HESI A2 Math Practice Test: The Basic Math Skills Section

Basic Math Skills delivers 55 questions in 50 minutes. Fifty of them are scored. That works out to about 55 seconds a question, and the section ends when the clock does.

A basic four-function calculator is built into the exam platform. Handheld calculators — graphing, scientific or otherwise — are not allowed. Whatever you can do on a phone calculator you can do on test day; anything more than that, you do yourself.

This page covers what the section contains, what candidates consistently report about how it behaves, and a worked example for every topic on it.

What Elsevier says is on it

The published description of the section is short:

"Basic addition, subtraction, multiplication, fractions, decimals, ratios and proportions, household measures, etc."

That "etc." does real work. Topics corroborated beyond the official wording, across nursing program pages and prep publishers, are metric and cross-system conversion, military time, Roman numerals, basic algebra, and dosage-calculation-style word problems. Items mix straight calculation with multi-step word problems.

What test-takers report

These come from candidate accounts, not from Elsevier. Treat them as informed reports rather than published facts — but they are consistent, and they are the difference between practicing well and practicing comfortably.

1. Conversions usually start from numbers that aren't whole. This is the single most consistently reported trap. You get 2.75 L, not 3 L. You get 0.45 kg and 7.5 lb. If every conversion you have practiced started from a tidy number, you have been practicing an easier section than the one you will sit.

2. Fractions are the heaviest item type, with ratios second. Adding, subtracting, multiplying and dividing fractions, and moving between ratios, fractions, decimals and percentages. If you only have time to drill two things, drill those two.

3. Algebra and Roman numerals are sampled thinly. They are in the pool. Some candidates report sitting a form with none of either. Don't over-invest and don't skip them — a handful of practice problems each is the right amount.

4. The on-screen calculator is rudimentary, and at least one candidate reports keypresses not registering. Estimate your answer in your head before you read the display, so a mistyped entry looks obviously wrong instead of plausible. Note also that remote proctoring bans loose scratch paper: you get a whiteboard or a single sheet in a transparency sleeve. If you work conversions by writing them out, practice in that much space.

5. Sequencing matters. You choose the order you sit your exams in. Because each one is separately timed and closes for good when it ends, several candidates recommend taking the long 50-item exams — Math among them — while you are still fresh.

The topics, with worked examples

Fractions and decimals

The errors live in three places: unlike denominators, mixed numbers, and borrowing.

Subtract: 5 1/6 − 2 3/4. The LCD of 6 and 4 is 12, so the problem is 5 2/12 − 2 9/12. Two twelfths won't cover nine, so borrow a whole: 4 14/12 − 2 9/12 = 2 5/12.

Divide: 3 1/3 ÷ 5/6. Convert to improper fractions, then multiply by the reciprocal: 10/3 × 6/5 = 60/15 = 4.

Moving between forms should be automatic: 5/8 = 0.625, and 0.375 = 375/1000 = 3/8.

Ratio and proportion

Problem. A mixture is made in a ratio of 3 parts concentrate to 7 parts water. You need 250 mL of mixture. How much concentrate?

3 + 7 = 10 parts. 250 ÷ 10 = 25 mL per part. Concentrate is 3 parts: 3 × 25 = 75 mL. (Water is 175 mL; the two add to 250, which is your check.)

Problem. Solve 3/8 = x/20.

Cross-multiply: 8x = 60, so x = 7.5. Note the answer is not a whole number. That is normal here.

Household measures

Learn the chain, not the individual pairs: 3 teaspoons = 1 tablespoon, 2 tablespoons = 1 fluid ounce, 8 fluid ounces = 1 cup, 2 cups = 1 pint, 2 pints = 1 quart, 4 quarts = 1 gallon.

Problem. How many teaspoons are in 2.5 cups?

2.5 cups × 8 = 20 fl oz. 20 × 2 = 40 tbsp. 40 × 3 = 120 tsp. Check it the short way: 1 cup = 48 tsp, and 2.5 × 48 = 120.

Problem. How many fluid ounces are in 1.5 quarts?

1 quart = 2 pints = 4 cups = 32 fl oz. So 1.5 × 32 = 48 fl oz.

Metric and cross-system conversion

Within metric, you are moving a decimal point: 1 L = 1,000 mL, 1 kg = 1,000 g, 1 g = 1,000 mg, 1 mg = 1,000 mcg. Across systems, the two figures used in nursing math are 1 kg ≈ 2.2 lb and 1 fluid ounce ≈ 30 mL.

Problem. Convert 7.5 lb to kilograms.

Pounds to kilograms means dividing: 7.5 ÷ 2.2 = 3.409…, which rounds to 3.4 kg. Divide, don't multiply. A kilogram is heavier than a pound, so the number of kilograms is always the smaller number — that one check catches the error before it costs you.

Problem. Convert 1,500 mcg to grams.

