HESI A2 Study Guide: How to Pass on Your First Attempt

So you're applying to nursing school and just found out you need to take the HESI A2 exam. Maybe you're feeling a bit overwhelmed - I totally get it. When I was preparing for nursing school, the HESI A2 exam felt like this massive hurdle standing between me and my dream career.

Here's the thing though: with the right HESI A2 study guide and a solid game plan, this test is absolutely passable on your first attempt. I've helped dozens of nursing students prepare for this exam, and I'm going to share everything that actually works - not the generic advice you find everywhere else.

In this comprehensive guide, we'll cover exactly how to pass the HESI exam, break down each section, and give you actionable study strategies you can start using today. Whether you have two weeks or two months to prepare, you'll walk away knowing exactly what to do.

What Is the HESI A2 Exam?

Before diving into HESI exam prep, let's make sure we're on the same page about what this test actually is. The HESI A2 (Health Education Systems, Inc. Admission Assessment) is a standardized entrance exam used by nursing schools to evaluate whether you're academically ready for their program.

What is the HESI exam for nursing exactly? It's basically the gatekeeping test that nursing programs use to filter applicants. Schools want to know you can handle the rigorous coursework before they accept you - and your HESI score helps them figure that out.

HESI A2 vs Regular HESI - What's the Difference?

Quick clarification here because this confuses a lot of people. The difference between HESI and HESI A2 is pretty simple: the HESI A2 is the entrance exam you take before nursing school. There are other HESI exams (like the HESI Exit Exam) that nursing students take during or after their program.

For this guide, we're focused entirely on the HESI A2 - the one you need to get into nursing school in the first place.

How Many Questions Are on the HESI A2?

Here's where it gets a bit complicated. How many questions are on the HESI A2 depends on which sections your nursing school requires. The full exam has about 326 questions total across all sections, but most schools only require certain portions.

Typical question counts per section:

• Math: 55 questions
• Reading Comprehension: 55 questions
• Vocabulary: 55 questions
• Grammar: 55 questions
• Anatomy and Physiology: 30 questions
• Biology: 30 questions
• Chemistry: 30 questions
• Physics: 25 questions (rarely required)

Most nursing programs require the English and Math sections, plus one or two science sections. Check with your specific school to know exactly what you'll be tested on.

Is the HESI Exam Hard?

Alright, let's address the elephant in the room: is the HESI exam hard? The honest answer is - it depends on your background and how well you prepare.

If you recently took high school or college science classes and still remember the material, you might find it pretty manageable. If it's been years since you've cracked open a biology textbook, you'll need to put in more work.

What Makes the HESI A2 Challenging

A few things make this exam tricky for a lot of test-takers:

• Breadth of material: You're being tested on multiple subjects - math, reading, vocabulary, grammar, and sciences. That's a lot of ground to cover.
• Time pressure: Each section is timed, and some people struggle to finish.
• Science depth: The anatomy, biology, and chemistry sections go beyond basic knowledge. You need to actually understand the concepts, not just memorize facts.
• Vocabulary specificity: The vocab section focuses heavily on medical and healthcare terminology.

HESI Passing Scores - What You Need to Know

What is the passing score for HESI? This varies by school, which can be confusing. The HESI A2 is scored on a scale of 0-100 for each section, and then you get a cumulative score.

General score guidelines:

The catch? Competitive nursing programs often want scores in the mid-80s or higher. Some even require 90%+ on certain sections. So while technically "passing" might be 75%, you probably want to aim higher to actually get accepted.

Is the HESI Entrance Exam Hard Compared to Other Tests?

Is the HESI entrance exam hard compared to, say, the TEAS or other nursing entrance exams? They're actually pretty similar in difficulty. The HESI tends to go a bit deeper on science content, while the TEAS includes more general reading-focused questions.

Compared to the actual nursing school exams you'll take later? The HESI A2 is definitely more manageable. Consider this your warmup - if you can pass this, you can handle nursing school coursework.

HESI A2 Sections Breakdown

Let's break down each section so you know exactly what you're walking into. This is crucial for effective HESI exam prep.

