HESI A2 Study Guide: What to Study and in What Order

Search for a HESI A2 study guide and Google hands you nine places to buy a book. Almost none of them tell you the thing that decides your whole study plan: your school picks which exams you sit, and the sets genuinely differ. Study the wrong five and you have prepared beautifully for somebody else's exam.

So start here instead. This page covers what each exam actually contains, what Elsevier says a good score is, how long to spend, and the order to work in. Everything factual traces to Elsevier's published blueprint or to nursing program pages; where it comes from candidates rather than the publisher, it says so.

Before anything else: find out which exams you sit

There are seven academic exams in the HESI A2. Grammar, Reading Comprehension, Vocabulary and General Knowledge, and Basic Math Skills deliver 55 questions each; Anatomy & Physiology, Biology and Chemistry deliver 30. Your program chooses the set.

Those numbers come with a wrinkle that explains why prep sites disagree with each other. Only 50 of the 55 are scored, and 25 of the 30 — the rest are unscored pilot items, seeded to be tested for use on future forms. Both numbers are true, which is why one guide tells you 55 and the next tells you 50 and neither looks trustworthy. You cannot tell which questions are which, so the practical effect is nil: answer all of them.

Elsevier's own score report describes the composite as "Dependent on Exams Administered" — the average of the exams you actually took, and nothing else. Most programs choose five or six. Anatomy & Physiology appears at roughly half the programs we read. Chemistry at far fewer. At least one community college district administers no science exam at all.

No central list of who requires what exists. The only reliable method is to check your program's own admissions page, and to email the admissions office if it is ambiguous. Every credible source says this and then stops; we can't shortcut it either.

Do it first. A study plan built on the wrong exam set is the most expensive mistake available here, and it costs nothing to avoid.

What "a good score" actually means

This is the question the search results answer worst, so take it from the publisher.

Elsevier publishes four interpretive bands:

So a 92 is in Elsevier's top band. That is the only attributable answer to "is this a good score," and it is worth knowing that the bands overlap on purpose: 75–79% is satisfactory for an associate or baccalaureate program, while a certificate program's satisfactory range starts at 70. The threshold depends on the kind of program, which is why a single number posted on a forum is never the answer.

What Elsevier does not do is set a passing score. Your program does. Across published nursing program requirements, section minimums run from 60% to 85%, composite minimums from 72% to 81% where one exists at all — and many programs set none, using the composite only for ranking points. The modal requirement is 75%.

Two structural facts sit inside that range and matter for planning. Different programs at the same school often have different bars. And a low bar on one section can sit beside a high one on another — one program we read wants 82 on Reading and 68 on A&P.

One correction, because a lot of prep material gets it wrong. Your HESI A2 score is not out of 1500. The 0–1500 scale and the 850 benchmark belong to Elsevier's Specialty and Exit exams, not to the A2. At least four prep sites apply that framework to the A2 anyway, one publishing a conversion table for it. If a study guide tells you to aim for 850, it is describing a different test. how the exam is built and scored

What is on each exam

The official blueprint wording below is Elsevier's, quoted from the exam's published description. Everything under it is corroborated from nursing program pages and prep publishers. Where candidates report something the publisher doesn't, it is labeled.

Basic Math Skills — "basic addition, subtraction, multiplication, fractions, decimals, ratios and proportions, household measures, etc." That "etc." carries metric and cross-system conversion, military time, Roman numerals, basic algebra and dosage-calculation-style word problems. Candidates consistently report two things about it: fractions are the heaviest item type with ratios second, and conversions start from numbers that are not whole — 2.75 L, not 3 L. what the Basic Math Skills exam covers

Reading Comprehension — "health-related reading scenarios – to identify main ideas, understanding of passages and words in context, logical inferences." Passages run roughly 100–300 words. Non-prose stimuli are attested too: maps, pie charts, flow charts, bar graphs, diagrams, even recipes. Candidates describe time pressure, not difficulty, as the binding constraint.

Vocabulary and General Knowledge — "words used in healthcare and general settings." Both general English and healthcare terminology; no source gives the split. Two candidate reports worth planning around: words appear that are absent from Elsevier's own review book, and answer sets tend to pair two obvious wrong answers with two near-synonyms. The item is won or lost on that final pair.

Grammar — "important grammatical terms and uses in grammar, common grammatical errors, parts of speech." Parts of speech, agreement, sentence structure, modifiers, punctuation, commonly confused pairs. Candidates name Grammar and Vocabulary as the trickiest sections, and the reported trap is specific: misspellings hidden inside otherwise-correct sentences, missed by fast readers.

Anatomy & Physiology — "general A/P terminology, anatomical structures, and systems." Planes, directional terms, cells and tissues, and the body systems. This is the section candidates most consistently report scoring lowest on. It rewards recall breadth rather than conceptual depth — one candidate called it A&P trivia. Most-missed areas named repeatedly: heart valves, nephron function, hormones and gland identification, major nerves, blood cell types, digestive enzymes. the A&P section breakdown

Biology — "water, biological molecules, metabolism, cells, cellular functions, photosynthesis." Plus cellular respiration, membranes and transport, protein synthesis, DNA and RNA, mitosis and meiosis, Mendelian genetics. Generally reported as the most approachable science. Punnett squares are the named stumbling block.

