The HESI A2 Exam: What It Is and How It Works

There is no fixed HESI A2. Each nursing program chooses which exams its applicants sit, so two people can both say they took the HESI and have sat different tests, on different subjects, for different lengths of time. Elsevier's own score report puts it plainly: the composite is "Dependent on Exams Administered."

That fact governs everything below. There is no single question count for the HESI A2 exam, no single time limit, and no single syllabus. There is a set of exams Elsevier publishes, a set of rules about how they run, and a long list of decisions your school makes on its own — which exams you sit, what counts as a pass, how often you can retake, what it costs.

Most of the confusion around this test comes from sources stating a school's choice as though it were a property of the exam. A question count, a total sitting time, a subject list: each of those is true for whoever wrote it down, and none of them is necessarily true for you.

What the name means

HESI stands for Health Education Systems, Inc. A2 stands for Admission Assessment. Elsevier publishes and administers it. The same exam is also called the Evolve Reach Admission Assessment. Some school pages mention "HESI NG" — that is the delivery platform, not a newer or harder version of the test.

It is an entrance exam. Candidates usually sit it in the months before an application deadline. At many schools the score is not only a threshold to clear but a ranking input: it converts into admission points and competes with GPA. At one program the HESI average and the GPA carry identical maximum weight.

The seven exams Elsevier publishes

Elsevier's published table lists seven academic exams. Each is separately timed and separately scored.

The two number columns are why sources disagree about how many questions are on this test. Elsevier's table counts scored items. Every exam also delivers five pilot items on top of those, and pilot items do not count toward your score. Grammar is 50 scored questions inside 55 delivered. Anatomy & Physiology is 25 inside 30. Both numbers are correct. They are counting different things.

Pilot items are not identified to the test taker. There is no marker and no way to tell which five are unscored. Treat every question as if it counts, because you cannot know which ones do.

The minutes column is the part worth doing arithmetic on. Grammar, Vocabulary and Math each give you 50 minutes for 55 delivered questions, so roughly 55 seconds each. Reading gives you 60 minutes for 55, and that time includes reading the passages. The science exams are the tightest: 30 delivered questions in 25 minutes, or about 50 seconds each. If your school administers the common five-exam set — Reading, Vocabulary, Grammar, Math and Anatomy & Physiology — Elsevier's published times add up to 235 minutes of testing.

Four other modules, with thinner documentation

Four further modules exist and appear on school pages and in prep material, but in no official Elsevier document. Only second-tier sources describe them. We separate them for that reason, not because they are rare.

• Physics.
• Critical Thinking. Those sources describe it as a separately licensed paid add-on, scored on its own three-digit scale topping out around 1000, reported on a separate score sheet, and excluded from the composite. If you sit it, it does not move your composite percentage up or down.
• Learning Style, which is unscored.
• Personality Profile, also unscored.

That is what the sources show, and it is as far as we will go. We are not going to publish item counts and timings for these four as though Elsevier had confirmed them. If your program requires one, its own page will say so.

Which exams schools actually require

Across 18 nursing program pages surveyed:

• Reading Comprehension, Basic Math Skills, and Vocabulary and General Knowledge are near-universal.
• Grammar is required by most.
• Anatomy & Physiology was required at 9 programs, Biology at 8, Chemistry at 4.
• Physics was required at none.

The most common configuration is Reading, Vocabulary, Grammar, Math and Anatomy & Physiology. At the other end, two Arizona community colleges administer no science at all.

Physics is also absent from the current official review book, the 6th edition published in March 2024. Earlier editions carried a Physics chapter. That is what the editions show, and it is as far as the evidence goes. No source says Physics has been retired; what the record supports is that the current book omits it and no surveyed program required it. If your program's page lists Physics, believe your program.

The practical version of this section: your section set is a fact about your school, not about the exam, and there is exactly one place to look it up.

How the test behaves once it starts

The navigation rules matter more than people expect, because they change how you should spend time.

• You cannot skip a question.
• You cannot go back to a question.
• There is no flag-for-review tool.
• Your answer locks when you submit it.
• A skipped item counts as incorrect.

Each exam is scored and closed before the next one opens, and you see that score then. Unused time does not carry over to the next exam. You choose the order you sit them in. There is no scheduled break.

The consequence is that every question is a decision you make once. You cannot park a hard item, clear the easy ones, and come back with the time you saved. You answer it now or you take a zero on it, and the clock you are racing belongs to that one exam and no other.

Two things follow. First, guessing is always correct when you are stuck: a skipped question and a wrong question cost exactly the same, and a guess is free. Second, finishing an exam early buys you nothing except the next exam, so there is no reason to rush a section to bank time for a later one.

Seeing each score as you finish is a mixed blessing. It tells you where you stand. It also means you carry a disappointing number into the next exam with no break in between, which is a real part of the day and worth rehearsing. Untimed question lists do not rehearse any of this. HesiSimulator runs the section set your school requires, on the real per-section clocks, with answers that lock when you submit them.

