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HESI® A2 Study Guide

A HESI study guide starts with a question only your school can answer: which of the HESI A2's seven academic exams you have to take. Study those in proportion to their size, which is 50 scored questions each for Reading Comprehension, Vocabulary and General Knowledge, Grammar and Basic Math Skills, and 25 each for Biology, Chemistry, and Anatomy and Physiology. This guide sets out what each exam tests, where applicants lose points, and a six-week plan you can cut down to your own sections.

Almost everything on the A2 is something you were taught before: in a high school English class, a pre-algebra course, an introductory biology or chemistry class. That changes what studying means. You are not learning a profession's body of knowledge; you are finding the specific things you have forgotten or never quite understood, and repairing them one at a time. A missed practice question on the A2 usually points to one rule or one fact, and fixing it takes minutes.

Elsevier does not publish a numbered list of tasks for the A2. The topics below come from Elsevier's short descriptions of each exam, in our words, and the codes (1.1, 4.4 and so on) are ours, there only to help you keep your place. How the exam is registered for, timed, scored and priced is on the separate exam overview page, linked at the end of this one.

Where the points are

The share of the exam each part of the current outline carries. Where the weights differ, study time should follow them.

The HESI A2 outline, task by task

1Reading Comprehension18.2%

Reading passages on health-related subjects, each followed by questions. Be able to do four things with a passage: say what its main idea is, work out what a word or phrase means from how it is used, find what the passage states, and draw a conclusion the passage supports.

  • 1.1Identify the main idea of a health-related reading passage.
  • 1.2Work out what a word or phrase means from the way it is used in a passage.
  • 1.3Show understanding of what a passage states.
  • 1.4Draw logical inferences from the information in a passage.

Where people lose points: Answering from what you know instead of what the passage says. The passages are about health topics you may have opinions on, and an option that is true in general but not stated or supported in the text is wrong. The other habit to break is taking an inference one step too far: the right inference is the modest one the passage clearly supports.

2Vocabulary and General Knowledge18.2%

Word meanings, both in everyday English and as words are used in health care settings. You are asked what a word means, usually in a short sentence.

  • 2.1Know the meaning of words commonly used in general English-speaking settings.
  • 2.2Know the meaning of words commonly used in health care settings.

Where people lose points: Ordinary words with a narrower meaning in health care, and pairs that look alike. Lists of definitions fade fast; a word learned in a sentence stays. Because this is memory work, it rewards ten minutes every day far more than an hour once a week, so start it on day one whatever else you are studying.

3Grammar18.2%

The parts of speech and what each does in a sentence, the standard terms of grammar, and the errors that occur most often in writing. Be able to pick the correct sentence from four, or find the word that is wrong.

  • 3.1Identify the parts of speech and how each functions in a sentence.
  • 3.2Understand key grammatical terms and apply them correctly.
  • 3.3Recognize and correct commonly occurring grammatical errors.

Where people lose points: Trusting your ear. Spoken English tolerates things the exam counts as wrong: a verb that agrees with the nearest noun instead of its subject, the wrong pronoun case after a preposition, and commonly confused words such as affect and effect or lie and lay. Learn the rule for each, then practice until you can name the error, not just sense it.

4Basic Math Skills18.2%

Arithmetic with whole numbers, fractions and decimals; ratio and proportion problems of the kind used in health care; and household measures and conversions between them. Nothing here goes beyond pre-algebra.

  • 4.1Carry out basic arithmetic operations such as addition, subtraction and multiplication.
  • 4.2Solve problems involving fractions.
  • 4.3Solve problems involving decimals.
  • 4.4Set up and solve ratio and proportion problems of the kind used in health care.
  • 4.5Use and convert household measures.
  • 4.6Recall and apply general math facts.

Where people lose points: Fractions and conversions. Most misses are a dropped step: adding fractions without a common denominator, misplacing a decimal point, or converting between household measures the wrong way round. Set proportions up with the units written in, so that a wrong setup looks wrong. And practice by hand: whether you get an on-screen calculator is your school's decision.

5Biology9.1%

Introductory biology: the properties of water that matter to living things, the major biological molecules and what they do, metabolism, the structure and function of cells, cellular respiration and photosynthesis.

  • 5.1Explain basic concepts of biology.
  • 5.2Describe the properties of water that matter to living things.
  • 5.3Identify the major biological molecules and what they do.
  • 5.4Explain metabolism in living organisms.
  • 5.5Describe cells and how they function.
  • 5.6Explain cellular respiration.
  • 5.7Explain photosynthesis.

Where people lose points: Mixing up cellular respiration and photosynthesis. They are near mirror images, and questions ask which process uses what and produces what. Learn them side by side. Likewise the four classes of biological molecule: know each one's building block and its main job, because the questions pair them.

6Chemistry9.1%

Introductory chemistry: matter and its properties, chemical equations and reactions, reading the periodic table, the structure of the atom, basic nuclear chemistry, and how atoms bond.

  • 6.1Describe matter and its physical and chemical properties.
  • 6.2Read and balance chemical equations and describe chemical reactions.
  • 6.3Use the periodic table to find information about elements.
  • 6.4Describe the structure of the atom.
  • 6.5Explain basic nuclear chemistry.
  • 6.6Explain how atoms bond to form compounds.

Where people lose points: The numbers attached to an atom. Know what the atomic number counts, what the mass number counts, and how to get the number of neutrons from the two. Know the difference between an ionic and a covalent bond from a description. Balancing a simple equation is a method, like a math problem, and only practice makes it quick.

