The HESI A2 stands between you and your nursing school acceptance letter. Most BSN programs in the United States require a composite score of 80 percent or higher, and the most competitive ones want 92 percent or above. The good news is that the HESI A2 is highly predictable. The same math concepts, the same vocabulary roots, and the same anatomy facts come up exam after exam. With 8 weeks of structured prep you can absolutely break 90 percent.
This guide breaks down every section, gives you the formulas and word lists you actually need to memorize, and lays out an 8 week plan you can follow starting today. Plus 15 sample questions across all sections so you can see the real difficulty level.
Table of Contents
- What Is the HESI A2?
- 2026 Exam Format and Sections
- How HESI A2 Scoring Works
- The Core Four Sections (Almost Everyone Takes These)
- The Science Sections
- 8 Week Study Plan
- 25 HESI Math Formulas to Memorize
- 100 High Frequency Vocabulary Words
- 15 Practice Questions with Answers
- Test Day Strategy
- FAQ
What Is the HESI A2?
The HESI A2 (also called the Evolve Reach Admission Assessment) is a standardized entrance exam used by more than 600 nursing programs across the United States. It measures the skills you need to succeed in nursing school: reading comprehension, math, vocabulary, grammar, biology, chemistry, anatomy and physiology, physics, and a learning style and personality assessment.
Your nursing school decides which sections you take. The four academic sections almost every program requires are reading comprehension, math, vocabulary, and grammar (often called the “core four”). Most programs add anatomy and physiology because nursing school is grounded in body systems. Some programs also require chemistry or biology, especially if you have not taken those courses recently. Physics is required by very few programs.
2026 Exam Format and Sections
The full HESI A2 contains 10 components. You take it on a computer at a Pearson VUE site or sometimes at your nursing school’s testing center. The total time depends on which sections your program requires, but the full battery runs about 4 hours and 15 minutes.
Reading Comprehension. 47 questions, 60 minutes. You read short passages and answer questions about main idea, supporting details, inference, vocabulary in context, author’s purpose, and tone.
Math. 50 questions, 50 minutes. Basic math: addition, subtraction, multiplication, division, fractions, decimals, percentages, ratios, proportions, basic algebra, dosage calculations, and unit conversions including the metric system.
Vocabulary and General Knowledge. 50 questions, 50 minutes. Definitions of common medical and general English words. Identifying synonyms, antonyms, and using context to determine meaning.
Grammar. 50 questions, 50 minutes. Parts of speech, subject verb agreement, sentence structure, common errors, punctuation. Heavy on choosing the correct word from a list (their, there, they’re for example).
Biology. 25 questions, 25 minutes. Cell biology, photosynthesis, cellular respiration, genetics, biological molecules.
Chemistry. 25 questions, 25 minutes. Atoms, periodic table, bonding, chemical reactions, balancing equations, acids and bases, basic stoichiometry.
Anatomy and Physiology. 25 questions, 25 minutes. All major body systems: skeletal, muscular, nervous, circulatory, respiratory, digestive, urinary, endocrine, reproductive, integumentary, lymphatic.
Physics. 25 questions, 50 minutes. Newton’s laws, motion, force, energy, waves, optics, electricity. Rarely required.
Learning Style. 14 questions, 15 minutes. Not scored. Tells you whether you learn best by reading, hearing, or doing.
Personality Profile. 15 questions, 15 minutes. Not scored. Helps the program understand your work style.
How HESI A2 Scoring Works
Each scored section is reported as a percentage. There is no official passing score from HESI itself. Each program sets its own minimum.
General score interpretation: 90 percent and above is excellent and competitive at top BSN programs. 80 to 89 percent is acceptable for most ADN and BSN programs. 75 to 79 percent meets minimum at less competitive programs. Below 75 percent is below the threshold for most schools.
Your composite score is the simple average of your scored sections. So if your school requires 5 sections and you score 88, 92, 90, 86, and 84, your composite is 88. Most schools also publish a minimum score for each individual section, often 75 percent. You must hit both the composite and every individual minimum.