The calculator

A basic four-function calculator is built into the exam platform. Handheld calculators are not allowed — including your own basic one. It adds, subtracts, multiplies and divides, and does nothing else. Practice the arithmetic you would normally lay out on paper, and practice it with the operations that calculator actually has.

How scoring works

Each exam is scored as percent correct, from 0 to 100%. Your composite is the simple average of the exams you actually took.

That word "simple" is load-bearing. The average is unweighted, so a 25-question science exam counts as much toward your composite as a 50-question Reading exam. On the common five-exam set, each exam is worth one fifth of your composite, and Anatomy & Physiology — the shortest of the five — carries the same weight as Math. It also means your composite is not comparable to another candidate's unless you sat the same exams.

Elsevier publishes interpretive bands for these percentages:

The last two bands overlap, and the overlap is deliberate. Where the satisfactory line falls depends on the type of program. These bands describe performance. They are not pass marks, and no school is obliged to use them.

Your score is not out of 1500

If you have seen a 0–1500 scale or an 850 benchmark attached to the HESI A2, it does not belong to this exam. That scale belongs to the HESI Exit and Specialty exams, which students sit during a nursing program rather than to get into one. Elsevier states it directly: "The HESI Score is used to describe performance on nursing Specialty and Exit Exams."

The A2 reports percent correct. Several prep sites publish the 1500 framing for the A2 anyway, and one of them prints a percentage-to-1500 conversion table. There is nothing to convert; the two scales measure different exams taken at different points in a nursing education.

So if a number like 850 has been sitting in your head as the bar to clear, you can drop it. When your school states a HESI A2 requirement, it states a percentage, and the score you see on screen at the end of each exam is a percentage too.

There is no passing score set by Elsevier

Elsevier sets no pass mark for the A2. Every minimum you are held to comes from the school.

Observed across real program pages: section minimums from 60% to 85%. Composite minimums from 72% to 81%, where one exists at all — some programs set none. 75% is the most common requirement.

The distinction between the two kinds of minimum is worth reading carefully on your own program's page. Where per-section minimums apply, a strong composite does not rescue a section that came in under the line. Note also how coarse the short exams are: on a 25-item science exam, one question is four percentage points. And clearing a minimum is not the same as being admitted. Where the score also converts into admission points, the difference between 78% and 88% keeps mattering after you have passed.

Retakes, and the one variable that decides whether retaking is safe

Retake rules are set by the school, not by Elsevier. No vendor cap appears in any official source, so any blanket statement about "the HESI retake policy" is describing one school's rules and not the exam's.

Real policies observed vary on every dimension that matters:

• Wait period: from none at all to three months.
• Attempts: from one per application cycle to unlimited.
• Score validity: from one year to never expiring.

One variable outranks the rest. Some schools use your highest attempt. Some use your most recent. If your school takes your highest, a retake can only help you, and the cost of sitting again is the fee and the study time. If it takes your most recent, a bad day overwrites a better score you already hold, and a second sitting is a genuine risk rather than a free option.

You will rarely see this addressed anywhere, because it cannot be stated once for everyone. It is still the most consequential sentence in your program's policy. Find it before you book a retake, not after.

What it costs

The fee is set by the institution. Elsevier does not publish a list price. Observed fees in 2026 ran from $44 to $103.50 depending on the school and the channel.

Testing through a Prometric center runs materially higher than testing through a school. At one college the same exam cost about $107 through Prometric and about $70 through the school. Retakes are charged at full price, and fees are non-refundable.

Where you take it

Three delivery channels:

• A school testing center.
• Remotely, proctored by ProctorU, which is owned by Meazure Learning.
• A Prometric test center.

Remote testing carries requirements that catch people out. You run two stacked secure browsers. You show a government photo ID. You complete a room scan. And scratch paper is banned — you get a whiteboard instead.

That last one is not a technicality. If you work conversion and fraction problems by writing them out, a whiteboard changes how that feels: less space, a pen you are not used to, and everything you wrote for the last question in the way of the next one. Practice on one before test day rather than finding out during Math.

What to do next

1. Open your program's admissions page and find the section list. This is the only authority on which exams you sit. Not Elsevier's seven-exam table, not this page, not a prep publisher's blog.
2. Write down the minimums. Note whether they are per-section, composite, or both, and what the numbers are.
3. Find the retake rule. Wait period, attempts per cycle, score validity, and above all whether the school counts your highest attempt or your most recent.
4. Check the channel and the fee before you register, since the two are connected.
5. Then study to your own set, under the rules the exam enforces: one exam at a time, its own clock, no going back.

If the page does not answer one of those questions, email the nursing admissions office and ask. Those five answers are worth more to your preparation than any general description of the HESI A2, this one included. Once you have them, you can practice the exact set you will face, timed the way it will be timed, with answers that lock on submit.

Independent. Not affiliated with, endorsed by, or sponsored by Elsevier or HESI. HESI® and Evolve® are trademarks of Elsevier.