The Ultimate HESI A2 Study Guide for 2026: Pass Every Section

The HESI A2 is one of the most widely used nursing school entrance exams in the country. Whether you're wondering how to study for the HESI A2, what score you need, or which sections your school requires — this comprehensive guide covers it all.

1. What Is the HESI A2 Exam?

The HESI A2 (Health Education Systems Inc. Admission Assessment) is a computerized entrance exam used by nursing programs that partner with Elsevier. It evaluates your academic readiness across up to 8 content areas. Unlike the TEAS (which has 4 fixed sections), the HESI A2 is modular — your school chooses which sections you take.

The exam is commonly required by ADN and BSN programs across the US, particularly in the Southeast, Midwest, and parts of California. If your school uses Elsevier textbooks and courseware, there's a strong chance they require the HESI A2.

Students often ask "is the HESI A2 hard?" — it's rigorous but very manageable with structured preparation. The key is knowing exactly which sections your program requires and studying those deeply rather than spreading yourself thin across all 8.

2. HESI A2 Sections: Complete Breakdown

Here's what's on the HESI A2 exam — all 8 possible sections:

3. What HESI A2 Score Do You Need in 2026?

HESI scoring is different from the TEAS. Each section is scored independently on a scale of 0-100%. Here's what most programs expect:

Critical difference from the TEAS: many HESI programs require you to meet the minimum on every individual section, not just an overall composite. One weak section can disqualify you even if your other scores are excellent.

4. HESI A2 Vocabulary & Grammar: Your Secret Weapons

If you're asking "how to study for HESI vocabulary", you're targeting one of the most improvable sections. The Vocabulary and Grammar sections are unique to the HESI and catch many students off guard.

Vocabulary Strategy

The HESI vocabulary section tests medical and general academic terminology. The most effective approach is learning root words, prefixes, and suffixes — this lets you decode unfamiliar words on test day:

• Learn 10-15 new words daily using flashcards (physical or digital). Space repetition is key.
• Master 30 root words to unlock 500+ medical terms (e.g., card- = heart, hepat- = liver, ren- = kidney)
• Context clue strategy: When you see an unfamiliar word, break it apart. Tachycardia = tachy (fast) + cardia (heart) = fast heart rate
• Focus on commonly confused words: affect/effect, principal/principle, complement/compliment, adverse/averse

Download our free HESI A2 Vocabulary List (150 Must-Know Words) for a printable study reference.

For a deeper dive into grammar rules, see our HESI A2 Grammar Rules guide.

5. HESI A2 Math: What to Focus On

The HESI math section tests basic arithmetic through pre-algebra. There's no calculus, no trigonometry, and no advanced algebra. The most commonly tested topics:

1. Fractions — adding, subtracting, multiplying, dividing, converting to decimals
2. Percentages — calculating percent of a number, percent change, converting between fractions/decimals/percentages
3. Ratios & Proportions — cross-multiplication, dosage-style word problems
4. Unit Conversions — metric to standard (1 kg = 2.2 lbs, 1 inch = 2.54 cm)
5. Roman Numerals — used in prescription medication (I, V, X, L, C, D, M)
6. Military Time — converting standard time to 24-hour format

For our complete math formula reference, see HESI A2 Math Formulas & Study Tips.

6. Anatomy, Biology & Chemistry

The science sections are where most students lose points — but they're also the most improvable with targeted study.

Anatomy & Physiology (Most Important)

Focus on the same core body systems tested on the TEAS: cardiovascular, respiratory, nervous, digestive, musculoskeletal, and endocrine. Know the function of every major organ and how systems interact. For a comprehensive review, see our HESI A2 Anatomy Guide.

Biology

Focus on: cell structure (organelles and their functions), DNA/RNA, mitosis vs meiosis, Punnett squares and genetics, photosynthesis vs cellular respiration.

Chemistry

Focus on: atomic structure and subatomic particles, chemical bonds (ionic, covalent, hydrogen), pH scale (acids vs bases), solutions and concentration, balancing simple equations.

7. HESI A2 Study Schedule Templates

🔴 4-Week Plan (5 sections, 1.5 hrs/day)

• Week 1: Vocabulary (daily flashcards) + Math fundamentals
• Week 2: Grammar rules + Reading comprehension practice
• Week 3: Anatomy & Physiology deep dive
• Week 4: Full practice tests + weak area review + rest

🟢 8-Week Plan (7-8 sections, 1 hr/day)

Dedicate one week per section with daily vocabulary flashcards running throughout. Use weeks 7-8 for practice tests and review. See our detailed HESI A2 Study Timeline for a day-by-day plan.

8. HESI A2 vs TEAS 7: Which Do You Need?

Not sure which exam your program requires? Here's a quick comparison:

For a detailed comparison, read our HESI A2 vs TEAS 7: Complete Comparison Guide.

9. Free HESI A2 Resources & Downloads

Frequently Asked Questions

How many questions are on the HESI A2 exam?

The HESI A2 has 326 questions across 8 scored sections. Most nursing programs only require 4-5 sections. Check with your school to confirm which sections you need.

What is a good HESI A2 score in 2026?

Most programs require 75-80% minimum per section. Competitive programs may require 85%+. Some schools look at individual section scores while others use a cumulative average.

Is the HESI A2 harder than the TEAS 7?

The HESI A2 tests more subjects but each section is more straightforward. The vocabulary and grammar sections are unique and require specific prep. Overall difficulty is comparable.

How long does the HESI A2 take?

The full exam takes about 4-5 hours. Most schools require only 4-5 sections, which takes about 2.5-3.5 hours. Each section is individually timed.

Can I retake the HESI A2 if I fail?

Yes, but policies vary by school. Some require a 60-day wait, others allow immediate retakes. Most programs limit you to 2-3 attempts per admission cycle. Each retake costs $50-$100.

How should I study for HESI vocabulary?

Focus on medical terminology root words, prefixes, and suffixes. Learn 10-15 new words daily using flashcards. Our free 150-word vocabulary list covers the most commonly tested terms.

What math is on the HESI A2?

HESI math covers basic arithmetic, fractions, decimals, percentages, ratios, proportions, dosage calculations, unit conversions, and word problems. No trigonometry or calculus.

Do I need the HESI or TEAS for nursing school?

It depends on your school. Programs using Elsevier materials typically require the HESI A2. Programs using ATI materials typically require the TEAS 7. Check your specific school's admissions requirements.