and household-to-metric conversions. Basic dosage calculation appears here, which makes this section a direct rehearsal for nursing school.
Biology covers cellular structure and function, cellular respiration, photosynthesis, molecular biology, metabolism and classical genetics. Chemistry covers atomic structure, the periodic table, bonding, chemical equations, reaction types, solutions, and acids and bases. Both are pitched at introductory college level.
If your programme requires all three sciences, budget your time by weakness rather than evenly. Most applicants find Chemistry the least familiar and Biology the most, and dividing time equally between them tends to leave the weak one weak.
Reading, Vocabulary and Grammar
Reading Comprehension asks you to identify main ideas, find supporting detail, infer meaning, distinguish fact from opinion, and follow the logic of a passage. As with the TEAS, every answer is supported in the text and importing outside knowledge is how marks are lost.
Vocabulary and General Knowledge leans specifically toward terms used in healthcare settings. This is one of the few sections where straightforward flashcard revision genuinely pays, because the content is discrete and finite.
Grammar covers parts of speech, sentence structure, subject–verb agreement, pronoun use, punctuation and commonly confused words. It rewards a small amount of targeted revision and punishes none at all.
How it differs from the TEAS in practice
Beyond the modular structure, the two exams differ in feel. The TEAS is fixed in order and length; the HESI varies by programme. The TEAS gives you one composite; the HESI gives you section scores that must each clear a bar.
Timing is also handled differently. Most HESI sections are generously timed relative to the TEAS, so time pressure is less often the limiting factor. The limiting factor is depth, particularly in Anatomy and Physiology.
If your programme accepts either, the choice is genuinely strategic. Applicants with one weak science area usually fare better on the TEAS, where a composite can absorb it. Applicants who are strong across the board but slower under time pressure often prefer the HESI.
A preparation plan built around your section list
Start by writing down only the sections your programme requires and their minimum scores. Everything that follows should be built around that list and nothing else.
Sit a diagnostic in each required section before studying. Because the HESI is scored per section, your plan should allocate time inversely to your diagnostic scores — the section furthest below its minimum gets the most time, not the section you enjoy most.
Re-test each weak section individually as you go rather than waiting for a full mock. Section-level scoring means section-level feedback is what you actually need.
Retakes and what they cost
Elsevier does not set a universal retake limit; programmes do. Many allow two or three attempts within an admission cycle and impose a waiting period, often 30 or 60 days, between sittings.
Some programmes require you to re-sit the entire required battery rather than only the failed section, which turns a single weak area into a full repeat exam. Confirm this before you sit, because it changes how much preparation a first attempt deserves.
As with the TEAS, ask admissions which attempt counts — highest, most recent, or averaged. That single answer should shape whether you sit early to gauge yourself or wait until you are genuinely ready.
A Quick Quality Check
Use these signals when reviewing your own draft before submission.
Clinical Focus
Strong: The population, setting, and priority problem are explicit.
Revise: The discussion could apply to any patient or setting.
Evidence Link
Strong: Important claims are connected to an appropriate source or assessment cue.
Revise: Recommendations appear without a rationale or traceable evidence.
Measurable Result
Strong: The reader can tell what success looks like and when it will be assessed.
Revise: The conclusion uses broad words such as “better” without a measure.
References and Further Reading
- Elsevier. HESI Admission Assessment Exam Review.
- Section requirements and minimum scores are set by individual programmes; confirm with your admissions office.
About the Author
Mitchelle, Nurse Educator
Mitchelle is a nurse educator on the NursingAnswers team. She writes and reviews the study guides and question rationales used across our NCLEX-RN, TEAS and HESI banks.
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