You typically can retake the HESI A2 after a waiting period of 30 to 60 days. Most schools allow 2 or 3 attempts within a 12 month window. Confirm your specific school’s retake policy before you sign up.
The Core Four Sections (Almost Everyone Takes These)
Reading Comprehension Strategy. The reading section is the highest yield place to grab points because the questions are answerable directly from the passage. Read the questions before you read the passage so you know what to look for. Then skim for the answers. Watch for inference questions, those are where most students lose points. Inference questions ask what the author implies, not what is stated outright.
Math Strategy. Math is the section most nursing applicants worry about, but it is also the most learnable in the shortest time. The HESI math is at a 7th to 9th grade level. The hard part is the dosage calculations and conversions. Drill conversions until they are automatic: 1 g equals 1000 mg, 1 mg equals 1000 mcg, 1 L equals 1000 mL, 1 kg equals 2.2 lb. The math section does not allow a calculator on every test version, so practice without one.
Vocabulary Strategy. The vocabulary section pulls heavily from medical and clinical English. Words like hypertrophy, dyspnea, palliative, contraindicated, emaciated, lethargic. Buy or download a HESI A2 specific vocabulary list and drill 25 words per day for 8 weeks. By the test you will know all 600 of the most common words by sight.
Grammar Strategy. Grammar tests common errors, which means it tests the same dozen rules over and over. Subject verb agreement, who versus whom, lay versus lie, fewer versus less, affect versus effect, possessives versus contractions. Memorize 15 grammar rules and you can answer 80 percent of the section without thinking.
The Science Sections
Biology. Focus on cell structure (organelles and their functions), the cell cycle and mitosis vs meiosis, photosynthesis vs cellular respiration (inputs, outputs, ATP yield), Mendelian genetics (Punnett squares for monohybrid and dihybrid crosses), and biological macromolecules (proteins, lipids, carbs, nucleic acids).
Chemistry. Memorize the first 20 elements of the periodic table by symbol and atomic number. Know ionic vs covalent bonding, balancing simple chemical equations, and the pH scale. Acids release H plus, bases release OH minus. Watch for questions on the difference between an element, compound, and mixture.
Anatomy and Physiology. This is the most content heavy section. Build a single page summary for each body system showing: organs in the system, primary functions, key terms, and one common pathology. The cardiovascular and respiratory systems are tested most heavily because they relate directly to nursing assessment skills.
8 Week Study Plan
This plan assumes 10 to 12 hours per week. Bump it to 14 hours in weeks 7 and 8.
Week 1: Diagnostic and Math Foundations. Take a full HESI A2 practice test under timed conditions. Identify your weakest section. Then start the math review: fractions, decimals, percentages. Drill 30 problems per day.
Week 2: Math Continued and Vocabulary Start. Move into proportions, ratios, dosage calculations, and metric conversions. Begin a daily 25 word vocabulary list.
Week 3: Reading Comprehension and Grammar. Read one HESI passage per day and answer the questions. Watch for inference and tone questions. Memorize the 15 grammar rules and drill 30 grammar questions per day.
Week 4: Anatomy and Physiology Block 1. Cover the skeletal, muscular, nervous, and integumentary systems. One body system per day with a one page summary sheet.
Week 5: Anatomy and Physiology Block 2. Cardiovascular, respiratory, digestive, urinary, endocrine, reproductive, lymphatic. Heavy emphasis on cardio and respiratory because they are tested most.
Week 6: Biology and Chemistry. Cell biology, genetics, photosynthesis, cellular respiration. Then atoms, bonding, equations, acids and bases. If your school requires physics, add 4 hours of physics review here.
Week 7: Full Practice Test 2 and Targeted Review. Take a second full timed practice. Score it honestly. Spend the rest of the week drilling whichever section dropped lowest.
Week 8: Final Polish. Take one more full practice test early in the week. Spend the last 4 days reviewing your formula sheet, vocabulary list, and anatomy summaries. Light study only the day before. Sleep 8 hours.
