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The HESI A2 Exam: Complete 2026 Guide

Reflects the current Elsevier HESI A2 · Last reviewed July 2026 · Verify section requirements with your nursing program
Quick answer

The HESI A2 is a nursing school entrance exam built from up to eight academic sections — Math, Reading, Vocabulary, Grammar, Biology, Chemistry, A&P, and Physics — but your school chooses which sections you take (usually 4–6), the time limit (typically 2–4 hours), and the passing cutoff (75–80%+ is competitive). Cost is school-set, roughly $40–110. Step one of HESI prep is always the same: get your program's exact section list.

What is the HESI A2 exam?

The HESI A2 (Health Education Systems, Inc. Admission Assessment), published by Elsevier, is one of the two dominant nursing school entrance exams. Like the TEAS, it measures academic readiness rather than nursing knowledge — but its defining feature is configurability. Elsevier offers a menu of sections; each program assembles its own exam from that menu. Two applicants at different schools can both "take the HESI A2" and sit meaningfully different tests.

That configurability is why generic HESI advice fails. Studying physics for a program that doesn't test it wastes weeks; skipping vocabulary for one that requires it is fatal. Your program's admissions page — specifically its required-sections list and per-section minimums — is the actual syllabus.

HESI A2 format at a glance

StructureSchool-selected sections (usually 4–6 of 8)
Academic sectionsMath, Reading, Vocabulary, Grammar, Biology, Chemistry, A&P, Physics
Extras (some schools)Personality style & learning style assessments (unscored for admission)
Questions per section~25–55, multiple choice
Time limitSchool-set; typically 2–4 hours total
Passing scoreSchool-set; 75–80%+ competitive, often per-section
CostSchool-set; roughly $40–110 (+ possible proctoring fee)
CalculatorBuilt-in on-screen calculator for the math section

What's on the HESI A2? Section notes

The four near-universal sections are Math, Reading Comprehension, Vocabulary, and Grammar. Math is heavily practical: fractions, ratios, proportions, and conversions — the arithmetic underneath dosage calculations. Vocabulary leans medical and health-context, which surprises applicants expecting general SAT-style words. The science sections appear program-by-program: Anatomy & Physiology is the most commonly required (and the most failed), Biology and Chemistry follow, and Physics is rare outside imaging/radiology programs. Unlike the TEAS, the HESI doesn't let you return to previous questions — answer and move.

How hard is the HESI A2, really?

The average cumulative score across all test-takers sits far below what programs require — most schools want 75%+ while the typical result lands well under that — so the HESI functions as a genuine filter, not a formality. Its difficulty concentrates in two places: A&P sections that go deeper than most prerequisite courses did, and per-section minimums that remove the ability to let a strong Reading score carry a weak science one. Every required section is its own pass/fail gate at most programs.

How long should you study?

Plan 4–8 weeks and 40–70 hours, weighted by your section list. Take a diagnostic first, then apportion: A&P usually deserves the largest block, math the most consistent daily drip (conversions decay fast), and vocabulary responds best to short spaced sessions over many days — exactly the pattern cramming can't replicate.

How to study for the HESI A2 — and actually retain it

The techniques that actually work

HESI material is memory-dense: hundreds of vocabulary terms, A&P structures, and conversion facts that feel familiar after a read-through and vanish under a section clock. Familiarity isn't recall. What builds recall is testing yourself before you feel ready, spacing reviews so each fact resurfaces right before you'd lose it, and immediately re-learning every miss — the three techniques with the strongest evidence base in learning science.

How Trelos applies them

Trelos is built entirely around those techniques. It teaches each concept, drills it with HESI-style questions section by section, and schedules your reviews so the material sticks — so you can weight your prep to your program's exact section list.

Start the HESI A2 on Trelos — freeNo credit card. Feel the retention engine work in your first session.

What happens after you pass?

Scores appear immediately on completion, section by section, and Elsevier delivers a remediation-oriented report afterward. A strong HESI gets you in the door; the licensure exam at the far end of the program is the NCLEX — our NCLEX-RN and NCLEX-PN guides cover that side of the journey.

HESI A2 exam FAQ

Which sections will I take?
Whichever your program requires — usually 4–6 of the 8. This is the first thing to confirm before studying anything.
What score do I need?
Program-set, frequently 75% per required section. Check every school; requirements differ even between schools using identical sections.
Can I go back to previous questions?
No — the HESI doesn't allow backtracking, unlike the TEAS. Commit and move.
How fast do I get scores?
Immediately on-screen when you finish, with a detailed report to follow.
HESI A2 or TEAS?
Your program decides in most cases. If you genuinely get to choose, see our full comparison.
Study the HESI A2 the way it's actually testedTrelos teaches, drills, and locks in every concept — start free.
Trelos is an independent study tool and is not affiliated with or endorsed by Elsevier. HESI® is a registered trademark of Elsevier Inc. Exam details reflect the HESI A2 as commonly administered as of July 2026; section lists, timing, fees, and cutoffs are set by individual programs — always confirm with your school. Related guides: TEAS · TEAS vs HESI · NCLEX-RN Compare prep: Trelos vs Mometrix · Trelos vs Pocket Prep