1,500 mcg ÷ 1,000 = 1.5 mg. 1.5 mg ÷ 1,000 = 0.0015 g. Chain the steps; do not try to shift six decimal places at once.

Quick ones worth being able to do without thinking: 2.75 L = 2,750 mL. 0.45 kg = 450 g. 0.6 mg = 600 mcg. 1.5 L = 1,500 mL, which at 30 mL per ounce is 50 fl oz.

Military time

Two rules and two edge cases.

For 1:00 PM through 11:59 PM, add 12 to the hour: 4:45 PM → 1645. Morning times keep their hour and gain a zero in front: 7:20 AM → 0720. Going the other way, subtract 12 from any hour of 13 or more: 2115 → 9:15 PM.

The edge cases are the twelves. Midnight is 0000 and noon is 1200. So 12:30 AM is 0030 — not 1230 — and 12:30 PM is 1230, unchanged. Those two are where military-time errors concentrate.

Elapsed time shows up too. From 2145 to 0615: 2145 to 2400 is 2 hours 15 minutes, then 0000 to 0615 is 6 hours 15 minutes. Total 8 hours 30 minutes.

Roman numerals

The values: I = 1, V = 5, X = 10, L = 50, C = 100, D = 500, M = 1,000.

Read left to right and add, except where a smaller value sits before a larger one — then subtract it. The subtractive pairs are IV (4), IX (9), XL (40), XC (90), CD (400) and CM (900).

• Read it. XXIV = 10 + 10 + (5 − 1) = 24.
• Read it. MCMXCIV = 1,000 + 900 + 90 + (5 − 1) = 1,994.
• Write it. 49 = 40 + 9 = XLIX. Not IL — subtraction only uses the pairs listed above.
• Write it. 1,250 = 1,000 + 100 + 100 + 50 = MCCL.

Basic algebra

One- and two-step linear equations. Undo the addition or subtraction first, then the multiplication or division.

Solve 4x + 9 = 33. Subtract 9: 4x = 24. Divide by 4: x = 6. Check: 4(6) + 9 = 33.

Solve 2x + 13 = 4. Subtract 13: 2x = −9. Divide by 2: x = −4.5. Check: 2(−4.5) + 13 = −9 + 13 = 4. Negative and fractional answers are fair game; an answer that looks untidy is not evidence you made a mistake.

Dosage-calculation-style word problems

These are arithmetic problems dressed in clinical vocabulary. Nothing here is clinical guidance — it is a proportion with units attached.

Problem. A solution contains 250 mg per 5 mL. How many mL contain 400 mg?

Set up the proportion: 250/5 = 400/x. Cross-multiply: 250x = 2,000, so x = 8 mL. Check it: 250 mg per 5 mL is 50 mg per mL, and 8 × 50 = 400.

Problem. A solution contains 125 mcg per mL. How many mL contain 0.5 mg?

The units don't match, so convert first: 0.5 mg = 500 mcg. Then 500 ÷ 125 = 4 mL.

That two-step shape — convert, then proportion — is the version of this item type you are most likely to meet. Always make the units match before you divide.

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.

This kills the strategy most people bring from other tests: work the easy ones, leave the hard ones, come back with the time you saved. There is nothing to come back to. On a 55-second-per-item section, that changes your whole approach — you commit to an answer on a hard item and move, because the alternative is spending three minutes on it and losing the three items at the end of the section.

It also means a HESI A2 math practice test that lets you skip, flag and revise is not practice for this section. An untimed question list with a back button trains the wrong habit. You rehearse deliberating, revisiting and second-guessing, which are exactly the behaviors the real section will not let you use.

Each exam is scored and closed before the next opens. Unused time does not carry over. Finishing Math with six minutes left does not buy you six minutes anywhere else.

Five of the 55 items are pilot questions that don't count toward your score, and they are not identified. You cannot tell which ones they are, so answer all 55 as though they count.

The simulator on this site runs Basic Math Skills as a 55-item exam on a 50-minute clock, with answers locking on submit and the same four-function calculator the platform provides.

How your math score is read

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

Elsevier does not set a passing score. Your program does, and programs disagree. Across published nursing program requirements, section minimums run from 60% to 85%, with 75% the most common. Some programs set a different bar for Math than for their other sections, and different programs at the same school often set different bars. Your program's admissions page is the only authority on yours.

Elsevier does publish interpretive bands, in its own words:

That is the whole of the official framing. Everything beyond it is school policy.

What to do next

Find your program's Math minimum before you do anything else — it decides how much work this section actually needs from you.

Then practice in the order the traps suggest: fractions and ratios first and most, conversions second and always from messy numbers, household measures and military time until they are automatic, and a short pass over Roman numerals and two-step equations so a form that happens to contain them doesn't cost you anything.

When the arithmetic is solid, sit a full 55-item section on a 50-minute clock with no going back, and see what the number is. That is a different exercise from working through problems, and it is the one that tells you whether you are ready.

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