HESI A2 Grammar Practice Test: What the Section Actually Tests

The HESI A2 Grammar exam gives you 55 questions in 50 minutes, and 50 of them are scored. That is about 55 seconds a question. Most of them are short. The difficulty is not the rule — it is reading a sentence slowly enough to see what is wrong with it.

Most nursing programs that use the HESI A2 include Grammar, though a few drop it. Your program's admissions page decides. If it is on your list, this page covers what the section contains, what candidates report about how its questions are built, and how to practice for it under the conditions you will actually face.

What Elsevier says is on it

The published description is short:

"Important grammatical terms and uses in grammar, common grammatical errors, parts of speech."

Schools that describe the section in more detail name the same territory:

• Parts of speech — all eight, and identifying them in a sentence
• Agreement — subject with verb, pronoun with the noun it stands for
• Sentence structure — complete versus incomplete sentences, fragments, run-ons, misplaced modifiers
• Punctuation — commas, semicolons, colons, hyphens, parentheses, quotation marks, apostrophes, ellipses
• Capitalization and spelling
• Commonly confused words — word pairs like affect and effect, homophones and homographs

The questions come in three styles that school and prep descriptions agree on: fill in the blank, find the error, and "which of these sentences is grammatically correct" (or incorrect).

What test-takers report

These come from candidate accounts, not from Elsevier. Treat them as reports.

1. Misspellings hide inside sentences that are otherwise fine. Candidates describe items where the grammar is correct and a single word is spelled wrong — and fast readers read straight past it, because the brain fills in the word it expects.

2. The answer options look almost identical. Candidates describe sets of near-identical sentences where the difference is small enough to skim past. Skimming makes them the same sentence. Reading each one literally, word by word, is what separates them.

3. Some candidates name Grammar, with Vocabulary, as the trickiest part of the test. Not most — some. It is worth taking seriously even if English is your strong subject.

Five questions, worked

Every item here is original, written to the published description. None is a real HESI question.

Subject–verb agreement

Choose the word that completes the sentence: "The box of sterile gloves ___ on the top shelf."

• are
• is
• were
• have been

The subject is box, not gloves. "Of sterile gloves" is a prepositional phrase that describes the box, and it never changes the verb. Cross it out and the sentence reads "The box ___ on the top shelf." One box, so is.

Neither … nor

"Neither the residents nor the charge nurse ___ aware of the change in the schedule."

• were
• was
• are
• have been

With neither … nor and either … or, the verb agrees with the subject closest to it. That is the charge nurse — singular — so was. Flip the order ("Neither the charge nurse nor the residents…") and the answer becomes were.

The hidden misspelling

Which sentence contains a spelling error?

• The pharmacist confirmed the dosage before the patient left.
• The clinic recieved the lab results on Tuesday morning.
• Her symptoms were consistent with a mild allergic reaction.
• The surgeon explained the procedure in plain language.

Received follows the old rule — i before e, except after c. Every sentence here is grammatically sound, which is the point: if you are scanning for broken grammar, you will not see it.

Commonly confused words

"The new medication had no noticeable ___ on her blood pressure."

• affect
• effect
• affects
• effected

After no noticeable, the blank needs a noun. Effect is the noun — the result. Affect is usually the verb: the medication did not affect her blood pressure. (Effect as a verb exists — to effect a change, meaning to bring it about — which is why effected is in the list to catch you.)

Run-ons and the semicolon

Which sentence is punctuated correctly?

• The patient was discharged on Friday, her follow-up is next week.
• The patient was discharged on Friday; her follow-up is next week.
• The patient was discharged on Friday; and her follow-up is next week.
• The patient was discharged on Friday her follow-up is next week.

Two complete sentences, joined. A comma alone cannot do that — it makes a comma splice (option one). No punctuation at all is a run-on (option four). A semicolon can — but between two short clauses like these it does not take and after it (option three). Only the second sentence is correct.

The mechanics that change how you practice

You cannot skip and you cannot go back. There is no flag-for-review tool. Your answer locks when you submit it, and a blank counts as incorrect. On a grammar item that means the slow, literal read has to happen the first time.

Five of the 55 items are unscored pilot questions, and nothing marks which ones they are. Answer all 55 as though they count.

The exam is separately timed. Fifty minutes belongs to Grammar alone. Finish early and the time is gone — it does not roll into the next exam.

The simulator on this site runs Grammar as a 55-item exam on a 50-minute clock, with answers locking on submit. The items cover parts of speech, agreement, sentence structure, punctuation and commonly confused words, and each carries a worked explanation of why the right answer is right and why each wrong one is wrong.

How your grammar score is read

The exam is reported as a percentage, 0 to 100%. There is no percentile.

Elsevier does not set a passing score. Your program does. Across published nursing program requirements, section minimums run from 60% to 85%, with 75% the most common. Your program's admissions page is the only authority on yours.

Elsevier's own interpretive bands:

What to do next

Check whether your program includes Grammar, and its minimum. Then practice the habit the section rewards: read every option to the end, word by word, before you choose.

When that feels routine, sit all 55 on the clock with no going back. You can take one exam free, without a card, and Grammar is one of the choices. The Vocabulary section is the other short English exam and sits on most of the same lists; how both fit into the whole test is in the HESI A2 exam guide; the full HESI A2 practice test runs your school's set; and the study guide has the order to work in.

Independent. Not affiliated with, endorsed by, or sponsored by Elsevier or HESI.