7Anatomy and Physiology9.1%

The language of anatomy, the main structures of the body, and what each body system does. Of the three science exams, this is the one closest to what a nursing program goes on to teach.

  • 7.1Use general anatomy and physiology terminology correctly.
  • 7.2Identify anatomical structures of the human body.
  • 7.3Describe the body systems and how they function.

Where people lose points: Trying to memorize the whole body at one level of detail. Organize by system: for each, the main organs, the job of the system, and the path something takes through it, such as blood through the heart or food through the digestive tract. Directional and positional terms are easy points that people skip.

A study plan

  1. Before you start

    Find out which exams your school requires and what score it wants. Then take the free 25-question diagnostic, which samples all seven subjects, and ignore the results for any exam you will not be taking. Start a daily ten-minute vocabulary habit now and keep it to the end.

  2. Week 1: Basic Math Skills

    Whole-number arithmetic, then fractions, then decimals, then ratio and proportion, then household measures. Do every problem on paper. Math comes first because it improves fastest with practice and because the skill carries into the chemistry exam.

  3. Week 2: Grammar

    Parts of speech first, since every other rule is stated in terms of them. Then the common errors, one type a day: agreement, pronouns, modifiers, confused words. Finish each day with a short set of practice questions in tutor mode.

  4. Week 3: Reading Comprehension

    Timed passages. For each question, mark which of the four skills it tests: main idea, meaning in context, stated detail or inference. After a few days you will see which one costs you points, and you can practice that one deliberately.

  5. Week 4: Anatomy and Physiology

    One or two body systems a day, each as structure, function and pathway, with terminology first. If your school requires no science exams, use weeks 4 and 5 to go back over your two weakest English and math areas instead.

  6. Week 5: Biology and Chemistry

    Biology in the first half of the week, chemistry in the second. These are the two smallest exams and the most self-contained, which is why they come late in the plan.

  7. Week 6: timed practice, one exam at a time

    The A2 is delivered as separate exams, so practice it that way: one subject per sitting, at Elsevier's suggested time or your school's limit if it is different. Review every miss the same day.

The free HESI A2 diagnostic is being prepared and is not open yet. The exam facts and the content outline on this page are current.

First, find out which exams you are taking

A school that requires four exams and a school that requires seven are asking for very different amounts of preparation, and time spent on chemistry for a program that does not test it is time taken from the exams that decide your application.

Find your program's requirement on its admissions page or in your registration instructions. While you are there, note the minimum score and whether it applies to each exam separately. A program that wants a minimum on every exam turns your weakest subject into the one that matters most.

How to read the weights on this page

The weights table above shows each exam's share of the 275 scored questions you would face if you took all seven: about 18% for each English and math exam and about 9% for each science exam. That is a way of comparing their sizes, not a formula for your score. Each exam is scored separately, and your own mix depends on which ones your school requires.

So divide your study time by two things together: the size of each required exam, and how far your diagnostic result on it is from the score your program wants.

Pace

On Elsevier's suggested times, Reading Comprehension allows a little over a minute a question, and that includes reading the passages. Vocabulary, Grammar and Math allow a little under a minute. The science exams allow about 50 seconds. Those are suggestions that your school can change, so check its limits.

A pace like that leaves no room for working out a method during the test. It is the reason to practice math by hand until the setup is automatic, and to learn vocabulary and grammar rules well enough that recognition is immediate.

How long to study

Six weeks covers all seven exams at a steady pace. If your school requires only the English and math exams, three or four weeks may be enough. Let the diagnostic and your program's minimum decide, and work back from your application deadline rather than forward from today.

Do not plan around a retake. Whether you get one, and how long you must wait, is your program's decision, not Elsevier's.

What to study from

These are the sources the questions in the bank cite. The outline in force is the HESI Admission Assessment (A2): seven academic exams, as described in Elsevier's 2022 white paper (Table 1).

HESI A2 study guide: common questions

Is this HESI study guide free?

Yes. The guide on this page is free, and so is the 25-question diagnostic. The paid pass adds the full question bank and timed practice. This is an independent guide; it is not published or endorsed by Elsevier.

What should I study for the HESI A2?

Only the exams your school requires, out of seven: Reading Comprehension, Vocabulary and General Knowledge, Grammar, Basic Math Skills, Biology, Chemistry, and Anatomy and Physiology. Check your program's requirement before you start.

How long should I study for the HESI exam?

About six weeks if you are taking all seven exams, and less if your school requires only some. The better guide is your diagnostic result measured against the minimum score your program asks for.

Which HESI A2 section should I study first?

Basic Math Skills, alongside a daily vocabulary habit. Math improves quickest with practice and its methods carry into chemistry; vocabulary is memory work that needs the most calendar time.

Does Elsevier publish its own HESI study guide?

Elsevier publishes its own review book for the Admission Assessment, listed in the references on this page. This page is a separate, independent guide and is not affiliated with Elsevier.

Do I need to study physics for the HESI A2?

No current Elsevier document we read lists a Physics exam, so this guide does not cover it. If your school specifically says it requires physics, follow your school.

Can I use a calculator on the HESI math exam?

Your school decides. Ask your program, and practice the arithmetic by hand so that the answer does not depend on it.

HESI® is a registered trademark of Elsevier Inc. This site is an independent study resource and is not affiliated with, endorsed by, or sponsored by Elsevier or HESI. Practice questions here are original and are not actual HESI Admission Assessment questions.