HESI A2 Math Study Guide

The HESI A2 math section tests basic to intermediate math skills. You won't need calculus or advanced algebra - but you do need to be solid on fundamentals.

Topics covered:

• Basic operations (addition, subtraction, multiplication, division)
• Fractions, decimals, and percentages
• Ratios and proportions
• Dosage calculations (important for nursing!)
• Basic algebra
• Measurement conversions
• Roman numerals

Key tip: Dosage calculations are huge. Practice converting between units and solving medication math problems - this is directly relevant to nursing and heavily tested.

HESI A2 Reading Comprehension

This section gives you passages and asks questions about them. You'll need to:

• Identify main ideas and supporting details
• Make inferences from the text
• Understand the author's purpose and tone
• Identify logical conclusions

The passages are often healthcare-related, which is actually helpful - you start getting familiar with medical concepts while you read.

HESI A2 Vocabulary

The vocab section is heavily weighted toward medical and healthcare terminology. You'll see words like:

• Medical prefixes and suffixes (hyper-, hypo-, -itis, -osis)
• Anatomical terms
• Common healthcare vocabulary
• Scientific terms used in clinical settings

Study strategy: Learn your medical word roots. Understanding that "cardi-" means heart and "-itis" means inflammation helps you decode words you've never seen before.

HESI A2 Grammar

The HESI A2 grammar section tests your knowledge of:

• Subject-verb agreement
• Punctuation and capitalization
• Sentence structure
• Commonly confused words (their/there/they're, affect/effect)
• Parts of speech

This section trips up more people than you'd expect. Even if you're a native English speaker, brush up on the formal grammar rules - there's a difference between speaking correctly and knowing why something is correct.

HESI A2 Anatomy and Physiology Study Guide

The HESI A2 anatomy and physiology section is often the most challenging for students without recent science coursework. It covers:

• All major body systems (cardiovascular, respiratory, nervous, digestive, etc.)
• Organ functions and locations
• Basic cellular biology
• Homeostasis and body regulation
• Anatomical terminology and body planes

Pro tip: Focus on understanding how systems work together, not just memorizing isolated facts. The HESI loves questions about cause and effect - like how one system failure affects others.

HESI A2 Biology Study Guide

The HESI A2 biology section covers:

• Cell structure and function
• Metabolism (photosynthesis, cellular respiration)
• Genetics and heredity
• DNA and protein synthesis
• Biological molecules

This overlaps somewhat with A&P, so studying both together can be efficient.

HESI A2 Chemistry Study Guide

The HESI A2 chemistry section tests:

• Atomic structure
• Chemical bonding
• Chemical reactions and equations
• Solutions, acids, and bases
• The periodic table
• States of matter

Chemistry intimidates a lot of nursing students, but the HESI doesn't go super deep. Master the basics and you'll be fine.

How to Study for the HESI A2

Okay, now the practical stuff - how to prepare for the HESI exam effectively. I'm going to give you a study framework that actually works.

Step 1: Take a Diagnostic Test

Before you crack open a single study book, figure out where you stand. Take a full practice test (there are free HESI exam practice questions available online) and honestly assess your scores.

This tells you where to focus your energy. If you're scoring 85% in math but 60% in A&P, guess where you should be spending most of your study time?

Step 2: Choose Your Study Materials

You'll want a combination of resources. The best HESI A2 study guide options include:

• Official Elsevier HESI A2 Study Guide: The most comprehensive option, straight from the test makers
• Pocket Prep app: Great for on-the-go practice questions
• McGraw-Hill HESI A2 Review: Good for detailed content review
• Mometrix HESI Secrets: Known for test-taking strategies

Don't buy everything. Pick one comprehensive guide and one source for practice questions. Too many materials just leads to scattered studying.

