Introduction: The HESI A2 in 2026

The HESI A2 (also known as the HESI Admission Assessment or simply "the HESI") is one of the two primary nursing school entrance exams in the United States, alongside the ATI TEAS. Published by Elsevier, the HESI A2 is used by hundreds of nursing programs including many of the largest and most prestigious schools in the country. Unlike standardized tests that have a single fixed format, the HESI A2 is modular: it offers up to eight academic sections, and each nursing program chooses which sections their applicants must complete.

This modular structure means that your HESI A2 preparation must be tailored to your specific program requirements. A student applying to a program that requires only Math, Reading, Vocabulary, and Grammar will have a very different study plan than one whose program also requires Biology, Chemistry, and Anatomy & Physiology. The first and most important step in your preparation is determining exactly which sections you need.

In 2026, AI-powered study tools have become essential for efficient HESI A2 preparation. Tools like LectureScribe can process your prerequisite course lectures and generate organized flashcard decks covering the exact vocabulary, science concepts, and formulas you need to know. This is particularly powerful for the HESI A2 because its vocabulary section specifically tests medical and nursing terminology, the kind of content that is covered extensively in prerequisite coursework but requires systematic review for exam readiness. Discover more about how AI is shaping the nursing education experience on our AI tools for nursing students page.

Check Your Program Requirements First

Before you invest any time or money in HESI A2 preparation, you must determine exactly which sections your target nursing program requires. This is not optional; it is the foundation of an efficient study plan. Different programs have vastly different requirements, and studying for sections you do not need wastes valuable preparation time.

You should also determine how your program uses HESI A2 scores in the admissions process. Some programs use a simple pass/fail threshold (you meet the minimum or you do not). Others rank applicants by HESI A2 score and use it as a primary selection criterion. Some programs weight certain sections more heavily, for example, placing greater emphasis on science section scores. Understanding how your program uses the score will help you prioritize your study time.

Math Section: Strategies & Content

The HESI A2 Math section contains 55 questions (50 scored, 5 unscored pilot items) and covers basic math skills that are essential for nursing practice, particularly medication dosage calculations. The difficulty level is approximately high school algebra, but the emphasis is on healthcare-applicable math: ratios, proportions, unit conversions, and fractions. A calculator is provided for this section.

Key Math Formulas to Memorize

While a calculator is provided, you still need to know which operations to perform and in what order. The most commonly tested math skills on the HESI A2 are ratio and proportion problems, which form the basis of nursing dosage calculations. Master the cross-multiplication method: if a/b = c/d, then a x d = b x c. This single technique solves the majority of HESI A2 Math questions.

Reading Comprehension & Vocabulary Sections

The Reading Comprehension and Vocabulary sections are among the most commonly required HESI A2 sections. Together, they assess your ability to understand written healthcare information and medical terminology, skills that are fundamental to nursing practice.

Reading Comprehension (55 Questions)

The HESI A2 Reading Comprehension section presents passages of varying lengths and asks questions about main ideas, supporting details, inferences, author purpose, and logical conclusions. Many passages use healthcare-related topics such as patient care scenarios, public health reports, and medical research summaries. The passages are typically more straightforward than those on college-level reading assessments, but the volume of questions combined with the time constraint creates the challenge.

Vocabulary & General Knowledge (55 Questions)

The HESI A2 Vocabulary section is uniquely challenging because it heavily emphasizes medical and nursing terminology. Unlike general vocabulary tests, you need to know the meaning of terms like "afebrile" (without fever), "emesis" (vomiting), "dyspnea" (difficulty breathing), and "bilateral" (affecting both sides). These are terms you will use every day in nursing practice, and the HESI A2 expects you to know them before you even begin your nursing program.

Grammar Section: Rules & Practice

The HESI A2 Grammar section contains 55 questions testing your knowledge of English grammar, sentence structure, and writing conventions. This section evaluates skills essential for nursing documentation, where precision in written communication directly affects patient care. A misplaced modifier or an ambiguous pronoun in a patient chart can lead to dangerous misunderstandings.

Commonly Confused Words on the HESI A2

The Grammar section frequently tests commonly confused word pairs. You need to know the difference between affect/effect, their/there/they're, accept/except, principal/principle, complement/compliment, and than/then. These distinctions come up repeatedly both on the HESI A2 and in professional nursing writing. Create flashcards for each pair with example sentences showing correct usage.

Science Sections: Biology, Chemistry, A&P, and Physics

The HESI A2 offers four separate science sections, each containing approximately 30 questions (25 scored, 5 unscored pilot items). Unlike the TEAS, which combines all science content into a single section, the HESI A2 separates each science discipline. This means the questions in each section are more focused and in-depth. Not all programs require all science sections, so confirm your requirements before investing time in sections you may not need.

Anatomy & Physiology (30 Questions)

The A&P section is the most commonly required science section and the one that most directly predicts success in nursing coursework. It tests your knowledge of all major organ systems, including their structure, function, and regulation. The questions tend to be more detailed than those on the TEAS, often requiring you to understand specific physiological processes and how disruptions lead to disease states.

Biology (30 Questions)

The HESI A2 Biology section covers cellular biology, genetics, metabolism, ecology, and molecular biology. The questions focus on fundamental biological principles that underlie all physiological processes. Understanding cellular function, DNA replication, protein synthesis, and basic genetics is essential for nursing courses where you will learn about disease processes at the molecular level.

Chemistry (30 Questions)

The HESI A2 Chemistry section tests foundational chemistry concepts that are applicable to nursing pharmacology and fluid/electrolyte management. You need to understand atomic structure, chemical bonding, the periodic table, reactions, solutions, and acids and bases. The questions are generally introductory-level but require solid conceptual understanding.

Physics (30 Questions)

Physics is the least commonly required HESI A2 section, but some programs do include it. The content covers Newtonian mechanics, energy, waves, electricity, and optics at an introductory level. If your program requires Physics, focus on understanding fundamental concepts and being able to apply basic formulas. The questions are generally conceptual rather than heavily calculation-based, but you should be comfortable with basic physics equations.

3-6 Week HESI A2 Study Timeline with AI Integration

Your HESI A2 study timeline depends on how many sections your program requires, how recently you completed prerequisite courses, and your target score. The plans below are designed for students taking the core four sections plus at least one science section.

Best AI Tools for HESI A2 Prep in 2026

AI tools have transformed HESI A2 preparation by automating the most time-consuming aspects of studying. Here are the best tools for each component of your prep.

Score Improvement Strategies: From 75% to 90%+

Improving your HESI A2 score requires a targeted approach. Since programs often look at individual section scores in addition to the composite, you need to identify and address weaknesses at the section level. Here is how to systematically improve based on your current performance.

Common HESI A2 Mistakes to Avoid

These are the most frequent mistakes that lower HESI A2 scores, based on analysis of hundreds of student study plans and results:

Test Day Preparation

The HESI A2 is typically administered at your nursing program's campus or through a designated testing center. Some programs have shifted to remote proctored testing. The total test time varies based on how many sections you are taking but can range from 2 to 5+ hours.

Your HESI A2 scores are typically available immediately after completing the exam. You will see individual section scores, a composite score, and a detailed breakdown of your performance by content area. If you need to retake the exam, your program will inform you of their retake policy, including waiting periods and how retake scores are used in the admissions process.

Frequently Asked Questions About HESI A2 Prep