Chemistry — "physical and chemical matter, periodic table, chemical equations, reactions, bonding." Plus scientific notation, the metric system, atomic structure, bonding, stoichiometry, redox, acids and bases. Candidate reports on Chemistry are genuinely split — some call it the hardest science, others call it reasonable. The spread itself is the useful signal: prepare for a wider range of difficulty here than elsewhere.

And Physics, honestly. It appears on the current exam menu, it is absent from Elsevier's own exam table, and it is not in the current edition of the official review book. Nobody has published a statement either way. If your program lists it, prepare for it; if it doesn't, it is not your problem.

How hard it is, and how long to give it

Two of the questions Google shows under this search are "is the HESI A2 really hard" and "how long does it take to study." Both deserve better answers than the search results give them.

On difficulty, the sources genuinely disagree, and the disagreement is informative. Two university pages describe the whole exam as high-school level. Two others encourage or require a completed Anatomy & Physiology course before you test, and candidates describe that section reaching the depths of a second-semester A&P course. Read across enough accounts and the split resolves: it is specific to A&P. Reports on Biology and Chemistry are consistent with high-school level; reports on A&P are not. So the honest answer is that most of this exam is a refresher and one part of it may not be — and which part that is depends on whether A&P is even in your set.

On duration, nobody publishes a figure, and any guide that gives you a confident number of weeks has invented it. What can be said is how to allocate whatever time you have.

Work in this order. A&P first, because it is the section most consistently reported as the lowest scorer and because recall breadth needs the most repetitions spread over the most days. Math second, because it is the largest scored section with the most trainable skills. Then Vocabulary and Grammar, which reward little-and-often review. Reading last, because it is the section practice improves least — it is a speed problem more than a knowledge problem.

Count days, not hours. Recall-heavy material — A&P, Vocabulary, Biology — consolidates across sleep, so the same total hours spread over three weeks beats the same hours in one weekend. Skill-heavy material — Math, and Reading speed — improves with repetition under a clock. If you are two weeks out, you can still move Math meaningfully; A&P is the one that punishes a late start.

Give A&P more days, not longer sessions. Recall breadth is built by retrieval, not rereading. Twenty minutes a day for three weeks beats a single seven-hour weekend, and the exam gives you 25 minutes for 30 questions — about 50 seconds each — so recall has to be fast as well as correct.

Drill Math's two heaviest types until they are automatic. Fractions in all four operations, and ratios and proportions. If you only have time for two things, those are the two.

Practice Vocabulary from context, not from a list. The reported gap between exam words and the review book's word list means memorising one list is not a strategy. Word parts — roots, prefixes, suffixes — generalise; a list does not.

Read the whole sentence in Grammar. The reported trap rewards slow, literal re-reading over speed. That is unusual, and it is worth rehearsing deliberately.

Two mechanics to rehearse, not just read about

Study content long enough and you will still be surprised on test day by two things that have nothing to do with content.

You cannot go back. Each exam is separately timed. You answer, you submit, it locks. Skipping is not allowed either — a skipped item is counted incorrect — so there is no returning at the end to the three you wanted to think about. If your practice has let you skip and revisit — and almost all free practice does — you have been rehearsing a habit the real exam will punish.

Each exam has its own clock. The per-exam times are HESI's defaults, and how they are enforced is partly a school setting — several programs label them "recommended" and cap the whole sitting instead. On rollover, one college states plainly that remaining time "does not accrue towards the remainder of the test," and no source contradicts it, but only that one says it outright. Plan as though finishing Math eleven minutes early buys you nothing for A&P, because that is the version you can't be caught out by.

You do choose the order you sit them in — that much is well attested — and several candidates recommend taking the long 55-question exams while you are still fresh.

Both of these are behaviours, and behaviours are rehearsed rather than learned. Our simulator runs the real per-exam clocks and locks answers on submit for exactly this reason — you can sit one on the clock free, one exam, with a worked explanation on every question. No card.

What to use, and what a study guide can't do for you

A printed study guide is a content refresher. It will not tell you which exams your program requires, it will not rehearse answer locking, and — going by candidate reports on both Vocabulary and Biology — its word lists and topic coverage will not match your form exactly. That is not a reason to skip one. It is a reason not to mistake it for preparation.

Its publisher's own review book is the closest thing to an official source. Third-party guides are fine as content refreshers. Free practice questions are useful for content and useless for behaviour.

The honest division of labour: books for the content you have forgotten, timed full-length sittings for the behaviour, and your program's admissions page for the only question that changes everything else.

If you have not sat a timed one yet, that is the cheapest gap to close: one timed exam, free, no card.

Every practice item in our own bank is original, written to Elsevier's published blueprint, and every math and science key had to survive an independent solve before it shipped. Elsevier's item bank is proprietary and secret. Anyone offering you real HESI A2 questions is telling you something that cannot be true, and we don't claim ours are.

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