25 HESI Math Formulas to Memorize
1. Percent: part over whole times 100
2. Percent change: (new minus old) over old times 100
3. Distance: rate times time
4. Average: sum of values over count of values
5. Area of rectangle: length times width
6. Area of triangle: one half base times height
7. Area of circle: pi times radius squared
8. Circumference: 2 pi r
9. Volume of rectangular prism: length times width times height
10. Pythagorean theorem: a squared plus b squared equals c squared
11. Fahrenheit to Celsius: C equals (F minus 32) times 5 over 9
12. Celsius to Fahrenheit: F equals C times 9 over 5 plus 32
13. 1 inch equals 2.54 cm
14. 1 foot equals 12 inches
15. 1 yard equals 3 feet
16. 1 mile equals 5280 feet
17. 1 kg equals 2.2 lb
18. 1 lb equals 16 oz
19. 1 L equals 1000 mL
20. 1 g equals 1000 mg
21. 1 mg equals 1000 mcg
22. 1 cup equals 8 oz
23. 1 pint equals 2 cups
24. 1 quart equals 2 pints
25. 1 gallon equals 4 quarts
100 High Frequency Vocabulary Words
Drill these in batches of 25 across week 2 to week 5. Look up any you do not know.
Medical and clinical: abate, acute, ambulate, anorexia, apnea, ascertain, aspirate, atrophy, augment, banish, benign, bilateral, bolus, cardiac, carotid, cephalad, chronic, cohort, compromised, consequence, contagious, contraindicate, contusion, cyanotic, debilitate.
General academic: deficit, deteriorate, dilate, dilute, distend, dyspnea, edema, efficacy, emaciated, emesis, empathy, enervate, ephemeral, etiology, exacerbate, expedite, exuberant, fatigue, flaccid, flushed, frequency, gait, hemorrhage, hyperventilate, hypothesis.
Action and assessment: impair, incidence, ingest, initiate, intact, intermittent, invasive, jaundice, lateral, lethargic, lucent, malaise, malignant, manifestation, melancholy, meticulous, monitor, mucous, neonate, oblique, occlude, ominous, otic, palliative, palpate.
Symptoms and conditions: paroxysmal, pathology, pectoral, perfuse, peripheral, pervasive, pneumonia, posterior, prognosis, proliferate, protocol, proximal, recur, regurgitate, sedentary, sequela, supine, suppress, syndrome, tachycardia, transitory, ubiquitous, vehement, vertigo, void.
15 Practice Questions with Answers
1. (Math) A patient needs 750 mg of acetaminophen. The bottle contains 250 mg per tablet. How many tablets should the nurse give?
A) 2 B) 3 C) 4 D) 5
Answer: B. 750 divided by 250 equals 3.
2. (Math) Convert 0.045 g to mg.
A) 0.045 mg B) 4.5 mg C) 45 mg D) 450 mg
Answer: C. Multiply by 1000 since 1 g equals 1000 mg.
3. (Math) What is 35 percent of 240?
A) 80 B) 84 C) 88 D) 96
Answer: B. 240 times 0.35 equals 84.
4. (Vocabulary) Apnea most nearly means:
A) Rapid breathing B) Difficulty breathing C) Cessation of breathing D) Painful breathing
Answer: C. Apnea is the temporary stopping of breathing.
5. (Vocabulary) Lethargic is closest in meaning to:
A) Energetic B) Sluggish C) Aggressive D) Hungry
Answer: B. Lethargic means sluggish or drowsy.
6. (Grammar) Choose the correct sentence:
A) Their going to the hospital tomorrow
B) There going to the hospital tomorrow
C) They’re going to the hospital tomorrow
D) They are going to the hospitle tomorrow
Answer: C. They’re is the contraction for they are. Hospital is the correct spelling.
7. (Grammar) Each of the nurses ____ a stethoscope.
A) have B) has C) are having D) having
Answer: B. Each is singular, requiring has.
8. (Reading) After reading a passage about hospital infection rates, the BEST example of an inference question is:
A) What was the infection rate in 2020?
B) What can be inferred about handwashing compliance based on the data?
C) Define nosocomial infection.
D) Who wrote the study?
Answer: B. Inference questions ask what is implied, not stated.
9. (Biology) Which organelle produces most of the cell’s ATP?
