The HESI A2 (Health Education Systems, Inc. Admissions Assessment) is one of the most widely used nursing school entrance exams in the United States. Developed by Elsevier, it is used by hundreds of nursing programs to assess academic preparedness before admission.

Unlike some standardized tests, the HESI A2 isn't entirely standardized — each school chooses which sections to require and what minimum scores to accept. This guide covers the full exam and helps you prepare thoroughly, regardless of which sections your target school requires.

HESI A2 Structure: What Sections Exist?

The HESI A2 consists of up to 10 sections. Schools may require anywhere from 4 to all 10:

Academic Sections (most commonly required):

• Math — 50 questions, 50 minutes
• Reading Comprehension — 47 questions, 60 minutes
• Vocabulary and General Knowledge — 50 questions, 50 minutes
• Grammar — 50 questions, 50 minutes
• Anatomy and Physiology — 25 questions, 25 minutes
• Biology — 25 questions, 25 minutes
• Chemistry — 25 questions, 25 minutes
• Physics — 25 questions, 50 minutes (less commonly required)

Personality and Learning Assessments (not scored, just recorded):

• Learning Style — identifies your preferred learning approach
• Personality Profile — identifies your personality type

HESI A2 Scoring: What You Need

HESI A2 scores are reported as percentages per section. Most nursing schools require:

• 75-80% as a minimum passing score per section (many schools require 75%)
• Some competitive programs require 80-85% for competitive placement
• A Composite Score (average of all sections) of 75%+ is typical for admission

Check your target school's specific requirements on their admissions page — this varies significantly.

Math Section Deep Dive

HESI Math focuses on fundamental math skills relevant to healthcare — especially dosage calculations, unit conversions, and fractions. A basic four-function calculator is typically provided on-screen.

Must-Know Math Topics:

• Fractions: Adding, subtracting, multiplying, dividing fractions and mixed numbers
• Percentages: Converting between fractions, decimals, and percentages; calculating percentage of a quantity
• Ratios and Proportions: Setting up and solving proportion problems (critical for drug calculations)
• Decimals: Operations with decimals, rounding, significant figures
• Measurement Conversions: Metric system (milli, centi, kilo), household to metric (ounces to mL, pounds to kg, inches to cm)
• Basic Algebra: Solving for a single unknown variable
• Roman Numerals: Still tested — know I through L at minimum

A note on dosage calculations: you'll see problems like "A patient weighs 154 lbs. The dose is 2 mg/kg. How many mg should be given?" Practice these systematically. They are high-frequency on the HESI and directly relevant to nursing practice.

Anatomy and Physiology: What to Actually Study

The HESI A&P section covers all major body systems. Unlike some exams, the HESI A&P requires actual knowledge recall — you need to know organ functions, anatomical terms, and physiological processes without context clues in the question.

High-Yield A&P Topics:

• Cardiovascular System: Heart anatomy (chambers, valves, vessels), cardiac cycle, blood pressure regulation, types of blood vessels
• Respiratory System: Upper and lower respiratory tract anatomy, breathing mechanics, gas exchange (alveolar level), oxygen transport
• Nervous System: CNS vs. PNS, neuron structure, synapse, major brain regions and their functions, autonomic nervous system divisions
• Endocrine System: Major glands, their hormones, and what each hormone does (especially pancreas, thyroid, adrenal, pituitary)
• Digestive System: Digestive pathway from mouth to anus, organ functions, enzyme roles, nutrient absorption
• Musculoskeletal System: Major bones and muscles, types of muscle tissue, joint types, bone composition
• Urinary System: Kidney anatomy and nephron function, filtration/reabsorption/secretion, urine formation
• Integumentary System: Skin layers and functions, hair and nail structures, sweat and sebaceous glands

Vocabulary: Healthcare-Specific Words Matter

The HESI Vocabulary section tests academic English vocabulary with a healthcare focus. Many words are Greek and Latin medical roots applied to clinical contexts.

High-Frequency HESI Vocabulary Categories:

• Medical prefixes: hyper-, hypo-, brady-, tachy-, inter-, intra-, post-, pre-, contra-, anti-
• Medical roots: cardi, pulm, neuro, hepat, nephr, hem/haem, derm, oste, arthr
• Medical suffixes: -itis (inflammation), -ectomy (surgical removal), -plasty (surgical repair), -scopy (visual examination), -ology (study of)
• General academic vocabulary: ambiguous, benign, compensate, contraindicate, deficit, exacerbate, facilitate, manifest, precipitate, subsequent

Create flashcards for medical terminology roots. Study 20-30 new terms per day in the 4 weeks before your test. Apps like Anki (free) are excellent for medical vocabulary spaced repetition.

HESI Grammar: Targeted Preparation

HESI Grammar tests standard English grammar rules. Key areas:

• Subject-verb agreement (including with collective nouns and indefinite pronouns)
• Pronoun case (I vs. me, who vs. whom)
• Apostrophe use (possessives vs. contractions)
• Comma rules (especially in compound and complex sentences)
• Commonly confused words (affect/effect, then/than, lay/lie, fewer/less)
• Parallel structure in lists

Bigman's HESI A2 Prep Resources

We offer a comprehensive HESI A2 preparation package including subject-specific study guides, practice test banks, anatomy flashcard sets, and expert tutoring for any HESI section. Our tutors include registered nurses and healthcare educators who know exactly what the HESI tests and how to help you pass it.

Browse our HESI prep materials or book a HESI tutoring session today.