What Is the HESI A2 Exam?

The HESI A2 exam (the HESI Admission Assessment) is a pre-admission test that nursing and health-professions programs use to screen applicants, published by Elsevier and delivered through its Evolve platform. Unlike admissions exams with a single fixed form, the A2 is modular: each school selects which subtests its applicants must take, from areas such as reading comprehension, vocabulary, math, biology, and anatomy and physiology, and each school sets its own score requirements. This article explains the subtests, how scoring works, how retake and fee policies vary, and how the A2 compares with its main rival, the ATI TEAS.

Elsevier describes HESI as its "comprehensive review and testing solution for nursing and health professions education," a product line that follows students from admission through graduation; the A2 is the admissions piece. Because schools assemble their own battery, there is no universal list of sections or times, and any table you see online is one school's configuration. A concrete example: Gateway Community and Technical College in Kentucky requires five subtests.

• Reading comprehension: 55 questions in 60 minutes at Gateway; identifying main ideas, understanding words in context, and making logical inferences.

• Vocabulary and general knowledge: 55 questions in 50 minutes at Gateway; basic vocabulary commonly used in healthcare settings.

• Basic math skills: 55 questions in 50 minutes at Gateway; arithmetic, fractions, decimals, ratios, proportions, and household measures.

• Biology: 30 questions in 25 minutes at Gateway.

• Anatomy and physiology: 30 questions in 25 minutes at Gateway; general terminology, anatomical structures, and body systems.

Other schools choose differently. Arizona College of Nursing, for instance, requires only four subtests (anatomy and physiology, reading comprehension, vocabulary, and math) with four hours allotted for the whole assessment, and schools may add subtests such as grammar, chemistry, or physics. The practical rule: your school's admissions page, not a prep site, defines your exam.

Each subtest is reported as a percentage score with a maximum of 100 percent, and students also receive a cumulative score, the average of their subtest scores. Results typically appear in your Evolve account about 24 hours after testing, per Arizona College's admissions page.

There is no national passing score, and schools use the numbers in visibly different ways. Arizona College requires a minimum 60 percent weighted score for applicants with a GPA of at least 2.75, and 75 percent for lower GPAs. Gateway instead awards admission points by band: scores from 90 to 100 percent earn 3 points, 82 to 89 percent earn 2, 75 to 81 percent earn 1, and below 75 percent earns none, with a warning that low scores limit admission chances. Same exam, two entirely different scoring regimes.

These are also program-set, and the two verified examples show the spread. Arizona College allows up to three attempts within 12 months, with a 3-day wait between the first two attempts and 5 business days before the third. Gateway allows only two attempts per eligibility period with a 2-week wait, charges $75 at its assessment center, and treats scores as valid for 18 months. Schools cap retakes for a reason: scores on content-heavy exams rise with repeated exposure, so unlimited attempts would erode the screen.

The A2's main competitor is the ATI TEAS test, and schools decide which one they accept. The structural differences are real. The TEAS is one fixed exam: 170 questions in 209 minutes across four sections, with a single 50-question science section. The A2 is modular, so its length depends on the subtests your school picks, and its science coverage comes as dedicated biology and anatomy and physiology subtests, with chemistry and physics available. Scoring differs too: the TEAS reports equated total and content-area scores, while the A2 reports straight percentage scores plus a cumulative average. Claims about which exam is harder are prep-site folklore; no published comparison backs them.

No. The A2 is an "achievement test": it measures learned content such as medical vocabulary, arithmetic, and anatomy facts, so scores mainly reflect preparation and prior coursework. General cognitive ability does contribute to how quickly people learn that content, which is part of why academic tests predict later performance, though a 2022 reanalysis by Sackett and colleagues revised the classic validity estimates downward. But an achievement test also confounds ability with opportunity to learn: a low A2 score can simply mean you have not taken anatomy yet.

An intelligence test is built the other way around, to measure reasoning abilities that do not depend on any recent syllabus. The RIOT IQ test, for example, reports six indices: Verbal Reasoning, Fluid Reasoning, Spatial Ability, Working Memory, Processing Speed, and Reaction Time. If you want a normed picture of your abilities rather than an admissions screen, you can start with the free RIOT IQ test. The same distinction runs through the whole achievement-test family, from the TEAS to college placement exams like the ACCUPLACER.

The A2 rewards studying more directly than almost any cognitive test does. On pure ability tests, a meta-analysis of 107 samples found practice and coaching raise scores by only about a quarter of a standard deviation. On a vocabulary-and-content exam like the A2, reviewing body systems, medical terminology, and fraction and ratio arithmetic rebuilds exactly the knowledge being tested, so the gains are real and often larger.

• Get your school's subtest list first: There is no point drilling physics if your program only requires four subtests.

• Prioritize vocabulary and anatomy: Both are memory-heavy and respond quickly to flashcard-style review.

• Rehearse under time: Timed practice matters most for the math and reading subtests, where pacing errors are common.

And if your interest is your cognitive profile rather than admission to a program, the RIOT IQ test at riotiq.com is normed on adults 18 and older and publishes a margin of error for every version.

Health Education Systems, Inc., the company that originally created the exam; college admissions pages still name it as the administrator. HESI is now an Elsevier product line.

There is no universal pass mark. Schools set their own rules: Arizona College requires 60 or 75 percent depending on GPA, while Gateway awards admission points in bands from 75 to 100 percent.

It varies by school. Gateway treats scores as valid for 18 months; other programs set their own windows, so check the admissions page.

No. Schools choose which subtests to require, how many attempts to allow, what to charge, and what scores to demand, so two applicants can face quite different exams under the same name.

1. Arizona College of Nursing. (n.d.). HESI admission assessment. arizonacollege.edu

2. Elsevier. (n.d.). HESI: Review and testing for nursing and health professions. elsevier.com

3. Gateway Community and Technical College. (n.d.). HESI A2 assessment. gateway.kctcs.edu

4. Hausknecht, J. P., Halpert, J. A., Di Paolo, N. T., & Moriarty Gerrard, M. O. (2007). Retesting in selection: A meta-analysis of coaching and practice effects for tests of cognitive ability. Journal of Applied Psychology, 92(2), 373-385. doi.org/10.1037/0021-9010.92.2.373

5. Sackett, P. R., Zhang, C., Berry, C. M., & Lievens, F. (2022). Revisiting meta-analytic estimates of validity in personnel selection: Addressing systematic overcorrection for restriction of range. Journal of Applied Psychology, 107(11), 2040-2068. doi.org/10.1037/apl0000994

6. Schmidt, F. L., & Hunter, J. E. (1998). The validity and utility of selection methods in personnel psychology: Practical and theoretical implications of 85 years of research findings. Psychological Bulletin, 124(2), 262-274. doi.org/10.1037/0033-2909.124.2.262