A) Nucleus B) Ribosome C) Mitochondrion D) Lysosome
Answer: C. Mitochondria produce ATP through cellular respiration.
10. (Biology) In a Punnett square, two heterozygous tall plants (Tt) are crossed. What is the probability of a tall offspring?
A) 25 percent B) 50 percent C) 75 percent D) 100 percent
Answer: C. Three of four offspring (TT, Tt, Tt) will be tall.
11. (Chemistry) The pH of a neutral solution is:
A) 0 B) 7 C) 14 D) 1
Answer: B. Pure water at 25 degrees C has pH 7.
12. (Chemistry) Which subatomic particle has no charge?
A) Proton B) Electron C) Neutron D) Nucleus
Answer: C. Neutrons have no charge. Protons are positive, electrons negative.
13. (A and P) Which of the following is NOT a function of the skeletal system?
A) Support B) Protection C) Producing hormones for digestion D) Producing blood cells
Answer: C. Skeletal system supports, protects, stores minerals, and produces blood cells. Digestive hormones are produced by the digestive system.
14. (A and P) The largest artery in the human body is the:
A) Pulmonary artery B) Carotid artery C) Aorta D) Femoral artery
Answer: C. The aorta carries oxygenated blood from the left ventricle to the body.
15. (A and P) Which structure regulates the body’s water balance and blood pressure?
A) Liver B) Pancreas C) Kidneys D) Spleen
Answer: C. The kidneys regulate water balance, electrolytes, and blood pressure.
Test Day Strategy
Sleep at least 7 hours the night before. Eat a real breakfast with protein and complex carbs. Caffeine is fine in your normal amount, do not change anything dramatically on test day.
Arrive 30 minutes early. Bring two forms of ID, both required by Pearson VUE. Bring your authorization to test (ATT) email or printout.
Use the bathroom before you start. Most centers do not stop the clock during breaks between sections, so if you need a bathroom break it costs you test time.
Pace yourself. Math has roughly one minute per question. Reading is closer to 75 seconds per question. Mark and skip anything that takes more than 90 seconds, come back at the end if you have time.
Do not leave any question blank. There is no penalty for guessing on the HESI A2. If you have no idea, eliminate two answers and pick from what is left.
FAQ
How long is the full HESI A2?
About 4 hours and 15 minutes for all 10 sections. If your school only requires 5 sections it will run roughly 3 hours.
What score do I need to pass?
There is no official passing score. Most BSN programs require 80 percent composite. Top programs require 90 percent or higher.
How much does the HESI A2 cost?
Around 50 to 100 USD depending on whether you take it at your school or at a Pearson VUE site.
Can I retake the HESI A2 if I fail?
Yes. Most schools allow 2 or 3 attempts within 12 months with a 30 to 60 day waiting period between attempts. Always check your specific program rules.
How is HESI A2 different from TEAS?
The HESI A2 covers more subjects (8 academic sections vs 4 on TEAS) and goes deeper on anatomy and physiology. TEAS is shorter and slightly easier overall. Some schools accept either, some only accept one.
Is a calculator allowed?
A basic on screen calculator is provided on the math section in 2026. Practice without one anyway in case your test version is non calculator.
Do my section scores have to be high individually or just the average?
Most schools require both. You typically need a minimum on each section (often 75 percent) AND a composite minimum (often 80 percent or higher).
How early should I start studying?
8 weeks is the sweet spot. 12 weeks is even better if you are weak in math or have not had biology recently.
Take a Free HESI A2 Practice Test
The fastest way to know where you stand is to take a timed practice exam. Take a free HESI A2 practice test right now and find out which section needs the most work. Then come back and follow the 8 week plan above.
Other related guides on practicetestvault.com that nursing students find useful:
- How to Pass the TEAS Test on Your First Try (2026)
- How to Pass the NCLEX RN on Your First Try (2026)
- USMLE Step 1 Study Plan 2026
- MCAT CARS Strategies 2026
You can do this. The HESI A2 rewards consistent prep more than raw intelligence. Eight weeks is enough. Now open your math practice and get to work.