Step 3: Create a Study Schedule

Consistency beats cramming every time. Here's how to structure your prep:

• Dedicate specific time blocks: 1-2 hours daily is better than 8-hour weekend sessions
• Rotate subjects: Don't study the same thing every day - variety helps retention
• Schedule regular practice tests: Take a full practice exam every 1-2 weeks to track progress
• Build in review time: Go back over weak areas, not just new material

Step 4: Focus on High-Yield Topics

Not everything is weighted equally on the HESI. Spend more time on:

• Math: Dosage calculations, conversions, fractions
• Vocabulary: Medical prefixes, suffixes, and root words
• A&P: Body systems and their functions
• Reading: Practice identifying main ideas quickly

Step 5: Use Active Learning Techniques

Reading a textbook is passive. To actually remember information:

• Teach it back: Explain concepts out loud as if you're teaching someone else
• Use flashcards: Especially for vocabulary and A&P terms
• Draw diagrams: Visualize body systems and chemical processes
• Practice problems: Don't just read about math - do math problems

HESI A2 Study Tips That Actually Work

Let me share some HESI A2 study tips from students who've actually passed this exam - not just theoretical advice.

Tip 1: Master Medical Terminology First

This is honestly one of the best investments of your study time. Learning word roots like:

• cardi- (heart)
• neuro- (nerve)
• pulmo- (lung)
• hemo- (blood)
• -itis (inflammation)
• -ectomy (surgical removal)

...helps you across multiple sections. You'll recognize terms in vocabulary, reading passages, and science sections.

Tip 2: Don't Skip the Grammar Section Prep

A lot of people assume they'll just "wing" grammar because they speak English. Big mistake. Review subject-verb agreement, comma rules, and commonly confused words. This is often where students unexpectedly lose points.

Tip 3: Practice Under Test Conditions

When you take practice tests, simulate the real experience:

• Time yourself strictly
• No phone or distractions
• Sit at a desk, not on your couch
• Take the whole test in one sitting when possible

Test anxiety is real. The more familiar the testing conditions feel, the calmer you'll be on exam day.

Tip 4: Understand, Don't Just Memorize

Especially for science sections, rote memorization won't cut it. The HESI asks application questions - you need to understand concepts well enough to apply them to new scenarios.

Instead of memorizing "the heart pumps blood," understand the pathway: right atrium → right ventricle → lungs → left atrium → left ventricle → body. Know why, not just what.

Tip 5: Use Process of Elimination

When you're stuck on a question, eliminate obviously wrong answers first. Often you can narrow it down to two choices - that gives you much better odds than guessing randomly.

Tip 6: Read Questions Carefully

This sounds obvious but it trips up so many people. Watch out for:

• NOT/EXCEPT questions: "Which of the following is NOT..."
• MOST/BEST questions: Multiple answers might be true, but pick the best one
• Double negatives: Read slowly and parse carefully

How Long Should You Study for the HESI?

How long to study for HESI A2 depends on your starting point, but here are general guidelines:

How long does it take to study for the HESI exam also depends on how much time you can dedicate daily. Someone studying 3 hours a day can prepare faster than someone only managing 30 minutes.

Creating Your Study Timeline

Here's a sample 6-week plan for someone with moderate science background:

• Week 1: Diagnostic test, identify weak areas, gather materials
• Week 2-3: Focus on weakest subject (usually A&P or chemistry)
• Week 4: Review math and vocabulary, practice test #2
• Week 5: Grammar and reading, address gaps from practice test
• Week 6: Final review, practice test #3, light review before exam

Frequently Asked Questions

Your HESI A2 Success Plan

Let's wrap this up with a clear action plan. Passing the HESI A2 isn't about being a genius - it's about being prepared and strategic.

Here's what you need to do:

• Find out exactly what your school requires. Which sections? What minimum score? This shapes your entire study plan.
• Take a diagnostic practice test. Know your starting point so you can focus on what actually needs work.
• Get the right study materials. The Elsevier HESI A2 study guide plus a good practice question app is a solid combination.
• Create a realistic study schedule. Consistency over intensity. 1-2 hours daily beats 10-hour weekend cram sessions.
• Focus on high-yield topics. Medical vocabulary, dosage calculations, and body systems are your priorities.
• Practice under test conditions. Timed, focused, no distractions. Get comfortable with the pressure.
• Get help where you need it. If a subject isn't clicking, don't waste weeks struggling alone.

The HESI A2 is just a hurdle on your path to becoming a nurse - it's not the end goal. Thousands of people pass this exam every year, and with the right preparation, you will too.

Now stop reading and start studying. Your nursing career is waiting.