HESI A2 vs TEAS 7: Which Nursing Entrance Exam Is Harder?
The TEAS 7 is generally considered harder due to its stringent time limits and newer 'Select All That Apply' question formats. The HESI A2 is straightforward multiple-choice and allows you to pace yourself across the entire exam.
If you're applying to nursing school, chances are you'll encounter one of these two gatekeepers: the ATI TEAS 7 or the HESI A2. Here's everything you need to know to understand the difference — and how to prepare for whichever one (or both) your school requires.
| Feature | ATI TEAS 7 | HESI A2 |
|---|---|---|
| Made by | ATI (Assessment Technologies Institute) | Elsevier (Health Education Systems) |
| Total Questions | 170 (150 scored) | Varies by school (25–55 per section) |
| Time Allowed | 209 minutes | Varies (approx. 5–6 hours total) |
| Sections | Reading, Math, Science, English | A&P, Math, Reading, Vocab, Grammar, Biology, Chemistry, Physics |
| School Choice | Standardized — you take all 4 sections | Each school picks which sections you take |
| Typical Score Needed | 60–75%+ composite | 75–80%+ per required section |
| Calculator Allowed? | On-screen basic calculator | On-screen basic calculator |
Which Exam Is Harder?
The honest answer: it depends on your personal strengths.
Most students find the TEAS 7 harder overall because it is a single, comprehensive standardized exam with a fixed structure — you cannot choose to skip the Science section just because your school doesn't care about it. The Science section alone (50 questions in 60 minutes) trips up a large number of students who haven't studied biology, chemistry, or anatomy recently.
The HESI A2 can feel more manageable because your school tells you exactly which sections to take. If your program only requires Math, Reading, Vocabulary, and Anatomy, you can focus all of your preparation energy there. However, if your program requires Chemistry or Physics — subjects the TEAS 7 doesn't even test — the HESI A2 suddenly becomes the harder exam.
Key Differences in Content
Science: TEAS 7 Goes Deeper
The TEAS 7 Science section is notoriously the most challenging section on the exam. It covers:
- Human anatomy and physiology — body systems, organ functions, anatomical terminology
- Biology — cells, DNA, genetics, and ecology
- Chemistry — basic atoms, molecules, and reactions
- Scientific reasoning — experimental design interpretation
The HESI A2 covers Anatomy & Physiology as its own dedicated section, but its chemistry and biology content are lighter unless your school requires those specific modules.
Vocabulary: HESI A2 Wins Here
The HESI A2 has a dedicated Vocabulary & General Knowledge section testing medical and academic vocabulary with context clues. The TEAS 7 incorporates vocabulary as part of its English & Language Usage section rather than as a standalone module. Students who struggle with medical terminology tend to find HESI A2 vocabulary questions more challenging.
Math: Both Are Similar in Difficulty
Both exams test the same core math skills: fractions, decimals, ratios, percentages, basic algebra, and measurement conversions. Neither exam requires calculus or trigonometry. Both allow a basic on-screen calculator. If you can do dosage calculation math confidently, you're in good shape for both exams.
Costs & Retake Policies: The Hidden Differences
When considering which exam to take (if your target nursing program accepts both), many students fail to factor in testing logistics and costs.
- Exam Cost: The TEAS 7 is generally more expensive. It costs between $115 and $125 per attempt, depending on whether you take it remotely via ATI or in-person at a testing center. The HESI A2 is usually cheaper, typically ranging from $40 to $60 if taken at a community college, though Prometric center testing can push it to $100.
- Retake Limits: ATI permits students to retake the TEAS 7 up to three times per year, but individual nursing schools often enforce stricter limits (e.g., "only two attempts within a 5-year window"). The HESI A2 is similar; Elsevier allows retakes, but individual programs are notorious for setting rules like "you must wait 60 days between attempts." If you find yourself needing to retake either exam, see our guide on what to do after a failed TEAS or HESI score and how to prep for a retake.
- Score Transfer Fees: If you apply to five nursing schools that require the TEAS, ATI charges $29.99 per score transcript sent after the very first one. This adds up fast. Elsevier charges a $15 fee to send your HESI A2 transcript to additional institutions.
Which Exam Does My School Require?
This is the most important question, and the answer varies widely. Generally:
- TEAS 7 is required by most large BSN programs, many state university nursing schools, and national programs like those at Chamberlain University and other ATI-partnered schools.
- HESI A2 is commonly used by community colleges, LPN programs, and schools that use Elsevier educational materials.
Many students applying to multiple programs will encounter both exams. In that case, you can prepare for them simultaneously since the core academic content overlaps significantly. Keep in mind that doing well on these exams goes hand-in-hand with completing your essential nursing school prerequisites.
How to Prepare for Each Exam
For the TEAS 7: Dedicate the most time to Science (Anatomy & Physiology specifically). Take at least two full-length practice tests before your exam date. Aim to understand why answers are correct rather than just memorizing. Explore our TEAS 7 prep resources →
For the HESI A2: First, confirm your school's required sections. Then build your study plan around exactly those modules. Medical vocabulary flashcards are highly effective for the Vocabulary section. Explore our HESI A2 prep resources →
In both cases, structured, diagnostic-driven prep dramatically outperforms aimless studying because an initial assessment identifies your specific weak areas and focuses your limited time there rather than covering material you already know well.
Can I Prepare for Both At the Same Time?
Yes — and it's actually very efficient. Because the content overlaps so heavily (especially Math, Reading Comprehension, and Anatomy & Physiology), most of your general prep work applies to both exams simultaneously. Here's a smart approach if you're facing both:
- Build your Anatomy foundation first. A&P is on both exams and is the heaviest memorization lift. Tackling it first gives you the biggest efficiency gain.
- Practice Math for both at once. The math content tested is nearly identical — fractions, ratios, algebra, and dosage calculations. One solid math study plan covers both exams.
- Then split your prep for exam-specific sections. Spend your final 1–2 weeks before each test date reviewing format-specific content: TEAS 7 Science reasoning, or HESI A2 Vocabulary, depending on which test is next.
🪑 From the Tutor's Desk
Last year, a student named Olivia spent 4 weeks studying for the HESI A2 — bought the Elsevier book, drilled vocab, practiced chemistry. Then she called her nursing program to schedule the exam and discovered they'd switched to the TEAS 7 the previous semester. Four wasted weeks. This happens more often than you'd think: about 2-3 students per year come to me after studying for the wrong test. Before you buy a single study resource, call your program's admissions office directly and ask: "Which entrance exam do you currently accept, and is there a specific version?" One 5-minute phone call saves you a month.